title: Cognitive deterioration in adult epilepsy: Does accelerated cognitive ageing exist?
abstract: A long-standing concern has been whether epilepsy contributes to cognitive decline or so-called 'epileptic dementia'. Although global cognitive decline is generally reported in the context of chronic refractory epilepsy, it is largely unknown what percentage of patients is at risk for decline. This review is focused on the identification of risk factors and characterization of aberrant cognitive trajectories in epilepsy. Evidence is found that the cognitive trajectory of patients with epilepsy over time differs from processes of cognitive ageing in healthy people, especially in adulthood-onset epilepsy. Cognitive deterioration in these patients seems to develop in a 'second hit model' and occurs when epilepsy hits on a brain that is already vulnerable or vice versa when comorbid problems develop in a person with epilepsy. Processes of ageing may be accelerated due to loss of brain plasticity and cognitive reserve capacity for which we coin the term 'accelerated cognitive ageing'. We believe that the concept of accelerated cognitive ageing can be helpful in providing a framework understanding global cognitive deterioration in epilepsy.
authors.affiliation: Department of Behavioral Sciences, Department of Neurology, Department of Research and Development, Epilepsy Centre Kempenhaeghe, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands. Electronic address: breuerl@kempenhaeghe.nl.
authors.forename: L E M
authors.initials: LE
authors.lastname: Breuer
authors.affiliation: Department of Behavioral Sciences, Department of Neurology, Department of Research and Development, Epilepsy Centre Kempenhaeghe, P.O. Box 61, 5590 AB Heeze, The Netherlands; Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Boon
authors.affiliation: Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: J W M
authors.initials: JW
authors.lastname: Bergmans
authors.affiliation: Department of Neurology, Department of Clinical Neurophysiology, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: W H
authors.initials: WH
authors.lastname: Mess
authors.affiliation: Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: R M H
authors.initials: RM
authors.lastname: Besseling
authors.affiliation: Department of Behavioral Sciences, Department of Neurology, Department of Research and Development, Epilepsy Centre Kempenhaeghe, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: de Louw
authors.affiliation: Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: Tijhuis
authors.affiliation: Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Zinger
authors.affiliation: Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Bernas
authors.affiliation: Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: D C W
authors.initials: DC
authors.lastname: Klooster
authors.affiliation: Department of Behavioral Sciences, Department of Neurology, Department of Research and Development, Epilepsy Centre Kempenhaeghe, P.O. Box 61, 5590 AB Heeze, The Netherlands; Department of Electrical Engineering, Department of Biomedical Engineering, University of Technology, P.O. Box 513, 5600 MB Eindhoven, The Netherlands; Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium; Department of Neurology, Department of Clinical Neurophysiology, Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: A P
authors.initials: AP
authors.lastname: Aldenkamp
mesh_terms: D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D000066492:Cognitive Aging / Q000502:physiology; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*; D006801:Humans
keywords: Accelerated cognitive ageing; Cognition; Cognitive ageing; Cognitive decline; Cognitive deterioration; Cognitive trajectory; Epilepsy; Risk factors