RESUMO
BACKGROUND AND OBJECTIVE: Eyes-closed-awake electroencephalogram (EEG) is a useful tool in the diagnosis of Alzheimer's. However, there is eyes-closed-awake EEG with dominant or rare alpha rhythm. In this paper, we show that random selection of EEG epochs disregarding the alpha rhythm will lead to bias concerning EEG-based Alzheimer's Disease diagnosis. METHODS: We compared EEG epochs with more than 30% and with less than 30% alpha rhythm of mild Alzheimer's Disease patients and healthy elderly. We classified epochs as dominant alpha scenario and rare alpha scenario according to alpha rhythm (8-13 Hz) percentage in O1, O2 and Oz channels. Accordingly, we divided the probands into four groups: 17 dominant alpha scenario controls, 15 mild Alzheimer's patients with dominant alpha scenario epochs, 12 rare alpha scenario healthy elderly and 15 mild Alzheimer's Disease patients with rare alpha scenario epochs. We looked for group differences using one-way ANOVA tests followed by post-hoc multiple comparisons (p < 0.05) over normalized energy values (%) on the other four well-known frequency bands (delta, theta, beta and gamma) using two different electrode configurations (parieto-occipital and central). RESULTS: After carrying out post-hoc multiple comparisons, for both electrode configurations we found significant differences between mild Alzheimer's patients and healthy elderly on beta- and theta-energy (%) only for the rare alpha scenario. No differences were found for the dominant alpha scenario in any of the five frequency bands. CONCLUSIONS: This is the first study of Alzheimer's awake-EEG reporting the influence of alpha rhythm on epoch selection, where our results revealed that, contrarily to what was most likely expected, less synchronized EEG epochs (rare alpha scenario) better discriminated mild Alzheimer's than those presenting abundant alpha (dominant alpha scenario). In addition, we find out that epoch selection is a very sensitive issue in qEEG research. Consequently, for Alzheimer's studies dealing with resting state EEG, we propose that epoch selection strategies should always be cautiously designed and thoroughly explained.
Assuntos
Ritmo alfa , Doença de Alzheimer/fisiopatologia , Eletroencefalografia/métodos , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: We evaluated quantitative EEG measures to determine a screening index to discriminate Alzheimer's disease (AD) patients from normal individuals. METHODS: Two groups of individuals older than 50 years, comprising a control group of 57 normal volunteers and a study group of 50 patients with probable AD, were compared. EEG recordings were obtained from subjects in a wake state with eyes closed at rest for 30 min. Logistic regression analysis was conducted. RESULTS: Spectral potentials of the alpha and theta bands were computed for all electrodes and the alpha/theta ratio calculated. Logistic regression of alpha/theta of the mean potential of the C3 and O1 electrodes was carried out. A formula was calculated to aid the diagnosis of AD yielding 76.4% sensitivity and 84.6% specificity for AD with an area under the ROC curve of 0.92. CONCLUSION: Logistic regression of alpha/theta of the spectrum of the mean potential of EEG represents a good marker discriminating AD patients from normal controls.
RESUMO
Changes in electroencephalography (EEG) amplitude modulations have recently been linked with early-stage Alzheimer's disease (AD). Existing tools available to perform such analysis (e.g., detrended fluctuation analysis), however, provide limited gains in discriminability power over traditional spectral based EEG analysis. In this paper, we explore the use of an innovative EEG amplitude modulation analysis technique based on spectro-temporal signal processing. More specifically, full-band EEG signals are first decomposed into the five well-known frequency bands and the envelopes are then extracted via a Hilbert transform. Each of the five envelopes are further decomposed into four so-called modulation bands, which were chosen to coincide with the delta, theta, alpha and beta frequency bands. Experiments on a resting-awake EEG dataset collected from 76 participants (27 healthy controls, 27 diagnosed with mild-AD, and 22 with moderate-AD) showed significant differences in amplitude modulations between the three groups. Most notably, i) delta modulation of the beta frequency band disappeared with an increase in disease severity (from mild to moderate AD), ii) delta modulation of the theta band appeared with an increase in severity, and iii) delta modulation of the beta frequency band showed to be a reliable discriminant feature between healthy controls and mild-AD patients. Taken together, it is hoped that the developed tool can be used to assist clinicians not only with early detection of Alzheimer's disease, but also to monitor its progression.
Assuntos
Doença de Alzheimer/fisiopatologia , Encéfalo/fisiopatologia , Doença de Alzheimer/patologia , Ondas Encefálicas , Estudos de Casos e Controles , Eletroencefalografia , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , VigíliaRESUMO
There is not a specific test to diagnose Alzheimer's disease (AD). Its diagnosis should be based upon clinical history, neuropsychological and laboratory tests, neuroimaging and electroencephalography (EEG). Therefore, new approaches are necessary to enable earlier and more accurate diagnosis and to follow treatment results. In this study we used a Machine Learning (ML) technique, named Support Vector Machine (SVM), to search patterns in EEG epochs to differentiate AD patients from controls. As a result, we developed a quantitative EEG (qEEG) processing method for automatic differentiation of patients with AD from normal individuals, as a complement to the diagnosis of probable dementia. We studied EEGs from 19 normal subjects (14 females/5 males, mean age 71.6 years) and 16 probable mild to moderate symptoms AD patients (14 females/2 males, mean age 73.4 years. The results obtained from analysis of EEG epochs were accuracy 79.9% and sensitivity 83.2%. The analysis considering the diagnosis of each individual patient reached 87.0% accuracy and 91.7% sensitivity.