New research indicates that epilepsy is substantially more common in individuals with frontotemporal dementia (FTD) than previously recognized. The findings underscore the need to consider epileptic seizures when managing and treating patients with this neurodegenerative condition.

The study, a collaborative effort led by Neurocenter Finland involving the University of Eastern Finland and the University of Oulu, investigated the prevalence of epilepsy in FTD patients. The research,leveraging one of the world’s largest datasets of its kind,was recently published in JAMA neurology.

Early Onset of Epilepsy in FTD Patients

While epilepsy is already known to be associated with conditions like Alzheimer’s disease, the connection between FTD and epilepsy has remained less clear. This new study addresses this gap, demonstrating a higher incidence of epilepsy in FTD patients than prior estimates suggested.

Researchers analyzed data from university hospitals in Kuopio and Oulu spanning from 2010 to 2021. The analysis included 245 FTD patients and 1,326 Alzheimer’s disease patients, identified from a pool of 12,490 medical records. The study also compared these groups to a control group of healthy individuals.

“Our results show that epilepsy is considerably more common among those with FTD than those with Alzheimer’s disease or in healthy controls.”

According to Doctoral Researcher Annemari Kilpeläinen, a medical specialist in neurology and the study’s first author, “Our results show that epilepsy is considerably more common among those with FTD than those with Alzheimer’s disease or in healthy controls.”

Kilpeläinen added,”It is noteworthy that epilepsy occurred in some patients with FTD already ten years before their dementia diagnosis,and it was more common in all the examined stages of the disease than previous international studies have reported.”

The study assessed epilepsy prevalence at various points,from ten years before to five years after the dementia diagnosis.In FTD patients, the prevalence of epilepsy increased over time, reaching approximately 11% five years post-diagnosis. The increased use of epilepsy medications among FTD patients further supports these findings.

Challenges in Diagnosing Epilepsy in FTD Patients

Diagnosing epilepsy in FTD patients can be tough because the symptoms of FTD can mimic epileptic seizures, potentially leading to underdiagnosis and delayed treatment. However, failure to treat epilepsy can negatively impact a patient’s condition.

“Identifying epilepsy is important because its treatment can improve patients’ functional capacity and quality of life. Knowledge about the association between epilepsy and FTD raises new research questions: do these diseases share some pathophysiological mechanisms and could some FTD symptoms be caused by alterations in the specific electrical systems of the brain,” said Associate Professor Eino Solje, the project’s principal investigator and Director of UEF Brain Research Unit.

The research project involved collaboration between the University of Oulu and the University of Eastern Finland, integrating extensive patient data with unique registers and expertise from various scientific fields, including medicine and law. Kuopio University Hospital and Oulu University Hospital are part of the international European Reference Network EpiCARE.