Leuchter A F, Spar J E, Walter D O, Weiner H
Department of Psychiatry and Behavioral Sciences, UCLA.
Arch Gen Psychiatry. 1987 Nov;44(11):993-8. doi: 10.1001/archpsyc.1987.01800230073012.
The accurate diagnosis of dementia is difficult because there are no specific physiologic tests. Computer-analyzed electroencephalography (EEG) has shown promise as a tool for the differential diagnosis of dementia, but topographic methods for data collection and analysis have seldom been used. We used these methods to investigate EEG differences among three groups of elderly subjects: those with mild to moderate dementia of the Alzheimer's type (DAT), those with mild to moderate multi-infarct dementia (MID), and age- and sex-matched normal controls. The two groups of demented subjects were distinguished from the control group by a new criterion, the ratio of high-frequency to low-frequency electrical activity in the left temporal region, which was greatly diminished in demented subjects. Using this single variable, all control subjects and 15 of 18 demented subjects were correctly classified (sensitivity 83%, specificity 100%). The three misclassified subjects were among the least impaired subjects with DAT. Examination of coherence, or synchronization of the EEG signal, enabled us to distinguish subjects with DAT from those with MID. Using discriminant analysis of both EEG frequency and coherence, 92% (22/24) of subjects were accurately classified. These results justify further evaluation of topographic, computer-based EEG analysis as a test for the differential diagnosis of dementia.
由于没有特定的生理测试,痴呆症的准确诊断很困难。计算机分析脑电图(EEG)已显示出有望成为痴呆症鉴别诊断的工具,但很少使用地形学方法进行数据收集和分析。我们使用这些方法研究了三组老年受试者的脑电图差异:患有轻度至中度阿尔茨海默病型痴呆(DAT)的受试者、患有轻度至中度多发梗死性痴呆(MID)的受试者以及年龄和性别匹配的正常对照组。两组痴呆受试者与对照组的区别在于一个新的标准,即左颞区高频与低频电活动的比率,痴呆受试者的该比率大大降低。使用这个单一变量,所有对照组受试者和18名痴呆受试者中的15名被正确分类(敏感性83%,特异性100%)。三名分类错误的受试者是DAT受损最轻的受试者。对脑电图信号的相干性或同步性进行检查,使我们能够区分患有DAT的受试者和患有MID的受试者。使用脑电图频率和相干性的判别分析,92%(22/24)的受试者被准确分类。这些结果证明对基于计算机的地形学脑电图分析作为痴呆症鉴别诊断测试进行进一步评估是合理的。