The EEG as a diagnostic tool in distinguishing between dementia with Lewy bodies and Alzheimer's disease
The EEG as a diagnostic tool in distinguishing between dementia with Lewy bodies and Alzheimer's disease
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DOI：
10.1016/j.clinph.2014.11.021
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发表时间：
2015-09-01
影响因子：
4.7
通讯作者：
Roks, Gerwin
中科院分区：
文献类型：
--
作者：
Lee, Hennie;Brekelmans, Geert J. F.;Roks, Gerwin
目的：路易体痴呆症的当前诊断标准（DLB）将脑电图（EEG）异常视为支持性特征。还有人提出，DLB中的脑电图异常比阿尔茨海默氏病（AD）更广泛。尽管如此，由于研究和缺乏可靠的评分方法，在日常临床实践中，将定性脑电图分析用作区分DLB和AD的诊断工具仍然很少见。一项研究中使用了总脑电图（GTE）评分，以良好的敏感性和特异性区分DLB与AD（Roks等，2008）。方法：来自29例DLB患者的EEG和54例AD患者的脑电图。 GTE评分：DLB患者的中位数分数明显高于AD患者：9与4。 GTE截止分数为6.5，灵敏度为79％，特异性为76％。 GTE与DLB之间的关联独立于年龄，性别，迷你心理状态检查和药物使用。在17.2％的DLB患者中，额叶间歇性节奏的三角洲活性（FIRDA）与AD相比为1.8％。除了较低的截止分数以外，我们的结果与先前关于GTE分数的研究相当。结论：GTE评分已被证明是适用于日常临床实践的可靠且简单的评分方法。定性脑电图分析可以有助于将DLB与AD区分开，具有良好的敏感性和特异性。表述：EEG在每日临床实践中应作为将DLB与AD区分开的诊断工具在日常临床实践中发挥更重要的作用。 DLB诊断标准的未来修订应考虑GTE评分（尤其是FIRDA）中提到的其他EEG异常。 （c）2014年国际临床神经生理联合会。 Elsevier Ireland Ltd.保留所有权利。
Objective: Current diagnostic criteria for dementia with Lewy bodies (DLB) regard electroencephalogram (EEG) abnormalities as a supportive feature. It has also been suggested that EEG abnormalities in DLB are more extensive than in Alzheimer's disease (AD). Still, the use of qualitative EEG analysis as a diagnostic tool to distinguish between DLB and AD remains rare in daily clinical practice because of conflicting studies and absence of a reliable scoring method. The Grand Total EEG (GTE) score has been used in one study to differentiate DLB from AD with good sensitivity and specificity (Roks et al., 2008).Methods: EEGs from 29 patients with DLB and 54 with AD were visually rated according to the GTE score.Results: Patients with DLB had significantly higher median scores than patients with AD: 9 vs. 4. Patients with DLB could be distinguished from those with AD at a GTE cut-off score of 6.5 with a sensitivity of 79% and a specificity of 76%. The association between GTE and DLB was independent of age, gender, Mini Mental State Examination and use of medication. Frontal intermittent rhythmic delta activity (FIRDA) was found in 17.2% of patients with DLB compared to 1.8% with AD. Except for the lower cut-off score our results are comparable to the previous study on the GTE score.Conclusion: The GTE score has proven to be a reliable and simple scoring method applicable to daily clinical practice. Qualitative EEG analysis can help to differentiate DLB from AD with good sensitivity and specificity.Significance: EEG should play a more prominent role in daily clinical practice as a diagnostic tool in differentiating DLB from AD. Future revisions of the diagnostic criteria for DLB should consider the other EEG abnormalities as mentioned in the GTE score, especially FIRDA. (C) 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.