IEC 2025 | The potential use of plasma ptau217 as a biomarker in late-onset unexplained epilepsy

So, when we see someone in an epilepsy clinic who has unexplained seizures, and one of the questions we have might be, is this related to an underlying neurodegenerative disease? Plasma P-Tau217 might allow us to answer that question. Right now, ideally, it should be coupled and targeted towards patients with memory complaints. And so if someone’s completely asymptomatic and this is their first lifetime seizure, there’s a question mark about whether P-Tau217 should be used. In the Alzheimer’s field, they’ve really shifted towards only symptomatic patients who have cognitive complaints. So if you ask me now, I would say if someone is coming to an epilepsy clinic with new-onset seizures and cognitive complaints, and Alzheimer’s disease is on the differential diagnosis, that might be a scenario where plasma P-tau-217 could be used. We also know that plasma P-tau-217 is a good predictor of how patients are going to do over time from a cognitive standpoint. So it predicts whether you’re going to convert from mild cognitive impairment to dementia. And so this becomes a risk stratification tool as well. And that might ideally change the management plan. So if there is a concern that there’s underlying Alzheimer’s disease pathology, a positive screen might lead to an amyloid PET. And if that amyloid PET is positive, at least in the U.S., that patient might be eligible for the newer amyloid antibodies if their seizures are under control.

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