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Here, we characterize patterns of cortical atrophy and cognitive impairment in 73 older adults with temporal lobe epilepsy (&amp;gt;55 years) and compare these patterns to those observed in 70 healthy controls and 79 patients with amnestic mild cognitive impairment, the prodromal stage of Alzheimer\u2019s disease. Patients with temporal lobe epilepsy were recruited from four tertiary epilepsy surgical centres; amnestic mild cognitive impairment and control subjects were obtained from the Alzheimer\u2019s Disease Neuroimaging Initiative database. Whole brain and region of interest analyses were conducted between patient groups and controls, as well as between temporal lobe epilepsy patients with early-onset (age of onset &amp;lt;50 years) and late-onset (&amp;gt;50 years) seizures. Older adults with temporal lobe epilepsy demonstrated a similar pattern and magnitude of medial temporal lobe atrophy to amnestic mild cognitive impairment. Region of interest analyses revealed pronounced medial temporal lobe thinning in both patient groups in bilateral entorhinal, temporal pole, and fusiform regions (all P\u2009&amp;lt;\u20090.05). Patients with temporal lobe epilepsy demonstrated thinner left entorhinal cortex compared to amnestic mild cognitive impairment (P\u2009=\u20090.02). Patients with late-onset temporal lobe epilepsy had a more consistent pattern of cortical thinning than patients with early-onset epilepsy, demonstrating decreased cortical thickness extending into the bilateral fusiform (both P\u2009&amp;lt;\u20090.01). Both temporal lobe epilepsy and amnestic mild cognitive impairment groups showed significant memory and language impairment relative to healthy control subjects. However, despite similar performances in language and memory encoding, patients with amnestic mild cognitive impairment demonstrated poorer delayed memory performances relative to both early and late-onset temporal lobe epilepsy. Medial temporal lobe atrophy and cognitive impairment overlap between older adults with temporal lobe epilepsy and amnestic mild cognitive impairment highlights the risks of growing old with epilepsy. Concerns regarding accelerated ageing and Alzheimer\u2019s disease co-morbidity in older adults with temporal lobe epilepsy suggests an urgent need for translational research aimed at identifying common mechanisms and\/or targeting symptoms shared across a broad neurological disease spectrum.<\/jats:p>","DOI":"10.1093\/brain\/awaa397","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T03:26:43Z","timestamp":1603423603000},"page":"236-250","source":"Crossref","is-referenced-by-count":69,"title":["Atrophy and cognitive profiles in older adults with temporal lobe epilepsy are similar to mild cognitive impairment"],"prefix":"10.1093","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3252-5365","authenticated-orcid":false,"given":"Erik","family":"Kaestner","sequence":"first","affiliation":[{"name":"Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anny","family":"Reyes","sequence":"additional","affiliation":[{"name":"Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA"},{"name":"San Diego State University\/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Rao","sequence":"additional","affiliation":[{"name":"Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Christina","family":"Macari","sequence":"additional","affiliation":[{"name":"Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Yul","family":"Choi","sequence":"additional","affiliation":[{"name":"Epilepsy Center and Department of Neurology, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deqiang","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong Irene","family":"Wang","sequence":"additional","affiliation":[{"name":"Epilepsy Center and Department of Neurology, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L","family":"Drane","sequence":"additional","affiliation":[{"name":"Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Department of Neurology, University of Washington, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Hermann","sequence":"additional","affiliation":[{"name":"Matthews Neuropsychology Section, University of Wisconsin, Madison, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-4912","authenticated-orcid":false,"given":"Robyn M","family":"Busch","sequence":"additional","affiliation":[{"name":"Epilepsy Center and Department of Neurology, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0552-6736","authenticated-orcid":false,"given":"Vineet","family":"Punia","sequence":"additional","affiliation":[{"name":"Epilepsy Center and Department of Neurology, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie R","family":"McDonald","sequence":"additional","affiliation":[{"name":"Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA"},{"name":"San Diego State University\/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA"},{"name":"Department of Psychiatry, University of California, San Diego, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Alzheimer\u2019s Disease Neuroimaging 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