Epilepsy in Alzheimer's disease and related dementias

PROJECT SUMMARY/ABSTRACT Candidate and Goals: Dr. Ifrah Zawar is an Assistant Professor of Neurology at the University of Virginia (UVA) with clinical expertise in neurology and epilepsy and a research focus on epilepsy in older adults and people with Alzheimer’s disease and related dementias (ADRD). Her long-term career goal is to become a leading,

independent clinician investigator in ADRD and co-morbid epilepsy. Her current research, research funding, and history of dissemination demonstrate her ability to execute innovative, impactful research in this field. Career Development: Dr. Zawar proposes a plan of research, mentorship, and coursework, including ADRD

training via Virginia Alzheimer’s Disease Center Scholars Program, workshops, several data science courses and clinical study design and statistical modeling culminating with a Master’s Degree in Clinical Research. Research: Epilepsy is a common co-morbidity of ADRD. People with ADRD and co-morbid epilepsy appear to

have faster cognitive decline. Dr. Zawar’s preliminary data suggest that ADRD with co-morbid epilepsy have worse cognitive and mortality outcomes. Unfortunately, seizures are often under-recognized in the setting of dementia, leading to delayed diagnosis and treatment. However, no algorithms are available to identify people

with ADRD at high risk for epilepsy. The apolipoprotein E ε4 (APOE4) allele is the most common independent genetic risk factor for late-onset epilepsy. Yet, it has not been studied as a risk factor for epileptiform activity on prolonged electroencephalogram (EEG). Dr. Zawar hypothesizes that people with ADRD at high risk for epilepsy

can be identified using clinical and genetic risk factors. Dr. Zawar proposes to 1) Develop and test a risk stratification algorithm for epilepsy prediction in ADRD and 2) determine the feasibility of identifying the differences in EEG in people with AD with and without the APOE4 allele. Successful completion of this

research will develop a risk stratification algorithm to identify those at risk for developing epilepsy among ADRD and test the feasibility of assessing APOE4 as a predictor for epileptiform activity in AD. This tool could change clinical practice by identifying high-risk people with ADRD who can be monitored closely or considered for an

EEG for early identification and treatment of epilepsy with a goal of improving patient care and clinical outcomes. Mentors: Dr. Zawar’s primary mentor, Dr. Jaideep Kapur, MD, Ph.D., is an international leader in epilepsy. Her mentoring team brings in diverse, qualified, and recognized expertise in ADRD, neuropsychology, biostatistics,

predictive analytics, EEG, clinical trial design, data science, gerontology, and epilepsy in older adults. Environment: UVA has a strong, well-established record of research and an excellent research environment for the proposed research and training. The Virginia Alzheimer's Disease Center, FE Dreifus Epilepsy Program,

the Brain Institute, UVA School of Data Science, School of Public Health Sciences, the NIH-NCATS-funded CTSA, and the Center of Advanced Medical Analytics will provide the resources and the diverse and stimulating environment for Dr. Zawar to flourish as an independent investigator in this cutting-edge field.