Impact of Anticonvulsant Treatment on Cognitive Function and Epileptic Activity in Alzheimer's Disease Patients
Maria Chacon1, Linker Viñan Paucar2, Isabella Egüez2, Danny Japon2, Carlos Rodriguez Alarcon2, Andre Paszkiewicz-Salcedo2, Soledad Salazar2, María Rimbaldo2, Luis Leyton Aguilar2, Estefanía Suquilanda Rovayo2, Génesis Loor-Intriago2, Daniel Ocampo2, Presley Gruezo2, Luis Yepez2, Rocio Santibanez2
1Universidad de Especialidades Espíritu Santo, 2Universidad Católica Santiago de Guayaquil
Objective:
Investigate the correlation between demographic and clinical factors, including anticonvulsant treatment, cognitive performance, and seizure frequency in epilepsy patients diagnosed with Alzheimer's Disease (AD).
Background:
AD is associated with cognitive decline and is frequently complicated by epilepsy. This study explores the interplay between demographic factors, epilepsy characteristics, and cognitive outcomes in patients treated with anticonvulsants (phenobarbital and levetiracetam), aiming to better understand their relationships and impacts.
Design/Methods:
A cross sectional study was conducted with a cohort of 51 patients diagnosed with both AD and epilepsy. It was analyzed using Pearson correlation coefficients to assess relationships between age, sex, race, education level, Mini-Mental State Examination (MMSE) scores, MoCA scores (before and after treatment), anticonvulsant dosages, epilepsy frequency and type. Statistical significance was determined at the p<0.05 level.
Results:
Among the 51 patients the mean age was 82.29 years (SD=5.96) and 52.9% were female. Significant correlations were found. Age of AD diagnosis was strongly positively correlated with both current age (r=0.991, p<0.001) and age of epilepsy onset (r=0.728, p<0.001). A notable negative correlation was observed between sex and education level (r=0.325, p=0.020). MoCA Test scores six months after treatment were positively correlated with initial MoCA scores (r=0.629, p<0.001) with significant improvement from scores prior intervention. The frequency of epilepsy per month negatively correlated with post-treatment MoCA scores (r=-0.250, p=0.076) and was strongly negatively correlated with seizure frequency during treatment (r=-0.294, p=0.036). Additionally, higher anticonvulsant dosages were associated with poorer MMSE scores after six months of therapy (r=-0.917, p<0.001).
Conclusions:
Higher doses of anticonvulsants were associated with worse cognitive outcomes, while effective treatment resulted in reduced seizure frequency and improved cognitive scores. This highlights the need for personalized treatment approaches that prioritize both seizure control and cognitive preservation in AD patients. Further research is needed to explore the long-term effects of anticonvulsant therapy on cognitive decline.
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