Cognitive and Biomarker Signatures of Late-Onset Temporal Lobe Epilepsy: Toward Non-Alzheimer Neurodegenerative Mechanisms.
Late-onset temporal lobe epilepsy has a p/t-tau ratio below 0.17.
Cognitive and Biomarker Signatures of Late-Onset Temporal Lobe Epilepsy: Toward Non-Alzheimer Neurodegenerative Mechanisms.
Late-onset unexplained epilepsy (late-onset unexplained epilepsy) represents a substantial proportion of epilepsies with onset after 50 years and often manifests as temporal lobe epilepsy (LO-TLE).
This study aims to characterize the cognitive and CSF phenotype of LO-TLE and compare it with healthy controls (healthy controls) and patients with mild cognitive impairment due to alzheimer disease (MCI-alzheimer disease).
Underwent structural MRI, neuropsychological assessment, and CSF biomarkers assay, including neurofilament light chain (NfL) and the phosphorylated-to-total tau ratio (p/t-tau).
The study included 18 LO-TLE, 24 MCI-AD, and 17 healthy controls.
Despite normal imaging, LO-TLE showed lower performance compared with healthy controls in episodic memory ( t (53) = -7.79, p FDR < 0.001), short-term memory ( t (53) = -2.94, p FDR = 0.007), language ( t (53) = 4.12, p FDR < 0.001), and executive functions ( t (53) = -3.76, p FDR < 0.001), while attention was preserved.
The low p/t-tau ratio may reflect alternative pathophysiologic mechanisms and warrants further investigation in larger longitudinal studies to clarify the underlying pathology and clinical trajectories.