Brain Vascular Damage of Cholinergic Pathways and EEG Markers in Mild Cognitive Impairment

Moretti, Davide Vito; Pievani, Michela; Fracassi, Claudia; Geroldi, Cristina; Calabria, Marco; Carli, Charles S. De; Rossini, Paolo Maria; Frisoni, Giovanni B.

doi:10.3233/jad-2008-15302

Cited by 43 publications

(41 citation statements)

References 79 publications

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“…Changes of delta and theta waves were also related to pathological changes in cholinergic brain regions. A significant increase of these frequencies was found in patients with the highest total cholinergic burden as well as in patients with highest capsular pathway damage [27]. Abnormal high frontal delta waves under basic relaxed recording conditions can therefore be regarded as indicative for a biochemical and pathological brain dysfunction involving the cholinergic transmitter system.…”

Section: Discussionmentioning

confidence: 89%

Neurophysiological Biomarker of Mild Cognitive Impairment

Dimpfel¹

2014

AAD

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Mild cognitive impairment is sometimes regarded as related to aging. However, statistically every second case turns into full dementia, which still is resistant to any treatment. It is therefore desirable to recognize deviations from normality as early as possible. This might be feasible by using quantitative EEG analysis in the presence of mental work. The present retrospective data analysis revealed a new quantitative biomarker indicating the degree of impairment. Current source density was calculated from 16 channel EEG using CATEEM ® software. Four different conditions were analyzed: relaxed state, performing a d2-concentration test, a calculation performance test and a memory test for 5 min each. Subjects older than 40 years were divided into two groups according to their DemTect score: 13 -18 (HC; n = 44) or 8 -12 (MCI; n = 45). Spectral power was chopped into six frequency ranges (delta, theta, alpha 1, alpha 2, beta 1 and beta 2). Average spectral power was enhanced in the MCI group in comparison to healthy subjects with respect to delta (p = 0.05) during relaxed state when all electrode positions were regarded. With respect to EEG recording during performance of three different psychometric tests it was recognized that mainly spectral changes during performance of the d2-concentration test were related to mild cognitive impairment. With regard to all electrode positions statistically significantly lower spectral power values were reached during the d2-test for delta (p = 0.001), theta (p = 0.0001) and alpha 1 waves (p = 0.08) in impaired subjects in comparison to healthy subjects. Regarding regions of interest increases of delta and theta power were seen in the fronto-temporal brain during performance of the d2-concentration test. These increases disappeared when looking at MCI data. In the centro-parietal region decreases of alpha and beta 1 power emerged, which were even larger in MCI subjects. No MCI-dependent changes were observed in the other two tests. A correlation was found between psychometric performance of the d2-test and the DemTect score (r = 0.51). MCI subjects had statistically significant worse performance in all three mental challenges in comparison to healthy volunteers. It is concluded that MCI can be characterized at an early stage by EEG recording in the relaxed state. High spectral delta and theta power in general and specifically at fronto-

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Section: Discussionmentioning

confidence: 89%

Neurophysiological Biomarker of Mild Cognitive Impairment

Dimpfel¹

2014

AAD

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“…A digital Fast Fourier Transform (FFT)-based power spectrum analysis (Welch technique, Hanning windowing function, no phase shift) computed the power density of EEG rhythms with a 0.5 Hz frequency resolution (range: 2–45 Hz). Two alpha frequencies – low alpha (8–10.5 Hz) and high alpha (10.5–13 Hz) – were selected according to the literature guidelines (Klimesch, 1997, 1999; Moretti et al, 2004, 2007a, b, 2008, 2009a, b). …”

Section: Methodsmentioning

confidence: 99%

“…EEG epochs with artifacts underwent preliminary identification by an automatic computerized procedure (Moretti et al, 2003, 2004, 2007a, b, 2008, 2009a, b, 2011a, b), then automatic selections were double-checked and confirmed manually by two expert electro-encephalographists and epochs with muscular, ocular and other types of artifacts were discarded.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the effects of transdermal and oral rivastigmine on cognitive function and EEG markers in patients with Alzheimerâ€™s disease

Moretti

Frisoni

Binetti

et al. 2014

Front. Aging Neurosci.

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Background: Alzheimer’s disease (AD) is the most common cause of dementia in older patients. Rivastigmine (RV, Exelon, Novartis), a reversible cholinesterase inhibitor, improves clinical manifestations of AD and may enhance ACh-modulated electroencephalogram (EEG) alpha frequency. This pilot study aimed to determine the effects of two formulations of RV [transdermal patch (RV-TDP) and oral capsules (TV-CP)] on alpha frequency, in particular the posterior dominant rhythm, and cognitive function [assessed by the Mini-Mental State Examination (MMSE)] in patients with AD.Methods: Subjects with AD were assigned to receive either RV-TDP 10 cm2 or RV-CP 12 mg/day. All patients underwent EEG recordings at the beginning and end of the 18-month study period using P3, P4, O1, and O2 electrodes, each at high (10.5–13.0 Hz) and low (8.0–10.5 Hz) frequency. MMSE scores were determined at the start of the study (T0) and at three successive 6-month intervals (T1, T2, and T3).Results: RV-TDP administration (n = 10) maintained cognitive function as evidenced by stable MMSE scores from baseline to 18 months (21.07 ± 2.4–21.2 ± 3.1) compared with a decrease in MMSE score with RV-CP (n = 10) over 18 months [18.3 ± 3.6–13.6 ± 5.06 (adjusted for covariates p = 0.006)]. MMSE scores were significantly different between treatment groups from 6 months (p = 0.04). RV-TDP also increased the spectral power of alpha waves in the posterior region measured with electrode P3 in a significantly great percentage of patients than TV-CP from baseline to 18 months; 80% vs 30%, respectively [p = 0.025 (χ2 test)].Conclusions: RV-TDP was associated with a greater proportion of patients with increased posterior region alpha wave spectral power and significantly higher cognitive function at 18 months, compared with RV-CP treatment. Our findings suggest that RV-TDP provides an effective long-term management option in patients with AD compared with oral RV-CP. This study is a pilot, open-label study with a clear explorative purpose and with a small number of patients. Further randomized, double-blind, placebo-controlled trial studies with a bigger sample size as well as healthy controls are needed to support these initial results.

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“…The average number of epochs analyzed was 140, ranging from 130 to 150. The epochs with ocular, muscular, and other types of artifacts were discarded by two skilled electroencephalographists (39). EEG recordings were performed at baseline as well as at each of the follow-up control visits.…”

Section: Methodsmentioning

confidence: 99%

“…The relative power density for each frequency band was computed as the ratio between the absolute power and the mean power spectra from 2 to 45 Hz. The relative band power at each band was defined as the mean of the relative band power for each frequency bin within that band (39). …”

Section: Methodsmentioning

confidence: 99%

Behavioral and Neurophysiological Effects of Transdermal Rotigotine in Atypical Parkinsonism

et al. 2014

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Effective therapies for the so-called atypical parkinsonian syndrome (APS) such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), or corticobasal syndrome (CBS) are not available. Dopamine agonists (DA) are not often used in APS because of inefficacy and in a minority of case, their side effects, like dyskinesias, impairment of extrapyramidal symptoms or the appearance of psychosis, and REM sleep behavioral disorders (RBD). Transdermal rotigotine (RTG) is a non-ergot dopamine agonist indicated for use in early and advanced Parkinson’s disease with a good tolerability and safety. Moreover, its action on a wide range of dopamine receptors, D1, D2, D3, unlike other DA, could make it a good option in APS, where a massive dopamine cell loss is documented. In this pilot, observational open-label study we evaluate the efficacy and tolerability of RTG in patients affected by APS. Thirty-two subjects with diagnosis of APS were treated with transdermal RTG. APS diagnosis was: MSA parkinsonian type (MSA-P), MSA cerebellar type (MSA-C), PSP, and CBS. Patients were evaluated by UPDRS-III, neuropsychiatric inventory, mini mental state examination at baseline, and after 6, 12, and 18 months. The titration schedule was maintained very flexible, searching the major clinical effect and the minor possible adverse events (AEs) at each visit. AEs were recorded. APS patients treated with RTG show an overall decrease of UPDRS-III scores without increasing behavioral disturbances. Only three patients were dropped out of the study. Main AEs were hypotension, nausea, vomiting, drowsiness, and tachycardia. The electroencephalographic recording power spectra analysis shows a decrease of theta and an increase of low alpha power. In conclusion, transdermal RTG seems to be effective and well tolerated in APS patients.

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Brain Vascular Damage of Cholinergic Pathways and EEG Markers in Mild Cognitive Impairment

Cited by 43 publications

References 79 publications

Neurophysiological Biomarker of Mild Cognitive Impairment

Neurophysiological Biomarker of Mild Cognitive Impairment

Comparison of the effects of transdermal and oral rivastigmine on cognitive function and EEG markers in patients with Alzheimerâ€™s disease

Behavioral and Neurophysiological Effects of Transdermal Rotigotine in Atypical Parkinsonism

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