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Kučikienė D, Rajkumar R, Timpte K, Heckelmann J, Neuner I, Weber Y, Wolking S. EEG microstates show different features in focal epilepsy and psychogenic nonepileptic seizures. Epilepsia 2024; 65:974-983. [PMID: 38289522 DOI: 10.1111/epi.17897] [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: 08/17/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Electroencephalography (EEG) microstate analysis seeks to cluster the scalp's electric field into semistable topographical EEG activity maps at different time points. Our study aimed to investigate the features of EEG microstates in subjects with focal epilepsy and psychogenic nonepileptic seizures (PNES). METHODS We included 62 adult subjects with focal epilepsy or PNES who received video-EEG monitoring at the epilepsy monitoring unit. The subjects (mean age = 42.8 ± 21.2 years) were distributed equally between epilepsy and PNES groups. We extracted microstates from a 4.4 ± 1.0-min, 21-channel resting-state EEG. We excluded subjects with interictal epileptiform discharges during resting-state EEGs. After preprocessing, we derived five main EEG microstates-MS1 to MS5-for the full frequency band (1-30 Hz) and frequency subbands (delta, 1-4 Hz; theta, 4-8 Hz; alpha, 8-12 Hz; beta, 12-30 Hz), using the MATLAB-based EEGLAB toolkit. Statistical features of microstates (duration, occurrence, contribution, global field power [GFP]) were compared between the groups, using logistic regression corrected for age and sex. RESULTS We detected no differences in microstate parameters in the full frequency band. We found a longer duration (delta: B = -7.680, p = .046; theta: B = -16.200, p = .043) and a higher contribution (delta: B = -7.414, p = .035; theta: B = -7.509, p = .031) of MS4 in lower frequency bands in the epilepsy group. The PNES group showed a higher occurrence of MS5 in the delta subband (B = 3.283, p = .032). In the theta subband, a higher GFP of MS1 was associated with the PNES group (B = 5.674, p = .025), whereas a higher GFP of MS2 was associated with the epilepsy group (B = -6.579, p = .026). SIGNIFICANCE Microstate features show differences between patients with focal epilepsy and PNES. EEG microstates could be a promising parameter, helping to understand changes in brain dynamics in subjects with epilepsy, and should be explored as a potential biomarker.
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Affiliation(s)
- Domantė Kučikienė
- Department of Epileptology and Neurology, Rheinisch-Westfälische Technische Hochschule (RWTH) University Hospital Aachen, Aachen, Germany
| | - Ravichandran Rajkumar
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN-Translational Medicine, Jülich, Germany
- Institute of Neuroscience and Medicine, INM-4, Forschungszentrum Jülich, Jülich, Germany
| | - Katharina Timpte
- Department of Epileptology and Neurology, Rheinisch-Westfälische Technische Hochschule (RWTH) University Hospital Aachen, Aachen, Germany
| | - Jan Heckelmann
- Department of Epileptology and Neurology, Rheinisch-Westfälische Technische Hochschule (RWTH) University Hospital Aachen, Aachen, Germany
| | - Irene Neuner
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN-Translational Medicine, Jülich, Germany
- Institute of Neuroscience and Medicine, INM-4, Forschungszentrum Jülich, Jülich, Germany
| | - Yvonne Weber
- Department of Epileptology and Neurology, Rheinisch-Westfälische Technische Hochschule (RWTH) University Hospital Aachen, Aachen, Germany
| | - Stefan Wolking
- Department of Epileptology and Neurology, Rheinisch-Westfälische Technische Hochschule (RWTH) University Hospital Aachen, Aachen, Germany
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Niu X, Wang Y, Zhang X, Wang Y, Shao W, Chen L, Yang Z, Peng D. Quantitative electroencephalography (qEEG), apolipoprotein A-I (APOA-I), and apolipoprotein epsilon 4 (APOE ɛ4) alleles for the diagnosis of mild cognitive impairment and Alzheimer's disease. Neurol Sci 2024; 45:547-556. [PMID: 37673807 DOI: 10.1007/s10072-023-07028-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/19/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Alzheimer's disease (AD) is the most common type of dementia. Amnestic mild cognitive impairment (aMCI), a pre-dementia stage is an important stage for early diagnosis and intervention. This study aimed to investigate the diagnostic value of qEEG, APOA-I, and APOE ɛ4 allele in aMCI and AD patients and found the correlation between qEEG (Delta + Theta)/(Alpha + Beta) ratio (DTABR) and different cognitive domains. METHODS All participants were divided into three groups: normal controls (NCs), aMCI, and AD, and all received quantitative electroencephalography (qEEG), neuropsychological scale assessment, apolipoprotein epsilon 4 (APOE ɛ4) alleles, and various blood lipid indicators. Different statistical methods were used for different data. RESULTS The cognitive domains except executive ability were all negatively correlated with DTABR in different brain regions while executive ability was positively correlated with DTABR in several brain regions, although without statistical significance. The consequences confirmed that the DTABR of each brain area were related to MMSE, MoCA, instantaneous memory, and the language ability (p < 0.05), and the DTABR in the occipital area was relevant to all cognitive domains (p < 0.01) except executive function (p = 0.272). Also, occipital DTABR was most correlated with language domain when tested by VFT with a moderate level (r = 0.596, p < 0.001). There were significant differences in T3, T5, and P3 DTABR between both AD and NC and aMCI and NCs. As for aMCI diagnosis, the maximum AUC was achieved when using T3 combined with APOA-I and APOE ε4 (0.855) and the maximum AUC was achieved when using T5 combined with APOA-I and APOE ε4 (0.889) for AD diagnosis. CONCLUSION These findings highlight that APOA-I, APOE ɛ4, and qEEG play an important role in aMCI and AD diagnosis. During AD continuum, qEEG DTABR should be taken into consideration for the early detection of AD risk.
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Affiliation(s)
- Xiaoqian Niu
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Yuye Wang
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiangfei Zhang
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China
| | - Yu Wang
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Wen Shao
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China
| | - Leian Chen
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ziyuan Yang
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Dantao Peng
- Department of Neurology, China-Japan Friendship Hospital, No. 2 Yinghuayuan East Street, Chaoyang District, Beijing, 100029, China.
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Jun S, Malone SM, Iacono WG, Harper J, Wilson S, Sadaghiani S. Cognitive abilities are associated with rapid dynamics of electrophysiological connectome states. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.15.575736. [PMID: 38293067 PMCID: PMC10827041 DOI: 10.1101/2024.01.15.575736] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Time-varying changes in whole-brain connectivity patterns, or connectome state dynamics, hold significant implications for cognition. However, connectome dynamics at fast (> 1Hz) timescales highly relevant to cognition are poorly understood due to the dominance of inherently slow fMRI in connectome studies. Here, we investigated the behavioral significance of rapid electrophysiological connectome dynamics using source-localized EEG connectomes during resting-state (N=926, 473 females). We focused on dynamic connectome features pertinent to individual differences, specifically those with established heritability: Fractional Occupancy (i.e., the overall duration spent in each recurrent connectome state) in beta and gamma bands, and Transition Probability (i.e., the frequency of state switches) in theta, alpha, beta, and gamma bands. Canonical correlation analysis found a significant relationship between the heritable phenotypes of sub-second connectome dynamics and cognition. Specifically, principal components of Transition Probabilities in alpha (followed by theta and gamma bands) and a cognitive factor representing visuospatial processing (followed by verbal and auditory working memory) most notably contributed to the relationship. We conclude that the specific order in which rapid connectome states are sequenced shapes individuals' cognitive abilities and traits. Such sub-second connectome dynamics may inform about behavioral function and dysfunction and serve as endophenotypes for cognitive abilities.
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Affiliation(s)
- Suhnyoung Jun
- Psychology Department, University of Illinois at Urbana-Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign
| | - Stephen M Malone
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - William G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Jeremy Harper
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Twin Cities, USA
| | - Sepideh Sadaghiani
- Psychology Department, University of Illinois at Urbana-Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign
- Neuroscience Program, University of Illinois at Urbana-Champaign
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Jun S, Malone SM, Iacono WG, Harper J, Wilson S, Sadaghiani S. Rapid dynamics of electrophysiological connectome states are heritable. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.15.575731. [PMID: 38293031 PMCID: PMC10827044 DOI: 10.1101/2024.01.15.575731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Time-varying changes in whole-brain connectivity patterns, or connectome state dynamics, are a prominent feature of brain activity with broad functional implications. While infra-slow (<0.1Hz) connectome dynamics have been extensively studied with fMRI, rapid dynamics highly relevant for cognition are poorly understood. Here, we asked whether rapid electrophysiological connectome dynamics constitute subject-specific brain traits and to what extent they are under genetic influence. Using source-localized EEG connectomes during resting-state (N=928, 473 females), we quantified heritability of multivariate (multi-state) features describing temporal or spatial characteristics of connectome dynamics. States switched rapidly every ~60-500ms. Temporal features were heritable, particularly, Fractional Occupancy (in theta, alpha, beta, and gamma bands) and Transition Probability (in theta, alpha, and gamma bands), representing the duration spent in each state and the frequency of state switches, respectively. Genetic effects explained a substantial proportion of phenotypic variance of these features: Fractional Occupancy in beta (44.3%) and gamma (39.8%) bands and Transition Probability in theta (38.4%), alpha (63.3%), beta (22.6%), and gamma (40%) bands. However, we found no evidence for heritability of spatial features, specifically states' Modularity and connectivity pattern. We conclude that genetic effects strongly shape individuals' connectome dynamics at rapid timescales, specifically states' overall occurrence and sequencing.
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Affiliation(s)
- Suhnyoung Jun
- Psychology Department, University of Illinois at Urbana-Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign
| | - Stephen M Malone
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - William G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Jeremy Harper
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota, Twin Cities, USA
| | - Sepideh Sadaghiani
- Psychology Department, University of Illinois at Urbana-Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign
- Neuroscience Program, University of Illinois at Urbana-Champaign
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Jiao B, Li R, Zhou H, Qing K, Liu H, Pan H, Lei Y, Fu W, Wang X, Xiao X, Liu X, Yang Q, Liao X, Zhou Y, Fang L, Dong Y, Yang Y, Jiang H, Huang S, Shen L. Neural biomarker diagnosis and prediction to mild cognitive impairment and Alzheimer's disease using EEG technology. Alzheimers Res Ther 2023; 15:32. [PMID: 36765411 PMCID: PMC9912534 DOI: 10.1186/s13195-023-01181-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Electroencephalogram (EEG) has emerged as a non-invasive tool to detect the aberrant neuronal activity related to different stages of Alzheimer's disease (AD). However, the effectiveness of EEG in the precise diagnosis and assessment of AD and its preclinical stage, amnestic mild cognitive impairment (MCI), has yet to be fully elucidated. In this study, we aimed to identify key EEG biomarkers that are effective in distinguishing patients at the early stage of AD and monitoring the progression of AD. METHODS A total of 890 participants, including 189 patients with MCI, 330 patients with AD, 125 patients with other dementias (frontotemporal dementia, dementia with Lewy bodies, and vascular cognitive impairment), and 246 healthy controls (HC) were enrolled. Biomarkers were extracted from resting-state EEG recordings for a three-level classification of HC, MCI, and AD. The optimal EEG biomarkers were then identified based on the classification performance. Random forest regression was used to train a series of models by combining participants' EEG biomarkers, demographic information (i.e., sex, age), CSF biomarkers, and APOE phenotype for assessing the disease progression and individual's cognitive function. RESULTS The identified EEG biomarkers achieved over 70% accuracy in the three-level classification of HC, MCI, and AD. Among all six groups, the most prominent effects of AD-linked neurodegeneration on EEG metrics were localized at parieto-occipital regions. In the cross-validation predictive analyses, the optimal EEG features were more effective than the CSF + APOE biomarkers in predicting the age of onset and disease course, whereas the combination of EEG + CSF + APOE measures achieved the best performance for all targets of prediction. CONCLUSIONS Our study indicates that EEG can be used as a useful screening tool for the diagnosis and disease progression evaluation of MCI and AD.
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Affiliation(s)
- Bin Jiao
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China ,grid.216417.70000 0001 0379 7164Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China ,Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China ,grid.216417.70000 0001 0379 7164Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Rihui Li
- grid.168010.e0000000419368956Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA USA ,Brainup Institute of Science and Technology, Chongqing, China
| | - Hui Zhou
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Kunqiang Qing
- Brainup Institute of Science and Technology, Chongqing, China
| | - Hui Liu
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hefu Pan
- Brainup Institute of Science and Technology, Chongqing, China
| | - Yanqin Lei
- Brainup Institute of Science and Technology, Chongqing, China
| | - Wenjin Fu
- Brainup Institute of Science and Technology, Chongqing, China
| | - Xiaoan Wang
- Brainup Institute of Science and Technology, Chongqing, China
| | - Xuewen Xiao
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xixi Liu
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qijie Yang
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xinxin Liao
- grid.216417.70000 0001 0379 7164Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Yafang Zhou
- grid.216417.70000 0001 0379 7164Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Liangjuan Fang
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yanbin Dong
- Brainup Institute of Science and Technology, Chongqing, China
| | - Yuanhao Yang
- grid.1003.20000 0000 9320 7537Mater Research Institute, The University of Queensland, Woolloongabba, Queensland 4102 Australia
| | - Haiyan Jiang
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Sha Huang
- grid.216417.70000 0001 0379 7164Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China. .,National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China. .,Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China. .,Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China. .,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China. .,Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China.
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Hyperconnectivity matters in early-onset Alzheimer's disease: a resting-state EEG connectivity study. Neurophysiol Clin 2022; 52:459-471. [DOI: 10.1016/j.neucli.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
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Liu Z, Si L, Xu W, Zhang K, Wang Q, Chen B, Wang G. Characteristics of EEG Microstate Sequences During Propofol-Induced Alterations of Brain Consciousness States. IEEE Trans Neural Syst Rehabil Eng 2022; 30:1631-1641. [PMID: 35696466 DOI: 10.1109/tnsre.2022.3182705] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Monitoring the consciousness states of patients and ensuring the appropriate depth of anesthesia (DOA) is critical for the safe implementation of surgery. In this study, a high-density electroencephalogram (EEG) combined with blood drug concentration and behavioral response indicators was used to monitor propofol-induced sedation and evaluate the alterations in consciousness states. Microstate analysis, which can reflect the semi-stable state of the sub-second activation of the brain functional network, can be used to assess the brain's consciousness states. In this research, the EEG microstate sequences were constructed to compare the characteristics of corresponding sequences. Compared with the baseline (BS) state, the microstate sequences in the moderate sedation (MD) state exhibited higher complexity indexes of the multiscale sample entropy. With respect to the transition probability (TP) of microstates, most microstates tended to be converted into microstate C in the BS state. In contrast, they tended to be converted into microstate F in the MD state. The significant difference between the expected TP and observed TP could lead to the conclusion that hidden layers were present when there were changes in the consciousness states. According to the hidden Markov model, the accuracy of distinguishing the BS and MD states was 80.16%. The characteristics of microstate sequence revealed the variations in the brain states caused by alterations in consciousness states during anesthesia from a new perspective and presented a new idea for monitoring the DOA.
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Tait L, Zhang J. MEG cortical microstates: Spatiotemporal characteristics, dynamic functional connectivity and stimulus-evoked responses. Neuroimage 2022; 251:119006. [PMID: 35181551 PMCID: PMC8961001 DOI: 10.1016/j.neuroimage.2022.119006] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/29/2022] [Accepted: 02/14/2022] [Indexed: 12/12/2022] Open
Abstract
EEG microstate analysis is an approach to study brain states and their fast transitions in healthy cognition and disease. A key limitation of conventional microstate analysis is that it must be performed at the sensor level, and therefore gives limited anatomical insight. Here, we generalise the microstate methodology to be applicable to source-reconstructed electrophysiological data. Using simulations of a neural-mass network model, we first established the validity and robustness of the proposed method. Using MEG resting-state data, we uncovered ten microstates with distinct spatial distributions of cortical activation. Multivariate pattern analysis demonstrated that source-level microstates were associated with distinct functional connectivity patterns. We further demonstrated that the occurrence probability of MEG microstates were altered by auditory stimuli, exhibiting a hyperactivity of the microstate including the auditory cortex. Our results support the use of source-level microstates as a method for investigating brain dynamic activity and connectivity at the millisecond scale.
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Affiliation(s)
- Luke Tait
- Centre for Systems Modelling & Quantitative Biomedicine (SMQB), University of Birmingham, Birmingham, UK; Cardiff University Brain Research Imaging Centre, Cardiff, UK.
| | - Jiaxiang Zhang
- Cardiff University Brain Research Imaging Centre, Cardiff, UK
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Lin N, Gao J, Mao C, Sun H, Lu Q, Cui L. Differences in Multimodal Electroencephalogram and Clinical Correlations Between Early-Onset Alzheimer's Disease and Frontotemporal Dementia. Front Neurosci 2021; 15:687053. [PMID: 34421518 PMCID: PMC8374312 DOI: 10.3389/fnins.2021.687053] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background Alzheimer’s disease (AD) and frontotemporal dementia (FTD) are the two main types of dementia. We investigated the electroencephalogram (EEG) difference and clinical correlation in early-onset Alzheimer’s disease (EOAD), and FTD using multimodal EEG analyses. EOAD had more severe EEG abnormalities than late-onset AD (LOAD). Group comparisons between EOAD and LOAD were also performed. Methods Thirty patients diagnosed with EOAD, nine patients with LOAD, and 14 patients with FTD (≤65 y) were recruited (2008.1–2020.2), along with 24 healthy controls (≤65 y, n = 18; >65 y, n = 6). Clinical data were reviewed. Visual EEG, EEG microstate, and spectral analyses were performed. Results Compared to controls, markedly increased mean microstate duration, reduced mean occurrence, and reduced global field power (GFP) peaks per second were observed in EOAD and FTD. We found increased durations of class B in EOAD and class A in FTD. EOAD had reduced occurrences in classes A, B, and C, while only class C occurrence was reduced in FTD. The visual EEG results did not differ between AD and FTD. Microstate B showed correlations with activities of daily living score (r = 0.780, p = 0.008) and cerebrospinal fluid (CSF) Aβ42 (r = −0.833, p = 0.010) in EOAD. Microstate D occurrence was correlated with the CSF Aβ42 level in FTD (r = 0.786, p = 0.021). Spectral analysis revealed a general slowing EEG, which may contribute to microstate dynamic loss. Power in delta was significantly higher in EOAD than in FTD all over the head. In addition, EOAD had a marked increased duration and decreased occurrence than late-onset AD (LOAD), with no group differences in visual EEG results. Conclusion The current study found that EOAD and FTD had different EEG changes, and microstate had an association with clinical severity and CSF biomarkers. EEG microstate is more sensitive than visual EEG and may be useful for the differentiation between AD and FTD. The observations support that EEG can be a potential biomarker for the diagnosis and assessment of early-onset dementias.
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Affiliation(s)
- Nan Lin
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Jing Gao
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Chenhui Mao
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Heyang Sun
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Qiang Lu
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
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Nonlinear Phase Synchronization Analysis of EEG Signals in Amnesic Mild Cognitive Impairment with Type 2 Diabetes Mellitus. Neuroscience 2021; 472:25-34. [PMID: 34333062 DOI: 10.1016/j.neuroscience.2021.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/22/2021] [Accepted: 07/25/2021] [Indexed: 01/21/2023]
Abstract
Studying the nonlinear synchronization of electroencephalogram (EEG) in type 2 diabetic mellitus (T2DM) to find the EEG characteristics related to cognitive impairment is beneficial to the early prevention and diagnosis of mild cognitive impairment. Correlation between probabilities of recurrence (CPR) is a nonlinear phase synchronization method based on recurrence and recurrence probability, which had shown its superiority in detecting epilepsy. In this study, CPR method was used for the first time to analyze the synchronization of eye-closed resting EEG signals with T2DM. The 27 participants were divided into amnesic mild cognitive impairment (aMCI) group (17 case) and control group (10 cases with age and education matched). The CPR values in two groups were statistically analyzed by Mann-Whitney U test, and the correlation between EEG synchronization and cognitive function was studied by Spearman's correlation. The results showed that aMCI group had lower CPR values at each electrode pair than control group, and two groups had decreased CPR values with the increase of the spatial distance of the electrode pair in inter hemispheric. The CPR values were significantly different in frontal, parietal and temporal regions in intra hemispheric between two groups. The CPR values of C3-F7, F4-C4 and FP2-T6 were significantly positively correlated with the MOCA values. This study showed that the synchronization values of EEG signals obtained by the CPR method were significantly different between aMCI and control group, and they were the EEG characteristics associated with cognitive impairment in T2DM.
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Teipel SJ, Brüggen K, Temp AGM, Jakobi K, Weber MA, Berger C. Simultaneous Assessment of Electroencephalography Microstates and Resting State Intrinsic Networks in Alzheimer's Disease and Healthy Aging. Front Neurol 2021; 12:637542. [PMID: 34220668 PMCID: PMC8249002 DOI: 10.3389/fneur.2021.637542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 05/24/2021] [Indexed: 12/02/2022] Open
Abstract
Electroencephalography (EEG) microstate topologies may serve as building blocks of functional brain activity in humans. Here, we studied the spatial and temporal correspondences between simultaneously acquired EEG microstate topologies and resting state functional MRI (rs-fMRI) intrinsic networks in 14 patients with Alzheimer's disease (AD) and 14 healthy age and sex matched controls. We found an anteriorisation of EEG microstates' topologies in AD patients compared with controls; this corresponded with reduced spatial expression of default mode and increased expression of frontal lobe networks in rs-fMRI. In a hierarchical cluster analysis the time courses of the EEG microstates were associated with the time courses of spatially corresponding rs-fMRI networks. We found prevalent negative correlations of time courses between anterior microstate topologies and posterior rs-fMRI components as well as between posterior microstate topology and anterior rs-fMRI components. These negative correlations were significantly more expressed in controls than in AD patients. In conclusion, our data support the notion that the time courses of EEG microstates underlie the temporal expression of rs-fMRI networks. Furthermore, our findings indicate that the anterior-to-posterior connectivity of microstates and rs-fMRI components may be reduced in AD, indicative of a break-down of long-reaching intrahemispheric connections.
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Affiliation(s)
- Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Katharina Brüggen
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | | | - Kristina Jakobi
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Christoph Berger
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
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12
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Kim K, Duc NT, Choi M, Lee B. EEG microstate features for schizophrenia classification. PLoS One 2021; 16:e0251842. [PMID: 33989352 PMCID: PMC8121321 DOI: 10.1371/journal.pone.0251842] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/04/2021] [Indexed: 12/11/2022] Open
Abstract
Electroencephalography (EEG) microstate analysis is a method wherein spontaneous EEG activity is segmented at sub-second levels to analyze quasi-stable states. In particular, four archetype microstates and their features are known to reflect changes in brain state in neuropsychiatric diseases. However, previous studies have only reported differences in each microstate feature and have not determined whether microstate features are suitable for schizophrenia classification. Therefore, it is necessary to validate microstate features for schizophrenia classification. Nineteen microstate features, including duration, occurrence, and coverage as well as thirty-one conventional EEG features, including statistical, frequency, and temporal characteristics were obtained from resting-state EEG recordings of 14 patients diagnosed with schizophrenia and from 14 healthy (control) subjects. Machine-learning based multivariate analysis was used to evaluate classification performance. EEG recordings of patients and controls showed different microstate features. More importantly, when differentiating among patients and controls, EEG microstate features outperformed conventional EEG ones. The performance of the microstate features exceeded that of conventional EEG, even after optimization using recursive feature elimination. EEG microstate features applied with conventional EEG features also showed better classification performance than conventional EEG features alone. The current study is the first to validate the use of microstate features to discriminate schizophrenia, suggesting that EEG microstate features are useful for schizophrenia classification.
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Affiliation(s)
- Kyungwon Kim
- Department of Biomedical Science and Engineering (BMSE), Institute Integrated Technology (IIT), Gwangju Institute of Science and Technology (GIST), Cheomdan-gwagiro, Gwangju, South Korea
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Nguyen Thanh Duc
- Department of Biomedical Science and Engineering (BMSE), Institute Integrated Technology (IIT), Gwangju Institute of Science and Technology (GIST), Cheomdan-gwagiro, Gwangju, South Korea
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
- McConnel Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada
| | - Min Choi
- Department of Biomedical Science and Engineering (BMSE), Institute Integrated Technology (IIT), Gwangju Institute of Science and Technology (GIST), Cheomdan-gwagiro, Gwangju, South Korea
| | - Boreom Lee
- Department of Biomedical Science and Engineering (BMSE), Institute Integrated Technology (IIT), Gwangju Institute of Science and Technology (GIST), Cheomdan-gwagiro, Gwangju, South Korea
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13
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Isla AG, Balleza-Tapia H, Fisahn A. Efficacy of preclinical pharmacological interventions against alterations of neuronal network oscillations in Alzheimer's disease: A systematic review. Exp Neurol 2021; 343:113743. [PMID: 34000250 DOI: 10.1016/j.expneurol.2021.113743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/13/2021] [Accepted: 05/04/2021] [Indexed: 12/29/2022]
Abstract
Despite the development of multiple pharmacological approaches over the years aimed at treating Alzheimer's Disease (AD) only very few have been approved for clinical use in patients. To date there still exists no disease-modifying treatment that could prevent or rescue the cognitive impairment, particularly of memory aquisition, that is characteristic of AD. One of the possibilities for this state of affairs might be that the majority of drug discovery efforts focuses on outcome measures of decreased neuropathological biomarkers characteristic of AD, without taking into acount neuronal processes essential to the generation and maintenance of memory processes. Particularly, the capacity of the brain to generate theta (θ) and gamma (γ) oscillatory activity has been strongly correlated to memory performance. Using a systematic review approach, we synthesize the existing evidence in the literature on pharmacological interventions that enhance neuronal theta (θ) and/or gamma (γ) oscillations in non-pathological animal models and in AD animal models. Additionally, we synthesize the main outcomes and neurochemical systems targeted. We propose that functional biomarkers such as cognition-relevant neuronal network oscillations should be used as outcome measures during the process of research and development of novel drugs against cognitive impairment in AD.
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Affiliation(s)
- Arturo G Isla
- Neuronal Oscillations Laboratory, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Akademiska Stråket 1, J10:30, 17164 Solna, Stockholm, Sweden
| | - Hugo Balleza-Tapia
- Neuronal Oscillations Laboratory, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Akademiska Stråket 1, J10:30, 17164 Solna, Stockholm, Sweden
| | - André Fisahn
- Neuronal Oscillations Laboratory, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Akademiska Stråket 1, J10:30, 17164 Solna, Stockholm, Sweden.
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14
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Tait L, Tamagnini F, Stothart G, Barvas E, Monaldini C, Frusciante R, Volpini M, Guttmann S, Coulthard E, Brown JT, Kazanina N, Goodfellow M. EEG microstate complexity for aiding early diagnosis of Alzheimer's disease. Sci Rep 2020; 10:17627. [PMID: 33077823 PMCID: PMC7572485 DOI: 10.1038/s41598-020-74790-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 10/05/2020] [Indexed: 11/25/2022] Open
Abstract
The dynamics of the resting brain exhibit transitions between a small number of discrete networks, each remaining stable for tens to hundreds of milliseconds. These functional microstates are thought to be the building blocks of spontaneous consciousness. The electroencephalogram (EEG) is a useful tool for imaging microstates, and EEG microstate analysis can potentially give insight into altered brain dynamics underpinning cognitive impairment in disorders such as Alzheimer's disease (AD). Since EEG is non-invasive and relatively inexpensive, EEG microstates have the potential to be useful clinical tools for aiding early diagnosis of AD. In this study, EEG was collected from two independent cohorts of probable AD and cognitively healthy control participants, and a cohort of mild cognitive impairment (MCI) patients with four-year clinical follow-up. The microstate associated with the frontoparietal working-memory/attention network was altered in AD due to parietal inactivation. Using a novel measure of complexity, we found microstate transitioning was slower and less complex in AD. When combined with a spectral EEG measure, microstate complexity could classify AD with sensitivity and specificity > 80%, which was tested on an independent cohort, and could predict progression from MCI to AD in a small preliminary test cohort of 11 participants. EEG microstates therefore have potential to be a non-invasive functional biomarker of AD.
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Affiliation(s)
- Luke Tait
- Living Systems Institute, University of Exeter, Exeter, UK.
- EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, UK.
- College of Engineering, Maths, and Physical Sciences, University of Exeter, Exeter, UK.
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Maindy Road, Cardiff, CF24 4HQ, UK.
| | - Francesco Tamagnini
- School of Pharmacy, University of Reading, Reading, UK
- University of Exeter Medical School, Exeter, UK
| | | | - Edoardo Barvas
- San Marino Neurological Unit, San Marino Hospital, San Marino, Republic of San Marino
| | - Chiara Monaldini
- San Marino Neurological Unit, San Marino Hospital, San Marino, Republic of San Marino
| | - Roberto Frusciante
- San Marino Neurological Unit, San Marino Hospital, San Marino, Republic of San Marino
| | - Mirco Volpini
- San Marino Neurological Unit, San Marino Hospital, San Marino, Republic of San Marino
| | - Susanna Guttmann
- San Marino Neurological Unit, San Marino Hospital, San Marino, Republic of San Marino
| | | | - Jon T Brown
- University of Exeter Medical School, Exeter, UK
| | - Nina Kazanina
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Marc Goodfellow
- Living Systems Institute, University of Exeter, Exeter, UK
- EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, UK
- College of Engineering, Maths, and Physical Sciences, University of Exeter, Exeter, UK
- Centre for Biomedical Modelling and Analysis, University of Exeter, Exeter, UK
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15
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Farina FR, Emek-Savaş DD, Rueda-Delgado L, Boyle R, Kiiski H, Yener G, Whelan R. A comparison of resting state EEG and structural MRI for classifying Alzheimer's disease and mild cognitive impairment. Neuroimage 2020; 215:116795. [PMID: 32278090 DOI: 10.1016/j.neuroimage.2020.116795] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 12/31/2022] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia, accounting for 70% of cases worldwide. By 2050, dementia prevalence will have tripled, with most new cases occurring in low- and middle-income countries. Mild cognitive impairment (MCI) is a stage between healthy aging and dementia, marked by cognitive deficits that do not impair daily living. People with MCI are at increased risk of dementia, with an average progression rate of 39% within 5 years. There is urgent need for low-cost, accessible and objective methods to facilitate early dementia detection. Electroencephalography (EEG) has potential to address this need due to its low cost and portability. Here, we collected resting state EEG, structural MRI (sMRI) and rich neuropsychological data from older adults (55+ years) with AD, amnestic MCI (aMCI) and healthy controls (~60 per group). We evaluated a range of candidate EEG markers (i.e., frequency band power and functional connectivity) for AD and aMCI classification and compared their performance with sMRI. We also tested a combined EEG and cognitive classification model (using Mini-Mental State Examination; MMSE). sMRI outperformed resting state EEG at classifying AD (AUCs = 1.00 vs 0.76, respectively). However, both EEG and sMRI were only moderately good at distinguishing aMCI from healthy aging (AUCs = 0.67-0.73), and neither method achieved sensitivity above 70%. The addition of EEG to MMSE scores had no added benefit relative to MMSE scores alone. This is the first direct comparison of EEG and sMRI for classification of AD and aMCI.
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Affiliation(s)
- F R Farina
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland.
| | - D D Emek-Savaş
- Department of Psychology, Faculty of Letters, Dokuz Eylul University, Izmir, 35160, Turkey; Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, 35340, Turkey; Global Brain Health Institute, Trinity College Dublin, Dublin 2, Ireland
| | - L Rueda-Delgado
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - R Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - H Kiiski
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland
| | - G Yener
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, 35340, Turkey; Department of Neurology, Dokuz Eylul University Medical School, Izmir, 35340, Turkey
| | - R Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin 2, Ireland.
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16
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Tait L, Stothart G, Coulthard E, Brown JT, Kazanina N, Goodfellow M. Network substrates of cognitive impairment in Alzheimer’s Disease. Clin Neurophysiol 2019; 130:1581-1595. [DOI: 10.1016/j.clinph.2019.05.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/26/2019] [Accepted: 05/17/2019] [Indexed: 12/28/2022]
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17
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Lo Giudice P, Mammone N, Morabito FC, Pizzimenti RG, Ursino D, Virgili L. Leveraging network analysis to support experts in their analyses of subjects with MCI and AD. Med Biol Eng Comput 2019; 57:1961-1983. [PMID: 31301007 DOI: 10.1007/s11517-019-02004-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/09/2019] [Indexed: 11/25/2022]
Abstract
In this paper, we propose a network analysis-based approach to help experts in their analyses of subjects with mild cognitive impairment (hereafter, MCI) and Alzheimer's disease (hereafter, AD) and to investigate the evolution of these subjects over time. The inputs of our approach are the electroencephalograms (hereafter, EEGs) of the patients to analyze, performed at a certain time and, again, 3 months later. Given an EEG of a subject, our approach constructs a network with nodes that represent the electrodes and edges that denote connections between electrodes. Then, it applies several network-based techniques allowing the investigation of subjects with MCI and AD and the analysis of their evolution over time. (i) A connection coefficient, supporting experts to distinguish patients with MCI from patients with AD; (ii) A conversion coefficient, supporting experts to verify if a subject with MCI is converting to AD; (iii) Some network motifs, i.e., network patterns very frequent in one kind of patient and absent, or very rare, in the other. Patients with AD, just by the very nature of their condition, cannot be forced to stay motionless while undergoing examinations for a long time. EEG is a non-invasive examination that can be easily done on them. Since AD and MCI, if prodromal to AD, are associated with a loss of cortical connections, the adoption of network analysis appears suitable to investigate the effects of the progression of the disease on EEG. This paper confirms the suitability of this idea Graphical Abstract Ability of our proposed model to distinguish a control subject from a patient with MCI and a patient with AD. Blue edges represent strong connections among the corresponding brain areas; red edges denote middle connections, whereas green edges indicate weak connections. In the control subject (at the top), most connections are blue. In the patient with MCI (at the middle), most connections are red and green. In the patient with AD (at the bottom), most connections are either absent or green. .
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Affiliation(s)
- Paolo Lo Giudice
- DIIES, University Mediterranea of Reggio Calabria, Reggio Calabria, Italy
| | - Nadia Mammone
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | | | | | - Luca Virgili
- DII, Polytechnic University of Marche, Ancona, Italy
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18
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Mondragón-Rodríguez S, Gu N, Fasano C, Peña-Ortega F, Williams S. Functional Connectivity between Hippocampus and Lateral Septum is Affected in Very Young Alzheimer’s Transgenic Mouse Model. Neuroscience 2019; 401:96-105. [DOI: 10.1016/j.neuroscience.2018.12.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/20/2018] [Accepted: 12/22/2018] [Indexed: 12/29/2022]
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19
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Song Z, Deng B, Wang J, Wang R. Biomarkers for Alzheimer's Disease Defined by a Novel Brain Functional Network Measure. IEEE Trans Biomed Eng 2019; 66:41-49. [DOI: 10.1109/tbme.2018.2834546] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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20
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Cassani R, Estarellas M, San-Martin R, Fraga FJ, Falk TH. Systematic Review on Resting-State EEG for Alzheimer's Disease Diagnosis and Progression Assessment. DISEASE MARKERS 2018; 2018:5174815. [PMID: 30405860 PMCID: PMC6200063 DOI: 10.1155/2018/5174815] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/12/2018] [Accepted: 07/29/2018] [Indexed: 12/17/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder that accounts for nearly 70% of the more than 46 million dementia cases estimated worldwide. Although there is no cure for AD, early diagnosis and an accurate characterization of the disease progression can improve the quality of life of AD patients and their caregivers. Currently, AD diagnosis is carried out using standardized mental status examinations, which are commonly assisted by expensive neuroimaging scans and invasive laboratory tests, thus rendering the diagnosis time consuming and costly. Notwithstanding, over the last decade, electroencephalography (EEG) has emerged as a noninvasive alternative technique for the study of AD, competing with more expensive neuroimaging tools, such as MRI and PET. This paper reports on the results of a systematic review on the utilization of resting-state EEG signals for AD diagnosis and progression assessment. Recent journal articles obtained from four major bibliographic databases were analyzed. A total of 112 journal articles published from January 2010 to February 2018 were meticulously reviewed, and relevant aspects of these papers were compared across articles to provide a general overview of the research on this noninvasive AD diagnosis technique. Finally, recommendations for future studies with resting-state EEG were presented to improve and facilitate the knowledge transfer among research groups.
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Affiliation(s)
- Raymundo Cassani
- Institut national de la recherche scientifique (INRS-EMT), University of Québec, Montreal, Canada
| | - Mar Estarellas
- Institut national de la recherche scientifique (INRS-EMT), University of Québec, Montreal, Canada
- Department of Bioengineering, Imperial College London, London, UK
| | - Rodrigo San-Martin
- Center for Mathematics, Computation and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil
| | - Francisco J. Fraga
- Engineering, Modeling and Applied Social Sciences Center, Universidade Federal do ABC, São Bernardo do Campo, Brazil
| | - Tiago H. Falk
- Institut national de la recherche scientifique (INRS-EMT), University of Québec, Montreal, Canada
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21
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Yuan H, Phillips R, Wong CK, Zotev V, Misaki M, Wurfel B, Krueger F, Feldner M, Bodurka J. Tracking resting state connectivity dynamics in veterans with PTSD. NEUROIMAGE-CLINICAL 2018; 19:260-270. [PMID: 30035020 PMCID: PMC6051475 DOI: 10.1016/j.nicl.2018.04.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 04/09/2018] [Accepted: 04/12/2018] [Indexed: 11/24/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a trauma- and stressor-related disorder that may emerge following a traumatic event. Neuroimaging studies have shown evidence of functional abnormality in many brain regions and systems affected by PTSD. Exaggerated threat detection associated with abnormalities in the salience network, as well as abnormalities in executive functions involved in emotions regulations, self-referencing and context evaluation processing are broadly reported in PTSD. Here we aimed to investigate the behavior and dynamic properties of fMRI resting state networks in combat-related PTSD, using a novel, multimodal imaging approach. Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) was employed to measure neurobiological brain activity among 36 veterans with combat-related PTSD and 20 combat-exposed veterans without PTSD. Based on the recently established method of measuring temporal-independent EEG microstates, we developed a novel strategy to integrate EEG and fMRI by quantifying the fast temporal dynamics associated with the resting state networks. We found distinctive occurrence rates of microstates associated with the dorsal default mode network and salience networks in the PTSD group as compared with control. Furthermore, the occurrence rate of the microstate for the dorsal default mode network was positively correlated with PTSD severity, whereas the occurrence rate of the microstate for the anterior salience network was negatively correlated with hedonic tone reported by participants with PTSD. Our findings reveal a novel aspect of abnormal network dynamics in combat-related PTSD and contribute to a better understanding of the pathophysiology of the disorder. Simultaneous EEG and fMRI will be a valuable tool in continuing to study the neurobiology underlying PTSD. Concurrent EEG-fMRI study of resting brain activity in combat related PTSD. EEG-microstates were associated with fMRI resting state networks in PTSD. PTSD associated with alterations in dorsal default mode and salience networks. Occurrence rates of EEG-microstates were related to PTSD symptoms.
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Affiliation(s)
- Han Yuan
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA; University of Oklahoma Institute for Biomedical Engineering, Science and Technology, Norman, OK, USA; Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Chung Ki Wong
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Brent Wurfel
- Laureate Institute for Brain Research, Tulsa, OK, USA; Laureate Psychiatric Clinic and Hospital, Tulsa, OK, USA
| | - Frank Krueger
- Laureate Institute for Brain Research, Tulsa, OK, USA; School of Systems Biology, George Mason University, Fairfax, VA, USA
| | - Matthew Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Jerzy Bodurka
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA; University of Oklahoma Institute for Biomedical Engineering, Science and Technology, Norman, OK, USA; Laureate Institute for Brain Research, Tulsa, OK, USA.
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22
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Höller Y, Bathke AC, Uhl A, Strobl N, Lang A, Bergmann J, Nardone R, Rossini F, Zauner H, Kirschner M, Jahanbekam A, Trinka E, Staffen W. Combining SPECT and Quantitative EEG Analysis for the Automated Differential Diagnosis of Disorders with Amnestic Symptoms. Front Aging Neurosci 2017; 9:290. [PMID: 28936173 PMCID: PMC5594223 DOI: 10.3389/fnagi.2017.00290] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/23/2017] [Indexed: 12/17/2022] Open
Abstract
Single photon emission computed tomography (SPECT) and Electroencephalography (EEG) have become established tools in routine diagnostics of dementia. We aimed to increase the diagnostic power by combining quantitative markers from SPECT and EEG for differential diagnosis of disorders with amnestic symptoms. We hypothesize that the combination of SPECT with measures of interaction (connectivity) in the EEG yields higher diagnostic accuracy than the single modalities. We examined 39 patients with Alzheimer's dementia (AD), 69 patients with depressive cognitive impairment (DCI), 71 patients with amnestic mild cognitive impairment (aMCI), and 41 patients with amnestic subjective cognitive complaints (aSCC). We calculated 14 measures of interaction from a standard clinical EEG-recording and derived graph-theoretic network measures. From regional brain perfusion measured by 99mTc-hexamethyl-propylene-aminoxime (HMPAO)-SPECT in 46 regions, we calculated relative cerebral perfusion in these patients. Patient groups were classified pairwise with a linear support vector machine. Classification was conducted separately for each biomarker, and then again for each EEG- biomarker combined with SPECT. Combination of SPECT with EEG-biomarkers outperformed single use of SPECT or EEG when classifying aSCC vs. AD (90%), aMCI vs. AD (70%), and AD vs. DCI (100%), while a selection of EEG measures performed best when classifying aSCC vs. aMCI (82%) and aMCI vs. DCI (90%). Only the contrast between aSCC and DCI did not result in above-chance classification accuracy (60%). In general, accuracies were higher when measures of interaction (i.e., connectivity measures) were applied directly than when graph-theoretical measures were derived. We suggest that quantitative analysis of EEG and machine-learning techniques can support differentiating AD, aMCI, aSCC, and DCC, especially when being combined with imaging methods such as SPECT. Quantitative analysis of EEG connectivity could become an integral part for early differential diagnosis of cognitive impairment.
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Affiliation(s)
- Yvonne Höller
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria
| | - Arne C Bathke
- Department of Mathematics, Paris Lodron University of SalzburgSalzburg, Austria
| | - Andreas Uhl
- Multimedia Signal Processing and Security Lab, Department of Computer Sciences, Paris Lodron University of SalzburgSalzburg, Austria
| | - Nicolas Strobl
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria
| | - Adelheid Lang
- Department of Psychology, Centre for Cognitive Neuroscience, Paris Lodron University of SalzburgSalzburg, Austria
| | - Jürgen Bergmann
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria
| | - Raffaele Nardone
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University of SalzburgSalzburg, Austria.,Department of Neurology, Franz Tappeiner HospitalMerano, Italy
| | - Fabio Rossini
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria
| | - Harald Zauner
- Cardiovascular and Neurological Rehabilitation CenterGroßgmain, Austria
| | - Margarita Kirschner
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria
| | | | - Eugen Trinka
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University of SalzburgSalzburg, Austria
| | - Wolfgang Staffen
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University of SalzburgSalzburg, Austria
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23
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Höller Y, Uhl A, Bathke A, Thomschewski A, Butz K, Nardone R, Fell J, Trinka E. Reliability of EEG Measures of Interaction: A Paradigm Shift Is Needed to Fight the Reproducibility Crisis. Front Hum Neurosci 2017; 11:441. [PMID: 28912704 PMCID: PMC5582168 DOI: 10.3389/fnhum.2017.00441] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 08/16/2017] [Indexed: 12/04/2022] Open
Abstract
Measures of interaction (connectivity) of the EEG are at the forefront of current neuroscientific research. Unfortunately, test-retest reliability can be very low, depending on the measure and its estimation, the EEG-frequency of interest, the length of the signal, and the population under investigation. In addition, artifacts can hamper the continuity of the EEG signal, and in some clinical situations it is impractical to exclude artifacts. We aimed to examine factors that moderate test-retest reliability of measures of interaction. The study involved 40 patients with a range of neurological diseases and memory impairments (age median: 60; range 21–76; 40% female; 22 mild cognitive impairment, 5 subjective cognitive complaints, 13 temporal lobe epilepsy), and 20 healthy controls (age median: 61.5; range 23–74; 70% female). We calculated 14 measures of interaction based on the multivariate autoregressive model from two EEG-recordings separated by 2 weeks. We characterized test-retest reliability by correlating the measures between the two EEG-recordings for variations of data length, data discontinuity, artifact exclusion, model order, and frequency over all combinations of channels and all frequencies, individually for each subject, yielding a correlation coefficient for each participant. Excluding artifacts had strong effects on reliability of some measures, such as classical, real valued coherence (~0.1 before, ~0.9 after artifact exclusion). Full frequency directed transfer function was highly reliable and robust against artifacts. Variation of data length decreased reliability in relation to poor adjustment of model order and signal length. Variation of discontinuity had no effect, but reliabilities were different between model orders, frequency ranges, and patient groups depending on the measure. Pathology did not interact with variation of signal length or discontinuity. Our results emphasize the importance of documenting reliability, which may vary considerably between measures of interaction. We recommend careful selection of measures of interaction in accordance with the properties of the data. When only short data segments are available and when the signal length varies strongly across subjects after exclusion of artifacts, reliability becomes an issue. Finally, measures which show high reliability irrespective of the presence of artifacts could be extremely useful in clinical situations when exclusion of artifacts is impractical.
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Affiliation(s)
- Yvonne Höller
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical UniversitySalzburg, Austria
| | - Andreas Uhl
- Department of Computer Sciences, Paris Lodron UniversitySalzburg, Austria
| | - Arne Bathke
- Department of Mathematics, Paris Lodron UniversitySalzburg, Austria
| | - Aljoscha Thomschewski
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical UniversitySalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria
| | - Kevin Butz
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical UniversitySalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria
| | - Raffaele Nardone
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical UniversitySalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria.,Department of Neurology, Franz Tappeiner HospitalMerano, Italy
| | - Jürgen Fell
- Department of Epileptology, University of BonnBonn, Germany
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical UniversitySalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria
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24
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Höller Y, Butz K, Thomschewski A, Schmid E, Uhl A, Bathke AC, Zimmermann G, Tomasi SO, Nardone R, Staffen W, Höller P, Leitinger M, Höfler J, Kalss G, Taylor AC, Kuchukhidze G, Trinka E. Reliability of EEG Interactions Differs between Measures and Is Specific for Neurological Diseases. Front Hum Neurosci 2017; 11:350. [PMID: 28725190 PMCID: PMC5496950 DOI: 10.3389/fnhum.2017.00350] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 06/20/2017] [Indexed: 11/21/2022] Open
Abstract
Alterations of interaction (connectivity) of the EEG reflect pathological processes in patients with neurologic disorders. Nevertheless, it is questionable whether these patterns are reliable over time in different measures of interaction and whether this reliability of the measures is the same across different patient populations. In order to address this topic we examined 22 patients with mild cognitive impairment, five patients with subjective cognitive complaints, six patients with right-lateralized temporal lobe epilepsy, seven patients with left lateralized temporal lobe epilepsy, and 20 healthy controls. We calculated 14 measures of interaction from two EEG-recordings separated by 2 weeks. In order to characterize test-retest reliability, we correlated these measures for each group and compared the correlations between measures and between groups. We found that both measures of interaction as well as groups differed from each other in terms of reliability. The strongest correlation coefficients were found for spectrum, coherence, and full frequency directed transfer function (average rho > 0.9). In the delta (2–4 Hz) range, reliability was lower for mild cognitive impairment compared to healthy controls and left lateralized temporal lobe epilepsy. In the beta (13–30 Hz), gamma (31–80 Hz), and high gamma (81–125 Hz) frequency ranges we found decreased reliability in subjective cognitive complaints compared to mild cognitive impairment. In the gamma and high gamma range we found increased reliability in left lateralized temporal lobe epilepsy patients compared to healthy controls. Our results emphasize the importance of documenting reliability of measures of interaction, which may vary considerably between measures, but also between patient populations. We suggest that studies claiming clinical usefulness of measures of interaction should provide information on the reliability of the results. In addition, differences between patient groups in reliability of interactions in the EEG indicate the potential of reliability to serve as a new biomarker for pathological memory decline as well as for epilepsy. While the brain concert of information flow is generally variable, high reliability, and thus, low variability may reflect abnormal firing patterns.
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Affiliation(s)
- Yvonne Höller
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Kevin Butz
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Aljoscha Thomschewski
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria
| | - Elisabeth Schmid
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria
| | - Andreas Uhl
- Department of Computer Sciences, Paris Lodron University of SalzburgSalzburg, Austria
| | - Arne C Bathke
- Department of Mathematics, Paris Lodron University of SalzburgSalzburg, Austria
| | - Georg Zimmermann
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria.,Department of Mathematics, Paris Lodron University of SalzburgSalzburg, Austria
| | - Santino O Tomasi
- Department of Neurosurgery, Christian Doppler Medical Centre, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Raffaele Nardone
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria.,Department of Neurology, Franz Tappeiner HospitalMerano, Italy
| | - Wolfgang Staffen
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Peter Höller
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria
| | - Markus Leitinger
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Julia Höfler
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Gudrun Kalss
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Alexandra C Taylor
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Giorgi Kuchukhidze
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria
| | - Eugen Trinka
- Department of Neurology, Christian Doppler Medical Centre and Centre for Cognitive Neuroscience, Paracelsus Medical University SalzburgSalzburg, Austria.,Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical UniversitySalzburg, Austria
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