Abstract Details

Title Association of Cognitive and Structural Correlates of Brain Aging and Incident Epilepsy. The Framingham Heart Study.

Topic General Neurology

Presentation(s) S19 - Neuroepidemiology (5:18 PM-5:30 PM)

Poster/Presentation
Number 010

Background Late life epilepsy is often due to acquired insults such as strokes and clinical dementia, but its cause remains unknown in up to 30% of cases. There is growing evidence that occult cerebrovascular disease contributes to higher incidence of epilepsy with increasing age.

Objective To relate imaging and cognitive correlates of subclinical brain injury to incident epilepsy in the Framingham Heart Study (FHS), a community-based cohort.

Design/Methods Participants of the Offspring Cohort who attended FHS exam 7(1998-2001), were at least 45 years old at that time, had neuropsychological evaluation (NP), brain MRI, and no prior history of stroke, dementia or epilepsy were included in the study. Cognitive measures included Visual Reproductions Delayed Recall, Logical Memory Delayed Recall, Similarities, Trail Making B-A(TrB-TrA) and the Hooper Visual Organization Test. MRI measures included total cerebral brain volume, cortical grey matter volume (CGMV), white matter hyperintensities (WMHV) and hippocampal volume. Adjudication of epilepsy cases included medical chart review to exclude seizure mimics. Cox proportional hazards regression models were used for the analyses.

Results Among participants who underwent NP testing (n=2353,45.81% male) 30 incident epilepsy cases were identified during follow-up. Better performance in TrB-TrA was associated with lower risk of developing epilepsy (HR 0.25,95%CI[0.08,0.73],p= 0.011). In the subgroup of participants with available MRI (n=2056,46% male), 27 developed epilepsy. Higher WMHV was associated with increased epilepsy risk (HR 1.5,95%CI[1.01,2.20],p= 0.042), but higher CGMV (HR 0.73,95%CI[0.57,0.93],p= 0.001) was protective against epilepsy. All analyses were adjusted for age, sex and educational level.

Conclusions Better performance in TrB-TrA, a measure of executive function and processing speed, and higher cortical volumes are protective against epilepsy. Conversely, higher WMHV, a measure of occult vascular injury, increases the risk. Our study shows that non-invasive tests performed in mid-life may help identify people at risk for developing epilepsy later in life.

Authors/Disclosures
Maria Stefanidou, MD (Boston University School of Medicine) PRESENTER	Dr. Stefanidou has nothing to disclose.
Jayandra Himali	No disclosure on file
Claudia L. Satizabal, PhD (UT Health San Antonio)	The institution of Dr. Satizabal has received research support from NIH and TARCC.
Alexa Beiser	No disclosure on file
Orrin Devinsky, MD, FAAN (NYU Epilepsy Center)	Dr. Devinsky has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Devinsky has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for California Cannabis Enterprises. Dr. Devinsky has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Engage. Dr. Devinsky has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Privateer Holdings. Dr. Devinsky has received personal compensation in the range of $1,000,000+ for serving on a Scientific Advisory or Data Safety Monitoring board for Receptor Holdings. Dr. Devinsky has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Rettco. Dr. Devinsky has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Silver Spike. Dr. Devinsky has received personal compensation in the range of $100,000-$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Tevard. Dr. Devinsky has received personal compensation in the range of $1,000,000+ for serving on a Scientific Advisory or Data Safety Monitoring board for Tilray. Dr. Devinsky has received personal compensation in the range of $100,000-$499,999 for serving as an officer or member of the Board of Directors for Engage. Dr. Devinsky has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Tevard Biosciences. Dr. Devinsky has received stock or an ownership interest from Engage. Dr. Devinsky has received stock or an ownership interest from Empatica. Dr. Devinsky has received stock or an ownership interest from California Cannabis Enterprises. Dr. Devinsky has received stock or an ownership interest from Empatica. Dr. Devinsky has received stock or an ownership interest from Silver Spike. Dr. Devinsky has received stock or an ownership interest from Docklight Brands. Dr. Devinsky has received stock or an ownership interest from Egg Rock/Papa Barkley. Dr. Devinsky has received stock or an ownership interest from Leafly. Dr. Devinsky has received stock or an ownership interest from Left Coast Ventures. Dr. Devinsky has received stock or an ownership interest from Privateer Holdings. Dr. Devinsky has received stock or an ownership interest from Receptor Holdings. Dr. Devinsky has received stock or an ownership interest from Qstate. The institution of Dr. Devinsky has received research support from GW Pharma. The institution of Dr. Devinsky has received research support from Zogenix. The institution of Dr. Devinsky has received research support from PTC Pharma. The institution of Dr. Devinsky has received research support from NIH. The institution of Dr. Devinsky has received research support from DOD. The institution of Dr. Devinsky has received research support from NIH. The institution of Dr. Devinsky has received research support from Epilepsy Foundation. The institution of Dr. Devinsky has received research support from NIH. The institution of Dr. Devinsky has received research support from NIH. The institution of Dr. Devinsky has received research support from NSF. Dr. Devinsky has received intellectual property interests from a discovery or technology relating to health care. Dr. Devinsky has received intellectual property interests from a discovery or technology relating to health care. Dr. Devinsky has received publishing royalties from a publication relating to health care.
Sudha Seshadri, MD, FAAN (Glenn Biggs Institute for Alzheimer'S and Neurodegenerative Diseases)	Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Seshadri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Seshadri has received research support from NIH. The institution of Dr. Seshadri has received research support from Alzheimer Association.
Daniel Friedman, MD (NYU Langone Medical Center)	The institution of Dr. Friedman has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Epilepsy Study Consortium (non-profit). Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Meili Technology. Dr. Friedman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurelis. Dr. Friedman has stock in Neuroview Technology. The institution of Dr. Friedman has received research support from NIH. The institution of Dr. Friedman has received research support from CDC. The institution of Dr. Friedman has received research support from Epitel. The institution of Dr. Friedman has received research support from Neuropace. Dr. Friedman has received intellectual property interests from a discovery or technology relating to health care. Dr. Friedman has received intellectual property interests from a discovery or technology relating to health care. Dr. Friedman has received publishing royalties from a publication relating to health care. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Speaker Honorarium with SK Life Sciences. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Speaker Honorarium with AAN. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Travel Reimbursement with Epilepsy Foundation of America.