INSIGHT-LOEU protocol: biomarkers, cognition and sleep in late-onset epilepsy
This protocol proposes combining cognitive testing, biomarkers, neurophysiological measures and sleep assessment in late-onset epilepsy of unknown cause, aiming to identify high-risk profiles and windows for neuroprotective intervention. [1]
Automatic summary · not editorially reviewed
The key findings
Longitudinal studies are reported to show early cognitive impairment at seizure onset and a substantially elevated dementia risk within a decade of diagnosis in late-onset epilepsy of unknown cause. [1]
Emerging data suggest that β-amyloid and tau pathology may precede the onset of epilepsy. [1]
The protocol proposes combining neuropsychological assessment, advanced biomarkers, neurophysiological measures and systematic sleep evaluation to identify high-risk phenotypes and windows for neuroprotective interventions. [1]
The source at a glance
- Study type / format
- Study protocol (abstract)
- Population / context
- People with late-onset epilepsy of unknown aetiology (LOEU), as described in the protocol abstract.
- Summary based on
- Study abstract
- Original publication
- August 21, 2026
Why LOEU is linked to later dementia
In about 20% of late-onset epilepsy cases the cause stays unknown (LOEU). The abstract reports that longitudinal studies found early cognitive impairment at seizure onset, progressive memory decline and a substantially elevated dementia risk within a decade of diagnosis, plus more subsequent neurodegenerative disorders, especially Alzheimer's disease. LOEU is also linked to cognitive network alterations and epileptiform activity, though the links remain unclear. Emerging data suggest β-amyloid and tau processes may precede epilepsy onset. The authors therefore argue LOEU should be reconceptualised as a multidimensional neurological condition.
Supporting source [1]
Proposed combined assessment in the protocol
The protocol advocates an integrated approach: neuropsychological assessment, advanced biomarkers, neurophysiological measures and systematic sleep evaluation. The stated aim is to identify high-risk phenotypes and define optimal windows for neuroprotective interventions in LOEU. The authors say this strategy could improve early detection of cognitive decline, guide personalised management and ultimately enhance quality of life. They also note that affective symptoms and sleep disturbances are described as key determinants of subjective well-being, while epilepsy's impact on quality of life in older adults remains unclear.
Supporting source [1]
Abstract-only scope of this protocol
This is a study protocol abstract, not a report of completed results. It describes the planned integrated approach and the hoped-for benefits, such as better early detection and long-term sustainability of healthcare systems in an ageing population, with LOEU as a model for dementia prevention. No sample size, follow-up duration, measured outcomes or findings are reported in the abstract. The links between LOEU, network alterations and epileptiform activity are explicitly described as unclear, and the biomarker suggestion is framed as emerging data. The full text was not reviewed.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. This is a protocol describing a proposed approach, not completed results. No sample size, follow-up, measured outcomes or findings are reported. The links between LOEU, network alterations and epileptiform activity are described as unclear, and the biomarker suggestion is framed as emerging data.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Bergamo G, Fernandes M, Maio S, Albanesi G, Antonucci M, Barbaro I, Cirillo F, Fernando L, Amicucci G, Centonze D, Liguori C. · europepmc.org · August 21, 2026