Differential diagnosis of Lewy body dementias using multivariate EEG classifiers

Abstract

AbstractBackgroundLewy body dementia (LBD) results from pathology in ɑ‐synuclein and is the second most common cause of dementia. LBD has two manifestations: Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB). There is currently no non‐invasive, fast, reliable way to distinguish between early‐stage PDD, DLB, and Alzheimer’s disease (AD). Although previous traditional EEG visual rating methods have not been useful in delineating dementia subtypes, resting‐state electroencephalography (rsEEG) is a promising method for differential diagnosis of dementia, because it is inexpensive, non‐invasive, and widely available for clinical use. Here, we demonstrate how a multivariate classifier using rsEEG as input can differentiate PDD, DLB, and Alzheimer’s disease.MethodWe analyzed rsEEG data from older adults (N = 133, age 59‐89) with AD (n = 33), DLB (n = 27) or PDD (n = 45). We computed the aperiodic and periodic parameterization of brain activity, along with metrics of variation in fractal dimension within specific frequency bands. We then used these features, along with age and sex, to develop XGBoost machine‐learning models to predict patient diagnoses. Models were evaluated using cross‐validation with balanced accuracy, weighted sensitivity, and weighted specificity.ResultThe first task was a two‐way classification: Control vs Dementia (accuracy = 86%, sensitivity = 93%, specificity = 79%, p < .001). The second task was a three‐way classification: AD vs DLB vs PDD (accuracy = 66%, sensitivity = 70%, specificity = 82%, p < .001). We also evaluated two‐way models distinguishing between AD vs DLB (accuracy = 86%, sensitivity = 87%, specificity = 86%, p < .001), AD vs PDD (accuracy = 84%, sensitivity = 85%, specificity = 83%, p < .001), AD vs LBD (combined DLB and PDD; accuracy = 82%, sensitivity = 85%, specificity = 78%, p < .01), and DLB vs PDD (accuracy = 68%, sensitivity = 71%, specificity = 65%, p < .05).ConclusionMachine‐learning and rsEEG are capable of distinguishing between AD and LBD. Moreover, machine‐learning combined with spectral and fractal features can distinguish between DLB and PDD, despite both forms of dementia arising from ɑ‐synuclein pathology.