AUTHOR=Cretin Benjamin , Bousiges Olivier , Hautecloque Geoffroy , Philippi Nathalie , Blanc Frederic , Dibitonto Laure , Martin-Hunyadi Catherine , Sellal François 

TITLE=CSF in Epileptic Prodromal Alzheimer's Disease: No Diagnostic Contribution but a Pathophysiological One

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.623777

DOI=10.3389/fneur.2021.623777

ISSN=1664-2295

ABSTRACT=<p><bold>Objective:</bold> To study whether cerebrospinal fluid (CSF) analysis may serve as a diagnostic test for the screening of epilepsy in sporadic prodromal Alzheimer's disease (AD).</p><p><bold>Methods:</bold> A total of 29 patients with epileptic prodromal sporadic AD patients (epADs) were included and were retrospectively compared with 38 non-epileptic prodromal AD patients (nepADs) for demographics, clinical features, Mini-Mental Status Examination (MMSE) results, CSF biomarkers, and electro-radiological features.</p><p><bold>Results:</bold> Our study did not show any significant differences in CSF biomarkers regarding neurodegeneration, albumin levels, and inflammation between epADs and nepADs. The epADs were significantly older at diagnosis (<italic>p</italic> = 0.001), more hypertensive (<italic>p</italic> = 0.01), and displayed larger white matter hyperintensities on brain magnetic resonance imaging (MRI; <italic>p</italic> = 0.05). There was a significant correlation between the CSF Aβ-42 and Aβ-40 levels with interictal epileptiform discharges and delta slowing on EEGs recordings, respectively (<italic>p</italic> = 0.03).</p><p><bold>Conclusions:</bold> Our study suggests that CSF may not serve as a surrogate marker of epilepsy in prodromal AD and cannot circumvent the operator-dependent and time-consuming interpretation of EEG recordings. In humans, AD-related epileptogenesis appears to involve the Aβ peptides but likely also additional non-amyloid factors such as small-vessel disease (i.e., white matter hyperintensities).</p>