Radić Borislav, Petrović Ratimir, Golubić Anja, Bilić Ervina, Borovečki Fran
Department of Neurology, University Hospital Center Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia,
Psychiatr Danub. 2019 Mar;31(1):111-115. doi: 10.24869/psyd.2019.111.
Alzheimer's disease (AD) and vascular dementia (VaD) represent a leading public-health problem given the rising age of the population. Early diagnosis of dementia, especially at the stage of mild cognitive impairment (MCI) has become an important goal of the modern patient work-up. Brain perfusion single-photon emission computed tomography (SPECT) has become a mainstay of diagnostic algorithms in patients with dementia showing specific patterns of hypoperfusion in temporal and parietal lobes. Clinical electroencephalography (EEG) is a relatively simple and inexpensive diagnostic tool showing potential in assessing cortical thinning and lower perfusion in temporoparoetal regions.
Our study was a cross sectional and included retrospective analysis of the group of patients diagnosed with AD, VaD and MCI. The study group consisted of 50 patients - 29 females and 21 males. All patients underwent EEG and SPECT analysis as part of regular work-up.
Patients with AD exhibit EEG changes mostly in the form of theta waves, focal abnormalities and spike-and-wave complexes in frontotemporal regions with the reduction in the amplitude of alpha waves. SPECT in most patients exhibited hypoperfusion in temporoparietal regions with occasional unilateral abnormalities in frontotemporal region. EEG changes in patients with VaD are predominantly in the form of theta waves while SPECT findings show mostly "patchy" abnormalities. EEG readings are normal or exhibit minimal changes in the group of patients with MCI, while SPECT imaging exhibits mostly normal CBF.
EEG and SPECT are diagnostic methods which show specific changes, especially in AD. EEG can be used to monitor the therapeutic effect and progression of AD as well as the possible transition from MCI to early stage AD. SPECT on the other hand, being a more expensive and less available method, can be utilized as an add-on method to increase the specificity and sensitivity of the diagnostic algorithm.
鉴于人口老龄化，阿尔茨海默病（AD）和血管性痴呆（VaD）成为一个主要的公共卫生问题。痴呆症的早期诊断，尤其是在轻度认知障碍（MCI）阶段，已成为现代患者检查的一个重要目标。脑灌注单光子发射计算机断层扫描（SPECT）已成为痴呆症患者诊断算法的主要手段，显示出颞叶和顶叶特定的灌注不足模式。临床脑电图（EEG）是一种相对简单且廉价的诊断工具，在评估颞顶叶区域的皮质变薄和灌注降低方面显示出潜力。
我们的研究是一项横断面研究，包括对诊断为AD、VaD和MCI的患者组进行回顾性分析。研究组由50名患者组成，其中29名女性和21名男性。所有患者作为常规检查的一部分接受了EEG和SPECT分析。
AD患者的EEG变化主要表现为θ波、局灶性异常以及额颞区的棘波和慢波复合波，同时α波振幅降低。大多数AD患者的SPECT显示颞顶叶区域灌注不足，额颞区偶尔出现单侧异常。VaD患者的EEG变化主要为θ波形式，而SPECT结果大多显示“斑片状”异常。MCI患者组的EEG读数正常或仅有微小变化，而SPECT成像大多显示脑血流（CBF）正常。
EEG和SPECT是显示特定变化的诊断方法，尤其是在AD中。EEG可用于监测AD的治疗效果和进展以及MCI向AD早期阶段的可能转变。另一方面，SPECT作为一种更昂贵且可用性较低的方法，可作为一种辅助方法来提高诊断算法的特异性和敏感性。
