Quantitative EEG in patients with presenile and senile dementia of the Alzheimer type

Investigation of Cyclo-Z Therapeutic Effect on Insulin Pathway in Alzheimer's Rat Model: Biochemical and Electrophysiological Parameters

Cyclo (his-pro-CHP) plus zinc (Zn⁺²) (Cyclo-Z) is the only known chemical that increases the production of insulin-degrading enzyme (IDE) and decreases the number of inactive insulin fragments in cells. The aim of the present study was to systematically characterize the effects of Cyclo-Z on the insulin pathway, memory functions, and brain oscillations in the Alzheimer's disease (AD) rat model. The rat model of AD was established by bilateral injection of Aβ42 oligomer (2,5nmol/10μl) into the lateral ventricles. Cyclo-Z (10mg Zn+2/kg and 0.2mg CHP/kg) gavage treatment started seven days after Aβ injection and lasted for 21 days. At the end of the experimental period, memory tests and electrophysiological recordings were performed, which were followed by the biochemical analysis. Aβ42 oligomers led to a significant increase in fasting blood glucose, serum insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and phospho-tau-Ser356 levels. Moreover, Aβ42 oligomers caused a significant decrement in body weight, hippocampal insulin, brain insulin receptor substrate (IRS-Ser612), and glycogen synthase kinase-3 beta (GSK-3β) levels. Also, Aβ42 oligomers resulted in a significant reduction in memory. The Cyclo-Z treatment prevented the observed alterations in the ADZ group except for phospho-tau levels and attenuated the increased Aβ42 oligomer levels in the ADZ group. We also found that the Aβ42 oligomer decreased the left temporal spindle and delta power during ketamine anesthesia. Cyclo-Z treatment reversed the Aβ42 oligomer-related alterations in the left temporal spindle power. Cyclo-Z prevents Aβ oligomer-induced changes in the insulin pathway and amyloid toxicity, and may contribute to the improvement of memory deficits and neural network dynamics in this rat model.

Critical Flicker Fusion Frequency: A Narrative Review

This review presents the current knowledge of the usage of critical flicker fusion frequency (CFF) in human and animal model studies. CFF has a wide application in different fields, especially as an indicator of cortical arousal and visual processing. In medicine, CFF may be helpful for diagnostic purposes, for example in epilepsy or minimal hepatic encephalopathy. Given the environmental studies and a limited number of other methods, it is applicable in diving and hyperbaric medicine. Current research also shows the relationship between CFF and other electrophysiological methods, such as electroencephalography. The human eye can detect flicker at 50-90 Hz but reports are showing the possibility to distinguish between steady and modulated light up to 500 Hz. Future research with the use of CFF is needed to better understand its utility and application.

Robust EEG Based Biomarkers to Detect Alzheimer's Disease

Biomarkers to detect Alzheimer's disease (AD) would enable patients to gain access to appropriate services and may facilitate the development of new therapies. Given the large numbers of people affected by AD, there is a need for a low-cost, easy to use method to detect AD patients. Potentially, the electroencephalogram (EEG) can play a valuable role in this, but at present no single EEG biomarker is robust enough for use in practice. This study aims to provide a methodological framework for the development of robust EEG biomarkers to detect AD with a clinically acceptable performance by exploiting the combined strengths of key biomarkers. A large number of existing and novel EEG biomarkers associated with slowing of EEG, reduction in EEG complexity and decrease in EEG connectivity were investigated. Support vector machine and linear discriminate analysis methods were used to find the best combination of the EEG biomarkers to detect AD with significant performance. A total of 325,567 EEG biomarkers were investigated, and a panel of six biomarkers was identified and used to create a diagnostic model with high performance (≥85% for sensitivity and 100% for specificity).

Electroencephalographic markers in dementia

Dementia is a global health problem with a huge impact on the lives of those afflicted. There are several distinct diseases that are classified under the umbrella term "dementia" ranging from neurodegenerative disorders such as Alzheimer's disease to chronic infections of the central nervous system such as subacute sclerosing panencephalitis (SSPE), a rare complication of measles virus infection in childhood. Clinical features, neuropsychological profiles and imaging characteristics of the various dementia syndromes can be sufficiently distinct to distinguish them from one another. However, in some cases, the cognitive, psychiatric and behavioural features can sufficiently overlap such that neurophysiologic testing may be of help. While it is recognized the electroencephalogram (EEG) may have a special role to play in the diagnosis of certain dementing illnesses such as SSPE and Creutzfeldt-Jakob disease (CJD) that have characteristic EEG changes, current research focusses on the potential utility of quantitative EEG as one more tool in the armamentarium of clinicians dealing with patients who suffer from a dementing illness. We searched PubMed and the Cochrane Database from 1 January 1946 up to 1 January 2016, combining the search terms "EEG," "electroencephalography," "dementia" and "status epilepticus"; identified papers from these searches were then read in detail and summarized. Here, we discuss both the qualitative and quantitative EEG findings in the various types of dementia.

Impaired theta-gamma coupling in APP-deficient mice

Amyloid precursor protein (APP) is critically involved in the pathophysiology of Alzheimer's disease, but its physiological functions remain elusive. Importantly, APP knockout (APP-KO) mice exhibit cognitive deficits, suggesting that APP plays a role at the neuronal network level. To investigate this possibility, we recorded local field potentials (LFPs) from the posterior parietal cortex, dorsal hippocampus and lateral prefrontal cortex of freely moving APP-KO mice. Spectral analyses showed that network oscillations within the theta- and gamma-frequency bands were not different between APP-KO and wild-type mice. Surprisingly, however, while gamma amplitude coupled to theta phase in all recorded regions of wild-type animals, in APP-KO mice theta-gamma coupling was strongly diminished in recordings from the parietal cortex and hippocampus, but not in LFPs recorded from the prefrontal cortex. Thus, lack of APP reduces oscillatory coupling in LFP recordings from specific brain regions, despite not affecting the amplitude of the oscillations. Together, our findings reveal reduced cross-frequency coupling as a functional marker of APP deficiency at the network level.

EEG Spectral Features Discriminate between Alzheimer's and Vascular Dementia

Alzheimer's disease (AD) and vascular dementia (VaD) present with similar clinical symptoms of cognitive decline, but the underlying pathophysiological mechanisms differ. To determine whether clinical electroencephalography (EEG) can provide information relevant to discriminate between these diagnoses, we used quantitative EEG analysis to compare the spectra between non-medicated patients with AD (n = 77) and VaD (n = 77) and healthy elderly normal controls (NC) (n = 77). We use curve-fitting with a combination of a power loss and Gaussian function to model the averaged resting-state spectra of each EEG channel extracting six parameters. We assessed the performance of our model and tested the extracted parameters for group differentiation. We performed regression analysis in a multivariate analysis of covariance with group, age, gender, and number of epochs as predictors and further explored the topographical group differences with pair-wise contrasts. Significant topographical differences between the groups were found in several of the extracted features. Both AD and VaD groups showed increased delta power when compared to NC, whereas the AD patients showed a decrease in alpha power for occipital and temporal regions when compared with NC. The VaD patients had higher alpha power than NC and AD. The AD and VaD groups showed slowing of the alpha rhythm. Variability of the alpha frequency was wider for both AD and VaD groups. There was a general decrease in beta power for both AD and VaD. The proposed model is useful to parameterize spectra, which allowed extracting relevant clinical EEG key features that move toward simple and interpretable diagnostic criteria.

Comparison of quantitative EEG between patients with Alzheimer's disease and those with Parkinson's disease dementia

OBJECTIVE

Dementia frequently occurs in Parkinson's disease (PD) but its pathophysiological basis is little known. Comparative EEG studies of Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) are still rare, but could provide knowledge on the different pathophysiological mechanisms involved. The objective of the present study was to comparatively evaluate the absolute power and coherence on the EEG for patients with AD and PDD.

METHODS

This study assessed 38 adults with AD, 12 with PDD, 31 with Parkinson's disease without dementia, and 37 controls (CG) by a neurological evaluation, CERAD neuropsychological battery, executive functions tests and qEEG, calculating global absolute powers for the delta, theta, alpha and beta bands and inter- and intra-hemispheric coherences.

RESULTS

The delta and theta powers were highest in PDD and lowest in CG (p<0.05). The beta frontal-occipital inter-hemispheric coherence was highest in PDD (p<0.05). Whereas, alpha and beta frontal inter-hemispheric coherence was highest in PDD and lowest in AD (p<0.05).

CONCLUSION

These results suggest that qEEG power and coherence measures are different in AD and PDD.

SIGNIFICANCE

These qEEG differences must be related to the distinct mechanisms of cortical neural connections in AD and PDD.

Alzheimer's disease: relationship between cognitive aspects and power and coherence EEG measures

OBJECTIVE: To evaluate the relationship between specific cognitive aspects and quantitative EEG measures, in patients with mild or moderate Alzheimer's disease (AD). METHOD: Thirty-eight AD patients and 31 controls were assessed by CERAD neuropsychological battery (Consortium to Establish a Registry for AD) and the electroencephalogram (EEG). The absolute power and coherences EEG measures were calculated at rest. The correlations between the cognitive variables and the EEG were evaluated. RESULTS: In the AD group there were significant correlations between different coherence EEG measures and Mini-Mental State Examination, verbal fluency, modified Boston naming, word list memory with repetition, word list recall and recognition, and constructional praxis (p<0.01). These correlations were all negative for the delta and theta bands and positive for alpha and beta. There were no correlations between cognitive aspects and absolute EEG power. CONCLUSION: The coherence EEG measures reflect different forms in the relationship between regions related to various cognitive dysfunctions.

Young Alzheimer patients show distinct regional changes of oscillatory brain dynamics

The objective of this study was to examine the differences in oscillatory brain dynamics in Alzheimer's disease (AD) according to age at onset using quantitative electroencephalography (EEG). We examined resting state electroencephalograms of 320 probable AD patients and 246 controls, both categorized into a young (≤ 65 years) and old (> 65 years) group. Relative power in 4 different frequency bands was calculated. The effect of age on global and regional relative power was examined. Globally, young AD patients showed lower alpha- and higher delta-power than old AD patients. Regional analysis showed that these differences were most pronounced in the parieto-occipital region. Young AD patients had lower beta- and higher theta-power than old patients in all but the temporal regions. In controls, there was no age effect on global relative power in any frequency band. Young AD patients present with more severe slowing of spontaneous oscillatory activity than old AD patients, which is most pronounced in the posterior brain areas. This finding supports the hypothesis that early onset AD presents with a distinct endophenotype.

EEG theta and alpha reactivity on opening the eyes in the diagnosis of Alzheimer's disease

The objective of this study was to evaluate the contribution of EEG theta and alpha reactivity on opening the eyes, in the diagnosis of slight and moderate Alzheimer's disease (AD). Thirty four patients with AD and a control group of 30 individuals were studied, all being assessed using a neurological evaluation, CERAD neuropsychological battery (consortium to establish a registry for Alzheimer's disease), incorporating the Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR) and a qEEG analysis of the absolute band power at rest, with the eyes both open and closed. The theta and alpha reactivity indices were calculated on opening the eyes, defined from the relationship between the absolute powers in the respective bands in the periods with the eyes open and with them closed, the quotient of the relationship between the alpha and theta indices, the alpha/theta ratio, was also calculated. Multiple regression models were used to determine the accuracy in discriminating between the AD and control groups. A regression model using only cognitive data provided an accuracy of 92.2%, whereas a regression model combining cognitive data and qEEG measurements provided an accuracy of 95.3% in the classification between AD and the controls. The variable for the qEEG was the left hemisphere alpha/theta index, since the other parameters were shown to be inferior with respect to the clinical data in the regression analysis. The integrated study of the theta and alpha reactivity indices on opening the eyes and the alpha/theta index, was shown to be a useful approach in qEEG in the evaluation of AD and should be evaluated with larger samples and with other data analysis methods, with the aim of increasing the accuracy.

Diagnosis of Alzheimer's disease in Brazil: Supplementary exams

This article presents a review of the recommendations on supplementary exams employed for the clinical diagnosis of Alzheimer's disease (AD) in Brazil published in 2005. A systematic assessment of the consensus reached in other countries, and of articles on AD diagnosis in Brazil available on the PUBMED and LILACS medical databases, was carried out. Recommended laboratory exams included complete blood count, serum creatinine, thyroid stimulating hormone (TSH), albumin, hepatic enzymes, Vitamin B12, folic acid, calcium, serological reactions for syphilis and serology for HIV in patients aged younger than 60 years with atypical clinical signs or suggestive symptoms. Structural neuroimaging, computed tomography or - preferably - magnetic resonance exams, are indicated for diagnostic investigation of dementia syndrome to rule out secondary etiologies. Functional neuroimaging exams (SPECT and PET), when available, increase diagnostic reliability and assist in the differential diagnosis of other types of dementia. The cerebrospinal fluid exam is indicated in cases of pre-senile onset dementia with atypical clinical presentation or course, for communicant hydrocephaly, and suspected inflammatory, infectious or prion disease of the central nervous system. Routine electroencephalograms aid the differential diagnosis of dementia syndrome with other conditions which impair cognitive functioning. Genotyping of apolipoprotein E or other susceptibility polymorphisms is not recommended for diagnostic purposes or for assessing the risk of developing the disease. Biomarkers related to the molecular alterations in AD are largely limited to use exclusively in research protocols, but when available can contribute to improving the accuracy of diagnosis of the disease.

Quantitative electroencephalography power and coherence measurements in the diagnosis of mild and moderate Alzheimer's disease

OBJECTIVE: To evaluate the contribution of quantitative electroencephalographic (qEEG) analyses in the diagnosis of Alzheimer's disease (AD). METHOD: Thirty-five patients from the Neurology Outpatients Clinic of PUC-Campinas, diagnosed with AD according to the NINCDS/ADRDA were evaluated, and compared with a control group consisting of 30 individuals with no cognitive deficit. The procedures consisted of clinical-neurological, cognitive and behavioral analyses and the qEEG (absolute power and coherence). RESULTS: The AD group presented greater absolute power values in the delta and theta bands, greater theta/alpha indices and less frontal alpha and beta coherence. Logistic multiple regression models were constructed and those only showing variations in the qEEG (frontal alpha coherence and left frontal absolute theta power) showed an accuracy classification (72.3%) below that obtained in the mini-mental state examination (93%). CONCLUSION: The study of coherence and power in the qEEG showed a relatively limited accuracy with respect to its application in routine clinical practice.

Evidence-based evaluation of diagnostic accuracy of resting EEG in dementia and mild cognitive impairment

Cognitive impairment is the most frequent chronic condition in the elderly, and dementia is the most disabling form of cognitive impairment in elderly. In the absence of specific and reliable markers of etiologically different dementia syndromes and their preclinical stages, diagnosis in living patients is probabilistic and based on standardized clinical diagnostic criteria. There is still not enough information on the validity of the EEG method in dementia work-up, and an updated evidence-based consensus on appropriateness of this method in the initial evaluation of patients with suspected cognitive disorder and dementia is missing. Using an evidence-based technique we searched for articles on diagnostic accuracy of spontaneous EEG in dementia disorders published from 1980 until June 2008. Inclusion criteria were: original article published in English with 10 or more subjects per diagnostic group, diagnosed according to the established consensus clinical diagnostic criteria used as a "gold standard." In addition, it should have been possible to calculate from the reported results indexes of diagnostic test accuracy: sensitivity, specificity, likelihood ratios and diagnostic odds ratios. Forty-six articles were retrieved that satisfied eligibility criteria. Thirty-four (74%) studies employed case-control design where study population was recruited from consecutive patients at specialist clinic settings, 12 (26%) were prospective in terms of reported clinical followup of study population. Four (9%) studies used population-based samples and 5 (11%) studies stated in methods the recruitment procedures for patients and healthy subjects. Number of patients included in diagnostic groups and healthy subjects varied in included studies between 10 and 180 and 10 and 171, respectively. Figures on sensitivity and specificity across the studies varied widely. Positive likelihood ratio in studies reporting classification accuracies between Alzheimer's disease and controls ranged between 2.3 and 38.5, and diagnostic odds ratios consequently showed large variations between 7 and 219. In conclusion, despite the wealth of published research and reported high indexes of diagnostic accuracy of EEG, and qEEG in particular, in individual studies, evidence of diagnostic utility of resting EEG in dementia and mild cognitive impairment (MCI) is still not sufficient to establish this method for the initial evaluation of subjects with cognitive impairment in the routine clinical practice. Joint effort of preferably multicenter studies using uniform standards should develop optimized methods, investigate added diagnostic value of EEG in clinically established dementia diagnosis and predictive utility of EEG in MCI and questionable dementia.

Choline pivaloyl ester strengthened the benefit effects of Tacrine and Galantamine on electroencephalographic and cognitive performances in nucleus basalis magnocellularis-lesioned and aged rats

The aim of the present work was the assessment of the effects produced on the electroencephalographic (EEG) activity and the cognitive and memory performances of nucleus basalis magnocellularis (NBM)-lesioned or aged rats by the combined treatment with [2-(2,2-dimethylpropionyloxy)ethyl]trimethylammonium 2,2-dimethylpropionate (choline pivaloyl ester) (CPE) and the Cholinesterase inhibitors (ChEIs) Tacrine (THA) and Galantamine (GAL). Intraperitoneal administration of CPE combined with THA or GAL to both NBM-lesioned or aged rats, produced EEG desynchronisation, and a significant decrease in the energy of the total EEG spectrum and the lower frequency bands (delta 0.25-3 and theta 4-7 Hz) lasting many minutes. Furthermore, drug associations reversed in aged rats the scopolamine (0.2 mg/kg, i.p.)-induced increase in EEG power, slow waves and high-voltage spindle (HVS). Furthermore, the combined administration of CPE and Cholinesterase inhibitors in both NBM-lesioned or aged animals, improved performances in all behavioural tasks, enhancing object discrimination, increasing locomotory activity and alternation choice in T-maze, ameliorating retention in passive avoidance and decreasing escape latency in Morris water maze. In all test, AChEIs and CPE combinations proved to be more effective than CPE, THA or GAL given alone. In conclusion, the present work shows the ability of choline pivaloyl ester in strengthening the positive cerebral activity of THA and GAL.

Alzheimer's disease: models of computation and analysis of EEGs

In a recent article the authors presented a comprehensive review of research performed on computational modeling of Alzheimer's disease (AD) and its markers with a focus on computer imaging, classification models, connectionist neural models, and biophysical neural models. The popularity of imaging techniques for detection and diagnosis of possible AD stems from the relative ease with which neurological markers can be converted to visual markers. However, due to the expense of specialized experts and equipment involved in the use of imaging techniques, a subject of significant research interest is detecting markers in EEGs obtained from AD patients. In this article, the authors present a state-of-the-art review of models of computation and analysis of EEGs for diagnosis and detection of AD. This review covers three areas: time-frequency analysis, wavelet analysis, and chaos analysis. The vast number of physiological parameters involved in the poorly understood processes responsible for AD yields a large combination of parameters that can be manipulated and studied. A combination of parameters from different investigation modalities seems to be more effective in increasing the accuracy of detection-and diagnosis.

Electroencephalographic effects induced by choline pivaloyl esters in scopolamine-treated or nucleus basalis magnocellularis lesioned rats

The electroencephalographic (EEG) effects of two choline pivaloyl esters, [2-(2,2-dimethylpropionyloxy)ethyl]trimethylammonium iodide (1) and [2-(2,2-dimethylpropionyloxy)ethyl]trimethylammonium 2,2-dimethylpropionate (2), were evaluated in scopolamine-treated or nucleus basalis magnocellularis (NBM) lesioned rats. In scopolamine-treated animals, Compounds 1 and 2 prevented or reduced EEG effects, such as increased amplitude of total spectra and high-voltage spindle (HVS) activity as well. Furthermore, choline esters showed a noticeable effectiveness in reversing the EEG changes produced in rats by AMPA-induced lesion of NBM. Indeed, Compounds 1 and 2 were able to induce EEG desynchronisation, a significant decrease in the total EEG power (0.25-16 Hz) and in the lower frequency delta and theta bands (0.25-3 and 3-6 Hz, respectively). The EEG effects produced by Compounds 1 and 2 were well comparable with that evoked by Tacrine, used as a reference compound. The results of the present work allow us to put forward the hypothesis that the EEG effects observed are most likely mediated through the stimulation of the cholinergic neurotransmission ensuing from enhanced cerebral levels of acetylcholine (ACh) consequent upon acetylcholinesterase (AChE) inhibition by choline pivaloyl esters.

Effects of scopolamine on MEG spectral power and coherence in elderly subjects

OBJECTIVE

Scopolamine, a muscarinic receptor antagonist, can produce temporary cognitive impairments as well as electroencephalographic changes that partially resemble those observed in Alzheimer's disease. In order to test the sensitivity of spectral power and hemispheric coherence to changes in cholinergic transmission, we evaluated quantitative magnetoencephalogram (MEG) after intravenous injection of scopolamine.

METHODS

MEG of 8 elderly healthy subjects (59-80 years) were measured with a whole-head magnetometer after intravenous injection of scopolamine. An injection of glycopyrrolate, a peripheral muscarinic antagonist, was used as the placebo in a double-blind, randomized, cross-over design. Spectral power and coherence were computed over 7 brain regions in 3 frequency bands.

RESULTS

Scopolamine administration increased theta activity (4-8 Hz) and resulted in the abnormal pattern of MEG desynchronization in eyes-open vs. eyes-closed conditions in the alpha band (8-13 Hz). These effects were most prominent over the posterior regions. Interhemispheric and left intrahemispheric coherence was significantly decreased in the theta band (4-8 Hz).

CONCLUSIONS

Spontaneous cortical activity at the theta and alpha range and functional coupling in the theta band are modulated by the cholinergic system. MEG may provide a tool for monitoring brain dynamics in neurological disorders associated with cholinergic abnormalities.

The diagnostic value of EEG in Alzheimer disease: correlation with the severity of mental impairment

The aim of our study was to analyze EEG changes in patients with Alzheimer disease (AD) and to determine how closely EEG reflects the progression of mental impairment in people with AD. Ninety-five patients with probable AD according to National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria treated in our Clinic for Memory Disorders were selected for this study. Patients were divided into three subgroups with mild, marked, and severe dementia according to the results of psychometric scales. The EEG findings were classified using an eight-degree scale according to the background activity, presence and amount of theta and delta waves, focal changes, lateralization of focal changes, synchronization, and presence of sharp and spike waves. A significant correlation between the degree of EEG abnormalities and cognitive impairment was found. We did not observe any correlation between the presence of delta waves and the results of neuropsychological tests. Our study revealed an important diagnostic value of EEG in the estimation of the severity of dementia parallel to psychometric scales.

Frequency-specific effects of flicker on recognition memory

The functions of the electroencephalographic rhythms are uncertain. Correlational evidence has linked 10-12Hz alpha rhythms to memory formation in healthy people. Moreover, loss of 10Hz alpha correlates with memory problems in Alzheimer's disease. Going beyond mere correlation, brain stimulation or peptides that alter electroencephalographic rhythms can modulate behaviour and enhance memory in rats. This latter finding fits with evidence that electroencephalogram-frequency stimulation can enhance long-term potentiation, the neural basis of memory. I aimed to test if manipulations of alpha-frequency electroencephalographic activity enhance human memory. Flicker provides an experimental means of modulating the human electroencephalogram: 9-12Hz flicker can entrain alpha-like activity. In rats, the frequency-specificity of brain stimulation's behavioural effects excludes the possibility that they result from non-specific (i.e. non-electroencephalographic) mechanisms. I tested if flicker manipulations would show analogous frequency-specific effects in man. In view of the above correlational data, I predicted that flicker at 10Hz (a frequency near to the peak power of endogenous alpha) would enhance human memory, but adjacent frequencies (8.7 and 11.7 Hz) would not. The results confirmed this prediction. This suggests that 10Hz electroencephalographic alpha subserves memory formation in man: 10Hz flicker enhances memory in healthy people and may have therapeutic potential in memory disorders.

Discrimination of Alzheimer's disease and mild cognitive impairment by equivalent EEG sources: a cross-sectional and longitudinal study

OBJECTIVES

The spatial aspects of brain electrical activity can be assessed by equivalent EEG frequency band generators. We aimed to describe alterations of these EEG generators in Alzheimer's disease (AD) and healthy aging and whether they could serve as predictive markers of AD in subjects at risk.

METHODS

The amplitude and 3-dimensional localization of equivalent EEG sources were evaluated using FFT dipole approximation in 38 mild AD patients, 31 subjects with mild cognitive impairment (MCI) and 24 healthy control subjects.

RESULTS

AD patients showed an increase of delta and theta global field power (GFP), which corresponds to the generalized EEG amplitude, as well as a reduction of alpha GFP when compared to the controls. A decrease of alpha and beta GFP was found in AD patients, as compared to the MCI subjects. With respect to topography in the antero-posterior direction, sources of alpha and beta activity shifted more anteriorly in AD patients compared to both the controls and MCI subjects. No significant difference was found between MCI and controls. Combined alpha and theta GFP were the best discriminating variables between AD patients and controls (84% correct classification) and AD and MCI subjects (78% correctly classified). MCI subjects were followed longitudinally (25 months on average) in order to compare differences in baseline EEG variables between MCI subjects who progressed to AD (PMCI) and those who remained stable (SMCI). Compared to SMCI, PMCI had decreased alpha GFP and a more anterior localization of sources of theta, alpha and beta frequency. In a linear discriminant analysis applied on baseline values of the two MCI subgroups, the best predictor of future development of AD was found to be antero-posterior localization of alpha frequency.

CONCLUSIONS

FFT dipole approximation and frequency analysis performed by conventional FFT showed comparable classification accuracy between the studied groups. We conclude that localization and amplitude of equivalent EEG sources could be promising markers of early AD.

Changes in EEG spectral power in the prefrontal cortex of conscious rats elicited by drugs interacting with dopaminergic and noradrenergic transmission

1. The electroencephalographic (EEG) effects of drugs interacting with dopaminergic and noradrenergic systems were studied in conscious rats. Power spectra (0 - 30 Hz) were recorded from electrodes implanted bilaterally in the prefrontal cortex. Drug effects on EEG power were calculated as the spectral power following drug administration divided by the spectral power after vehicle administration. 2. Dopaminergic agonists at low doses, (apomorphine 0. 01 mg kg-1 s.c., quinpirole 0.01 mg kg-1 i.p.) and dopaminergic antagonists (haloperidol 1 mg kg-1 i.p., raclopride 2.5 mg kg-1 s.c. ), which decrease dopaminergic transmission, induced an increase of EEG power. Conversely, dopaminergic agonists at higher doses (apomorphine 0.5 mg kg-1 s.c., quinpirole 0.5 mg kg-1 i.p.) which increase activation of postsynaptic D2 and D3 receptors, induced a decrease of EEG power. 3. The alpha1-adrenoceptor antagonists (phenoxybenzamine 0.64 mg kg-1 s.c., prazosin 0.32 mg kg-1 s.c.) and the alpha2-adrenoceptor agonists (UK 14304 0.05 mg kg-1 s.c., clonidine 0.025 mg kg-1 i.p.), which decrease noradrenergic transmission, induced an increase of EEG power. Conversely, the alpha1-adrenoceptor agonist, cirazoline (0.05 mg kg-1 s.c.), the adrenergic agent modafinil (250, 350 mg kg-1 i.p.) and alpha2-adrenoceptor antagonists (RX 821002 0.01 mg kg-1 s.c., yohimbine 0.5 mg kg-1 i.p.), which increase noradrenergic transmission, induced a decrease of EEG power. The effects of prazosin (0.64 mg kg-1 s.c.) were dose-dependently antagonized by co-administration with modafinil and cirazoline, but not by apomorphine. 4. In conclusion, pharmacological modulation of dopaminergic and noradrenergic transmission may result in consistent EEG changes: decreased dopaminergic or noradrenergic activity induces an increase of EEG spectral power; while increased dopaminergic or noradrenergic activity decreases EEG spectral power.

EEG power spectrum differences in early and late onset forms of Alzheimer's disease

OBJECTIVE

To evaluate the relationship between some EEG spectral parameters and age of onset of Alzheimer's disease (AD).

METHODS

A study on the wakefulness EEG, recorded during eyes closed and open, was carried out on 150 AD patients (NINCDS-ADRDA criteria). Fifty-two normal subjects served as controls.

RESULTS

A significant prevalence of an EEG spectrum characterised by lack of a dominant peak in the 6.5-12 Hz band was found in early AD (EAD). Age of onset correlated inversely with the 1-6.5 Hz relative powers and positively with 6.5-12 Hz relative powers. A similar correlation was also found when a subgroup of mild initial AD was selected. Moreover, evidence of EEG changes peculiar to early onset AD emerged when 3 subgroups (with age of onset < or =60, range 61-69 and > or =70 years) were compared.

CONCLUSION

Irrespective of the severity of disease, this study provides evidence of specific changes of wakeful EEG in patients affected by early-onset AD.

Electroencephalographic abnormalities in patients with presenile dementia of the Alzheimer type: quantitative analysis at rest and during photic stimulation

In the present study, quantitative electroencephalographic (EEG) analysis was performed at rest and during photic stimulation (5, 10, and 15 Hz) in nine patients with presenile dementia of the Alzheimer type (AD; mean age at onset, 55 years) and nine sex- and age-matched control subjects. Compared with the normal controls, the AD patients had a significantly lower alpha-2 and beta band power in the resting EEG as well as a significant increase in delta and theta band power. EEG analysis during the photic stimulation demonstrated that the AD patients had a significantly lower EEG power during photic stimulation for the alpha (9.8-10.2 Hz) and beta bands (14.8-15.2 Hz) corresponding to photic stimulation at 10 Hz and 15 Hz, respectively. In addition, when we examined EEG changes from rest to the stimulus condition, the AD patients were found to show significantly smaller changes in EEG power mainly over the posterior regions, irrespective of the stimulus frequency. These findings provide evidence that AD patients have EEG abnormalities in both non-stimulus and stimulus conditions, and suggest diminished EEG reactivity to photic stimulation.

Quantified-EEG in normal aging and dementias

The value of quantitative electroencephalography (q-EEG) in the differential diagnosis of multi-infarct dementia (MID) and dementia of Alzheimer's type (DAT) is controversial. To evaluate the possible diagnostic role of q-EEG in these two conditions we studied 18 healthy adults, 16 healthy elderly (HE), 29 DAT patients and 45 MID patients. MID patients showed a significant increase of delta activity on the occipital regions, a significant widespread increase of theta activity, a significant widespread decrease of alpha activity. DAT patients showed a significant widespread increase of delta and theta activity, a significant widespread decrease of alpha activity. Spectral profile analysis showed an asymptotic exponential peak frequency at 4.33 HZ, and the disappearance of dominant activity in DAT patients; a 1 Hz decrease of peak frequency with a preserved normal profile in MID patients. We conclude that q-EEG is a useful ancillary test to differentiate MID from DAT.

An EEG power index (eyes open vs. eyes closed) to differentiate Alzheimer's from vascular dementia and healthy ageing

EEG differential power patterns between Alzheimer's (AD, 50 patients) and vascular (VaD, 37 patients) dementia and between these two and 36 healthy ageing subjects, were studied in the 6.5-12 Hz band of the ongoing EEG recorded during the rest eyes closed (REC) and eyes open (REO) conditions. From the EEGs (16 electrodes, 10-20 international system except for Fz, Cz, Pz), a 6.5-12 Hz band, wider than the alpha range (alpha-like), was chosen and processed to include the highest theta frequencies characterising the occipital dominant activity in dementia. A global and occipital EEG Power Index (PI) was calculated and used considering the absolute powers during REC and REO. The MANOVA was used to compare the figures. Bearing in mind that the higher the PI value the greater the difference between the 6.5-12 Hz EEG band powers of REC vs. REO, the results were as follows: (i) in the patients with Alzheimer's and vascular dementia the global and occipital PIs were significantly lower than those in controls; (ii) in the patients with Alzheimer's dementia the same PIs were significantly lower that those of the patients with VaD; (iii) healthy elderly subjects showed significantly lower powers in the 6.5-12 Hz frequencies at T5 and O1 in REO as compared to dementia patients. The pathophysiological implications and the clinical applications of these results are discussed.

Computerized electroencephalogram in untreated schizophrenics: a comparison between disorganized and paranoid types

Computerized electroencephalogram (CEEG) data were obtained from 30 patients with the disorganized type and 20 patients with the paranoid type of acute untreated schizophrenia and compared with data from age- and sex-matched controls. All patients with acute untreated schizophrenia exhibited more pronounced delta, theta, alpha 1 and beta 1 activity and less prominent alpha 2 activity than the control subjects. These findings support previous studies, and indicate the coexistence of cerebral hypofunction and excitability in acute schizophrenic patients. Compared with the controls, patients with disorganized type schizophrenia had significant increases in theta and beta 1 and decreases in alpha 2 activities; but a significant increase in delta and alpha 1 activities in the posterior regions and beta 2 activity in the frontal regions of the brain. Patients with paranoid type schizophrenia showed significantly increased delta activity in the posterior regions, increased alpha 1 activity in the anterior regions and decreased alpha 2 activity in both these regions. In the paranoid type, however, there was no significant finding for the theta, beta 1 and beta 2 activities. Disorganized type schizophrenics exhibited more increased theta and decreased alpha 2 activity than patients with paranoid type schizophrenia. The CEEG differences between the disorganized and the paranoid types appear to reflect different clinical entities and may help to differentiate both schizophrenias.