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Abstract
Mild cognitive impairment (MCI) as a precursor of dementia with Lewy bodies (DLB) is the focus of recent research, trying to explore the early mechanisms and possible biomarkers of DLB. Quantitative electroencephalogram (QEEG) methods are able to differentiate early DLB from Alzheimer's disease (AD). The aim of the present study was to assess whether QEEG abnormalities, characterized by dominant frequency <8 Hz and dominant frequency variability >1.5 Hz, typical of early DLB, are already present at the stage of MCI and to evaluate whether EEG abnormalities can predict the development of DLB. Forty-seven MCI subjects were followed for 3 years. EEG recordings were obtained at admission and at the end of the study. At the end of follow-up, 20 subjects had developed probable DLB (MCI-DLB), 14 had probable AD (MCI-AD), 8 did not convert to dementia, 5 developed a non-AD/DLB dementia. One hundred percent of MCI-DLB showed EEG abnormalities at admission. Ninety three percent of MCI-AD maintained a normal EEG throughout the study. QEEG may represent a powerful tool to predict the progression from MCI to DLB with a sensitivity and specificity close to 100%.
Highlights
The early identification of dementia is becoming increasingly important, as it is likely that it is during this time period, before the manifestation of significant pathophysiological change that disease modifying treatments will have their biggest impact
Key: MCI who converted to AD (MCI-AD), mild cognitive impairment converted to Alzheimer’s disease; MCIDLB, mild cognitive impairment converted to dementia with Lewy bodies; MCINC, mild cognitive impairment non converters
Our first finding was that, control subjects showed a normal EEG recording with stable dominant alpha frequency, more than 50% of MCI subjects analyzed in our study showed EEG abnormalities, characterized by unstable dominant frequency inside the alpha band or between alpha and pre-alpha frequency bands, akin to abnormalities found in DLB patients in our previous EEG study (Bonanni et al, 2008)
Summary
The early identification of dementia is becoming increasingly important, as it is likely that it is during this time period, before the manifestation of significant pathophysiological change that disease modifying treatments will have their biggest impact. Patients with amnestic MCI are considered more likely to progress to Alzheimer’s disease (AD) (Petersen et al, 2001), whereas patients with naMCI are more likely to progress to a nonAD dementia, including, for example, dementia with Lewy bodies (DLB) (Boeve, 2012)
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