Slowing on quantitative EEG is associated with transition to dementia in mild cognitive impairment

ABSTRACT Electroencephalographic (EEG) abnormalities are greater in mild cognitive impairment (MCI) with Lewy bodies (MCI-LB) than in MCI due to Alzheimer’s disease (MCI-AD) and may anticipate the onset of dementia. We aimed to assess whether quantitative EEG (qEEG) slowing would predict a higher annual hazard of dementia in MCI across these etiologies. MCI patients (n = 92) and healthy comparators (n = 31) provided qEEG recording and underwent longitudinal clinical and cognitive follow-up. Associations between qEEG slowing, measured by increased theta/alpha ratio, and clinical progression from MCI to dementia were estimated with a multistate transition model to account for death as a competing risk, while controlling for age, cognitive function, and etiology classified by an expert consensus panel. Over a mean follow-up of 1.5 years (SD = 0.5), 14 cases of incident dementia and 5 deaths were observed. Increased theta/alpha ratio on qEEG was associated with increased annual hazard of dementia (hazard ratio = 1.84, 95% CI: 1.01–3.35). This extends previous findings that MCI-LB features early functional changes, showing that qEEG slowing may anticipate the onset of dementia in prospectively identified MCI.

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Elucidating the risk factors for progression from amyloid-negative amnestic mild cognitive impairment to dementia

Current Alzheimer Research ◽

10.2174/1567205017666201130094259 ◽

2020 ◽

Vol 17 ◽

Author(s):

Hyung-Ji Kim ◽

Jae-Hong Lee ◽

E-nae Cheong ◽

Sung-Eun Chung ◽

Sungyang Jo ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Amnestic Mild Cognitive Impairment ◽

Amyloid Pet ◽

Clinical Progression ◽

Amnestic Mci

Background: Amyloid PET allows for the assessment of amyloid β status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s disease-mimicking conditions. Around 15–20% of patients with clinically probable Alzheimer’s disease have been found to have no significant Alzheimer’s pathology on amyloid PET. However, a limited number of studies had been conducted this subpopulation in terms of clinical progression. Objective: We investigated the risk factors that could affect the progression to dementia in patients with amyloid-negative amnestic mild cognitive impairment (MCI). Methods: This study was a single-institutional, retrospective cohort study of patients over the age of 50 with amyloidnegative amnestic MCI who visited the memory clinic of Asan Medical Center with a follow-up period of more than 36 months. All participants underwent brain magnetic resonance imaging (MRI), detailed neuropsychological testing, and fluorine-18[F18]-florbetaben amyloid PET. Results: During the follow-up period, 39 of 107 patients progressed to dementia from amnestic MCI. In comparison with the stationary group, the progressed group had a more severe impairment in verbal and visual episodic memory function and hippocampal atrophy, which showed an Alzheimer’s disease-like pattern despite the lack of evidence for significant Alzheimer’s disease pathology. Voxel-based morphometric MRI analysis revealed that the progressed group had a reduced gray matter volume in the bilateral cerebellar cortices, right temporal cortex, and bilateral insular cortices. Conclusion: Considering the lack of evidence of amyloid pathology, clinical progression of these subpopulation may be caused by other neuropathologies such as TDP-43, abnormal tau or alpha synuclein that lead to neurodegeneration independent of amyloid-driven pathway. Further prospective studies incorporating biomarkers of Alzheimer’s diseasemimicking dementia are warranted.

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Quantitative EEG in progressingvsstable mild cognitive impairment (MCI): results of a 1-year follow-up study

International Journal of Geriatric Psychiatry ◽

10.1002/gps.2042 ◽

2008 ◽

Vol 23 (11) ◽

pp. 1148-1155 ◽

Cited By ~ 40

Author(s):

Christian Luckhaus ◽

Brigitte Grass-Kapanke ◽

Ingo Blaeser ◽

Ralf Ihl ◽

Tillmann Supprian ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Quantitative Eeg ◽

Follow Up Study

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Quantitative Eeg as a Biomarker in Mild Cognitive Impairment With Lewy Bodies

10.21203/rs.3.rs-28736/v1 ◽

2020 ◽

Author(s):

Julia Schumacher ◽

John-Paul Taylor ◽

Calum A. Hamilton ◽

Michael Firbank ◽

Ruth A. Cromarty ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Lewy Bodies ◽

Quantitative Eeg ◽

Dominant Frequency ◽

Alpha Power ◽

Healthy Controls ◽

Operating Characteristics ◽

Frequency Bands ◽

Beta Power

Abstract Objectives:To investigate using quantitative EEG (1) differencesbetween patients with mild cognitive impairment with Lewy bodies (MCI-LB) and MCI with Alzheimer’s disease (MCI-AD) and (2) its utilityas a potential biomarker for early differential diagnosis.Methods:We analyzed eyes-closed, resting state, high-density EEG data from highly phenotyped participants (39 MCI-LB, 36 MCI-AD, and 31 healthy controls). EEG measures included spectral power in different frequency bands (delta, theta, pre-alpha, alpha, and beta), theta/alpha ratio, dominant frequency, and dominant frequency variability.Receiver operating characteristics (ROC) analyses were performed to assess diagnostic accuracy.Results:There was a shift in power from beta and alpha frequency bands towards slower frequencies in the pre-alpha and theta range in MCI-LB compared to healthy controls. Additionally, dominant frequency was slower in MCI-LB compared to controls. We found significantly increased pre-alpha power, decreased beta power, and slower dominant frequency in MCI-LB compared to MCI-AD. EEG abnormalities were more apparent in MCI-LB cases with more diagnostic features.There were no significant differences between MCI-AD and controls. In the ROC analysis, beta power and dominant frequency showed the highest area under the curve values of 0.71 and 0.70, respectively. While specificity was high for some measures (up to 0.97 for alpha power and 0.94 for theta/alpha ratio), sensitivity was generally much lower. Conclusions:Early EEG slowing is a specific feature of MCI-LB compared to MCI-AD.However, there is overlap between the two MCI groups which makes it difficult to distinguish between them based on EEG alone.

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Neuropsychological Criteria for Mild Cognitive Impairment in the Framingham Heart Study’s Old-Old

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000493541 ◽

2018 ◽

Vol 46 (5-6) ◽

pp. 253-265 ◽

Cited By ~ 2

Author(s):

Christina G. Wong ◽

Kelsey R. Thomas ◽

Emily C. Edmonds ◽

Alexandra J. Weigand ◽

Katherine J. Bangen ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Operational Definition ◽

Cox Models ◽

Cognitively Normal ◽

Incident Dementia ◽

Heart Study ◽

Risk Of Progression ◽

Diagnostic Approaches

Background/Aims: Mild cognitive impairment (MCI) lacks a “gold standard” operational definition. The Jak/Bondi actuarial neuropsychological criteria for MCI are associated with improved diagnostic stability and prediction of progression to dementia compared to conventional MCI diagnostic approaches, although its utility in diagnosing MCI in old-old individuals (age 75+) is unknown. Therefore, we investigated the applicability of neuropsychological MCI criteria among old-old from the Framingham Heart Study. Methods: A total of 347 adults (ages 79–102) were classified as cognitively normal or MCI via Jak/Bondi and conventional Petersen/Winblad criteria, which differ on cutoffs for cognitive impairment and number of impaired scores required for a diagnosis. Cox models examined MCI status in predicting risk of progression to dementia. Results: MCI diagnosed by both the Jak/Bondi and Petersen/Winblad criteria was associated with incident dementia; however, when both criteria were included in the regression model together, only the Jak/Bondi criteria remained statistically significant. At follow-up, the Jak/Bondi criteria had a lower MCI-to-normal reversion rate than the Petersen/Winblad criteria. Conclusions: Our findings are consistent with previous research on the Jak/Bondi criteria and support the use of a comprehensive neuropsychological diagnostic approach for MCI among old-old individuals.

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Olfactory function and neuropsychological profile to differentiate dementia with Lewy bodies from Alzheimer's disease in patients with mild cognitive impairment: A 5-year follow-up study

Journal of the Neurological Sciences ◽

10.1016/j.jns.2015.06.013 ◽

2015 ◽

Vol 355 (1-2) ◽

pp. 174-179 ◽

Cited By ~ 44

Author(s):

Jung Han Yoon ◽

Min Kim ◽

So Young Moon ◽

Seok Woo Yong ◽

Ji Man Hong

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Olfactory Function ◽

Follow Up Study ◽

Neuropsychological Profile

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The Impact of the COVID-19 Pandemic and Lockdown on Mild Cognitive Impairment, Alzheimer's Disease and Dementia With Lewy Bodies in China: A 1-Year Follow-Up Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.711658 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zhi-Chao Chen ◽

Shuai Liu ◽

Jinghuan Gan ◽

Lingyun Ma ◽

Xiaoshan Du ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Dementia With Lewy Bodies ◽

Neuropsychiatric Symptoms ◽

Lewy Bodies ◽

Social Contact ◽

The Impact

Background: While the lockdown strategies taken by many countries effectively limited the spread of COVID-19, those were thought to have a negative impact on older people. This study aimed to investigate the impact of lockdown on cognitive function and neuropsychiatric symptoms over a 1-year follow-up period in patients with mild cognitive impairment (MCI), Alzheimer's disease (AD) and dementia with Lewy bodies (DLB).Methods: We enrolled consecutive patients with MCI, probable AD or DLB who were receiving outpatient memory care before the COVID-19 pandemic and followed-up with them after 1 year by face-to-face during the COVID-19 pandemic to assess changes in physical activity, social contact, cognitive function and neuropsychiatric symptoms (NPS).Results: Total 105 probable AD, 50 MCI and 22 probable DLB patients were included and completed the 1-year follow-up between October 31 and November 30, 2020. Among the respondents, 42% of MCI, 54.3% of AD and 72.7% of DLB patients had a decline in MMSE scores and 54.4% of DLB patients had worsening Neuropsychiatric inventory (NPI) scores. Patients with DLB showed a more rapid decline of MMSE than those with AD. Diminished physical activity and social contact might have hastened the deterioration of cognition and the worsening of NPS.Conclusion: Social isolation and physical inactivity even after strict lockdown for at least 6 months were correlated with accelerated decline of cognitive function and NPS in patients with AD and DLB.

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Quantitative EEG as a biomarker in mild cognitive impairment with Lewy bodies

10.21203/rs.3.rs-28736/v2 ◽

2020 ◽

Author(s):

Julia Schumacher ◽

John-Paul Taylor ◽

Calum A. Hamilton ◽

Michael Firbank ◽

Ruth A. Cromarty ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Lewy Bodies ◽

Quantitative Eeg ◽

Dominant Frequency ◽

Alpha Power ◽

Healthy Controls ◽

Operating Characteristics ◽

Frequency Bands ◽

Beta Power

Abstract Objectives: To investigate using quantitative EEG (1) differences between patients with mild cognitive impairment with Lewy bodies (MCI-LB) and MCI with Alzheimer’s disease (MCI-AD) and (2) its utility as a potential biomarker for early differential diagnosis. Methods: We analyzed eyes-closed, resting state, high-density EEG data from highly phenotyped participants (39 MCI-LB, 36 MCI-AD, and 31 healthy controls). EEG measures included spectral power in different frequency bands (delta, theta, pre-alpha, alpha, and beta), theta/alpha ratio, dominant frequency, and dominant frequency variability. Receiver operating characteristics (ROC) analyses were performed to assess diagnostic accuracy. Results: There was a shift in power from beta and alpha frequency bands towards slower frequencies in the pre-alpha and theta range in MCI-LB compared to healthy controls. Additionally, dominant frequency was slower in MCI-LB compared to controls. We found significantly increased pre-alpha power, decreased beta power, and slower dominant frequency in MCI-LB compared to MCI-AD. EEG abnormalities were more apparent in MCI-LB cases with more diagnostic features. There were no significant differences between MCI-AD and controls. In the ROC analysis to distinguish MCI-LB from MCI-AD, beta power and dominant frequency showed the highest area under the curve values of 0.71 and 0.70, respectively. While specificity was high for some measures (up to 0.97 for alpha power and 0.94 for theta/alpha ratio), sensitivity was generally much lower. Conclusions: Early EEG slowing is a specific feature of MCI-LB compared to MCI-AD. However, there is overlap between the two MCI groups which makes it difficult to distinguish between them based on EEG alone.

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Magnetic Resonance Imaging in Stable Mild Cognitive Impairment, Prodromal Alzheimer’s Disease, and Prodromal Dementia with Lewy Bodies

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000510951 ◽

2020 ◽

pp. 1-6

Author(s):

Tahreem Ghazal Siddiqui ◽

Timothy Whitfield ◽

Sudhakar Janaki Praharaju ◽

Dilman Sadiq ◽

Hiba Kazmi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Dementia With Lewy Bodies ◽

Lewy Bodies ◽

Mri Scans ◽

Prodromal Alzheimer’S Disease ◽

Prodromal Dementia

Introduction: Fifteen percent of people with mild cognitive impairment (MCI) will progress to dementia within 2 years. There is increasing focus on the evaluation of biomarkers which point towards the underlying pathology. This enables better prediction of clinical outcomes. Early diagnosis of the dementia subtype is crucial for appropriate management and accurate prognosis. The aim of this study was to compare MRI measures in stable mild cognitive impairment patients (stable-MCI), prodromal Alzheimer’s disease (pro-AD), and prodromal dementia with Lewy bodies (pro-DLB). Methods: Out of 1,814 patients assessed in Essex memory clinic between 2002 and 2017, 424 had MCI at baseline with follow-up data. All patients underwent comprehensive clinical and cognitive assessment at each assessment. MRI scans were acquired at patients’ baseline assessment, corresponding to the time of initial MCI clinical diagnosis. Patients were grouped according to their diagnosis at the end of follow-up. All baseline scans were visually rated according to established rating scales for medial temporal atrophy (MTA), global cortical atrophy (GCA), and white matter lesions (WMLs). Results: MRI scans were available for 28 pro-DLB patients and were matched against 27 pro-AD and 28 stable-MCI patients for age, sex, and education. The mean follow-up duration was 34 months for the pro-AD group, 27 months for the pro-DLB group, and 21 months for the stable-MCI group. MTA scores were significantly greater in pro-AD patients compared to pro-DLB (p = 0.047) and stable-MCI patients (p = 0.012). There was no difference on GCA or WMLs between pro-AD, pro-DLB, and stable-MCI. Conclusions: This study indicates that a simple visual rating of MTA at the stage of MCI already differs at a group level between patients that progress to AD, DLB, or continue to be stable-MCI. This could aid clinicians to differentiate between MCI patients who are likely to develop AD, versus those who might progress to DLB or remain stable.

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