Different metabolic and clinical profiles between patients with pure Alzheimer dementia and epileptic Alzheimer dementia: a metabolic study

Yıl 2022, , 301 - 306, 31.12.2022

Ece Özdemir Öktem , Kübra Soğukkanlı , Tansel Çakır , Ahmet Özşimşek , Şeyda Çankaya , Lütfü Hanoğlu

https://doi.org/10.30565/medalanya.1195485

Öz

Aim: To investigate the clinical characteristics and cerebral FDG PET metabolisms of dementia patients who were also diagnosed with epilepsy and compare the differences with pure Alzheimer dementia patients.

Methods: In this case-control study, a total of 14 patients, 7 patients with pure Alzheimer disease as a control group and 7 age and gender-matched patients with Alzheimer disease and concomitant epilepsy as a study group, were included. Detailed neurocognitive battery and brain fludeoxyglucose positron emission tomography (FDG PET-CT) were performed for all subjects.

Results: In comparison of neurocognitive test scores, there was no significant difference between the study and control groups. However, geriatric depression scale scores were significantly lower in study group than the controls (p= 0.026). In cerebral FDG-PET CT profiles of subjects we detected significantly lower metabolism in left and right cerebellum, left lentiform nucleus, right thalamus and vermis in the study group (p=0.008, p=0.023, p=0.003, p=0.002, p=0.002, respectively). In the right parietotemporal cortex and right and left associative visual cortex, we found higher metabolism in the study group than controls (p=0.023, p=0.012, p=0.003, respectively).

Conclusion: Epileptic patients with Alzheimer’s dementia may have distinct clinical and metabolic profiles, than pure Alzheimer’s disease patients. Even if there is no difference in the neurocognitive clinical scores of the patients, depression and related functional abnormalities may be a biomarker of epileptic AD.

Anahtar Kelimeler

Alzheimer disease, epilepsy, FDG-PET CT, metabolism, depression

Saf Alzheimer Demansı ile Epileptik Alzheimer Demansı Hastaları Arasındaki Faklı Metabolik ve Klinik Profiller: Metabolik bir çalışma

Öz

Amaç: Epileptik Alzheimer hastalarının klinik özelliklerini ve serebral FDG PET metabolizmalarını araştırmak ve saf Alzheimer demansı hastaları ile arasındaki farkları karşılaştırmaktır.

Yöntemler: Bu vaka-kontrol çalışmasına Alzheimer hastalığı olan 7 hastadan oluşan control grubu ve Alzheimer hastalığına eşlik eden epilepsisi olan 7 hastadan oluşan çalışma grubu olmak üzere toplam 14 hasta dahil edildi. Tüm katılımcılara ayrıntılı nörobilişsel bateri ve beyin florodeoksiglukoz pozitron emisyon tomografisi (FDG PET-CT) uygulandı.

Bulgular: Nörobilişsel test puanları karşılaştırıldığında, çalışma ve kontrol grupları arasında anlamlı bir fark yoktu. Ancak geriatrik depresyon ölçeği puanları çalışma grubunda kontrollere göre anlamlı derecede düşüktü (p= 0.026). Çalışma grubundaki olguların serebral FDG-PET BT profillerinde sol ve sağ serebellum, sol lentiform nükleus, sağ talamus ve vermiste anlamlı düzeyde daha düşük metabolizma saptadık (p=0,008, p=0,023, p=0,003, p=0,002, p =0,002, sırasıyla). Sağ parietotemporal korteks ve sağ ve sol birleştirici görsel kortekste, çalışma grubunda kontrollere göre daha yüksek metabolizma bulduk (sırasıyla p=0.023, p=0.012, p=0.003).

Sonuç: Alzheimer demansı olan epileptik hastalar, saf Alzheimer hastalarından farklı klinik ve metabolik profile sahip olabilir. Hastaların nörokognitif klinik skorlarında fark olmasa bile depresyon ve ilişkili fonksiyonel anormallikler epileptik AD hastaları için bir biyobelirteç olabilir.

Anahtar Kelimeler

Alzheimer hastalığı, epilepsi, FDG-PET BT, metabolizma, depresyon

Kaynakça

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