If there is a sign of hyperexcitability, then you might think about treating that. So, bring back the normal excitation-inhibition balance. You can use anti-seizure medication for that because epilepsy is treatable. The problem with this is that anti-seizure medication is actually approved for patients who had epileptic seizures. But now we are not talking about seizures. We are just talking about signs of increased hyperexcitability on the EEG...
If there is a sign of hyperexcitability, then you might think about treating that. So, bring back the normal excitation-inhibition balance. You can use anti-seizure medication for that because epilepsy is treatable. The problem with this is that anti-seizure medication is actually approved for patients who had epileptic seizures. But now we are not talking about seizures. We are just talking about signs of increased hyperexcitability on the EEG. So how to approach this? How can we give antiseizure medication to a patient who is not epileptic per se? So this is a question. It has not been resolved yet. But we have a few studies, not too many, maybe three, four studies on a handful of patients, not a very high number of patients, which shows that if hyperexcitability or epileptic activity is present in a patient with Alzheimer’s disease, then the progression of Alzheimer’s disease is much faster, one and a half times faster at least, than in those patients who have Alzheimer’s disease but do not have epilepsy. So there is a significant increase in the speed of the progression of this disease if you have epilepsy or epileptic activity. Therefore, we should think about treating those patients who do not have epilepsy but have signs of increased hyperexcitability. We have to figure out a way how to do that. Maybe some drugs should be approved for treating interictal epileptiform activity as well. And then, of course, we need larger studies to prove that if you use these antiseizure medications to decrease hyperexcitability, then the outcome of the patient will be better, and for that, you need not one month or two months, you need a longer period of time, so you have to follow patients for a longer period of time, AD patients, which requires a lot of effort, a lot of money, and this is ahead of us.
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