Journal of Neural Transmission

, Volume 121, Issue 1, pp 59–69 | Cite as

The diagnostic utility of EEG in early-onset dementia: a systematic review of the literature with narrative analysis

  • Christina Micanovic
  • Suvankar PalEmail author
Neurology and Preclinical Neurological Studies - Review Article


Early-onset dementia (EOD) is characterized by functionally impairing deterioration in memory, language, personality or visuospatial skills emerging under the age of 65. Cerebral functioning can be assessed by visual electroencephalography (EEG) interpretation. The aim of this systematic review is to evaluate the diagnostic utility of visual EEG in EOD focusing on Alzheimer’s disease (AD), vascular dementia (VAD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD). Medline, Embase, Scopus, Web of Knowledge, and Google Scholar were systematically searched for studies where EEGs were included in the diagnostic evaluation of patients with dementia under the age of 65. Each paper was quality assessed and the results grouped according to dementia cause with a narrative summary. 4,157 papers were screened, 12 studies met the eligibility criteria with a total of 965 patients. An abnormal EEG was common to all causes of EOD. EEG abnormalities are more severe in early-onset AD patients. EEG severity grade is independent of disease duration. Slow wave activity is common to all dementias, but is most prominent in DLB. Frontal intermittent rhythmic delta activity could be considered as supportive for the diagnosis of DLB as can a Grand Total EEG score of over 9.5. EEG is usually normal in FTD. Focal changes can be seen in advanced VAD. Studies employed small patient groups, varying diagnostic criteria, and only a minority of patient diagnoses was pathologically confirmed. EEG may be useful as an adjunct in the diagnosis of DLB and AD. Further prospective well-powered studies are required to investigate diagnostic utility more robustly.


Electroencephalography Early-onset dementia Alzheimer’s disease Lewy body dementia Vascular dementia Frontotemporal dementia 



Suvankar Pal is funded by an award from NHS Research Scotland.

Conflict of interest



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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  1. 1.College of Medicine and Veterinary MedicineUniversity of EdinburghEdinburghUK
  2. 2.Department of NeurologyForth Valley Royal Hospital, NHS Forth ValleyLarbertUK
  3. 3.Division of Clinical NeurosciencesWestern General HospitalEdinburghUK
  4. 4.Anne Rowling Regenerative Neurology ClinicUniversity of EdinburghEdinburghUK

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