Ricerc@Sapienza

Although the highest incidence of epilepsy occurs after 60 years old in developed countries, so far no study has deeply investigated the possible specific pathophysiological mechanisms of late onset epilepsy (LOE). LOE patients have unknown etiology (LOEU) in more than 30% of cases and recent findings showed that LOEU patients are more likely to develop cognitive dysfunction and dementia during follow-up. Growing evidences pointed to a pivotal role of neurodegeneration in the pathophysiology of LOEU and many authors hypothesized that epileptic seizures in LOEU could be a very prodromal clinical manifestation of an occult amyloid pathology. In the last 20 years, several transcranial magnetic stimulation (TMS)-EMG and TMS-EEG studies have been performed to study neurophysiological aspects of Alzheimer's Disease (AD). Similarly, TMS protocols have been widely used in patients with epilepsy, and TMS is now accepted as a safe and valuable method to assess epilepsy pathophysiology, response to treatment and prognosis. Surprisingly, so far no study has investigated the pathophysiological mechanisms of LEOU using TMS techniques. Moreover, none has investigated the presence of possible shared neurophysiological biomarkers between AD patients and LOEU patients. Such findings could be used in future to identify patients among LOEU more likely to convert to AD dementia.