Abstract
Dementia with Lewy bodies (DLB) belongs to the spectrum of Lewy body dementia (LBD) that also encompasses Parkinson’s disease dementia (PDD). It is a common neurodegenerative disorder characterized by memory decline, cognitive fluctuations, visual hallucinations, autonomic nervous system disturbance, REM sleep behavior disorder, and parkinsonism. Definite diagnosis can be established only through neuropathological confirmation of Lewy bodies’ presence in brain tissue. Probable or possible diagnosis relies upon clinical features, imaging, polysomnography, and electroencephalogram (EEG) findings. Potential neurophysiological biomarkers for the diagnosis, management, and evaluation of treatment-response in DLB should be affordable and widely available outside academic centers. Increasing evidence supports the use of quantitative EEG (qEEG) as a potential DLB biomarker, with promising results in discriminating DLB from other dementias and in identifying subjects who are on the trajectory to develop DLB. Several studies evaluated the diagnostic value of EEG in DLB. Visual analysis and qEEG techniques have been implemented, showing a superiority of the last in terms of sensitivity and objectivity. In this systematic review, we attempt to provide a general synthesis of the current knowledge on EEG application in DLB. We review the findings from original studies and address the issues remaining to be further clarified.
Similar content being viewed by others
References
McKeith I (2005) Dementia with Lewy bodies. Dialogues Clin Neurosci 6:333–341
McKeith IG, Boeve BF, Dickson DW, et al (2017) Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium 89:88–100. https://doi.org/10.1212/WNL.0000000000004058
McKeith IG, Dickson DW, Lowe J et al (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65:1863–1872. https://doi.org/10.1212/01.wnl.0000187889.17253.b1
Kosaka K (1978) Lewy bodies in cerebral cortex, report of three cases. Acta Neuropathol 42:127–134. https://doi.org/10.1007/bf00690978
Howlett DR, Whitfield D, Johnson M et al (2015) Regional multiple pathology scores are associated with cognitive decline in Lewy body dementias. Brain Pathol 25:401–408. https://doi.org/10.1111/bpa.12182
Dugger BN, Adler CH, Shill HA et al (2014) Concomitant pathologies among a spectrum of parkinsonian disorders. Parkinsonism Relat Disord 20:525–529. https://doi.org/10.1016/j.parkreldis.2014.02.012
Liedorp M, Van Der Flier WM, Hoogervorst EL et al (2009) Associations between patterns of EEG abnormalities and diagnosis in a large memory clinic cohort. Dement Geriatr Cogn Disord 27:18–23. https://doi.org/10.1159/000182422
Briel RCG, McKeith IG, Barker WA et al (1999) EEG findings in dementia with Lewy bodies and Alzheimer’s disease. J Neurol Neurosurg Psychiatry 66:401–403. https://doi.org/10.1136/jnnp.66.3.401
Walker MP, Ayre GA, Cummings JL et al (2000) Quantifying fluctuation in dementia with Lewy bodies, Alzheimer’s disease, and vascular dementia. Neurology 54:1616–1625. https://doi.org/10.1212/wnl.54.8.1616
Londos E, Passant U, Brun A et al (2003) Regional cerebral blood flow and EEG in clinically diagnosed dementia with Lewy bodies and Alzheimer’s disease. Arch Gerontol Geriatr 36:231–245. https://doi.org/10.1016/S0167-4943(02)00168-1
Kai T, Asai Y, Sakuma K et al (2005) Quantitative electroencephalogram analysis in dementia with Lewy bodies and Alzheimer’s disease. J Neurol Sci 237:89–95. https://doi.org/10.1016/j.jns.2005.05.017
Roks G, Korf ES, Flier WM et al (2008) The use of EEG in the diagnosis of dementia with Lewy bodies. J Neurol Neurosurg Psychiatry 79:377–380. https://doi.org/10.1136/jnnp.2007.125385
Bonanni L, Thomas A, Tiraboschi P et al (2008) EEG comparisons in early Alzheimer’s disease, dementia with Lewy bodies and Parkinson’s disease with dementia patients with a 2-year follow-up. Brain 131:690–705. https://doi.org/10.1093/brain/awm322
Andersson M, Hansson O, Minthon L et al (2008) Electroencephalogram variability in dementia with Lewy Bodies, Alzheimer’s disease and controls. Dement Geriatr Cogn Disord 26:284–290. https://doi.org/10.1159/000160962
Snaedal J, Johannesson GH, Gudmundsson TE et al (2012) Diagnostic accuracy of statistical pattern recognition of electroencephalogram registration in evaluation of cognitive impairment and dementia. Dement Geriatr Cogn 34:51–60. https://doi.org/10.1159/000339996
Lee H, Brekelmans GJ, Roks G (2014) The EEG as a diagnostic tool in distinguishing between dementia with Lewy bodies and Alzheimer’s disease. Clin Neurophysiol 126:1735–1739. https://doi.org/10.1016/j.clinph.2014.11.021
Engedal K, Snaedal J, Hoegh P et al (2015) Quantitative EEG applying the statistical recognition pattern method: a useful tool in dementia diagnostic workup. Dement Geriatr Cogn Disord 40:1–12. https://doi.org/10.1159/000381016
Van Dellen E, De Waal H, Van der Flier W et al (2015) Loss of EEG Network Efficiency is related to cognitive impairment in dementia with Lewy bodies. Mov Disord 30:1785–1793. https://doi.org/10.1002/mds.26309
Bonanni L, Perfetti B, Bifolchetti S et al (2015) Quantitative electroencephalogram utility in predicting conversion of mild cognitive impairment to dementia with Lewy bodies. Neurobiol Aging 36:434–445. https://doi.org/10.1016/j.neurobiolaging.2014.07.009
Caviness J, Utianski R, Hentz J et al (2016) Differential spectral quantitative electroencephalography pattern between control and Parkinson’s disease cohorts. Eur J Neurol 23:387–392. https://doi.org/10.1111/ene.12878
Dauwan M, Van der Zande J, Dellen E et al (2016) Random forest to differentiate dementia with Lewy bodies from Alzheimer’s disease. Alzheimer’s Dement Diagn Assess Dis Monit 4:99–106. https://doi.org/10.1016/j.dadm.2016.07.003
Colloby S, Cromarty R, Peraza L et al (2016) Multimodal EEG-MRI in the differential diagnosis of Alzheimer’s disease and dementia with Lewy bodies. J Psychiatr Res 78:48–55. https://doi.org/10.1016/j.jpsychires.2016.03.010
Bonanni L, Franciotti R, Nobili F et al (2016) EEG Markers of dementia with Lewy Bodies: a multicenter cohort study. Journal of Alzheimer’s Disease 54:1649–1657. https://doi.org/10.3233/JAD-160435
Ferreira D, Jelic V, Cavallin L et al (2016) Electroencephalography is a good complement to currently established dementia biomarkers. Dement Geriatr Cogn Disord 42:80–92. https://doi.org/10.1159/000448394
Garn H, Coronel C, Waser M et al (2017) Differential diagnosis between patients with probable Alzheimer’s disease, Parkinson’s disease dementia, or dementia with Lewy bodies and frontotemporal dementia, behavioral variant, using quantitative electroencephalographic features. J Neural Transm 124:569–581. https://doi.org/10.1007/s00702-017-1699-6
Babiloni C, Del Percio C, Lizio R et al (2018) Abnormalities of cortical neural synchronization mechanisms in patients with dementia due to Alzheimer’s and Lewy body diseases: an EEG study. Neurobiol Aging 55:143–158. https://doi.org/10.1016/j.neurobiolaging.2017.03.030
Peraza L, Cromarty L, Kobeleva X et al (2018) Electroencephalographic derived network differences in Lewy body dementia compared to Alzheimer’s disease patients. Sci Rep 8:4637. https://doi.org/10.1038/s41598-018-22984-5
Stylianou M, Murphy N, Peraza L et al (2018) Quantitative electroencephalography as a marker of cognitive fluctuations in dementia with Lewy bodies and an aid to differential diagnosis. Clin Neurophysiol 129:1209–1220. https://doi.org/10.1016/j.clinph.2018.03.013
Gibb WR, Luthert PJ, Janota I et al (1989) Cortical Lewy body dementia: clinical features and classification. J Neurol Neurosurg Psychiatry 52:185–192. https://doi.org/10.1136/jnnp.52.2.185
Yamamoto T, Imai T (1988) A case of diffuse Lewy body and Alzheimer’s diseases with periodic synchronous discharges. J Neuropathol Exp Neurology 47:536–548. https://doi.org/10.1097/00005072-198809000-00005
Byrne EJ, Lennox G, Lowe J et al (1989) Diffuse Lewy body disease: clinical features in 15 cases. J Neurol Neurosurg Psychiatry 52:709–717. https://doi.org/10.1136/jnnp.52.6.709
Hely MA, Reid WGJ, Halliday GM et al (1996) Diffuse Lewy body disease: clinical features in nine cases without coexistent AD. J Neurol Neurosurg Psychiatry 60:531–538. https://doi.org/10.1136/jnnp.60.5.531
Walker MP, Ayre GA, Cummings JL et al (2000) The clinician assessment of fluctuation and the one day fluctuation assessment scale. Two methods to assess fluctuating confusion in dementia. Br J Psychiatry 177:252–256. https://doi.org/10.1192/bjp.177.3.252
Douw L, Schoonheim MM, Landi D, et al (2011) Cognition is related to resting-state small-world network topology: an magnetoencephalographic study. Neuroscience 175:169–177. https://doi.org/10.1016/j.neuroscience.2010.11.039
Franciotti R, Falasca NW, Bonanni L et al (2013) Default network is not hypoactive in dementia with fluctuating cognition: an Alzheimer disease/dementia with Lewy bodies comparison. Neurobiol Aging 34:1148–1158. https://doi.org/10.1016/j.neurobiolaging.2012.09.015
Kenny ER, Blamire AM, Firbank MJ et al (2012) Functional connectivity in cortical regions in dementia with Lewy bodies and Alzheimer’s disease. Brain 135:569–581. https://doi.org/10.1093/brain/awr327
Breiman L (2009) Random forest. Mach Learn 45:1–35. https://doi.org/10.1023/A:1010933404324
Karnaze DS, MarshallBickford LFRRG (1982) EEG monitoring of clinical coma: the compressed spectral array. Neurology 32:289–292. https://doi.org/10.1212/wnl.32.3.289
Johnsen K, Johannesson G, Emilsdottir Á, et al (2009) MentisCura diagnostic tool for dementia. https://www.mentiscura.com
Kurita A, Murakami M, Takagi S et al (2010) Visual hallucinations and altered visual information processing in Parkinson disease and dementia with Lewy bodies. Mov Disord 25:167–171. https://doi.org/10.1002/mds.22919
Perriol MP, Dujardin K, Derambure P et al (2005) Disturbance of sensory filtering in dementia with Lewy bodies: comparison with Parkinson’s disease dementia and Alzheimer’s disease. J Neurol Neurosurg Psychiatry 76:106–108. https://doi.org/10.1136/jnnp.2003.035022
Bosboom JL, Stoffers D, Stam CJ et al (2009) Cholinergic modulation of MEG resting-state oscillatory activity in Parkinson’s disease related dementia. Clin Neurophysiol 120:910–915. https://doi.org/10.1016/j.clinph.2009.03.004
Franciotti R, Iacono D, Penna SD et al (2006) Cortical rhythms reactivity in AD, LBD and normal subjects: a quantitative MEG study. Neurobiol Aging 27:1100–1109. https://doi.org/10.1016/j.neurobiolaging.2005.05.027
Di Lazzaro V, Pilato F, Dileone M et al (2007) Functional evaluation of cerebral cortex in dementia with Lewy bodies. Neuroimage 37:422–429. https://doi.org/10.1016/j.neuroimage.2007.05.003
Celebi O, Temucin CM, Elibol B et al (2012) Short latency afferent inhibition in Parkinson’s disease patients with dementia. Mov Disord 27:1052–1055. https://doi.org/10.1016/j.neuroimage.2007.05.003
Funding
This work received no financial support from third parties.
Author information
Authors and Affiliations
Contributions
Study concept and design: SC and IM. Acquisition of data: IM. Analysis and interpretation of data: SC, JM, EK, DK. Preparation of manuscript: SC and JM. Revision of manuscript: EK, DK and FP.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interest to disclosure.
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any authors.
Informed consent
For this type of study, formal consent is not required.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Chatzikonstantinou, S., McKenna, J., Karantali, E. et al. Electroencephalogram in dementia with Lewy bodies: a systematic review. Aging Clin Exp Res 33, 1197–1208 (2021). https://doi.org/10.1007/s40520-020-01576-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40520-020-01576-2