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EEG ABNORMALITIES IN PATIENTS WITH DELIRIUM AS A PREDICTIVE BIOMARKER OF DEMENTIA WITH LEWY BODIES
Abstract
Aims
Delirium is an acute neurological dysfunction, characterized by altered conscious state, akin to fluctuating cognition. It is frequent in elderly patients when hospitalized and is characterized by an increased risk of developing dementia, especially Dementia with Lewy Bodies (DLB). EEG Prominent posterior slow-wave activity in the pre-alpha/ theta range is a supportive biomarker for DLB diagnosis from the prodromal stage. This EEG pattern correlates with fluctuating cognition and is the electrophysiological underpinning of the so called thalamo-cortical dysrhythmia. We aim to assess whether non demented hospitalized patients with delirium show specific QEEG abnormalities typical of thalamo-cortical dysrhythmia.
Methods
24 consecutive patients admitted to Neurology Clinic of University of Chieti were administered Mini Mental State Examination (MMSE) as per clinical routine. The presence of delirium was assessed by 4AT test. All subjects underwent resting state EEG recording.
Results
11 (7 females) presented delirium (delirium, D) according to 4AT (9 with hypokinetic, 2 with hyperkinetic type), 13 (5 females) did not show it (controls, C). The two groups did not differ for age and gender. In all but one D (91%), we observed alterations of EEG parameters (DF lower than alpha with increased DFV (>1.2 Hz)). In C, DF and DFV were normal in 92% , (alpha DF and DFV<1.2 Hz) (DF in D vs. C p=0.002 ).
Conclusions
We found strong correlation between the presence of delirium and EEG abnormalities typical of thalamocortical dysrhythmia and of DLB. Our evidence suggests a pathophysiological explanation for delirium. EEG may represent a powerful tool to detect delirium.