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Examining Brain Markers for Late-Onset Epilepsy

Neurology; ePub 2019 Jan 25; Johnson, et al

Associations were found between earlier-life white matter hyperintensities on MRI and later-life incident epilepsy, and between cortical volumes measured later in life and late-onset epilepsy, according to a recent study. These findings, therefore, may help illuminate the causes of late-onset epilepsy. In 1993–1995, 1,920 participants (median age 62.7, 59.9% female) in the community-based Atherosclerosis Risk in Communities (ARIC) Study underwent MRI, and white matter hyperintensities were measured. In addition, in 2011–2013, 1,964 ARIC participants (median age 72.4, 61.1% female) underwent MRI, and cortical volumes and white matter hyperintensities were measured. Researchers identified cases of late-onset epilepsy (starting at age ≥60) from ARIC hospitalization records and Medicare claims data. They found:

  • 97 ARIC participants developed epilepsy after having an MRI in 1993–1995 (incidence 3.34 per 1,000 person-years).
  • The degree of white matter hyperintensities measured at ages 49–72 years was associated with the risk of late-onset epilepsy (hazard ratio 1.27 per age-adjusted standard deviation [SD]).
  • Lower cortical volume scores were associated cross-sectionally with higher odds of late-onset epilepsy (odds ratio 1.87) per age-adjusted SD.

Johnson EL, Krauss GL, Lee AK, et al. Association between white matter hyperintensities, cortical volumes, and late-onset epilepsy. [Published online ahead of print January 25, 2019]. Neurology. doi:10.1212/WNL.0000000000007010.