Quantitative electroencephalography: A new approach to the diagnosis of cerebral dysfunction in systemic lupus erythematosus

Abstract

Objective. Neuropsychiatric manifestations are common in patients with systemic lupus erythematosus (SLE), but accurate diagnosis is often difficult. We conducted a prospective study to determine the utility of neurometric quantitative electroencephalography (QEEG) as an indicator of cerebral dysfunction in SLE patients. Methods. Fifty-two SLE patients were divided into 4 groups based on the results of neuropsychiatric evaluations. These included patients with objective evidence of neuropsychiatric SLE (NPSLE), patients with neuropsychiatric symptoms, patients with no evidence of NPSLE, and patients with a prior history of NPSLE. All QEEG findings were compared with data in an age-regressed normative database and with findings in an independent sample of normal subjects.Results. QEEG sensitivity was 87%, and specificity was 75%. QEEG results were abnormal in 74% of the SLE patients with neuropsychiatric symptoms and in 28% of the patients with no evidence of active NPSLE. QEEG profiles varied as a function of the severity and type of neuropsychiatric manifestation present. Within this patient population, QEEG was more sensitive than magnetic resonance imaging, computed tomography scanning, or conventional EEG.Conclusion. Neurometric QEEG may be a sensitive indicator of cerebral dysfunction in patients with NPSLE and can differentiate patients with diverse neuropsychiatric manifestations. When combined with a careful clinical history and evaluation, QEEG provides information that may be useful for the early detection of NPSLE and for serial evaluation of disease activity and treatment efficacy.Neurologic and psychiatric manifestations of systemic lupus erythematosus (SLE) are common, occurring at any time during the illness, and often in the absence of generalized disease activity. Estimates of the prevalence of neuropsychiatric SLE (NPSLE) vary between 24% and 75% (1-7). This variability is partially due to the lack of uniform diagnostic criteria for determining central nervous system (CNS) involve-

Electroencephalography in the assessment of neuropsychiatric manifestations in antiphospholipid syndrome and systemic lupus erythematosus

“…Our results revealed an increased prevalence of temporal slow activity in all groups, which, in the absence of conditions such as toxic or metabolic disorders that may be associated with such activity, would suggest a degree of cerebrovascular insufficiency. Similar findings have been well documented in SLE (30,31). In our study, however, these EEG changes were highly associated with the presence of aPL, with a statistically significant difference between patients with aPL and SLE patients who were aPL negative.…”

Accuracy of 133-xenon regional cerebral blood flow and quantitative electroencephalography in systemic lupus erythematosus

“…Shortly before or after rCBF examination the EEG was recorded from 14 scalp electrodes by average reference on both paper and computer (ERA 21; ESAOTE, Florence, Italy) according to the procedure described in detail elsewhere32,33 Electrodes were positioned on Fpl, F3, C3, 01, F7, T3, T5, Fp2, F4, C4, 02, F8, T4, T6, according to the [10][11][12][13][14][15][16][17][18][19][20] International System. The EEG signal was processed by a fast Fourier Transform and the obtained spectra were then averaged to obtain a mean power spectrum (mPS) for each channel (quantitative EEG = qEEG).…”

The Need for Individualization in Neurofeedback: Heterogeneity in QEEG Patterns Associated with Diagnoses and Symptoms

“…The QEEG has also proven to be sensitive to alterations in cerebral blood flow (Ahn et al 1980;Jonkman et al 1985;Van Huffelen et al 1984;Ritchlin et al 1992), and thus has the potential to make unique contributions in evaluating patients with ischemia or risk for stroke.…”