Role of Central and Peripheral Physiological Markers in Understanding and Monitoring the Clinical Illness in Dementia

Abstract

Patients with Alzheimer's dementia are known to have electrophysiological abnormalities such as increased slow wave power of resting electroencephalography (EEG), cortical excitability as detected using EEG epileptiform and epileptic activity, and deficits in cortical plasticity detected using brain stimulation combined with EEG. Understanding these neurophysiological abnormalities is important to improve our understanding of the mechanisms leading to brain dysfunction thus leading to the development of novel treatment interventions. Further, EEG is a non-invasive, low-cost, and portable technique that is widely available and can become an important tool in monitoring illness and response to treatment. To further improve objective measures to detect and monitor clinical symptoms of dementia, recently, there has been an increased interest in the development of peripheral physiological markers such as motor activity, skin conductance and temperature, and heart rate variability. These markers can be recorded using wearable devices and have shown usefulness in monitoring neuropsychiatric symptoms of dementia. Further development of these markers can improve clinical care by improving objective assessment of clinical profiles of persons with dementia living in the community or those admitted to hospitals and can help individualize care. In this session, we will first review novel findings from studies using EEG to assess central neurophysiological markers, and then discuss the role of peripheral physiological markers in the detection and monitoring of clinical symptoms of dementia in community and dementia care units.These talks will be followed by a discussion about the relevance of the central and peripheral physiological markers (biometrics) in dementia.