Insights From a Large-Scale Study on Differentiating Dementia Subtypes With EEG: Chris Berka

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"The interesting thing about frontotemporal dementia is it is difficult to distinguish, as is Lewy body dementia in the very early stages from Alzheimer dementia. Part of what we're trying to do with our quantitative EEG is to provide clinicians or researchers with a way to differentiate these dementia subtypes as early as possible."

Although Alzheimer disease (AD) and frontotemporal dementia (FTD) are common causes of dementia, and differentiating them can be a challenge for clinicians because of their overlapping symptoms.¹ In the field of dementia, quantitative electroencephalography (EEG) has emerged as a promising tool to recognize potential biosignatures that can distinguish AD and FTD.^2-5 In a recent pilot study, investigators were able to identify distinctive EEG biosignatures associated with FTD and AD, although further research is needed to validate the results of these EEG biosignatures in differentiating these subtypes of dementia.

In the study, a quantitative analysis of the posterior dominant rhythm (PDR) displayed that both patients with AD and patients with FTD demonstrated slowing of the PDR frequency. Despite this finding, authors noted that the power of PDR significantly reduced in the AD and was relatively preserved in FTD. Additionally, researchers noted that FTD subtypes may also reveal distinct EEG abnormalities such as more pronounced PDR slowing in behavioral-variant FTD and more delayed event-related potential components in primary progressive aphasia FTD.⁶

These results were presented at the 2024 Alzheimer’s Association International Conference (AAIC), July 28 to August 1, in Philadelphia, Pennsylvania, by senior author Chris Berka, CEO and cofounder at Advanced Brain Monitoring. At the conference, Berka sat down with NeurologyLive^® in an interview to discuss how the preservation of the posterior dominant Alpha rhythm in Alzheimer contrast with its obliteration in Lewy body dementia. She also talked about the role that EEG data plays in the early differentiation of dementia subtypes, according to the study. Furthermore, Berka spoke about the significance of mild cognitive impairment not always progressing to dementia, and how this impacts the study's findings.

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REFERENCES
1. DeLozier SJ, Davalos D. A Systematic Review of Metacognitive Differences Between Alzheimer's Disease and Frontotemporal Dementia. Am J Alzheimers Dis Other Demen. 2016;31(5):381-388. doi:10.1177/1533317515618899
2. Yener GG, Leuchter AF, Jenden D, Read SL, Cummings JL, Miller BL. Quantitative EEG in frontotemporal dementia. Clin Electroencephalogr. 1996;27(2):61-68. doi:10.1177/155005949602700204
3. Chang J, Chang C. Quantitative Electroencephalography Markers for an Accurate Diagnosis of Frontotemporal Dementia: A Spectral Power Ratio Approach. Medicina (Kaunas). 2023;59(12):2155. Published 2023 Dec 13. doi:10.3390/medicina59122155
4. Nardone R, Sebastianelli L, Versace V, et al. Usefulness of EEG Techniques in Distinguishing Frontotemporal Dementia from Alzheimer's Disease and Other Dementias. Dis Markers. 2018;2018:6581490. Published 2018 Sep 3. doi:10.1155/2018/6581490
5. Nishida K, Yoshimura M, Isotani T, et al. Differences in quantitative EEG between frontotemporal dementia and Alzheimer's disease as revealed by LORETA. Clin Neurophysiol. 2011;122(9):1718-1725. doi:10.1016/j.clinph.2011.02.011
6. Meghdadi AH, Verma A, Mendez MF, Berka C. Comparative EEG biosignatures in Alzheimer’s disease and frontotemporal dementia: A pilot study. Presented at: 2024 Alzheimer’s Association International Conference; July 18 to August 1; Philadelphia, Pennsylvania. Abstract 332.