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Diagnostic and prognostic value of EEG in prodromal dementia with Lewy bodies
Open accessAbstract
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). Methods We compared 37 patients with MCI who developed DLB during follow-up or had an abnormal 123I-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. 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). Conclusions Profound EEG abnormalities are already present in the prodromal stage of DLB and have diagnostic and prognostic value. Classification of evidence This study provides Class III evidence that EEG abnormalities are more common in MCI-DLB than MCI-AD.
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Metadata
- Authors
- van der Zande, J. J., Gouw, A. A., van Steenoven, I., van de Beek, M., Scheltens, P., Stam, C. J., & Lemstra, A. W.
- Affiliations
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience (J.J.v.d.Z., A.A.G., I.v.S., M.v.d.B., P.S., A.W.L.), and Department of Clinical Neurophysiology (A.A.G., C.J.S.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands.
- Amsterdam Neuroscience (NL)
- Venue
- Neurology
- Published
- 2020-08-11
- Volume
- 95
- Issue
- 6
- Pages
- e662-e670
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W3041993762
- Cited by
- 43
- References
- 42
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 8 · 2023: 10 · 2022: 3 · 2021: 12 · 2020: 2
- FWCI
- 4.92
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- other-oa
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- dementia with Lewy bodies, prodromal dementia, mild cognitive impairment, EEG abnormalities, Alzheimer's disease, dementia progression, EEG spectral power, biomarkers
- MeSH terms
- Aged, Alzheimer Disease, Diagnosis, Differential, Electroencephalography, Female, Follow-Up Studies, Fourier Analysis, Humans, Iodine Radioisotopes, Male, Middle Aged, Netherlands, Peptide Fragments, Prospective Studies, Time Factors, Tropanes, Tomography, Emission-Computed, Single-Photon, Amyloid beta-Peptides, tau Proteins, Disease Progression, Radiopharmaceuticals, Lewy Body Disease, Early Diagnosis, Cognitive Dysfunction, Symptom Assessment
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