Objective: To determine whether cognitive performance correlates with posterior dominant frequency across Lewy body diseases.

Background: DLB and PDD are associated with prominent posterior slow-wave activity, i.e., reduced dominant frequency (DF), on EEG and this feature has been proposed as a supportive criterion for DLB[1]. Prior studies have restricted DF ranges between delta (3-3.5 Hz) and alpha (8-12 Hz) frequencies[2]. It is unknown if cognitive performance correlates with DF beyond this range.

Method: Two 5-minute segments of resting EEG data with eyes closed (EC) and eyes open (EO) were collected for 28 patients with diagnoses of DLB (n=13), PDD (n=6), and PD (n=9). Participants performed a cognitive battery. EEG data were processed using MATLAB software (r2023b). Continuous, artifact-free EEG segments of at least 50 seconds were manually identified and divided into 10-second non-overlapping epochs for each channel. Epochs were bandpassed from 0.25 to 30 Hz. The amplitude spectrum of each epoch was computed using Welch’s method with 128-sample windows and 64-sample overlap, zero-padded to 256 samples. The resulting spectra were transformed to log-log coordinates, and the linear trend was subtracted to remove the 1/f characteristic. The frequency bin with the largest magnitude was selected as the DF for each epoch. DF was averaged over all epochs in all posterior EEG channels. Correlation analyses were performed with averaged posterior DF and cognitive test scores.

Results: Mean age was 74 (SD=5.8) and there were 39% females. EO and EC DF each had a range of 9-33 Hz and mean of 20 (SD=7.7) and 19 (SD=8.1), respectively. Age was correlated with DF EO EEG DF (r=-0.36, p=0.049) but not EC EEG DF. EO and EC EEG DF values were negatively correlated with global cognition as measured by the Montreal Cognitive Assessment (r=-0.71, p<0.0001 and r=-0.70, p<0.0001, respectively). EO and EC EEG DF were also negatively correlated with tests of memory, executive function, and language; and EC EEG DF was negatively correlated with visuospatial function (all p<0.05).

Conclusion: DF, when assessed over an expanded frequency range, was highly negatively correlated with global cognition and moderately negatively correlated with tests of memory, executive function, visuospatial function, and language in PDD, DLB, and PD. This EEG feature should be further evaluated as a biomarker of cognitive status in Lewy body diseases.

References: 1. McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor J-P, Weintraub D, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology 2017;89:88–100. https://doi.org/10.1212/WNL.0000000000004058.
2. Bonanni L, Thomas A, Tiraboschi P, Perfetti B, Varanese S, Onofrj M. EEG comparisons in early Alzheimer’s disease, dementia with Lewy bodies and Parkinson’s disease with dementia patients with a 2-year follow-up. Brain 2008;131:690–705. https://doi.org/10.1093/brain/awm322.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/eeg-dominant-frequency-as-a-potential-biomarker-of-cognition-in-lewy-body-diseases/