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Jeong HT, Youn YC, Park KY, Choi BS, Nam TK, Sung HH. Difference between subjective and objective cognitive decline confirmed by power spectral density. Cogn Neuropsychiatry 2024; 29:194-207. [PMID: 39068667 DOI: 10.1080/13546805.2024.2364960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/31/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION The study aims to use power spectrum changes in subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI), preclinical stages of Alzheimer's disease (AD), for future biomarker studies in early AD diagnosis. METHODS We recruited 23 SCD and 32 aMCI subjects and conducted comparative analysis using relative power spectral density (PSD). Automated preprocessing and statistical analysis were performed using iSync Brain® (iMediSync Inc., Republic of Korea) (https://isyncbrain.com/). RESULTS Theta band power in the temporal region was 14.826 ± 7.2394 for the SCD group and 20.003 ± 10.1768 for the aMCI group. In the parietal region, theta band power was 13.614 ± 7.5689 for SCD and 19.894 ± 11.1387 for aMCI. Beta1 band power in the frontal region was 6.639 ± 2.2904 for SCD and 5.465 ± 1.8907 for aMCI, and in the temporal region it was 7.359 ± 2.5619 for SCD and 5.921 ± 2.1605 for aMCI. CONCLUSION PSD analysis of resting-state EEG predicted SCD, a preclinical stage of AD. This cross-sectional study observed electrical-physiological characteristics of preclinical AD; however, follow-up studies are needed to evaluate predictive value for future cognitive decline.
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Affiliation(s)
- Ho Tae Jeong
- Department of Neurology, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Kwang-Yeol Park
- Department of Neurology, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Byung-Sun Choi
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Taek-Kyun Nam
- Department of Neurosurgery, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Hyun Ho Sung
- Department of Clinical Laboratory Science, Dongnam Health University, Suwon, Korea
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Arjmandi-Rad S, Vestergaard Nieland JD, Goozee KG, Vaseghi S. The effects of different acetylcholinesterase inhibitors on EEG patterns in patients with Alzheimer's disease: A systematic review. Neurol Sci 2024; 45:417-430. [PMID: 37843690 DOI: 10.1007/s10072-023-07114-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the most common type of dementia. The early diagnosis of AD is an important factor for the control of AD progression. Electroencephalography (EEG) can be used for early diagnosis of AD. Acetylcholinesterase inhibitors (AChEIs) are also used for the amelioration of AD symptoms. In this systematic review, we reviewed the effect of different AChEIs including donepezil, rivastigmine, tacrine, physostigmine, and galantamine on EEG patterns in patients with AD. METHODS PubMed electronic database was searched and 122 articles were found. After removal of unrelated articles, 24 articles were selected for the present study. RESULTS AChEIs can decrease beta, theta, and delta frequency bands in patients with AD. However, conflicting results were found for alpha band. Some studies have shown increased alpha frequency, while others have shown decreased alpha frequency following treatment with AChEIs. The only difference was the type of drug. CONCLUSIONS We found that studies reporting the decreased alpha frequency used donepezil and galantamine, while studies reporting the increased alpha frequency used rivastigmine and tacrine. It was suggested that future studies should focus on the effect of different AChEIs on EEG bands, especially alpha frequency in patients with AD, to compare their effects and find the reason for their different influence on EEG patterns. Also, differences between the effects of AChEIs on oligodendrocyte differentiation and myelination may be another important factor. This is the first article investigating the effect of different AChEIs on EEG patterns in patients with AD.
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Affiliation(s)
- Shirin Arjmandi-Rad
- Institute for Cognitive & Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | | | - Kathryn G Goozee
- KaRa Institute of Neurological Diseases Pty Ltd, Macquarie, NSW, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Salar Vaseghi
- Cognitive Neuroscience Lab, Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj, Iran.
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Smailovic U, Ferreira D, Ausén B, Ashton NJ, Koenig T, Zetterberg H, Blennow K, Jelic V. Decreased Electroencephalography Global Field Synchronization in Slow-Frequency Bands Characterizes Synaptic Dysfunction in Amnestic Subtypes of Mild Cognitive Impairment. Front Aging Neurosci 2022; 14:755454. [PMID: 35462693 PMCID: PMC9031731 DOI: 10.3389/fnagi.2022.755454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMild cognitive impairment (MCI) is highly prevalent in a memory clinic setting and is heterogeneous regarding its clinical presentation, underlying pathophysiology, and prognosis. The most prevalent subtypes are single-domain amnestic MCI (sd-aMCI), considered to be a prodromal phase of Alzheimer’s disease (AD), and multidomain amnestic MCI (md-aMCI), which is associated with multiple etiologies. Since synaptic loss and dysfunction are the closest pathoanatomical correlates of AD-related cognitive impairment, we aimed to characterize it in patients with sd-aMCI and md-aMCI by means of resting-state electroencephalography (EEG) global field power (GFP), global field synchronization (GFS), and novel cerebrospinal fluid (CSF) synaptic biomarkers.MethodsWe included 52 patients with sd-aMCI (66.9 ± 7.3 years, 52% women) and 30 with md-aMCI (63.1 ± 7.1 years, 53% women). All patients underwent a detailed clinical assessment, resting-state EEG recordings and quantitative analysis (GFP and GFS in delta, theta, alpha, and beta bands), and analysis of CSF biomarkers of synaptic dysfunction, neurodegeneration, and AD-related pathology. Cognitive subtyping was based on a comprehensive neuropsychological examination. The Mini-Mental State Examination (MMSE) was used as an estimation of global cognitive performance. EEG and CSF biomarkers were included in a multivariate model together with MMSE and demographic variables, to investigate differences between sd-aMCI and md-aMCI.ResultsPatients with sd-aMCI had higher CSF phosphorylated tau, total tau and neurogranin levels, and lower values in GFS delta and theta. No differences were observed in GFP. The multivariate model showed that the most important synaptic measures for group separation were GFS theta, followed by GFS delta, GFP theta, CSF neurogranin, and GFP beta.ConclusionPatients with sd-aMCI when compared with those with md-aMCI have a neurophysiological and biochemical profile of synaptic damage, neurodegeneration, and amyloid pathology closer to that described in patients with AD. The most prominent signature in sd-aMCI was a decreased global synchronization in slow-frequency bands indicating that functional connectivity in slow frequencies is more specifically related to early effects of AD-specific molecular pathology.
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Affiliation(s)
- Una Smailovic
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Clinical Neurophysiology, Karolinska University Hospital, Stockholm, Sweden
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Birgitta Ausén
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Clinic for Cognitive Disorders, Karolinska University Hospital-Huddinge, Stockholm, Sweden
- Women’s Health and Allied Health Professionals Theme, Medical Unit Medical Psychology, Karolinska University Hospital, Huddinge, Sweden
| | - Nicholas James Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, United Kingdom
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, United Kingdom
| | - Thomas Koenig
- Psychiatric Electrophysiology Unit, Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, Queen Square, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, Hong Kong SAR, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Vesna Jelic
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Clinic for Cognitive Disorders, Karolinska University Hospital-Huddinge, Stockholm, Sweden
- *Correspondence: Vesna Jelic,
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Elsherif M, Esmael A. Hippocampal atrophy and quantitative EEG markers in mild cognitive impairment in temporal lobe epilepsy versus extra-temporal lobe epilepsy. Neurol Sci 2021; 43:1975-1986. [PMID: 34406537 DOI: 10.1007/s10072-021-05540-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Cognitive impairment in temporal lobe epilepsy is widely acknowledged as one of the most well-known comorbidities. This study aimed to explore cognitive impairment and to determine the potential clinical, radiological, and quantitative electroencephalography markers for cognitive impairment in temporal lobe epilepsy patients versus extra-temporal lobe epilepsy. METHODS Forty-five patients with temporal lobe epilepsy and forty-five patients with extra-temporal lobe epilepsy were recruited for an administered digit span test, verbal fluency test, mini-mental state examination, digital symbol test, and Montreal cognitive assessment. Also, they were subjected to magnetic resonance imaging assessment for hippocampal atrophy and a quantitative electroencephalography assessment for electroencephalography markers (median frequency, peak frequency, and the alpha-to-theta ratio). RESULTS Patients with extra-temporal lobe epilepsy showed non-significant higher epilepsy durations and a higher frequency of seizures. Temporal lobe epilepsy patients showed a more statistically significant family history of epilepsy (37.7%), more history of febrile convulsions (13.3%), higher hippocampal atrophy (17.8%), and lower cognitive scales, especially mini-mental state examination and Montreal cognitive assessment; lower digital symbol test, verbal fluency test, and backward memory of digit span test. Also, temporal lobe epilepsy patients had a strong negative correlation with electroencephalography markers: median frequency, peak frequency, and the alpha-to-theta ratio (r = - 0.68, P < 0.005 and r = - 0.64, P < 0.005 and r = - 0.66, P < 0.005 respectively). CONCLUSION Cognitive impairment in patients with temporal lobe epilepsy was correlated with hippocampal atrophy and quantitative electroencephalography abnormalities, especially peak frequency, median frequency, and alpha-to-theta ratio that could be used alone for the identification of early cognitive impairment. TRIAL REGISTRATION Clinicaltrials.gov: NCT04376671.
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Affiliation(s)
- Mohammed Elsherif
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 35516, Dakahlia, Egypt.
| | - Ahmed Esmael
- Department of Neurology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 35516, Dakahlia, Egypt
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Sungura R, Onyambu C, Mpolya E, Sauli E, Vianney JM. The extended scope of neuroimaging and prospects in brain atrophy mitigation: A systematic review. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2020.100875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Tarasova IV, Trubnikova OA, Barbarash OL. EEG and Clinical Factors Associated with Mild Cognitive Impairment in Coronary Artery Disease Patients. Dement Geriatr Cogn Disord 2019; 46:275-284. [PMID: 30404079 DOI: 10.1159/000493787] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 09/15/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although an impaired cognitive status in patients with coronary artery disease (CAD) is not rare, the neurophysiological and clinical indicators of mild cognitive impairment (MCI) have been insufficiently investigated so far. METHODS EEG and neuropsychological testing as well as clinical examination were performed on 122 patients with CAD, who were divided into two groups, those with MCI (n = 60; mean age 57.4 ± 5.81 years) and those without MCI (n = 62; mean age 57.0 ± 5.04 years). Binary logistic regression was used to identify the relationship between EEG and clinical variables and the probability of MCI. RESULTS Higher theta/alpha ratios, theta1 rhythm power with closed eyes in the frontal and occipital areas of the left hemisphere, and alpha2 rhythm power with eyes open in the frontal areas of the right hemisphere were associated with an increased risk for MCI in CAD patients. A low educational level, type 2 diabetes mellitus, and severe coronary lesions according to the SYNTAX Score (≥23 points) increased the risk for MCI as well. CONCLUSIONS The findings of our study show that a theta activity increase in frontal and occipital sites, as well as high theta/alpha ratios, may be considered as the earliest EEG markers of vascular cognitive disorders.
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Affiliation(s)
- Irina V Tarasova
- Department of Cardiovascular Diagnostics, Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Diseases", Kemerovo, Russian Federation,
| | - Olga A Trubnikova
- Department of Multifocal Atherosclerosis, Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Diseases", Kemerovo, Russian Federation
| | - Olga L Barbarash
- Department of Multifocal Atherosclerosis, Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Diseases", Kemerovo, Russian Federation
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Safavynia SA, Arora S, Pryor KO, García PS. An update on postoperative delirium: Clinical features, neuropathogenesis, and perioperative management. CURRENT ANESTHESIOLOGY REPORTS 2018; 8:252-262. [PMID: 30555281 PMCID: PMC6290904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE OF REVIEW We present a focused review on postoperative delirium for anesthesiologists, encompassing clinical features, neuropathogenesis, and clinical identification and management strategies based on risk factors and current delirium treatments. RECENT FINDINGS The literature on postoperative delirium is dominated by non-experimental studies. We review delirium phenotypes, diagnostic criteria, and present standard nomenclature based on current literature. Disruption of cortical integration of complex information (CICI) may provide a framework to understand the neuropathogenesis of postoperative delirium, as well as risk factors and clinical modifiers in the perioperative period. We further divide risk factors into patient factors, surgical factors, and medical/pharmacological factors, and present specific considerations for each in the preoperative, intraoperative, and postoperative periods. SUMMARY Postoperative delirium is prevalent, poorly understood, and often missed with current screening techniques. Proper identification of risk factors is useful for perioperative interventions and can help tailor patient-specific management strategies.
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Affiliation(s)
- Seyed A. Safavynia
- Department of Anesthesiology, Weill Cornell Medical
College, New York, NY, USA
| | - Sona Arora
- Department of Anesthesiology, Emory University, Atlanta,
GA, USA
| | - Kane O. Pryor
- Department of Anesthesiology, Weill Cornell Medical
College, New York, NY, USA
| | - Paul S. García
- Department of Anesthesiology, Emory University, Atlanta,
GA, USA
- Neuroanesthesia Laboratory, Atlanta VA Medical Center/Emory
University, Atlanta, GA, USA
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Safavynia SA, Arora S, Pryor KO, García PS. An Update on Postoperative Delirium: Clinical Features,
Neuropathogenesis, and Perioperative Management. CURRENT ANESTHESIOLOGY REPORTS 2018. [DOI: 10.1007/s40140-018-0282-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Mariani S, Tarokh L, Djonlagic I, Cade BE, Morrical MG, Yaffe K, Stone KL, Loparo KA, Purcell SM, Redline S, Aeschbach D. Evaluation of an automated pipeline for large-scale EEG spectral analysis: the National Sleep Research Resource. Sleep Med 2018; 47:126-136. [PMID: 29803181 PMCID: PMC5976521 DOI: 10.1016/j.sleep.2017.11.1128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVES We present an automated sleep electroencephalogram (EEG) spectral analysis pipeline that includes an automated artifact detection step, and we test the hypothesis that spectral power density estimates computed with this pipeline are comparable to those computed with a commercial method preceded by visual artifact detection by a sleep expert (standard approach). METHODS EEG data were analyzed from the C3-A2 lead in a sample of polysomnograms from 161 older women participants in a community-based cohort study. We calculated the sensitivity, specificity, accuracy, and Cohen's kappa measures from epoch-by-epoch comparisons of automated to visual-based artifact detection results; then we computed the average EEG spectral power densities in six commonly used EEG frequency bands and compared results from the two methods using correlation analysis and Bland-Altman plots. RESULTS Assessment of automated artifact detection showed high specificity [96.8%-99.4% in non-rapid eye movement (NREM), 96.9%-99.1% in rapid eye movement (REM) sleep] but low sensitivity (26.7%-38.1% in NREM, 9.1-27.4% in REM sleep). However, large artifacts (total power > 99th percentile) were removed with sensitivity up to 87.7% in NREM and 90.9% in REM, with specificities of 96.9% and 96.6%, respectively. Mean power densities computed with the two approaches for all EEG frequency bands showed very high correlation (≥0.99). The automated pipeline allowed for a 100-fold reduction in analysis time with regard to the standard approach. CONCLUSION Despite low sensitivity for artifact rejection, the automated pipeline generated results comparable to those obtained with a standard method that included manual artifact detection. Automated pipelines can enable practical analyses of recordings from thousands of individuals, allowing for use in genetics and epidemiological research requiring large samples.
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Affiliation(s)
- Sara Mariani
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Chronobiology and Sleep Research, Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Ina Djonlagic
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Michael G Morrical
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Kristine Yaffe
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Katie L Stone
- Research Institute, California Pacific Medical Center, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | | | - Shaun M Purcell
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Case Western Reserve University, Cleveland, OH, USA
| | - Daniel Aeschbach
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Division of Sleep and Human Factors Research, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
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Kim D, Kim K. Detection of Early Stage Alzheimer's Disease using EEG Relative Power with Deep Neural Network. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:352-355. [PMID: 30440409 DOI: 10.1109/embc.2018.8512231] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Electroencephalogram (EEG) signal based early diagnosis of Alzheimer's Disease (AD), especially a discrimination between healthy control (HC) and mild cognitive impairment (MCI) has received remarkable attentions to complement conventional diagnosing methods in clinical fields. A relative power (RP) metric which quantifies the abnormal EEG pattern 'slowing' has widely been used as a major feature to distinguish HC and MCI, however, the optimal spectral ranges of the RP are influenced by the given dataset. In this study, we proposed the deep neural network based classifier using the RP to fully exploit and recombine the features through its own learning structure. The DNN enhanced the diagnosis results compared to shallow neural network, and enabled to interpret the results as we used the wellknown RP features as the domain knowledge. We investigated and explored the potentials of DNN based detection of the earlystage AD.
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Discrimination of stroke-related mild cognitive impairment and vascular dementia using EEG signal analysis. Med Biol Eng Comput 2017; 56:137-157. [DOI: 10.1007/s11517-017-1734-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022]
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Neto E, Biessmann F, Aurlien H, Nordby H, Eichele T. Regularized Linear Discriminant Analysis of EEG Features in Dementia Patients. Front Aging Neurosci 2016; 8:273. [PMID: 27965568 PMCID: PMC5127828 DOI: 10.3389/fnagi.2016.00273] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/31/2016] [Indexed: 10/24/2022] Open
Abstract
The present study explores if EEG spectral parameters can discriminate between healthy elderly controls (HC), Alzheimer's disease (AD) and vascular dementia (VaD) using. We considered EEG data recorded during normal clinical routine with 114 healthy controls (HC), 114 AD, and 114 VaD patients. The spectral features extracted from the EEG were the absolute delta power, decay from lower to higher frequencies, amplitude, center and dispersion of the alpha power and baseline power of the entire frequency spectrum. For discrimination, we submitted these EEG features to regularized linear discriminant analysis algorithm with a 10-fold cross-validation. To check the consistency of the results obtained by our classifiers, we applied bootstrap statistics. Four binary classifiers were used to discriminate HC from AD, HC from VaD, AD from VaD, and HC from dementia patients (AD or VaD). For each model, we measured the discrimination performance using the area under curve (AUC) and the accuracy of the cross-validation (cv-ACC). We applied this procedure using two different sets of predictors. The first set considered all the features extracted from the 22 channels. For the second set of features, we automatically rejected features poorly correlated with their labels. Fairly good results were obtained when discriminating HC from dementia patients with AD or VaD (AUC = 0.84). We also obtained AUC = 0.74 for discrimination of AD from HC, AUC = 0.77 for discrimination of VaD from HC, and finally AUC = 0.61 for discrimination of AD from VaD. Our models were able to separate HC from dementia patients, and also and to discriminate AD from VaD above chance. Our results suggest that these features may be relevant for the clinical assessment of patients with dementia.
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Affiliation(s)
- Emanuel Neto
- Section for Clinical Neurophysiology, Haukeland University HospitalBergen, Norway; Institute of Biological and Medical Psychology, University of BergenBergen, Norway
| | | | - Harald Aurlien
- Section for Clinical Neurophysiology, Haukeland University Hospital Bergen, Norway
| | - Helge Nordby
- Institute of Biological and Medical Psychology, University of Bergen Bergen, Norway
| | - Tom Eichele
- Section for Clinical Neurophysiology, Haukeland University HospitalBergen, Norway; Institute of Biological and Medical Psychology, University of BergenBergen, Norway; K.G. Jebsen Center for Neuropsychiatric DisordersBergen, Norway
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Moretti DV. Electroencephalography-driven approach to prodromal Alzheimer's disease diagnosis: from biomarker integration to network-level comprehension. Clin Interv Aging 2016; 11:897-912. [PMID: 27462146 PMCID: PMC4939982 DOI: 10.2147/cia.s103313] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Decay of the temporoparietal cortex is associated with prodromal Alzheimer's disease (AD). Additionally, shrinkage of the temporoparietal cerebral area has been connected with an increase in α3/α2 electroencephalogram (EEG) power ratio in prodromal AD. Furthermore, a lower regional blood perfusion has been exhibited in patients with a higher α3/α2 proportion when contrasted with low α3/α2 proportion. Furthermore, a lower regional blood perfusion and reduced hippocampal volume has been exhibited in patients with higher α3/α2 when contrasted with lower α3/α2 EEG power ratio. Neuropsychological evaluation, EEG recording, and magnetic resonance imaging were conducted in 74 patients with mild cognitive impairment (MCI). Estimation of cortical thickness and α3/α2 frequency power ratio was conducted for each patient. A subgroup of 27 patients also underwent single-photon emission computed tomography evaluation. In view of α3/α2 power ratio, the patients were divided into three groups. The connections among cortical decay, cerebral perfusion, and memory loss were evaluated by Pearson's r coefficient. Results demonstrated that higher α3/α2 frequency power ratio group was identified with brain shrinkage and cutdown perfusion inside the temporoparietal projections. In addition, decay and cutdown perfusion rate were connected with memory shortfalls in patients with MCI. MCI subgroup with higher α3/α2 EEG power ratio are at a greater risk to develop AD dementia.
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Affiliation(s)
- Davide Vito Moretti
- Rehabilitation in Alzheimer’s Disease Operative Unit, IRCCS San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
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Moretti DV. Conversion of mild cognitive impairment patients in Alzheimer's disease: prognostic value of Alpha3/Alpha2 electroencephalographic rhythms power ratio. Alzheimers Res Ther 2015; 7:80. [PMID: 26715588 PMCID: PMC4696332 DOI: 10.1186/s13195-015-0162-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 11/04/2015] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The increase in electroencephalogram (EEG) alpha3/alpha2 frequency power ratio has been demonstrated as a biomarker characteristic of subjects with mild cognitive impairment (MCI) who will develop Alzheimer's disease (AD). METHODS Seventy-four adult subjects with MCI underwent clinical and neuropsychological evaluation, EEG recording, and high-resolution 3D magnetic resonance imaging (MRI). This group has been evaluated after a three years follow-up. Twenty-seven of these subjects underwent perfusion single-photon emission computed tomography (SPECT) evaluation also. Increasing alpha3/alpha2 power ratio, was computed for each subject. Differences in EEG markers, cortical thickness, brain perfusion among the groups were estimated. RESULTS In the higher alpha3/alpha2 frequency power ratio group, greater memory impairment was correlated with greater cortical atrophy and lower perfusional rate in the temporo-parietal cortex. After a follow-up of three years, these patients converted in AD. CONCLUSION High EEG upper/low alpha power ratio was associated with cortical thinning and lower perfusion in the temporo-parietal lobe. Moreover, atrophy and lower perfusion rate were both significantly correlated with memory impairment in MCI subjects. The increase of EEG upper/low alpha frequency power ratio could be useful for identifying individuals at risk for progression to AD dementia and may be of value in the clinical context.
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Affiliation(s)
- D V Moretti
- Alzheimer' Disease Rehabilitation Unit, IRCCS S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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Moretti DV. Association of EEG, MRI, and regional blood flow biomarkers is predictive of prodromal Alzheimer's disease. Neuropsychiatr Dis Treat 2015; 11:2779-91. [PMID: 26604762 PMCID: PMC4629965 DOI: 10.2147/ndt.s93253] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Thinning in the temporoparietal cortex, hippocampal atrophy, and a lower regional blood perfusion is connected with prodromal stage of Alzheimer's disease (AD). Of note, an increase of electroencephalography (EEG) upper/low alpha frequency power ratio has also been associated with these major landmarks of prodromal AD. METHODS Clinical and neuropsychological assessment, EEG recording, and high-resolution three-dimensional magnetic resonance imaging were done in 74 grown up subjects with mild cognitive impairment. This information was gathered and has been assessed 3 years postliminary. EEG recording and perfusion single-photon emission computed tomography assessment was done in 27 subjects. Alpha3/alpha2 frequency power ratio, including cortical thickness, was figured for every subject. Contrasts in cortical thickness among the groups were assessed. Pearson's r relationship coefficient was utilized to evaluate the quality of the relationship between cortical thinning, brain perfusion, and EEG markers. RESULTS The higher alpha3/alpha2 frequency power ratio group corresponded with more prominent cortical decay and a lower perfusional rate in the temporoparietal cortex. In a subsequent meetup after 3 years, these patients had AD. CONCLUSION High EEG upper/low alpha power ratio was connected with cortical diminishing and lower perfusion in the temporoparietal brain area. The increase in EEG upper/low alpha frequency power ratio could be helpful in recognizing people in danger of conversion to AD dementia and this may be quality information in connection with clinical assessment.
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Dimitriadis SI, Laskaris NA, Bitzidou MP, Tarnanas I, Tsolaki MN. A novel biomarker of amnestic MCI based on dynamic cross-frequency coupling patterns during cognitive brain responses. Front Neurosci 2015; 9:350. [PMID: 26539070 PMCID: PMC4611062 DOI: 10.3389/fnins.2015.00350] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/14/2015] [Indexed: 11/13/2022] Open
Abstract
The detection of mild cognitive impairment (MCI), the transitional stage between normal cognitive changes of aging and the cognitive decline caused by AD, is of paramount clinical importance, since MCI patients are at increased risk of progressing into AD. Electroencephalographic (EEG) alterations in the spectral content of brainwaves and connectivity at resting state have been associated with early-stage AD. Recently, cognitive event-related potentials (ERPs) have entered into the picture as an easy to perform screening test. Motivated by the recent findings about the role of cross-frequency coupling (CFC) in cognition, we introduce a relevant methodological approach for detecting MCI based on cognitive responses from a standard auditory oddball paradigm. By using the single trial signals recorded at Pz sensor and comparing the responses to target and non-target stimuli, we first demonstrate that increased CFC is associated with the cognitive task. Then, considering the dynamic character of CFC, we identify instances during which the coupling between particular pairs of brainwave frequencies carries sufficient information for discriminating between normal subjects and patients with MCI. In this way, we form a multiparametric signature of impaired cognition. The new composite biomarker was tested using data from a cohort that consists of 25 amnestic MCI patients and 15 age-matched controls. Standard machine-learning algorithms were employed so as to implement the binary classification task. Based on leave-one-out cross-validation, the measured classification rate was found reaching very high levels (95%). Our approach compares favorably with the traditional alternative of using the morphology of averaged ERP response to make the diagnosis and the usage of features from spectro-temporal analysis of single-trial responses. This further indicates that task-related CFC measurements can provide invaluable analytics in AD diagnosis and prognosis.
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Affiliation(s)
- Stavros I Dimitriadis
- Artificial Intelligence Information Analysis Lab, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece ; Neuroinformatics Group, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Nikolaos A Laskaris
- Artificial Intelligence Information Analysis Lab, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece ; Neuroinformatics Group, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Malamati P Bitzidou
- Artificial Intelligence Information Analysis Lab, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Ioannis Tarnanas
- Health-IS Lab, Chair of Information Management, ETH Zurich Zurich, Switzerland ; 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Magda N Tsolaki
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
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Schaapsmeerders P, Tuladhar AM, Maaijwee NAM, Rutten-Jacobs LCA, Arntz RM, Schoonderwaldt HC, Dorresteijn LDA, van Dijk EJ, Kessels RPC, de Leeuw FE. Lower Ipsilateral Hippocampal Integrity after Ischemic Stroke in Young Adults: A Long-Term Follow-Up Study. PLoS One 2015; 10:e0139772. [PMID: 26462115 PMCID: PMC4603678 DOI: 10.1371/journal.pone.0139772] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/17/2015] [Indexed: 11/18/2022] Open
Abstract
Background and purpose Memory impairment after stroke is poorly understood as stroke rarely occurs in the hippocampus. Previous studies have observed smaller ipsilateral hippocampal volumes after stroke compared with controls. Possibly, these findings on macroscopic level are not the first occurrence of structural damage and are preceded by microscopic changes that may already be associated with a worse memory function. We therefore examined the relationship between hippocampal integrity, volume, and memory performance long after first-ever ischemic stroke in young adults. Methods We included all consecutive first-ever ischemic stroke patients, without hippocampal strokes or recurrent stroke/TIA, aged 18–50 years, admitted to our academic hospital between 1980 and 2010. One hundred and forty-six patients underwent T1 MPRAGE, DTI scanning and completed the Rey Auditory Verbal Learning Test and were compared with 84 stroke-free controls. After manual correction of hippocampal automatic segmentation, we calculated mean hippocampal fractional anisotropy (FA) and diffusivity (MD). Results On average 10 years after ischemic stroke, lesion volume was associated with lower ipsilateral hippocampal integrity (p<0.05), independent of hippocampal volume. In patients with a normal ipsilateral hippocampal volume (volume is less than or equal to 1.5 SD below the mean volume of controls) significant differences in ipsilateral hippocampal MD were observed (p<0.0001). However, patients with a normal hippocampal volume and high hippocampal MD did not show a worse memory performance compared with patients with a normal volume and low hippocampal MD (p>0.05). Conclusions Patients with average ipsilateral hippocampal volume could already have lower ipsilateral hippocampal integrity, although at present with no attendant worse memory performance compared with patients with high hippocampal integrity. Longitudinal studies are needed to investigate whether a low hippocampal integrity after stroke might lead to exacerbated memory decline with increasing age.
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Affiliation(s)
- Pauline Schaapsmeerders
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Anil M. Tuladhar
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Noortje A. M. Maaijwee
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | | | - Renate M. Arntz
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Hennie C. Schoonderwaldt
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | | | - Ewoud J. van Dijk
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience and Centre for Cognition, Radboud University Nijmegen, Nijmegen, the Netherlands
- Department of Medical Psychology, Radboud university medical centre, Nijmegen, the Netherlands
| | - Frank-Erik de Leeuw
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, the Netherlands
- * E-mail:
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Moretti VD. Atrophy and lower regional perfusion of temporo-parietal brain areas are correlated with impairment in memory performances and increase of EEG upper alpha power in prodromal Alzheimer's disease. AMERICAN JOURNAL OF NEURODEGENERATIVE DISEASE 2015; 4:13-27. [PMID: 26389016 PMCID: PMC4568770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 08/28/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Temporo-parietal cortex thinning is associated with mild cognitive impairment (MCI) due to Alzheimer's disease (AD). The increase of the EEG upper/low alpha power ratio has been associated with MCI due to AD subjects and to the atrophy of temporo-parietal brain areas. Moreover, subjects with a higher alpha3/alpha2 frequency power ratio showed lower brain perfusion than in the low alpha3/alpha2 group. The two groups have significantly different hippocampal volumes and correlation with the theta frequency activity. METHODS 74 adult subjects with MCI underwent clinical and neuropsychological evaluation, electroencephalogram (EEG) recording, and high resolution 3D magnetic resonance imaging (MRI). 27 of them underwent EEG recording and perfusion single-photon emission computed tomography (SPECT) evaluation. The alpha3/alpha2 power ratio as well as cortical thickness was computed for each subject. The difference in cortical thickness between the groups was estimated. Pearson's r was used to assess the correlation topography between cortical thinning as well as between brain perfusion and memory impairment. RESULTS In the higher upper/low alpha group, memory impairment was more pronounced both in the MRI group and the SPECT MCI group. Moreover, it was correlated with greater cortical atrophy and lower perfusional rate in temporo-parietal cortex. CONCLUSION High EEG upper/low alpha power ratio was associated with cortical thinning lower perfusion in temporo-parietal. Moreover, atrophy and lower perfusional rate were both significantly correlated with memory impairment in MCI subjects. The increase of EEG upper/low alpha frequency power ratio could be useful for identifying individuals at risk for progression to AD dementia and may be of value in the clinical context.
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Moretti DV. Mild Cognitive Impairment: Structural, Metabolical, and Neurophysiological Evidence of a Novel EEG Biomarker. Front Neurol 2015. [PMID: 26217299 PMCID: PMC4491619 DOI: 10.3389/fneur.2015.00152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Recent studies demonstrate that the alpha3/alpha2 power ratio correlates with cortical atrophy, regional hypoperfusion, and memory impairment in subjects with mild cognitive impairment (MCI). METHODS Evidences were reviewed in subjects with MCI, who underwent EEG recording, magnetic resonance imaging (MRI) scans, and memory evaluation. Alpha3/alpha2 power ratio (alpha2 8.9-10.9 Hz range; alpha3 10.9-12.9 Hz range), cortical thickness, linear EEG coherence, and memory impairment have been evaluated in a large group of 74 patients. A subset of 27 subjects within the same group also underwent single photon emission computed tomography (SPECT) evaluation. RESULTS In MCI subjects with higher EEG upper/low alpha power ratio, a greater temporo-parietal and hippocampal atrophy was found as well as a decrease in regional blood perfusion and memory impairment. In this group, an increase of theta oscillations is associated with a greater interhemispheric coupling between temporal areas. CONCLUSION The increase of alpha3/alpha2 power ratio is a promising novel biomarker in identifying MCI subjects at risk for Alzheimer's disease.
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Moretti DV. Electroencephalography reveals lower regional blood perfusion and atrophy of the temporoparietal network associated with memory deficits and hippocampal volume reduction in mild cognitive impairment due to Alzheimer's disease. Neuropsychiatr Dis Treat 2015; 11:461-70. [PMID: 25750526 PMCID: PMC4348123 DOI: 10.2147/ndt.s78830] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND An increased electroencephalographic (EEG) upper/lower alpha power ratio has been associated with less regional blood perfusion, atrophy of the temporoparietal region of the brain, and reduction of hippocampal volume in subjects affected by mild cognitive impairment due to Alzheimer's disease as compared with subjects who do not develop the disease. Moreover, EEG theta frequency activity is quite different in these groups. This study investigated the correlation between biomarkers and memory performance. METHODS EEG α3/α2 power ratio and cortical thickness were computed in 74 adult subjects with prodromal Alzheimer's disease. Twenty of these subjects also underwent assessment of blood perfusion by single-photon emission computed tomography (SPECT). Pearson's r was used to assess the correlation between cortical thinning, brain perfusion, and memory impairment. RESULTS In the higher α3/α2 frequency power ratio group, greater cortical atrophy and lower regional perfusion in the temporoparietal cortex was correlated with an increase in EEG theta frequency. Memory impairment was more pronounced in the magnetic resonance imaging group and SPECT groups. CONCLUSION A high EEG upper/low alpha power ratio was associated with cortical thinning and less perfusion in the temporoparietal area. Moreover, atrophy and less regional perfusion were significantly correlated with memory impairment in subjects with prodromal Alzheimer's disease. The EEG upper/lower alpha frequency power ratio could be useful for identifying individuals at risk for progression to Alzheimer's dementia and may be of value in the clinical context.
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Affiliation(s)
- Davide Vito Moretti
- National Institute for the research and cure of Alzheimer’s disease, S. John of God, Fatebenefratelli, Brescia, Italy
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Neto E, Allen EA, Aurlien H, Nordby H, Eichele T. EEG Spectral Features Discriminate between Alzheimer's and Vascular Dementia. Front Neurol 2015; 6:25. [PMID: 25762978 PMCID: PMC4327579 DOI: 10.3389/fneur.2015.00025] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 01/29/2015] [Indexed: 11/13/2022] Open
Abstract
Alzheimer's disease (AD) and vascular dementia (VaD) present with similar clinical symptoms of cognitive decline, but the underlying pathophysiological mechanisms differ. To determine whether clinical electroencephalography (EEG) can provide information relevant to discriminate between these diagnoses, we used quantitative EEG analysis to compare the spectra between non-medicated patients with AD (n = 77) and VaD (n = 77) and healthy elderly normal controls (NC) (n = 77). We use curve-fitting with a combination of a power loss and Gaussian function to model the averaged resting-state spectra of each EEG channel extracting six parameters. We assessed the performance of our model and tested the extracted parameters for group differentiation. We performed regression analysis in a multivariate analysis of covariance with group, age, gender, and number of epochs as predictors and further explored the topographical group differences with pair-wise contrasts. Significant topographical differences between the groups were found in several of the extracted features. Both AD and VaD groups showed increased delta power when compared to NC, whereas the AD patients showed a decrease in alpha power for occipital and temporal regions when compared with NC. The VaD patients had higher alpha power than NC and AD. The AD and VaD groups showed slowing of the alpha rhythm. Variability of the alpha frequency was wider for both AD and VaD groups. There was a general decrease in beta power for both AD and VaD. The proposed model is useful to parameterize spectra, which allowed extracting relevant clinical EEG key features that move toward simple and interpretable diagnostic criteria.
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Affiliation(s)
- Emanuel Neto
- Institute of Biological and Medical Psychology, University of Bergen , Bergen , Norway ; Section for Clinical Neurophysiology, Haukeland University Hospital , Bergen , Norway
| | - Elena A Allen
- Institute of Biological and Medical Psychology, University of Bergen , Bergen , Norway ; K. G. Jebsen Center for Research on Neuropsychiatric Disorders , Bergen , Norway ; The Mind Research Network , Albuquerque, NM , USA
| | - Harald Aurlien
- Section for Clinical Neurophysiology, Haukeland University Hospital , Bergen , Norway
| | - Helge Nordby
- Institute of Biological and Medical Psychology, University of Bergen , Bergen , Norway
| | - Tom Eichele
- Institute of Biological and Medical Psychology, University of Bergen , Bergen , Norway ; Section for Clinical Neurophysiology, Haukeland University Hospital , Bergen , Norway ; K. G. Jebsen Center for Research on Neuropsychiatric Disorders , Bergen , Norway
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Moretti DV. Understanding early dementia: EEG, MRI, SPECT and memory evaluation. Transl Neurosci 2015; 6:32-46. [PMID: 28123789 PMCID: PMC4936613 DOI: 10.1515/tnsci-2015-0005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/01/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND An increase in the EEG upper/low α power ratio has been associated with mild cognitive impairment (MCI) due to Alzheimer's disease (AD) and to the atrophy of temporoparietal brain areas. Subjects with a higher α3/α2 frequency power ratio showed lower brain perfusion than in the low α3/α2 group. The two groups show significantly different hippocampal volumes and correlation with θ frequency activity. METHODS Seventy-four adult subjects with MCI underwent clinical and neuropsychological evaluation, electroencephalogram (EEG) recording, and high resolution 3D magnetic resonance imaging (MRI). Twenty-seven of them underwent EEG recording and perfusion single-photon emission computed tomography (SPECT) evaluation. The α3/α2 power ratio and cortical thickness were computed for each subject. The difference in cortical thickness between the groups was estimated. RESULTS In the higher upper/low α group, memory impairment was more pronounced in both the MRI group and the SPECT MCI groups. An increase in the production of θ oscillations was associated with greater interhemisperic coupling between temporal areas. It also correlated with greater cortical atrophy and lower perfusional rate in the temporoparietal cortex. CONCLUSION High EEG upper/low α power ratio was associated with cortical thinning and lower perfusion in temporoparietal areas. Moreover, both atrophy and lower perfusion rate significantly correlated with memory impairment in MCI subjects. Therefore, the increase in the EEG upper/low α frequency power ratio could be useful in identifying individuals at risk for progression to AD dementia in a clinical context.
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Affiliation(s)
- Davide Vito Moretti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Moretti DV. Alpha rhythm oscillations and MMSE scores are differently modified by transdermal or oral rivastigmine in patients with Alzheimer's disease. AMERICAN JOURNAL OF NEURODEGENERATIVE DISEASE 2014; 3:72-83. [PMID: 25232512 PMCID: PMC4162588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 08/14/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common cause of dementia in older patients. Rivastigmine, a reversible cholinesterase inhibitor, has been shown to improve the clinical manifestations of AD by delaying the breakdown of acetylcholine (ACh) released into synaptic clefts. Moreover, there is evidence that ACh modulates EEG alpha frequency. OBJECTIVES the objectives of this pilot study in patients with AD were to determine the effects of two formulations of RV (transdermal and oral) on Mini-Mental State Examination (MMSE) scores and on alpha frequency in particular the posterior dominant rhythm. METHODS twenty subjects with AD were randomly assigned to receive either RV transdermal patch (RV-TDP, n=10) or RV capsules (RV-CP, n=10) according to the standard recommended dosage regimen. All patients were driven to the maximum drug dosage. Diagnosis of AD was made according to NINCDS-ADRDA criteria and the Diagnostic and Statistical Manual of Mental Disorders IV. All patients underwent EEG recordings at the beginning and at the end of the 18-month study period using P3, P4, O1 and O2 electrodes each at high (10.5-13.0 Hz) and low (8.0-10.5 Hz) frequency. MMSE scores were determined at the start of the study and at three successive 6-month intervals (T0, T1, T2, and T3). RESULTS administration of RV-DP increases the spectral power of alpha waves in the posterior region and is associated with improved cognitive function as evidenced by significant changes in MMSE scores. CONCLUSION RV-DP provides an effective and long-term management option in patients with AD.
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Affiliation(s)
- Davide V Moretti
- Scientific Institute for Research and Care (IRCCS) of Alzheimer's and Psychiatric Diseases, S. Giovanni Di Dio, Fatebenefratelli Brescia, Italy
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Moretti DV, Frisoni GB, Binetti G, Zanetti O. Comparison of the effects of transdermal and oral rivastigmine on cognitive function and EEG markers in patients with Alzheimer's disease. Front Aging Neurosci 2014; 6:179. [PMID: 25100996 PMCID: PMC4107674 DOI: 10.3389/fnagi.2014.00179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 07/04/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common cause of dementia in older patients. Rivastigmine (RV, Exelon, Novartis), a reversible cholinesterase inhibitor, improves clinical manifestations of AD and may enhance ACh-modulated electroencephalogram (EEG) alpha frequency. This pilot study aimed to determine the effects of two formulations of RV [transdermal patch (RV-TDP) and oral capsules (TV-CP)] on alpha frequency, in particular the posterior dominant rhythm, and cognitive function [assessed by the Mini-Mental State Examination (MMSE)] in patients with AD. METHODS Subjects with AD were assigned to receive either RV-TDP 10 cm(2) or RV-CP 12 mg/day. All patients underwent EEG recordings at the beginning and end of the 18-month study period using P3, P4, O1, and O2 electrodes, each at high (10.5-13.0 Hz) and low (8.0-10.5 Hz) frequency. MMSE scores were determined at the start of the study (T0) and at three successive 6-month intervals (T1, T2, and T3). RESULTS RV-TDP administration (n = 10) maintained cognitive function as evidenced by stable MMSE scores from baseline to 18 months (21.07 ± 2.4-21.2 ± 3.1) compared with a decrease in MMSE score with RV-CP (n = 10) over 18 months [18.3 ± 3.6-13.6 ± 5.06 (adjusted for covariates p = 0.006)]. MMSE scores were significantly different between treatment groups from 6 months (p = 0.04). RV-TDP also increased the spectral power of alpha waves in the posterior region measured with electrode P3 in a significantly great percentage of patients than TV-CP from baseline to 18 months; 80% vs 30%, respectively [p = 0.025 (χ (2) test)]. CONCLUSIONS RV-TDP was associated with a greater proportion of patients with increased posterior region alpha wave spectral power and significantly higher cognitive function at 18 months, compared with RV-CP treatment. Our findings suggest that RV-TDP provides an effective long-term management option in patients with AD compared with oral RV-CP. This study is a pilot, open-label study with a clear explorative purpose and with a small number of patients. Further randomized, double-blind, placebo-controlled trial studies with a bigger sample size as well as healthy controls are needed to support these initial results.
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Affiliation(s)
- Davide V Moretti
- Scientific Institute for Research and Care of Alzheimer's and Psychiatric Diseases, San Giovanni Di Dio Fatebenefratelli Brescia, Italy
| | - Giovanni B Frisoni
- Scientific Institute for Research and Care of Alzheimer's and Psychiatric Diseases, San Giovanni Di Dio Fatebenefratelli Brescia, Italy
| | - Giuliano Binetti
- Scientific Institute for Research and Care of Alzheimer's and Psychiatric Diseases, San Giovanni Di Dio Fatebenefratelli Brescia, Italy
| | - Orazio Zanetti
- Scientific Institute for Research and Care of Alzheimer's and Psychiatric Diseases, San Giovanni Di Dio Fatebenefratelli Brescia, Italy
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Role of EEG as biomarker in the early detection and classification of dementia. ScientificWorldJournal 2014; 2014:906038. [PMID: 25093211 PMCID: PMC4100295 DOI: 10.1155/2014/906038] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/27/2014] [Accepted: 04/15/2014] [Indexed: 12/21/2022] Open
Abstract
The early detection and classification of dementia are important clinical support tasks for medical practitioners in customizing patient treatment programs to better manage the development and progression of these diseases. Efforts are being made to diagnose these neurodegenerative disorders in the early stages. Indeed, early diagnosis helps patients to obtain the maximum treatment benefit before significant mental decline occurs. The use of electroencephalogram as a tool for the detection of changes in brain activities and clinical diagnosis is becoming increasingly popular for its capabilities in quantifying changes in brain degeneration in dementia. This paper reviews the role of electroencephalogram as a biomarker based on signal processing to detect dementia in early stages and classify its severity. The review starts with a discussion of dementia types and cognitive spectrum followed by the presentation of the effective preprocessing denoising to eliminate possible artifacts. It continues with a description of feature extraction by using linear and nonlinear techniques, and it ends with a brief explanation of vast variety of separation techniques to classify EEG signals. This paper also provides an idea from the most popular studies that may help in diagnosing dementia in early stages and classifying through electroencephalogram signal processing and analysis.
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Tsolaki A, Kazis D, Kompatsiaris I, Kosmidou V, Tsolaki M. Electroencephalogram and Alzheimer's disease: clinical and research approaches. Int J Alzheimers Dis 2014; 2014:349249. [PMID: 24868482 PMCID: PMC4020452 DOI: 10.1155/2014/349249] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/16/2014] [Indexed: 01/08/2023] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder that is characterized by cognitive deficits, problems in activities of daily living, and behavioral disturbances. Electroencephalogram (EEG) has been demonstrated as a reliable tool in dementia research and diagnosis. The application of EEG in AD has a wide range of interest. EEG contributes to the differential diagnosis and the prognosis of the disease progression. Additionally such recordings can add important information related to the drug effectiveness. This review is prepared to form a knowledge platform for the project entitled "Cognitive Signal Processing Lab," which is in progress in Information Technology Institute in Thessaloniki. The team tried to focus on the main research fields of AD via EEG and recent published studies.
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Affiliation(s)
- Anthoula Tsolaki
- Medical Physics Laboratory, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dimitrios Kazis
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Exochi, 57010 Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Centre of Research and Technology, Information Technologies Institute, 6th Klm Charilaou-Thermi Road, P.O. Box 60361, Thermi, 57001 Thessaloniki, Greece
| | - Vasiliki Kosmidou
- Centre of Research and Technology, Information Technologies Institute, 6th Klm Charilaou-Thermi Road, P.O. Box 60361, Thermi, 57001 Thessaloniki, Greece
| | - Magda Tsolaki
- 3rd Department of Neurology, Aristotle University of Thessaloniki, Exochi, 57010 Thessaloniki, Greece
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Patients with mild cognitive impairment display reduced auditory event-related delta oscillatory responses. Behav Neurol 2014; 2014:268967. [PMID: 24825953 PMCID: PMC4006610 DOI: 10.1155/2014/268967] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 02/23/2014] [Accepted: 02/26/2014] [Indexed: 11/17/2022] Open
Abstract
Background. Event-related oscillations (ERO) may provide a useful tool for the identification of cognitive deficits in mild cognitive impairment (MCI) and Alzheimer's disease (AD). In the present study, we investigate peak-to-peak amplitude of auditory event-related delta oscillations of MCI subjects. Method. The study included twenty-two consecutive patients with MCI recruited in neurology clinic and 21 age- and education-matched normal elderly controls. A classical auditory oddball paradigm was used in the experiments. EEG was recorded from F3, Fz, F4, C3, Cz, C4, P3, Pz, P4, O1, Oz, and O2 locations. The maximum peak-to-peak amplitudes for each subject's averaged delta response (0.5–2.2 Hz) were measured. Results. The amplitudes between groups differed significantly at the frontal and mid-centroparietal locations. ANOVA on delta responses revealed a significant effect for groups (F(1.41) = 4.84, P = 0.033), indicating a larger delta response for healthy controls than MCI subjects. Post hoc comparisons revealed that peak-to-peak delta response was significantly larger for healthy controls than for MCI over electrode sites F3, Fz, F4, Cz, C4, and Pz. Discussion. Event-related delta frequency band seems to be the most affected oscillatory response in cognitive impairment due to AD. Therefore, it deserves to be investigated as a candidate electrophysiological biomarker in further studies.
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Computer-assisted interpretation of the EEG background pattern: a clinical evaluation. PLoS One 2014; 9:e85966. [PMID: 24475064 PMCID: PMC3901663 DOI: 10.1371/journal.pone.0085966] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/09/2013] [Indexed: 11/21/2022] Open
Abstract
Objective Interpretation of the EEG background pattern in routine recordings is an important part of clinical reviews. We evaluated the feasibility of an automated analysis system to assist reviewers with evaluation of the general properties in the EEG background pattern. Methods Quantitative EEG methods were used to describe the following five background properties: posterior dominant rhythm frequency and reactivity, anterior-posterior gradients, presence of diffuse slow-wave activity and asymmetry. Software running the quantitative methods were given to ten experienced electroencephalographers together with 45 routine EEG recordings and computer-generated reports. Participants were asked to review the EEGs by visual analysis first, and afterwards to compare their findings with the generated reports and correct mistakes made by the system. Corrected reports were returned for comparison. Results Using a gold-standard derived from the consensus of reviewers, inter-rater agreement was calculated for all reviewers and for automated interpretation. Automated interpretation together with most participants showed high (kappa > 0.6) agreement with the gold standard. In some cases, automated analysis showed higher agreement with the gold standard than participants. When asked in a questionnaire after the study, all participants considered computer-assisted interpretation to be useful for every day use in routine reviews. Conclusions Automated interpretation methods proved to be accurate and were considered to be useful by all participants. Significance Computer-assisted interpretation of the EEG background pattern can bring consistency to reviewing and improve efficiency and inter-rater agreement.
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Tarasova IV, Vol'f NV, Syrova ID, Barbarash OL, Barbarash LS. Mild cognitive impairment in patients with coronary artery disease: clinical-demographyc and EEG-correlates. Zh Nevrol Psikhiatr Im S S Korsakova 2014; 114:89-93. [DOI: 10.17116/jnevro201411412189-93] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ponomareva N, Andreeva T, Protasova M, Shagam L, Malina D, Goltsov A, Fokin V, Mitrofanov A, Rogaev E. Age-dependent effect of Alzheimer's risk variant of CLU on EEG alpha rhythm in non-demented adults. Front Aging Neurosci 2013; 5:86. [PMID: 24379779 PMCID: PMC3861782 DOI: 10.3389/fnagi.2013.00086] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/19/2013] [Indexed: 12/22/2022] Open
Abstract
Polymorphism in the genomic region harboring the CLU gene (rs11136000) has been associated with the risk for Alzheimer’s disease (AD). CLU C allele is assumed to confer risk for AD and the allele T may have a protective effect. We investigated the influence of the AD-associated CLU genotype on a common neurophysiological trait of brain activity (resting-state alpha-rhythm activity) in non-demented adults and elucidated whether this influence is modified over the course of aging. We examined quantitative electroencephalography (EEG) in a cohort of non-demented individuals (age range 20–80) divided into young (age range 20–50) and old (age range 51–80) cohorts and stratified by CLU polymorphism. To rule out the effect of the apolipoprotein E (ApoE) genotype on EEG characteristics, only subjects without the ApoE ε4 allele were included in the study. The homozygous presence of the AD risk variant CLU CC in non-demented subjects was associated with an increase of alpha3 absolute power. Moreover, the influence of CLU genotype on alpha3 was found to be higher in the subjects older than 50 years of age. The study also showed age-dependent alterations of alpha topographic distribution that occur independently of the CLU genotype. The increase of upper alpha power has been associated with hippocampal atrophy in patients with mild cognitive impairment (Moretti etal., 2012a). In our study, the CLU CC-dependent increase in upper alpha rhythm, particularly enhanced in elderly non-demented individuals, may imply that the genotype is related to preclinical dysregulation of hippocampal neurophysiology in aging and that this factor may contribute to the pathogenesis of AD.
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Affiliation(s)
- Natalya Ponomareva
- Brain Research Department, Research Center of Neurology Russian Academy of Medical Science Moscow, Russia
| | - Tatiana Andreeva
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia ; Center of Brain Neurobiology and Neurogenetics, Institute of Cytogenetics and Genetics, Russian Academy of Sciences Novosibirsk, Russia
| | - Maria Protasova
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia
| | - Lev Shagam
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia
| | - Daria Malina
- Brain Research Department, Research Center of Neurology Russian Academy of Medical Science Moscow, Russia
| | - Andrei Goltsov
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia
| | - Vitaly Fokin
- Brain Research Department, Research Center of Neurology Russian Academy of Medical Science Moscow, Russia
| | | | - Evgeny Rogaev
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia ; Center of Brain Neurobiology and Neurogenetics, Institute of Cytogenetics and Genetics, Russian Academy of Sciences Novosibirsk, Russia ; University of Massachusetts Medical School, Department of Psychiatry, BNRI Worcester, MA, USA
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Newsome RN, Pun C, Smith VM, Ferber S, Barense MD. Neural correlates of cognitive decline in older adults at-risk for developing MCI: Evidence from the CDA and P300. Cogn Neurosci 2013; 4:152-62. [DOI: 10.1080/17588928.2013.853658] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
| | - Carson Pun
- Department of Psychology, University of Toronto, Toronto, Canada
| | | | - Susanne Ferber
- Department of Psychology, University of Toronto, Toronto, Canada
- Rotman Research Institute, Toronto, Canada
| | - Morgan D. Barense
- Department of Psychology, University of Toronto, Toronto, Canada
- Rotman Research Institute, Toronto, Canada
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Demyelination in mild cognitive impairment suggests progression path to Alzheimer's disease. PLoS One 2013; 8:e72759. [PMID: 24023644 PMCID: PMC3758332 DOI: 10.1371/journal.pone.0072759] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 07/16/2013] [Indexed: 12/03/2022] Open
Abstract
The preclinical Alzheimer's disease (AD) - amnestic mild cognitive impairment (MCI) - is manifested by phenotypes classified into exclusively memory (single-domain) MCI (sMCI) and multiple-domain MCI (mMCI). We suggest that typical MCI-to-AD progression occurs through the sMCI-to-mMCI sequence as a result of the extension of initial pathological processes. To support this hypothesis, we assess myelin content with a Magnetization Transfer Ratio (MTR) in 21 sMCI and 21 mMCI patients and in 42 age-, sex-, and education-matched controls. A conjunction analysis revealed MTR reduction shared by sMCI and mMCI groups in the medial temporal lobe and posterior structures including white matter (WM: splenium, posterior corona radiata) and gray matter (GM: hippocampus; parahippocampal and lingual gyri). A disjunction analysis showed the spread of demyelination to prefrontal WM and insula GM in executive mMCI. Our findings suggest that demyelination starts in the structures affected by neurofibrillary pathology; its presence correlates with the clinical picture and indicates the method of MCI-to-AD progression. In vivo staging of preclinical AD can be developed in terms of WM/GM demyelination.
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