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Aim <p>We aim to determine whether individuals with adult-onset hydrocephalus have an increased risk of incident epilepsy over time.</p> Methods <p>We analysed data from the UK Biobank cohort. Diagnoses of “hydrocephalus” and “epilepsy” were identified through ICD-10-coded health records, excluding congenital and secondary cases. The association between these two diseases was investigated using logistic regression (adjusted for age and sex); subsequently, we performed a sampled cohort study to evaluate the hazard ratio (HR) for incident epilepsy in people with adult-onset hydrocephalus using Cox proportional hazards models with a dedicated sensitivity analysis including different sets of covariates such as demographic, lifestyle, vascular, and genetic factors.</p> Results <p>Our cohort included 483,790 controls, 5,028 individuals with epilepsy, and 320 with adult-onset hydrocephalus. Hydrocephalus and epilepsy were strongly associated (OR: 9.6, 95% CI: 6.4–13.8, <i>p</i> &lt; 0.001). Adjusted Cox models demonstrated a markedly increased risk of incident epilepsy in people with adult-onset hydrocephalus, with HR values ranging from 14.62 (95% CI: 7.91–27.00, <i>p</i> &lt; 0.001) to 23.80 (95% CI: 12.87–44.03, <i>p</i> &lt; 0.001) across models, after adjusting for multiple covariates. Results were also consistent after excluding people with comorbid neurodegenerative dementias such as Alzheimer’s disease.</p> Conclusions <p>We demonstrated a markedly increased risk of epilepsy in adult-onset hydrocephalus, independent of vascular and neurodegenerative comorbidities and not attributable to shunt-related complications. These findings underscore the importance of increased diagnostic vigilance, as seizures may be under-recognized in this population, and support further research to clarify mechanisms and optimize management strategies.</p>

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Risk of epilepsy in people with adult-onset hydrocephalus: insights from the UK Biobank

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月16日

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  • Jolanda Buonocore,
  • Francesco Fortunato,
  • Enrico Fratto,
  • Ilaria Sammarra,
  • Antonio Gambardella,
  • Aldo Quattrone,
  • Andrea Quattrone

摘要

Aim

We aim to determine whether individuals with adult-onset hydrocephalus have an increased risk of incident epilepsy over time.

Methods

We analysed data from the UK Biobank cohort. Diagnoses of “hydrocephalus” and “epilepsy” were identified through ICD-10-coded health records, excluding congenital and secondary cases. The association between these two diseases was investigated using logistic regression (adjusted for age and sex); subsequently, we performed a sampled cohort study to evaluate the hazard ratio (HR) for incident epilepsy in people with adult-onset hydrocephalus using Cox proportional hazards models with a dedicated sensitivity analysis including different sets of covariates such as demographic, lifestyle, vascular, and genetic factors.

Results

Our cohort included 483,790 controls, 5,028 individuals with epilepsy, and 320 with adult-onset hydrocephalus. Hydrocephalus and epilepsy were strongly associated (OR: 9.6, 95% CI: 6.4–13.8, p < 0.001). Adjusted Cox models demonstrated a markedly increased risk of incident epilepsy in people with adult-onset hydrocephalus, with HR values ranging from 14.62 (95% CI: 7.91–27.00, p < 0.001) to 23.80 (95% CI: 12.87–44.03, p < 0.001) across models, after adjusting for multiple covariates. Results were also consistent after excluding people with comorbid neurodegenerative dementias such as Alzheimer’s disease.

Conclusions

We demonstrated a markedly increased risk of epilepsy in adult-onset hydrocephalus, independent of vascular and neurodegenerative comorbidities and not attributable to shunt-related complications. These findings underscore the importance of increased diagnostic vigilance, as seizures may be under-recognized in this population, and support further research to clarify mechanisms and optimize management strategies.