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Abstract
ObjectivesTo investigate using quantitative EEG the (1) differences between patients with mild cognitive impairment with Lewy bodies (MCI-LB) and MCI with Alzheimer’s disease (MCI-AD) and (2) its utility as a potential biomarker for early differential diagnosis.MethodsWe analyzed eyes-closed, resting-state, high-density EEG data from highly phenotyped participants (39 MCI-LB, 36 MCI-AD, and 31 healthy controls). EEG measures included spectral power in different frequency bands (delta, theta, pre-alpha, alpha, and beta), theta/alpha ratio, dominant frequency, and dominant frequency variability. Receiver operating characteristic (ROC) analyses were performed to assess diagnostic accuracy.ResultsThere was a shift in power from beta and alpha frequency bands towards slower frequencies in the pre-alpha and theta range in MCI-LB compared to healthy controls. Additionally, the dominant frequency was slower in MCI-LB compared to controls. We found significantly increased pre-alpha power, decreased beta power, and slower dominant frequency in MCI-LB compared to MCI-AD. EEG abnormalities were more apparent in MCI-LB cases with more diagnostic features. There were no significant differences between MCI-AD and controls. In the ROC analysis to distinguish MCI-LB from MCI-AD, beta power and dominant frequency showed the highest area under the curve values of 0.71 and 0.70, respectively. While specificity was high for some measures (up to 0.97 for alpha power and 0.94 for theta/alpha ratio), sensitivity was generally much lower.ConclusionsEarly EEG slowing is a specific feature of MCI-LB compared to MCI-AD. However, there is an overlap between the two MCI groups which makes it difficult to distinguish between them based on EEG alone.
Highlights
The early diagnosis of dementia is becoming increasingly important as it is likely that potential disease-modifying treatments will have their greatest effect at this stage
mild cognitive impairment (MCI) with Lewy bodies (MCI-LB) patients had significantly lower years of education compared to controls, but there was no significant difference between the two MCI groups in terms of education
The MCI-LB group had more parkinsonism, higher cognitive fluctuation, and visual hallucination scores compared to the MCI-Alzheimer’s disease (AD) group
Summary
The early diagnosis of dementia is becoming increasingly important as it is likely that potential disease-modifying treatments will have their greatest effect at this stage. While much research has focused on MCI patients who Schumacher et al Alzheimer's Research & Therapy (2020) 12:82 later develop Alzheimer’s disease (AD), MCI in the context of dementia with Lewy bodies (DLB) has only been characterized more recently with research criteria recently published [4,5,6]. Differential diagnosis is often impeded by a substantial clinical overlap between AD and DLB, which is especially pronounced in early stages, highlighting the need for objective biomarkers. In DLB, dopaminergic brain imaging and myocardial scintigraphy are indicative biomarkers [7]; these can improve diagnostic accuracy at the MCI stage [8] and are included in the new research criteria for MCI with Lewy bodies (MCI-LB). Its value for differential diagnosis at the MCI stage is less certain
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