Michels Daan M, van Marum Sjoerd, Arends Samuel, Tavy D L J, Wirtz Paul W, de Bruijn Bas S F T M
Department of Neurology and Clinical Neurophysiology, Haga Hospital, The Hague, the Netherlands.
Department of Neurology, Erasmus MC, Rotterdam, the Netherlands .
J Clin Neurophysiol. 2025 Mar 1;42(3):243-250. doi: 10.1097/WNP.0000000000001107. Epub 2024 Jul 25.
Electroencephalography (EEG) is a noninvasive diagnostic tool that can be of diagnostic value in patients with cognitive disorders. In recent years, increasing emphasis has been on quantitative EEG analysis, which is not easily accessible in clinical practice. The aim of this study was to assess the diagnostic and prognostic value of visual EEG assessment to distinguish different causes of cognitive disorders.
Patients with cognitive disorders from a specialized memory clinic cohort underwent routine workup including EEG, neuropsychological testing and brain imaging. Electroencephalography parameters including posterior dominant rhythm, background activity, and response to photic stimulation (intermittent photic stimulation) were visually scored. Final diagnosis was made by an expert panel.
A total of 501 patients were included and underwent full diagnostic workup. One hundred eighty-three patients had dementia (111 Alzheimer disease, 30 vascular dementia, 15 frontotemporal dementia, and 9 dementia with Lewy bodies), 66 patients were classified as mild cognitive impairment, and in 176, no neurologic diagnosis was made. Electroencephalography was abnormal in 60% to 90% of patients with mild cognitive impairment and dementia, most profoundly in dementia with Lewy bodies and Alzheimer disease, while frontotemporal dementia had normal EEG relatively often. Only 30% of those without neurologic diagnosis had EEG abnormalities, mainly a diminished intermittent photic stimulation response. Odds ratio of conversion to dementia was 6.1 [1.5-24.7] for patients with mild cognitive impairment with abnormal background activity, compared with those with normal EEG.
Visual EEG assessment has diagnostic and prognostic value in clinical practice to distinguish patients with memory complaints without underlying neurologic disorder from patients with mild cognitive impairment or dementia.
脑电图（EEG）是一种非侵入性诊断工具，对认知障碍患者具有诊断价值。近年来，人们越来越重视脑电图定量分析，而这在临床实践中并不容易实现。本研究的目的是评估视觉脑电图评估对区分不同病因认知障碍的诊断和预后价值。
来自一家专业记忆门诊队列的认知障碍患者接受了包括脑电图、神经心理学测试和脑成像在内的常规检查。对脑电图参数，包括后头部优势节律、背景活动和对光刺激（间歇性光刺激）的反应进行视觉评分。最终诊断由专家小组做出。
共纳入501例患者并进行了全面诊断检查。183例患者患有痴呆（111例阿尔茨海默病、30例血管性痴呆、15例额颞叶痴呆和9例路易体痴呆），66例患者被归类为轻度认知障碍，176例未做出神经学诊断。轻度认知障碍和痴呆患者中60%至90%脑电图异常，最明显的是路易体痴呆和阿尔茨海默病患者，而额颞叶痴呆患者脑电图相对经常正常。未做出神经学诊断的患者中只有30%脑电图异常，主要是间歇性光刺激反应减弱。背景活动异常的轻度认知障碍患者与脑电图正常的患者相比，发展为痴呆的比值比为6.1[1.5 - 24.7]。
在临床实践中，视觉脑电图评估对区分无潜在神经疾病的记忆障碍患者与轻度认知障碍或痴呆患者具有诊断和预后价值。
