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P2–208: Baseline assessment of EEG BIS–AD in longitudinal trial predicts subjects who later sought pharmacological cognitive therapy
Author(s) -
Greenwald Scott D.,
Saini Vikas,
Smith Charles,
Devlin Philip
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.1047
Subject(s) - medicine , dementia , donepezil , cognition , longitudinal study , cognitive impairment , repeated measures design , disease , psychiatry , pathology , statistics , mathematics
Background: BIS-AD, an EEG-derived index, was developed as a sensitive, simple-to-use biomarker for the early detection of dementia. Previous reports have demonstrated that BIS-AD correlates with metrics of cognitive function (e.g., Mini-Mental State Exam (MMSE), Alzheimer’s Disease Assessment Scale (ADAScog)) in normal and demented subjects. Objective(s): This analysis evaluated BIS-AD in subjects in an ongoing longitudinal trial who were assessed at enrollment (i.e., unmedicated baseline), and before and after initial treatment with pharmacological cognitive enhancers. Methods: Following IRB approval, elderly subjects living independently in their community (age 75; baseline MMSE 25) entered an ongoing longitudinal trial designed to explore early detection of dementia. EEG, MMSE and ADAScog were recorded every 3 months. Unpaired t-tests, paired t-tests, and Fisher’s Exact Test were used to measure differences between groups or visits. P 0.05 was considered statistically significant. Results: To date, 205 subjects have enrolled (format: mean /SD [range]; age: 80.5 / 3.7 [75-91]; MMSE: 28.9 /1.1 [25-30] ; ADAScog: 7.4 /3.3 [1-17]; BIS-AD: 94.8 /3.2 [85-100]; Months in study: 9.4 /8.0 [0-30].) Four subjects (2%) began pharmacological cognitive enhancing therapy (donepezil HCL (n 3) or mementine HCL (n 1)) during the study (14.3 /6.2 [6-21] months after enrolling) . BIS-AD was lower (91.1 vs. 94.9, p 0.019) and MMSE (27.8 vs. 28.9, p 0.029) and ADAScog (13.6 vs 7.3, p 0.008) were worse at baseline in these 4 subjects who sought treatment compared to all others. In the 3 subjects monitored for more than 6 months prior to treatment, BIS-AD decreased from baseline prior to treatment (-2.3 /0.90, p 0.049). At the visit following initial treatment, BIS-AD increased from pre-treatment in the 3 subjects with improved cognitive assessments (2.5 /2.1 [0.5-4.6]), and decreased in the subject whose cognition worsened (-1.0 /DNE; p 0.25). Conclusions: BIS-AD was lower at baseline in subjects who later sought pharmacological cognitive therapy. Change in BIS-AD following treatment onset reflected the change in cognitive ability. BIS-AD might be useful for early detection of dementia, tracking the course of change of Alzheimer’s disease, and evaluating the impact of potential therapies on the progression of the disease.