Objective: To evaluate whether resting-state EEG functional connectivity (rsEEG-FC) forecasts cognitive decline three years later in Parkinson’s disease (PD).

Background: Cognitive performance and trajectories of decline vary widely in PD[1, 2]. rsEEG-FC associates with cognition in PD[3, 4] and is linked to future cognitive outcomes in other populations[5]. Increased pre-alpha power, in particular, has been associated with cognition in Dementia with Lewy bodies relative to Alzheimer’s disease and controls[6]. There is little evidence whether rsEEG‑FC predicts future cognition in established PD [7], so we tested this possibility three years after a baseline EEG.

Method: Participants were 114PD and 49 controls from the NZ Parkinson’s Progression Programme[8](63f; 75.7±7.8y.o.). Baseline rsEEG (64ch) was source reconstructed and FC quantified using amplitude envelope correlation (AEC) and debiased weighted phase lag index (dwPLI) across six frequency bands: delta(0.5–4 Hz), theta1(4–5.5 Hz), pre-alpha(5.6–7.9 Hz), alpha1(8–10 Hz), alpha2(10.01–12.99 Hz), and beta(13–30 Hz). A global cognition score was assessed three years later using MDS Level II neuropsychological testing[9] and four domains (attention/working memory, executive function, visuospatial ability, episodic memory)[10]. Machine learning models (elastic net, partial least squares, kernel ridge regression, random forest) were trained using 4-fold cross-validation to predict future cognition.

Results: Increased pre-alpha FC at baseline was negatively associated with future cognition. Both its dwPLI(r=.49[CI95% .35–.60]) and AEC(r=.46[CI95% .33–.57]) predicted future cognition. Connectivity measures in other bands also showed predictive associations [figure1], although weaker. Together, these findings suggest that theta-band and neighbouring EEG-FC changes precede cognitive decline in PD.

Conclusion: Baseline rsEEG-FC predicts cognitive decline three years later in PD, with effects across .5-13HZ, but highest performance at pre-alpha (5.6-7.9Hz). Dysfunctional thalamo-cortical changes may underpin these associations[6]. These findings highlight rsEEG-FC as a potential biomarker of cognitive decline in PD.

Prediction of cognition three years after rsEEG.

References: 1. Svenningsson P, Westman E, Ballard C, Aarsland D. Cognitive impairment in patients with Parkinson’s disease: diagnosis, biomarkers, and treatment. The Lancet Neurology. 2012;11(8):697-707.
2. Aarsland D, Batzu L, Halliday GM, et al. Parkinson disease-associated cognitive impairment. Nat Rev Dis Primers. 2021;7(1):1-21.
3. Zawiślak-Fornagiel, K., Gorzkowska, A., Galus, W., Węgrzynek-Gallina, J., Ledwoń, D., & Mitas, A. W. (2025). Application of quantitative EEG analysis in machine learning research on cognitive impairment in Parkinson’s disease: A systematic review. Clinical Neurophysiology, 2110945.
4. Zhang, Y., & Chen, Z. S. (2025). Harnessing electroencephalography connectomes for cognitive and clinical neuroscience. Nature Biomedical Engineering, 9(8), 1186-1201.
5. Finley, A. J., Angus, D. J., Knight, E. L., Van Reekum, C. M., Lachman, M. E., Davidson, R. J., & Schaefer, S. M. (2024). Resting EEG periodic and aperiodic components predict cognitive decline over 10 years. Journal of Neuroscience, 44(13).
6. D’Anselmo, A., Prete, G., Di Crosta, A., Bristot, L., Carrarini, C., Jaramillo-Jimenez, A., … & EDLB consortium. (2025). Increased pre-alpha functional connectivity in dementia with Lewy bodies. Journal of Alzheimer’s Disease, 108(3), 1132-1143.
7. Spoa, M., Monti, S., Bjekić, J., Guerra, A., Fiorenzato, E., Cauzzo, S., … & Antonini, A. (2025). Resting-state EEG changes associated with cognitive decline in Parkinson’s disease: a systematic review. Journal of Neural Transmission, 1-35.
8. MacAskill MR, Pitcher TL, Melzer TR, Myall DJ, Horne KL, Shoorangiz R, Almuqbel MM, Livingston L, Grenfell S, Pascoe MJ, Marshall ET, Marsh S, Perry SE, Meissner WG, Theys C, Le Heron CJ, Keenan RJ, Dalrymple-Alford JC, Anderson TJ. The New Zealand Parkinson’s progression programme. J R Soc N Z. 2022 Aug 14;53(4):466-488.
9. Litvan I, Goldman JG, Tröster AI, Schmand BA, Weintraub D, Petersen RC, Mollenhauer B, Adler CH, Marder K, Williams‐Gray CH, Aarsland D. Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Movement disorders. 2012 Mar;27(3):349-56.9.
10. Horne KL, MacAskill MR, Myall DJ, Livingston L, Grenfell S, Pascoe MJ, Young B, Shoorangiz R, Melzer TR, Pitcher TL, Anderson TJ, Dalrymple-Alford JC. Neuropsychiatric Symptoms Are Associated with Dementia in Parkinson’s Disease but Not Predictive of it. Mov Disord Clin Pract. 2021 Feb 18;8(3):390-399.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/increased-pre-alpha-eeg-functional-connectivity-forecasts-future-cognitive-decline-in-parkinsons-disease/