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Silent hippocampal seizures and spikes identified by foramen ovale electrodes in Alzheimer's disease

Nature Medicine volume 23, pages 678680 (2017) | Download Citation

Abstract

We directly assessed mesial temporal activity using intracranial foramen ovale electrodes in two patients with Alzheimer's disease (AD) without a history or EEG evidence of seizures. We detected clinically silent hippocampal seizures and epileptiform spikes during sleep, a period when these abnormalities were most likely to interfere with memory consolidation. The findings in these index cases support a model in which early development of occult hippocampal hyperexcitability may contribute to the pathogenesis of AD.

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Acknowledgements

This work was supported by NIH-NINDS R25-NS065743 (A.D.L.), the Massachusetts General Hospital Executive Committee on Research (A.D.L.), NIH-NINDS U01-NS090362 (A.G.), Citizens United for Research in Epilepsy (A.G.), NIH-NINDS R01-NS029709 (J.N.), and the Blue Bird Circle Foundation (J.N.).

Author information

Affiliations

  1. MGH Epilepsy Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

    • Alice D Lam
    • , Gina Deck
    •  & Andrew J Cole
  2. Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.

    • Alica Goldman
    •  & Jeffrey Noebels
  3. Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

    • Emad N Eskandar

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Contributions

A.D.L., G.D., A.G., E.N.E., J.N., and A.J.C. drafted and edited the manuscript. A.D.L., G.D., and A.G. prepared the figures. A.D.L. performed the spike quantification. A.G. performed the genetic analysis. A.J.C. and J.N. conceived the study.

Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Andrew J Cole.

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DOI

https://doi.org/10.1038/nm.4330

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