Abstract
Background: Semi-quantitative electroencephalogram (EEG) analysis is easy to perform and has been used to differentiate dementias, as well as idiopathic and vascular Parkinson's disease.Purpose: To study whether a semi-quantitative EEG analysis can aid in distinguishing idiopathic Parkinson's disease (IPD) from atypical parkinsonian disorders (APDs), and furthermore, whether it can help to distinguish between APDs.Materials and Methods: A comprehensive retrospective review of charts was performed to include patients with parkinsonian disorders who had at least one EEG recording available. A modified grand total EEG (GTE) score evaluating the posterior background activity, and diffuse and focal slow wave activities was used in further analyses.Results: We analyzed data from 76 patients with a final diagnosis of either IPD, probable corticobasal degeneration (CBD), multiple system atrophy (MSA), or progressive supra-nuclear palsy (PSP). IPD patients had the lowest mean GTE score, followed those with CBD or MSA, while PSP patients scored the highest. However, none of these differences were statistically significant. A GTE score of ≤9 distinguished IPD patients from those with APD (p < 0.01) with a sensitivity of 100% and a specificity of 33.3%.Conclusion: The modified GTE score can distinguish patients with IPD from those with CBD, PSP or MSA at a cut-off score of 9 with excellent sensitivity but poor specificity. However, this score is not able to distinguish a particular form of APD from other forms of the disorder.
Highlights
Parkinsonian disorders comprise a heterogenous group of neurodegenerative diseases that manifest the core symptoms of parkinsonism, which include bradykinesia, rigidity, resting tremor, loss of postural reflexes, flexed posture, and freezing of gait [1,2,3]
A total of 76 patients with 76 EEG records and a final diagnosis of Idiopathic Parkinson’s disease (IPD), corticobasal degeneration (CBD), multiple system atrophy (MSA), or progressive supranuclear palsy (PSP) were included in the analysis
There were a total of 19 IPD patients, 26 CBD patients, 13 MSA patients, and 18 PSP patients
Summary
Parkinsonian disorders comprise a heterogenous group of neurodegenerative diseases that manifest the core symptoms of parkinsonism, which include bradykinesia, rigidity, resting tremor, loss of postural reflexes, flexed posture, and freezing of gait [1,2,3]. APDs have more severe symptoms, exhibit more complications, progress more rapidly, and lead to a shorter survival time than IPD [6,7,8]. The differences between these forms of parkinsonian disorders in terms of prognosis and management have led to the recognition that it is important to distinguish between these disease entities. Purpose: To study whether a semi-quantitative EEG analysis can aid in distinguishing idiopathic Parkinson’s disease (IPD) from atypical parkinsonian disorders (APDs), and whether it can help to distinguish between APDs. Low to high voltage (>20 μV in bipolar montage).
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