mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2025-317mes-317Research ArticleНЕЙРОБИОЛОГИЯNEUROBIOLOGYДиагностическая значимость субклинической эпилептиформной активности у пациентов с болезнью АльцгеймераDiagnostic significance of subclinical epileptiform activity in patients with alzheimer’s diseasehttps://orcid.org/0000-0003-0804-7076БурдС. Г.BurdS. G.

Бурд Сергей Георгиевич - д-р мед. наук, профессор

Москва

Sergey G. Burd - Dr. Sci. (Med.), Professor

Moscow

burds@yandex.ruhttps://orcid.org/0000-0002-6327-3546БоголеповаА. Н.BogolepovaA. N.

Боголепова Анна Николаевна - д-р мед. наук, профессор

Москва

Anna N. Bogolepova - Dr. Sci. (Med.), Professor

Moscow

annabogolepova@yandex.ruhttps://orcid.org/0000-0001-8712-4775ЛебедеваА. В.LebedevaA. V.

Лебедева Анна Валерьяновна - д-р мед. наук, профессор

Москва

Anna V. Lebedeva - Dr. Sci. (Med.), Professor

Moscow

av_lebedeva@mail.ruhttps://orcid.org/0000-0002-3746-1797РублёваЮ. В.RublevaYu. V.

Рублева Юлия Владимировна - канд. мед. наук

Москва

Yulia V. Rubleva - Cand. Sci. (Med.)

Moscow

nevrology1@yandex.ruhttps://orcid.org/0000-0003-0828-9868КоваленкоЕ. А.KovalenkoE. A.

Коваленко Екатерина Андреевна - канд. мед. наук

Москва

Ekaterina A. Kovalenko - Cand. Sci. (Med.)

Moscow

ekaterinakov90@mail.ruhttps://orcid.org/0000-0002-8606-5715МахновичЕ. В.MakhnovichE. V.

Махнович Екатерина Владимировна - канд. мед. наук

Москва

Ekaterina V. Makhnovich - Dr. Sci. (Med.)

Moscow

ekaterinamakhnovich@mail.ruhttps://orcid.org/0000-0003-2313-571XОсиновскаяН. А.OsinovskayaN. A.

Осиновская Нина Алексеевна

Москва

Nina A. Osinovskaya

Moscow

4246290@mail.ruhttps://orcid.org/0000-0002-6824-8868ГилеваЕ. А.GilevaE. A.

Гилева Екатерина Андреевна

Москва

Ekaterina A. Gileva

Moscow

kati-xodakova@mail.ruhttps://orcid.org/0000-0003-2730-7662ПантинаН. В.PantinaN. V.

Пантина Нина Владимировна

Москва

Nina V. Pantina

Moscow

knv1412@gmail.comhttps://orcid.org/0000-0002-8496-7475КовалёваИ. И.KovalevaI. I.

Ковалева Ирина Ивановна

Москва

Irina I. Kovaleva

Moscow

i.-rina@mail.ruФедеральный центр мозга и нейротехнологий Федерального медико-биологического агентства; Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияFederal Center of Brain Research and Neurotechnologies; Pirogov Russian National Research Medical UniversityRussian FederationФедеральный центр мозга и нейротехнологий Федерального медико-биологического агентстваРоссияFederal Center of Brain Research and NeurotechnologiesRussian Federation202517112025274578586Copyright © Бурд С.Г., Боголепова А.Н., Лебедева А.В., Рублёва Ю.В., Коваленко Е.А., Махнович Е.В., Осиновская Н.А., Гилева Е.А., Пантина Н.В., Ковалёва И.И., 20252025Бурд С.Г., Боголепова А.Н., Лебедева А.В., Рублёва Ю.В., Коваленко Е.А., Махнович Е.В., Осиновская Н.А., Гилева Е.А., Пантина Н.В., Ковалёва И.И.Burd S.G., Bogolepova A.N., Lebedeva A.V., Rubleva Y.V., Kovalenko E.A., Makhnovich E.V., Osinovskaya N.A., Gileva E.A., Pantina N.V., Kovaleva I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/317Введение

Введение. Высокая распространенность и значительная инвалидизация пациентов с болезнью Альцгеймера (БА) требуют поиска новых маркеров прогрессирования этого заболевания, а также новых подходов к его лечению. В последнее время накапливается все больше сведений о значимости применения электроэнцефалографии у пациентов с БА с целью выявления эпилептиформной активности у данной категории.

Цель

Цель. Определение частоты встречаемости эпилептиформной активности у пациентов с БА и оценка ее клинической и диагностической значимости.

Обсуждение

Обсуждение. Установлено, что проведение ЭЭГ, особенно продолженной, с включением сна, позволяет выявить субклиническую эпилептиформную активность, которая ассоциирована с более выраженными когнитивными нарушениями и способствует прогрессированию заболевания. В обзоре рассмотрены данные исследований по распространенности и клинической значимости субклинической эпилептиформной активности у пациентов с БА без диагноза «эпилепсия». Также освещены основные патофизиологические механизмы взаимосвязи эпилептиформной активности и прогрессирования когнитивных нарушений в рамках БА. Кроме того, рассматривается вопрос о целесообразности назначения специфической противоэпилептической терапии при выявлении субклинической эпилептиформной активности.

Выводы

Выводы. Показана высокая клиническая значимость проведения электроэнцефалографии и выявления эпилептиформной активности у пациентов с болезнью Альцгеймера вследствие ее потенциального негативного влияния на прогрессирование когнитивных нарушений и повышения рисков развития эпилептических приступов.

Introduction

Introduction. The high prevalence and significant disability of patients with Alzheimer’s disease (AD) necessitate the search for new markers of disease progression and novel treatment approaches. Recent evidence is increasingly attracting the research attention to the value of electroencephalography (EEG) in detecting epileptiform activity in this patient population.

Objective

Objective. Detection of the frequency of epileptiform activity in patients with AD and evaluation of its clinical and diagnostic significance.

Discussion

Discussion. EEG, in particular, prolonged sleep-deprived EEG, is capable of detecting subclinical epileptiform activity, which is associated with more severe cognitive impairments and contributes to disease progression. This review examines research data on the prevalence and clinical significance of subclinical epileptiform activity in AD patients without an epilepsy diagnosis. It also highlights key pathophysiological mechanisms linking epileptiform activity to the progression of cognitive decline in AD. Furthermore, it addresses the rationale for prescribing specific antiepileptic therapy upon detection of subclinical epileptiform activity.

Conclusions

Conclusions. The high clinical significance of performing electroencephalography and detecting epileptiform activity in patients with Alzheimer’s disease, due to its potential negative impact on the progression of cognitive impairments and increased risks of developing epileptic seizures, has been demonstrated.

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The authors declare that there are no conflicts of interest present.