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Diagnostic and prognostic value of EEG in prodromal dementia with Lewy bodies.
- Source :
-
Neurology [Neurology] 2020 Aug 11; Vol. 95 (6), pp. e662-e670. Date of Electronic Publication: 2020 Jul 07. - Publication Year :
- 2020
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Abstract
- Objective: Early biomarkers for dementia with Lewy bodies (DLB) are lacking. To determine whether EEG differentiates the prodromal phase of DLB from other causes of mild cognitive impairment (MCI) and whether EEG is predictive for time to conversion from MCI to DLB, we compared EEGs and clinical follow-up of patients with MCI due to DLB with those of patients with MCI due to Alzheimer disease (MCI-AD).<br />Methods: We compared 37 patients with MCI who developed DLB during follow-up or had an abnormal <superscript>123</superscript> I-PF-CIT SPECT scan (MCI-DLB) with 67 age-matched patients with MCI-AD. EEGs were assessed visually with a score of increasing abnormality (range 1-5). We performed fast Fourier transform to analyze the power spectrum. With survival analyses, EEG characteristics were related to time to progression to dementia.<br />Results: The visual EEG score was higher in MCI-DLB (score >2 in 60%) compared to MCI-AD (score >2 in 8%, p < 0.001). We found frontal intermittent delta activity in 22% of MCI-DLB, not in MCI-AD. Patients with MCI-DLB had a lower peak frequency (7.5 [6.0-9.9] Hz vs 8.8 [6.8-10.2] in MCI-AD, p < 0.001) and more slow-wave activity. Several individual EEG measures showed good performance to discriminate MCI-DLB from MCI-AD (areas under the curve up to 0.94). In MCI-DLB, high visual EEG score, diffuse abnormalities, and low α2 power were related to time to progression to dementia (hazard ratios 4.1, 9.9, 5.1, respectively).<br />Conclusions: Profound EEG abnormalities are already present in the prodromal stage of DLB and have diagnostic and prognostic value.<br />Classification of Evidence: This study provides Class III evidence that EEG abnormalities are more common in MCI-DLB than MCI-AD.<br /> (© 2020 American Academy of Neurology.)
- Subjects :
- Aged
Alzheimer Disease diagnostic imaging
Alzheimer Disease physiopathology
Amyloid beta-Peptides cerebrospinal fluid
Cognitive Dysfunction cerebrospinal fluid
Cognitive Dysfunction diagnostic imaging
Cognitive Dysfunction physiopathology
Diagnosis, Differential
Disease Progression
Early Diagnosis
Female
Follow-Up Studies
Fourier Analysis
Humans
Iodine Radioisotopes
Lewy Body Disease cerebrospinal fluid
Lewy Body Disease diagnostic imaging
Lewy Body Disease physiopathology
Male
Middle Aged
Netherlands
Peptide Fragments cerebrospinal fluid
Prospective Studies
Radiopharmaceuticals
Symptom Assessment
Time Factors
Tomography, Emission-Computed, Single-Photon
Tropanes
tau Proteins cerebrospinal fluid
Electroencephalography
Lewy Body Disease diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1526-632X
- Volume :
- 95
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 32636325
- Full Text :
- https://doi.org/10.1212/WNL.0000000000009977