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Quantitative electroencephalography as a marker of cognitive fluctuations in dementia with Lewy bodies and an aid to differential diagnosis
Authors:Myrto Stylianou  Nicholas Murphy  Luis R Peraza  Sara Graziadio  Ruth Cromarty  Alison Killen  John T O&#x; Brien  Alan J Thomas  Fiona EN LeBeau  John-Paul Taylor
Institution:1. Institute of Neuroscience, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, UK;2. NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle Upon Tyne Hospitals Foundation Trust, Newcastle upon Tyne, UK;3. Department of Psychiatry, University of Cambridge, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
Abstract:

Objective

We investigated for quantitative EEG (QEEG) differences between Alzheimer’s disease (AD), dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) patients and healthy controls, and for QEEG signatures of cognitive fluctuations (CFs) in DLB.

Methods

We analysed eyes-closed, resting state EEGs from 18 AD, 17 DLB and 17 PDD patients with mild dementia, and 21 age-matched controls. Measures included spectral power, dominant frequency (DF), frequency prevalence (FP), and temporal DF variability (DFV), within defined EEG frequency bands and cortical regions.

Results

DLB and PDD patients showed a leftward shift in the power spectrum and DF. AD patients showed greater DFV compared to the other groups. In DLB patients only, greater DFV and EEG slowing were correlated with CFs, measured by the clinician assessment of fluctuations (CAF) scale. The diagnostic accuracy of the QEEG measures was 94% (90.4–97.9%), with 92.26% (80.4–100%) sensitivity and 83.3% (73.6–93%) specificity.

Conclusion

Although greater DFV was only shown in the AD group, within the DLB group a positive DFV – CF correlation was found. QEEG measures could classify DLB and AD patients with high sensitivity and specificity.

Significance

The findings add to an expanding literature suggesting that EEG is a viable diagnostic and symptom biomarker in dementia, particularly DLB.
Keywords:Dementia with Lewy bodies  Alzheimer's disease  Parkinson's disease dementia  Cognitive fluctuations  Quantitative electroencephalography
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