AIMS, Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.
J Alzheimers Dis. 2022;90(4):1739-1747. doi: 10.3233/JAD-220693.
Distinguishing between Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD) results in poor diagnostic accuracy.
To investigate the utility of electroencephalography (EEG)-based biomarkers in comparison and in addition to established cerebrospinal fluid (CSF) biomarkers in the AD versus FTLD differential diagnosis.
The study cohort comprised 37 AD and 30 FTLD patients, of which 17 AD and 9 FTLD patients had definite diagnoses. All participants had CSF neurochemical (NCM) biomarker analyses (Aβ1-42, T-tau, P-tau181, and Nf-L) and underwent 19-channel resting-state EEG. From the EEG spectra, dominant frequency peaks were extracted in four regions resulting in four dominant frequencies. This produced eight features (4 NCM + 4 EEG).
When NCM and EEG markers were combined, the diagnostic accuracy increased significantly. In the whole group, the accuracy went up from 79% (NCM) to almost 82%, while in the definite group only, it went up from around 85% to almost 95%. Two differences in the occurrence of the dominant EEG frequency were discovered: people lacking a clear dominant peak almost all had definite AD, while people with two peaks more often had FTLD.
Combining EEG with NCM biomarkers resulted in differential diagnostic accuracies of 82% in clinically diagnosed AD and FTD patients and of 95% in patients having a definite diagnosis, which was significantly better than with EEG or NCM biomarkers alone. This suggests that NCM and EEG markers are complementary, revealing different aspects of the disease and therefore confirms again their relevance in developing additional diagnosis tools.
阿尔茨海默病（AD）和额颞叶变性（FTLD）的鉴别诊断准确率较差。
研究基于脑电图（EEG）的生物标志物在 AD 与 FTLD 鉴别诊断中的应用价值，并与已建立的脑脊液（CSF）生物标志物进行比较。
研究队列包括 37 例 AD 患者和 30 例 FTLD 患者，其中 17 例 AD 和 9 例 FTLD 患者有明确诊断。所有参与者均进行了 CSF 神经化学标志物分析（Aβ1-42、T-tau、P-tau181 和 Nf-L）和 19 通道静息状态 EEG。从 EEG 频谱中提取四个区域的主导频率峰值，得到四个主导频率。这产生了 8 个特征（4 个 CSF 标志物+4 个 EEG 标志物）。
当 CSF 标志物和 EEG 标志物联合使用时，诊断准确率显著提高。在整个组中，准确率从 79%（CSF）提高到近 82%，而在明确诊断组中，准确率从约 85%提高到近 95%。发现主导 EEG 频率出现了两个差异：几乎没有明确主导峰值的人几乎都患有明确的 AD，而有两个峰值的人更常患有 FTLD。
将 EEG 与 CSF 标志物相结合，可使临床诊断为 AD 和 FTD 的患者的鉴别诊断准确率达到 82%，明确诊断的患者的准确率达到 95%，明显优于单独使用 EEG 或 CSF 标志物。这表明 CSF 标志物和 EEG 标志物具有互补性，揭示了疾病的不同方面，再次证实了它们在开发额外诊断工具中的相关性。
