用于路易体痴呆早期鉴别诊断的定量脑电图
Quantitative EEG for early differential diagnosis of dementia with Lewy bodies.
作者信息
Iannaccone Sandro, Houdayer Elise, Spina Alfio, Nocera Gianluca, Alemanno Federica
机构信息
Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.
出版信息
Front Psychol. 2023 Apr 20;14:1150540. doi: 10.3389/fpsyg.2023.1150540. eCollection 2023.
INTRODUCTION
Differentiating between the two most common forms of dementia, Alzheimer's dementia and dementia with Lewy bodies (DLB) remains difficult and requires the use of invasive, expensive, and resource-intensive techniques. We aimed to investigate the sensitivity and specificity of electroencephalography quantified using the statistical pattern recognition method (qEEG-SPR) for identifying dementia and DLB.
METHODS
Thirty-two outpatients and 16 controls underwent clinical assessment (by two blinded neurologists), EEG recording, and a 6-month follow-up clinical assessment. EEG data were processed using a qEEG-SPR protocol to derive a Dementia Index (positive or negative) and DLB index (positive or negative) for each participant which was compared against the diagnosis given at clinical assessment. Confusion matrices were used to calculate sensitivity, specificity, and predictive values for identifying dementia and DLB specifically.
RESULTS
Clinical assessment identified 30 cases of dementia, 2 of which were diagnosed clinically with possible DLB, 14 with probable DLB and DLB was excluded in 14 patients. qEEG-SPR confirmed the dementia diagnosis in 26 out of the 32 patients and led to 6.3% of false positives (FP) and 9.4% of false negatives (FN). qEEG-SPR was used to provide a DLB diagnosis among patients who received a positive or inconclusive result of Dementia index and led to 13.6% of FP and 13.6% of FN. Confusion matrices indicated a sensitivity of 80%, a specificity of 89%, a positive predictive value of 92%, a negative predictive value of 72%, and an accuracy of 83% to diagnose dementia. The DLB index showed a sensitivity of 60%, a specificity of 90%, a positive predictive value of 75%, a negative predictive value of 81%, and an accuracy of 75%. Neuropsychological scores did not differ significantly between DLB and non- DLB patients. Head trauma or story of stroke were identified as possible causes of FP results for DLB diagnosis.
CONCLUSION
qEEG-SPR is a sensitive and specific tool for diagnosing dementia and differentiating DLB from other forms of dementia in the initial state. This non-invasive, low-cost, and environmentally friendly method is a promising diagnostic tool for dementia diagnosis which could be implemented in local care settings.
引言
区分两种最常见的痴呆形式，即阿尔茨海默病性痴呆和路易体痴呆（DLB）仍然很困难，需要使用侵入性、昂贵且资源密集型的技术。我们旨在研究使用统计模式识别方法（qEEG-SPR）量化的脑电图对识别痴呆和DLB的敏感性和特异性。
方法
32名门诊患者和16名对照者接受了临床评估（由两名盲法神经科医生进行）、脑电图记录以及为期6个月的随访临床评估。使用qEEG-SPR方案处理脑电图数据，为每位参与者得出痴呆指数（阳性或阴性）和DLB指数（阳性或阴性），并将其与临床评估给出的诊断结果进行比较。使用混淆矩阵专门计算识别痴呆和DLB的敏感性、特异性和预测值。
结果
临床评估确定了30例痴呆病例，其中2例临床诊断为可能的DLB，14例为很可能的DLB，14例患者排除了DLB。qEEG-SPR在32例患者中的26例中证实了痴呆诊断，并导致6.3%的假阳性（FP）和9.4%的假阴性（FN）。qEEG-SPR用于在痴呆指数结果为阳性或不确定的患者中提供DLB诊断，并导致13.6%的FP和13.6%的FN。混淆矩阵显示诊断痴呆的敏感性为80%，特异性为89%，阳性预测值为92%，阴性预测值为72%，准确性为83%。DLB指数显示敏感性为60%，特异性为90%，阳性预测值为75%，阴性预测值为81%，准确性为75%。DLB患者和非DLB患者的神经心理学评分无显著差异。头部外伤或中风病史被确定为DLB诊断中FP结果的可能原因。
结论
qEEG-SPR是一种在初始状态下诊断痴呆以及区分DLB与其他形式痴呆的敏感且特异的工具。这种非侵入性、低成本且环保的方法是一种很有前景的痴呆诊断工具，可在基层医疗环境中实施。
Zotero 插件