Advertisement

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 Pal
Neurology and Preclinical Neurological Studies - Review Article

Abstract

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.

Keywords

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

Notes

Acknowledgments

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

Conflict of interest

None.

References

  1. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4 text revision (DSM-IV-TR) edn. American Psychiatric Association, WashingtonGoogle Scholar
  2. Barber P, Varma R, Lloyd JJ, Haworth B, Snowden JS, Neary D (2000) The electroencephalogram in dementia with Lewy bodies. Acta Neurol Scand 101(1):53–56PubMedCrossRefGoogle Scholar
  3. Briel RCG, McKeith IG, Barker WA, Hewitt Y, Perry RH, Ince PG, Fairbairn AF (1999) EEG findings in dementia with Lewy bodies and Alzheimer’s disease. J Neurol Neurosurg Psychiatry 66:401–403PubMedCrossRefGoogle Scholar
  4. Brunovsky M, Matousek M, Edman A, Cervena K, Krajca V (2003) Objective assessment of the degree of dementia by means of EEG. Neuropsychobiology 48(1):19–26PubMedCrossRefGoogle Scholar
  5. Calzetti S, Bortone E, Negrotti A, Zinno L, Mancia D (2002) Frontal intermittent rhythmic delta activity (FIRDA) in patients with dementia with Lewy bodies: a diagnostic tool? Neurol Sci 23(Suppl 2):65–66CrossRefGoogle Scholar
  6. Chan D, Walters RJ, Sampson EL, Schott JM, Smith SJ, Rossor MN (2004) EEG abnormalities in frontotemporal lobar degeneration. Neurology 62(9):1628–1630PubMedCrossRefGoogle Scholar
  7. De Waal H, Stam CJ, Blankenstein M, YaL Pijnenburg, Scheltens P, van der Flier WM (2011) EEG abnormalities in early and late onset Alzheimer’s disease: understanding heterogeneity. J Neurol Neurosurg Psychiatry 82(1):67–71PubMedCrossRefGoogle Scholar
  8. Fogelson N et al (2003) Effects of rivastigmine on the quantitative EEG in demented Parkinsonian patients. Acta Neurol Scand 107:252–255PubMedCrossRefGoogle Scholar
  9. Gawel M, Zalewska E, Szmidt-Sałkowska E, Kowalski J (2007) Does EEG (visual and quantitative) reflect mental impairment in subcortical vascular dementia? J Neurol Sci 257(1–2):11–16PubMedCrossRefGoogle Scholar
  10. Haas LF (2003) Hans Berger (1873–1941), Richard Caton (1842–1926), and electroencephalography. J Neurol Neurosurg Psychiatry 74:9. doi: 10.1136/jnnp.74.1.9 PubMedCrossRefGoogle Scholar
  11. Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, Ross Russell RW, Symon L (1975) Cerebral blood flow in dementia. Arch Neurol 32(9):632–637PubMedCrossRefGoogle Scholar
  12. Harrison MJG, Thomas DJ, Boulay GH, Marshall J (1979) Multi infarct dementia. J Neurol Sci 40:97–103PubMedCrossRefGoogle Scholar
  13. Harvey RJ, Skelton-Robinson RM, Rossor MNJ (2003) The prevalence and causes of dementia in people under the age of 65 years. Neurol Neurosurg Psychiatry 74:1206–1209CrossRefGoogle Scholar
  14. Jelic V (2005) EEG in dementia, review of the past, view into the future. In: Sarbadhikari SN (ed) Depression and dementia: progress in brain research, clinical functioning and future trends. Nova Publisher, New York, pp 245–304Google Scholar
  15. Kowalski JW, Gawel M, Pfeffer A, Barcikowska M (2001) The diagnostic value of EEG in Alzheimer disease: correlation with the severity of mental impairment. Clin Neurophysiol 18(6):570–575Google Scholar
  16. Liedorp M, van der Flier W, Hoogervorst ELJ, Scheltens P, Stam CJ (2009) Associations between patterns of EEG abnormalities and diagnosis in a large memory clinic cohort. Dementia Geriatr Cogn Disord 27(1):18–23CrossRefGoogle Scholar
  17. McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H et al (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB consortium. Neurology 65(12):1992CrossRefGoogle Scholar
  18. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology 34(7):939–944PubMedCrossRefGoogle Scholar
  19. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151(4):264–269PubMedCrossRefGoogle Scholar
  20. Neary D, Snowden JS, Gustafson L, Passant U, Stuss D, Black S, Freedman M, Kertesz A, Robert PH, Albert M, Boone K, Miller BL, Cummings J, Benson DF (1998) Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 51(6):1546–1554PubMedCrossRefGoogle Scholar
  21. Pijnenburg Y, Strijers RLM, Made Y, van der Flier WM, Scheltens P, Stam CJL (2008) Investigation of resting-state EEG functional connectivity in frontotemporal lobar degeneration. Clin Neurophysiol 119(8):1732–1738 (pp 97–103)PubMedCrossRefGoogle Scholar
  22. Roks G, Korf ES, van der Flier WM, Scheltens P, Stam CJ (2008) The use of EEG in the diagnosis of dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 79(4):377–380PubMedCrossRefGoogle Scholar
  23. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A (1993) Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop 15. Neurology 43(2):250–260PubMedCrossRefGoogle Scholar
  24. Rossor MN, Fox N, Mummery CJ, Schott JM, Warren JD (2010) The diagnosis of young-onset dementia. Lancet Neurol 9(8):793–806PubMedCentralPubMedCrossRefGoogle Scholar
  25. Schreiter-Gasser U, Gasser T, Ziegler P (1994) Quantitative EEG analysis in early onset Alzheimer’s disease: correlations with severity, clinical characteristics, visual EEG and CCT. Electroencephalogr Clin Neurophysiol 90(4):267–272PubMedCrossRefGoogle Scholar
  26. Shucholeiki R (2012) Normal EEG waveforms, Medscape reference. http://emedicine.medscape.com/article/1139332-overview#showall. Accessed 26 September 2012 (last updated 28 March 2012)
  27. Smits LL et al (2012) Early onset Alzheimer’s disease is associated with a distinct neuropsychological profile. JAD 30:101–108PubMedGoogle Scholar
  28. Whiting P, Rutjes AWS, Reitsma JB, Bossuyt PMM, Kleijnen J (2003) The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 3:25PubMedCentralPubMedCrossRefGoogle Scholar

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

Personalised recommendations