Rivastigmine effects on EEG spectra and three-dimensional LORETA functional imaging in Alzheimer's disease.

OBJECTIVE: The objective of the study is to investigate the electrocortical and the global cognitive effects of 3 months rivastigmine medication in a group of mild to moderate Alzheimer's disease patients. MATERIALS AND METHODS: Multichannel EEG and cognitive performances measured with the Mini Mental State Examination in a group of 16 patients with mild to moderate Alzheimer's Disease were collected before and 3 months after the onset of rivastigmine medication. RESULTS: Spectral analysis of the EEG data showed a significant power decrease in the delta and theta frequency bands during rivastigmine medication, i.e., a shift of the power spectrum towards 'normalization'. Three-dimensional low resolution electromagnetic tomography (LORETA) functional imaging localized rivastigmine effects in a network that includes left fronto-parietal regions, posterior cingulate cortex, bilateral parahippocampal regions, and the hippocampus. Moreover, a correlation analysis between differences in the cognitive performances during the two recordings and LORETA-computed intracortical activity showed, in the alpha1 frequency band, better cognitive performance with increased cortical activity in the left insula. CONCLUSION: The results point to a 'normalization' of the EEG power spectrum due to medication, and the intracortical localization of these effects showed an increase of cortical activity in frontal, parietal, and temporal regions that are well-known to be affected in Alzheimer's disease. The topographic convergence of the present results with the memory network proposed by Vincent et al. (J. Neurophysiol. 96:3517-3531, 2006) leads to the speculation that in our group of patients, rivastigmine specifically activates brain regions that are involved in memory functions, notably a key symptom in this degenerative disease.

Correlation between disease severity and brain electric LORETA tomography in Alzheimer's disease.

OBJECTIVE: To compare EEG power spectra and LORETA-computed intracortical activity between Alzheimer's disease (AD) patients and healthy controls, and to correlate the results with cognitive performance in the AD group. METHODS: Nineteen channel resting EEG was recorded in 21 mild to moderate AD patients and in 23 controls. Power spectra and intracortical LORETA tomography were computed in seven frequency bands and compared between groups. In the AD patients, the EEG results were correlated with cognitive performance (Mini Mental State Examination, MMSE). RESULTS: AD patients showed increased power in EEG delta and theta frequency bands, and decreased power in alpha2, beta1, beta2 and beta3. LORETA specified that increases and decreases of power affected different cortical areas while largely sparing prefrontal cortex. Delta power correlated negatively and alpha1 power positively with the AD patients' MMSE scores; LORETA tomography localized these correlations in left temporo-parietal cortex. CONCLUSIONS: The non-invasive EEG method of LORETA localized pathological cortical activity in our mild to moderate AD patients in agreement with the literature, and yielded striking correlations between EEG delta and alpha1 activity and MMSE scores in left temporo-parietal cortex. SIGNIFICANCE: The present data support the hypothesis of an asymmetrical progression of the Alzheimer's disease.

Differences in the EMG pattern of leg muscle activation during locomotion in Parkinson's disease.

In this pilot study, EMG patterns of leg muscle activation were studied in five parkinsonian patients with (B1) and five without (B2) freezing. Gastrocnemius medialis (GM) and tibialis anterior (TA) activity was analysed, by means of surface electromyography (EMG), during treadmill walking at two different belt speeds. Both groups showed reduced GM activity and an overactive TA at the lower speed compared with controls. Upon increasing the speed, the B2 patients showed a marked GM response (increment index 100%), while a moderate change was observed in the B1 group. Poor recruitment of the GM characterises parkinsonian gait in general; this pattern is much more marked in parkinsonian patients with freezing of gait, who show a loss of GM adaptation to variation of locomotion speed.

The impact of the CERAD-NP on diagnosis of cognitive deficiencies in late onset depression and Alzheimer's disease.

OBJECTIVES: To identify the most appropriate test combination for distinguishing between late onset depression (LOD) and Alzheimer's disease (AD). To achieve this objective, the Consortium to Establish a Register for Alzheimer's Disease-Neuropsychological Battery (CERAD-NP) data of patients diagnosed with these two conditions were analyzed using multiple regression analysis. METHODS: In the first regression analysis, the following CERAD-NP subtests were included: verbal fluency, Boston naming test, word list learning, constructional praxis, word list recall, and constructional praxis recall. In a second regression analysis, only CERAD-NP memory parameters were included: word list learning, word list recall, word list intrusions, word list savings, word list recognition, word list false positive errors, constructional praxis recall, and constructional praxis savings. RESULTS: The combination of word list recall and constructional praxis recall best distinguished between LOD and AD, with a ROC of 0.91. In the stepwise regression of memory measures, word list recall, word list savings, and constructional praxis recall was the best combination, resulting in a ROC of 0.92. CONCLUSION: The most efficacious combination of the CERAD-NP battery for discriminating between LOD and AD consisted of word list recall and constructional praxis recall. Of the CERAD-NP memory measures, word list recall, word list savings, and constructional praxis recall represented the best diagnostic combination.