The association of quantitative EEG and MRI in Creutzfeldt-Jakob Disease

Rarely fast progressive memory loss diagnosed as Creutzfeldt-Jakob disease: A case report

BACKGROUND

Creutzfeldt-Jakob disease (CJD) is a rare degenerative disease of the central nervous system that can be contagious or hereditary and is a rare cause of rapidly progressive dementia. It almost always results in death within 1-2 years from symptom onset.

CASE SUMMARY

Here, we report the case of a 57-year-old male who initially experienced dizziness followed by a 1-mo fast decline in memory function. He presented to the local hospital and underwent magnetic resonance imaging and cerebrospinal fluid (CSF) examination, with no definitive diagnosis. However, the symptoms of progressive forgetting worsened. In addition, he exhibited progressive involuntary tremor of the limbs. Then, he came to our hospital, and according to the results of CSF examination, electroencephalography (EEG) and magnetic resonance imaging (MRI) tests and clinical manifestations of cerebellar ataxia, dementia, and myoclonus that rapidly progressed, with a short duration of illness, he was finally diagnosed with sporadic CJD (sCJD).

CONCLUSION

This case report aims to create awareness among physicians to emphasize auxiliary examination, CSF examination, EEG and MRI tests and recognition of cerebellar ataxia, dementia, and myoclonus that rapidly progress to prompt pursuit of an early diagnosis and identification of sCJD and to reduce complications.

Value of Magnetic Resonance Diffusion Tensor Imaging Combined with Quantitative Electroencephalogram in Diagnosis of Neurocognitive Impairment in Patients with White Matter Demyelination

This paper aimed to explore the clinical value of combined adoption of magnetic resonance diffusion tensor imaging (DTI) and quantitative electroencephalogram (QEEG) in assessing microstructure changes and mild neurocognitive dysfunction in patients with white matter demyelination. 128 cases of white matter demyelination admitted to the hospital from October 2018 to October 2019 were rolled into the research group, and 100 healthy patients physically examined during the same period were rolled into the control (ctrl) group. QEEG and magnetic resonance DTI examinations were performed for all patients. The wave power of δ, θ, α, and β and the ratio of α/θ and (δ + θ)/(α + β) were recorded. The FA values of white matter fibers in different brain areas were measured, and the Montreal Cognitive Assessment (MoCA) and Addenbrooke Cognitive Evaluation rating (ACE-R) were adopted to assess the neurocognitive function of patients. It was found that the dominant frequency of each brain area in the research group was 8-9 Hz slow α wave. In contrast with the ctrl, the α wave and α/θ values in the research group were lower, while θ wave and δ + θ/α + β values were higher (P < 0.05); the scores of ACE-R and MoCA were lower (P < 0.01); the fractional anisotropy (FA) values of the right frontal lobe white matter (0.335 ± 0.068), the left temporal lobe white matter (0.391 ± 0.032), and the corpus callosum knee white matter (0.658 ± 0.053) were lower (P < 0.05). The FA values of these three areas were positively correlated with attention and calculation, memory, and memory of MoCA scale, respectively (P < 0.05). The FA value of the right frontal white matter was positively correlated with the attention and calculation score of the ACE-R scale (P < 0.05). In conclusion, magnetic resonance DTI combined with QEEG could reflect the microstructural changes of white matter, which may be associated with mild neurocognitive impairment. The primary objective of the study was to explore the clinical value of combined adoption of magnetic resonance DTI and QEEG in assessing microstructure changes and mild neurocognitive dysfunction in patients with white matter demyelination, expected to provide a theoretical basis for the treatment of white matter demyelination.

Spatial distribution of abnormal EEG activity in Creutzfeldt-Jakob disease

OBJECTIVES

Electroencephalogram (EEG) pattern in Creutzfeldt-Jakob disease (CJD) is characterized by diffuse abnormal activity, although lateralization to one hemisphere has been described in the first stages of the disease. This study aimed to determine whether abnormal EEG activity predominantly occurs in anterior versus posterior brain regions.

METHODS

As part of a prospective study, the demographics, clinical features and MRI findings of genetic E200K CJD patients were collected. EEG was performed and the recordings reviewed for the typical periodic sharp wave complex (PSWC) and non-specific slow activity. Data were analyzed using the qEEG tool, and the activity in anterior and posterior regions of the brain compared.

RESULTS

Eleven genetic E200K CJD patients were included in the study (67% women). The average age was 59.1 ± 8.4 SD years and the average disease duration was 2.4 ± 2.1 months. EEG showed the classic PSWC pattern in 5/11 (45%) of the patients, and slow activity was seen in 9/11 (82%). EEG was normal in 2 patients. PSWC activity was diffuse in 2/5 patients and unilateral in 3/5 patients; slow activity was diffuse in 9 patients. Quantitative analysis of PSWC and slow activity showed no significant difference between anterior and posterior distribution.

CONCLUSION

The abnormal EEG activity in CJD is diffuse with no clear spatial predominance in anterior or posterior brain regions.

Changes in EEG Recordings in COVID-19 Patients as a Basis for More Accurate QEEG Diagnostics and EEG Neurofeedback Therapy: A Systematic Review

INTRODUCTION AND PURPOSE

The SARS-CoV-2 virus is able to cause abnormalities in the functioning of the nervous system and induce neurological symptoms with the features of encephalopathy, disturbances of consciousness and concentration and a reduced ability to sense taste and smell as well as headaches. One of the methods of detecting these types of changes in COVID-19 patients is an electroencephalogram (EEG) test, which allows information to be obtained about the functioning of the brain as well as diagnosing diseases and predicting their consequences. The aim of the study was to review the latest research on changes in EEG in patients with COVID-19 as a basis for further quantitative electroencephalogram (QEEG) diagnostics and EEG neurofeedback training. Description of the state of knowledge: Based on the available scientific literature using the PubMed database from 2020 and early 2021 regarding changes in the EEG records in patients with COVID-19, 17 publications were included in the analysis. In patients who underwent an EEG test, changes in the frontal area were observed. A few patients were not found to be responsive to external stimuli. Additionally, a previously non-emerging, uncommon pattern in the form of continuous, slightly asymmetric, monomorphic, biphasic and slow delta waves occurred.

CONCLUSION

The results of this analysis clearly indicate that the SARS-CoV-2 virus causes changes in the nervous system that can be manifested and detected in the EEG record. The small number of available articles, the small number of research groups and the lack of control groups suggest the need for further research regarding the short and long term neurological effects of the SARS-CoV-2 virus and the need for unquestionable confirmation that observed changes were caused by the virus per se and did not occur before. The presented studies described non-specific patterns appearing in encephalograms in patients with COVID-19. These observations are the basis for more accurate QEEG diagnostics and EEG neurofeedback training.