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BMC Neurology

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Open Access 01-12-2023 | Frontotemporal Dementia | Research

Electroencephalography in young onset dementia

Authors: Casey W Brown, Huei-Yang Chen, Peter K Panegyres

Published in: BMC Neurology | Issue 1/2023

Abstract

Background

Young onset dementia (YOD) is a major diagnostic and management problem.

Methods

We set out to explore if electroencephalography (EEG) might be useful in the diagnosis of young onset Alzheimer’s disease (YOAD) and young onset frontotemporal dementia (YOFTD). The ARTEMIS project is a 25-year prospective study of YOD based in Perth, Western Australia. 231 participants were included: YOAD: n = 103, YOFTD: n = 28, controls: n = 100. EEGs were performed prospectively, with 30-minute recording time for each subject, without knowledge of diagnosis or other diagnostic data.

Results

80.9% of patients with YOD had abnormal EEGs (P < 0.00001). Slow wave changes were more frequent in YOAD that YOFTD (P < 0.00001), but no difference in the frequency of epileptiform activity (P = 0.32), with 38.8% of YOAD and 28.6% of YOFTD patients having epileptiform activity. Slow wave changes were more generalized in YOAD (P = 0.001). Slow wave changes and epileptiform activity were not sensitive to the diagnosis of YOD, but highly specific (97–99%). The absence of slow wave changes and epileptiform activity had a 100% negative predictive value and likelihood radio 0.14 and 0.62 respectively, meaning that those without slow wave changes or epileptiform activity had low probability of having YOD. No relationship was established between EEG findings and the patient’s presenting problem. Eleven patients with YOAD developed seizures during the study, and only one with YOFTD.

Conclusions

The EEG is highly specific for the diagnosis of YOD with the absence of slow wave changes and epileptiform phenomena making the diagnosis unlikely, with 100% negative predictive value and with low probability for the dementia diagnosis.

Cunningham EL, McGuinness B, Herron B, Passmore AP. Dementia. Ulster Med J. 2015;84:79–87.

Panegyres PK, Frencham K. The course and causes of suspected dementia in young adults: a longitudinal study. Am J Alzheimers Dis Other Demen. 2007;22:48–56. https://doi.org/10.1177/1533317506295887CrossRefPubMed

Panegyres PK, Davis S, Connor C. Early onset dementia. Med J Aust. 2000;173:279–80. https://doi.org/10.5694/j.1326-5377.2000.tb125651.xCrossRefPubMed

Loi SM, Cations M, Velakoulis D. Young-onset dementia diagnosis, management and care: a narrative review. Med J Aust. 2023;218:182–9. https://doi.org/10.5694/mja2.51849CrossRefPubMed

Kuruppu DK, Matthews BR. Young-onset dementia. Semin Neurol. 2013;33:365–85. https://doi.org/10.1055/s-0033-1359320CrossRefPubMedPubMedCentral

Sampson EL, Warren JD, Rossor MN. Young onset dementia. Postgrad Med J. 2004;80(941):125–39. https://doi.org/10.1136/pgmj.2003.011171CrossRefPubMedPubMedCentral

NHS Health Advisory Service. Heading for better care commissioning and providing mental health services for people with Huntington’s disease acquired brain injury and early onset dementia; mental health services. London: HMSO; 1997.

Rossor MN, Fox NC, Mummery CJ, Schott JM, Warren JD. The diagnosis of young-onset dementia. Lancet Neurol. 2010;9:793–806. https://doi.org/10.1016/S1474-4422(10)70159-9CrossRefPubMedPubMedCentral

Sutton AL. Alzheimer disease sourcebook. 5th ed. Detroit: Peter E. Ruffner; 2011.

10.

Dauwels J, Vialatte FB, Cichocki A. On the early diagnosis of Alzheimer’s disease from EEG signals: a mini-review. Adv Cogn Neurodyn 2011;(II):709–16. https://doi.org/10.1007/978-90-481-9695-1_106

11.

Babiloni C, Ferri R, Binetti G, et al. Directionality of EEG synchronization in Alzheimer’s disease subjects. Neurobiol Aging. 2009;30:93–102. https://doi.org/10.1016/j.neurobiolaging.2007.05.007CrossRefPubMed

12.

Henderson G, Ifeachor E, Hudson N, et al. Development and assessment of methods for detecting dementia using the human electroencephalogram. IEEE Trans Biomed Eng. 2006;53:1557–68. https://doi.org/10.1109/TBME.2006.878067CrossRefPubMed

13.

Jeong J. EEG dynamics in patients with Alzheimer’s disease. Clin Neurophysiol. 2004;115:1490–505. https://doi.org/10.1016/j.clinph.2004. 01.001.CrossRefPubMed

14.

De Waal H, Stam CJ, Blankenstein MA, Pijnenburg YA, Scheltens P, van der Flier WM. EEG abnormalities in early and late onset Alzheimer’s disease: understanding heterogeneity. J Neurol Neurosurg Psychiatry. 2011;82:67–71. https://doi.org/10.1136/jnnp.2010.216432CrossRefPubMed

15.

Edwards-Lee T, Cook I, Fairbanks L, Leuchter A, Cummings J. Quantitative electroencephalographic correlates of psychosis in Alzheimer disease. Neuropsychiatry Neuropsychol Behav Neurol. 2000;13:163–70.PubMed

16.

Lopez OL, Becker JT, Brenner RP, Rosen J, Bajulaiye O, Reynolds C. Alzheimer’s disease with delusions and hallucinations: neuropsychological and electroencephalographic correlates. Neurology. 1991;41:906–12. https://doi.org/10.1212/wnl.41.6.906CrossRefPubMed

17.

Hamilton CA, Schumacher J, Matthews F, et al. Slowing on quantitative EEG is associated with transition to dementia in mild cognitive impairment. Int Psychogeriatr. 2021;33:1321–5. https://doi.org/10.1017/S1041610221001083CrossRefPubMed

18.

Lam AD, Sarkis RA, Pellerin KR, et al. Association of epileptiform abnormalities and seizures in Alzheimer disease. Neurology. 2020;95:e2259–70. https://doi.org/10.1212/WNL.0000000000010612CrossRefPubMedPubMedCentral

19.

Vossel KA, Ranasinghe KG, Beagle AJ, et al. Incidence and impact of subclinical epileptiform activity in Alzheimer’s disease. Ann Neurol. 2016;80:858–70. https://doi.org/10.1002/ana.24794CrossRefPubMedPubMedCentral

20.

Palop JJ, Chin J, Roberson ED, et al. Aberrant excitatory neuronal activity and compensatory remodeling of inhibitory hippocampal circuits in mouse models of Alzheimer’s disease. Neuron. 2007;55:697–711. https://doi.org/10.1016/j.neuron.2007.07.025CrossRefPubMedPubMedCentral

21.

Signorino M, Pucci E, Belardinelli N, Nolfe G, Angeleri F. EEG spectral analysis in vascular and Alzheimer dementia. Electroencephalogr Clin Neurophysiol. 1995;94:313–25. https://doi.org/10.1016/0013-4694(94)00290-2CrossRefPubMed

22.

Brunovsky M, Matousek M, Edman A, Cervena K, Krajca V. Objective assessment of the degree of dementia by means of EEG. Neuropsychobiology. 2003;48:19–26. https://doi.org/10.1159/000071824CrossRefPubMed

23.

Terranova R, Luca S, Marletta F, Marletta C. Spectral analysis of EEG signals in Alzheimer’s disease. Minerva Med. 1999;90:413–20.PubMed

24.

Gordon EB, Sim M. The E.E.G. in presenile dementia. J Neurol Neurosurg Psychiatry. 1967;30:285–91. https://doi.org/10.1136/jnnp.30.3.285CrossRefPubMedPubMedCentral

25.

Micanovic C, Pal S. The diagnostic utility of EEG in early-onset dementia: a systematic review of the literature with narrative analysis. J Neural Transm (Vienna). 2014;121:59–69. https://doi.org/10.1007/s00702-013-1070-5CrossRefPubMed

26.

van der Zande JJ, Gouw AA, van Steenoven I, Scheltens P, Stam CJ, Lemstra AW. EEG characteristics of dementia with Lewy bodies, Alzheimer’s disease and mixed pathology. Front Aging Neurosci. 2018;10:190. https://doi.org/10.3389/fnagi.2018.00190CrossRefPubMedPubMedCentral

27.

Schreiter-Gasser U, Gasser T, Ziegler P. Quantitative EEG analysis in early onset Alzheimer’s disease: correlations with severity, clinical characteristics, visual EEG and CCT. Electroencephalogr Clin Neurophysiol. 1994;90:267–72. https://doi.org/10.1016/0013-4694(94)90144-9CrossRefPubMed

28.

Lin N, Gao J, Mao C, Sun H, Lu Q, Cui L. Differences in multimodal electroencephalogram and clinical correlations between early-onset Alzheimer’s disease and frontotemporal dementia. Front Neurosci. 2021;15:687053. https://doi.org/10.3389/fnins.2021.687053CrossRefPubMedPubMedCentral

29.

Chan D, Walters R, Sampson E, Schott J, Smith S, Rossor M. EEG abnormalities in frontotemporal lobar degeneration. Neurology. 2004;62:1628–30. https://doi.org/10.1212/01.wnl.0000123103.89419.b7CrossRefPubMed

30.

Pijnenburg YA, Strijers RL, vd Made Y, van der Flier WM, Scheltens P, Stam CJ. Investigation of resting-state EEG functional connectivity in frontotemporal lobar degeneration. Clin Neurophysiol. 2008;119:1732–8. https://doi.org/10.1016/j.clinph.2008.02.024CrossRefPubMed

31.

Cretin B, Philippi N, Dibitonto L, Blanc F. Epilepsy at the prodromal stages of neurodegenerative diseases. Geriatr Psychol Neuropsychiatr Vieil. 2017;15:75–82. https://doi.org/10.1684/pnv.2017.0652CrossRefPubMed

32.

Vossel KA, Beagle AJ, Rabinovici GD, et al. Seizures and epileptiform activity in the early stages of Alzheimer disease. JAMA Neurol. 2013;70:1158–66. https://doi.org/10.1001/jamaneurol.2013.136CrossRefPubMedPubMedCentral

33.

Amatniek JC, Hauser WA, DelCastillo-Castaneda C, et al. Incidence and predictors of seizures in patients with Alzheimer’s disease. Epilepsia. 2006;47:867–72. https://doi.org/10.1111/j.1528-1167.2006.00554.xCrossRefPubMed

34.

American Psychiatric Association. Diagnostic and statistical Manual of Mental Disorders. 5th ed. San Francisco: DSM-5); 2013.CrossRef

35.

Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–86.CrossRefPubMed

36.

Barberger-Gateau P, Commenges D, Gagnon M, Letenneur L, Sauvel C, Dartigues JF. Instrumental activities of daily living as a screening tool for cognitive impairment and dementia in elderly community dwellers. J Am Geriatr Soc. 1992;40:1129–34. https://doi.org/10.1111/j.1532-5415.1992.tb01802.xCrossRefPubMed

37.

McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. 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. 1984;34:939–44. https://doi.org/10.1212/wnl.34.7.939CrossRefPubMed

38.

Dubois B, Feldman HH, Jacova C, et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS–ADRDA criteria. Lancet Neurol. 2007;6:734–46. https://doi.org/10.1016/S1474-4422(07)70178-3CrossRefPubMed

39.

McKhann GM, Albert MS, Grossman M, Miller B, Dickson D, Trojanowski JQ. Clinical and pathological diagnosis of frontotemporal dementia: report of the Work Group on Frontotemporal Dementia and pick’s Disease. Archives Neurol. 2001;58:1803–9. https://doi.org/10.1001/archneur.58.11.1803CrossRef

40.

Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology. 1998;51:1546–54. https://doi.org/10.1212/wnl.51.6.1546CrossRefPubMed

41.

Rascovsky K, Hodges JR, Kipps CM, et al. Diagnostic criteria for the behavioral variant of frontotemporal dementia (bvFTD): current limitations and future directions. Alzheimer Dis Assoc Disord. 2007;21:14–S8. https://doi.org/10.1097/WAD.0b013e31815c3445CrossRef

42.

Yamada M, Komatsu J, Nakamura K, Sakai K, Samuraki-Yokohama M, Nakajima K, Yoshita M. Diagnostic criteria for dementia with Lewy bodies: updates and future directions. J Mov Disord. 2020;13:1–10. https://doi.org/10.14802/jmd.19052CrossRefPubMed

43.

McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. Diagnosis and management of dementia with Lewy bodies: fourth consensus report of the DLB Consortium. Neurology. 2017;89:88–100. https://doi.org/10.1212/WNL.0000000000004058CrossRefPubMedPubMedCentral

44.

Sachdev P, Kalaria R, O’Brien J, Skoog I, Alladi S, Black SE, et al. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement. Alzheimer Dis Assoc Disord. 2014;28:206–18. https://doi.org/10.1097/WADCrossRefPubMedPubMedCentral

45.

Román GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, Amaducci L, Orgogozo JM, Brun A, Hofman A, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993;43:250–60. https://doi.org/10.1212/wnl.43.2.250CrossRefPubMed

46.

Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987;149:351–6. https://doi.org/10.2214/ajr.149.2.351CrossRefPubMed

47.

Blume WT, Kaibara M. Atlas of adult electroencephalography. New York: Raven Press Ltd; 1995.

48.

NCBI Bookshelf. StatPearls. StatPearls. Publishing LLC, Treasure Island FL; 2022.

49.

Hendricks S, Peetoom K, Bakker C, et al. Global prevalence of young onset dementia: a systematic review and meta-analysis. JAMA Neurol. 2021;78:1080–90. https://doi.org/10.1001/jamaneurol.2021.2161CrossRef

50.

Panegyres PK. The clinical spectrum of young onset dementia points to its stochastic origins. J Alzheimer’s Dis Reps. 2021;5:663–79.CrossRef

51.

Hsiao FJ, Wang YJ, Yan SH, Chen WT, Lin YY. Altered oscillation and synchronization of default-mode network activity in mild Alzheimer’s disease compared to mild cognitive impairment: an electrophysiological study. PLoS ONE. 2013;8(7):e68792. https://doi.org/10.1371/journal.pone.0068792CrossRefPubMedPubMedCentral

52.

Rae-Grant A, Blume W, Lau C, Hachinski VC, Fisman M, Merskey H. The electroencephalogram in Alzheimer-type dementia: a sequential study correlating the electroencephalogram with psychometric and quantitative pathologic data. Archives of Neurol. 1987;44:50–4.CrossRef

53.

Brenner RP, Reynolds CF, Ulrich RF. Diagnostic efficacy of computerized spectral versus visual EEG analysis in elderly normal, demented and depressed subjects. Sci Direct. 1988;69:110–7. https://doi.org/10.1016/0013-4694(88)90206-4CrossRef

54.

Czigler B, Csikós D, Hidasi Z, Anna Gaál Z, Csibri E, Kiss E, Salacz P, Molnár M. Quantitative EEG in early Alzheimer’s disease patients - power spectrum and complexity features. Int J Psychophysiol. 2008;68:75–80. https://doi.org/10.1016/j.ijpsycho.2007.11.002CrossRefPubMed

55.

Iqbal K, Liu F, Gong C-X, Grundke-Iqbal I. Tau in Alzheimer disease and related tauopathies. Curr Alzheimer Res. 2010;7:656–64. https://doi.org/10.2174/156720510793611592CrossRefPubMedPubMedCentral

56.

Rademakers R, Cruts M, Van Broeckhoven C. The role of tau (MAPT) in frontotemporal dementia and related tauopathies. Hum Mutat. 2004;24:277–95. https://doi.org/10.1002/humu.20086CrossRefPubMed

57.

Putra M, Puttachary S, Liu G, Lee G, Thippeswamy T. Fyn-tau ablation modifies PTZ-induced seizures and post-seizure hallmarks of early epileptogenesis. Front Cell Neurosci. 2020;14:592374. https://doi.org/10.3389/fncel.2020.592374CrossRefPubMedPubMedCentral

58.

Zheng P, Shultz S, Hovens C, O’Brien TJ. Animal models of acquired epilepsy and tauopathies. In Pitkanen A, Buckmaster PS, Galanopoulos AS, Moshe SL (eds) Models of Seizures and Epilepsy. Academic Press, 2017, pp. 1031–41.

59.

Okubo Y, Matsuura M, Asai T, et al. Epileptiform EEG discharges in healthy children: prevalence, emotional and behavioral correlates, and genetic influences. Epilepsia. 1994;35:832–41. https://doi.org/10.1111/j.1528-1157.1994.tb02520.xCrossRefPubMed

60.

Trenité DGK-N, Vermeiren R. The impact of subclinical epileptiform discharges on complex tasks and cognition: relevance for aircrew and air traffic controllers. Epilepsy Behav. 2005;6:31–4. https://doi.org/10.1016/j.yebeh.2004.10.005CrossRef

61.

Karantzoulis S, Galvin JE. Distinguishing Alzheimer’s disease from other major forms of dementia. Expert Rev Neurother. 2011;11:1579–91. https://doi.org/10.1586/ern.11.155CrossRefPubMedPubMedCentral

62.

Maloney EM, Chaila E, O’Reilly ÉJ, Costello DJ. Incidence of first seizures, epilepsy, and seizure mimics in a geographically defined area. Neurology. 2020;95:e576–90. https://doi.org/10.1212/WNL.0000000000009980CrossRefPubMed

63.

Hesdorffer D, Hauser W, Annegers J, Kokmen E, Rocca W. Dementia and adult-onset unprovoked seizures. Neurology. 1996;46:727–30. https://doi.org/10.1212/wnl.46.3.727CrossRefPubMed

64.

Cook M, Baker N, Lanes S, Bullock R, Wentworth C, Arrighi HM. Incidence of stroke and seizure in Alzheimer’s disease dementia. Age Ageing. 2015;44:695–9. https://doi.org/10.1093/ageing/afv061CrossRefPubMed

65.

Bateman RJ, Xiong C, Benzinger TL, et al. Clinical and biomarker changes in dominantly inherited Alzheimer’s disease. N Engl J Med. 2012;367:795–804. https://doi.org/10.1056/NEJMoa1202753CrossRefPubMedPubMedCentral

66.

Hof P, Giannakopoulos P, Bouras C. The neuropathological changes associated with normal brain aging. Histol Histopathol. 1996;11:1075–88.PubMed

67.

Johnson EL, Krauss GL, Lee AK, Schneider ALC, Dearborn JL, Kucharska-Newton AM, et al. Association between midlife risk factors and late-onset epilepsy: results from the atherosclerosis risk in communities study. JAMA Neurol. 2018;75:1375–82. https://doi.org/10.1001/jamaneurol.2018.1935CrossRefPubMedPubMedCentral

Title: Electroencephalography in young onset dementia
Authors: Casey W Brown
Huei-Yang Chen
Peter K Panegyres
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Frontotemporal Dementia
Frontotemporal Dementia
Alzheimer's Disease
Dementia
Electroencephalography
Alzheimer's Disease
Dementia
Published in: BMC Neurology / Issue 1/2023
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-023-03248-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Electroencephalography in young onset dementia

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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