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    Measures of resting state EEG rhythms for clinical trials in Alzheimer's disease: Recommendations of an expert panel
    (Wiley, 2021) Babiloni, Claudio; Arakaki, Xianghong; Azami, Hamed; Bennys, Karim; Blinowska, Katarzyna; Bonanni, Laura; Bujan, Ana; Carrillo, Maria C.; Cichocki, Andrzej; de Frutos-Lucas, Jaisalmer; del Percio, Claudio; Dubois, Bruno; Edelmayer, Rebecca; Egan, Gary; Epelbaum, Stephane; Escudero, Javier; Evans, Alan; Farina, Francesca; Fargo, Keith; Fernandez, Alberto; Ferri, Raffaele; Frisoni, Giovanni; Hampel, Harald; Harrington, Michael G.; Jelic, Vesna; Jeong, Jaeseung; Jiang, Yang; Kaminski, Maciej; Kavcic, Voyko; Kilborn, Kerry; Kumar, Sanjeev; Lam, Alice; Lim, Lew; Lizio, Roberta; Lopez, David; Lopez, Susanna; Lucey, Brendan; Maestu, Fernando; McGeown, William J.; McKeith, Ian; Moretti, Davide Vito; Nobili, Flavio; Noce, Giuseppe; Olichney, John; Onofrj, Marco; Osorio, Ricardo; Parra-Rodriguez, Mario; Rajji, Tarek; Ritter, Petra; Soricelli, Andrea; Stocchi, Fabrizio; Tarnanas, Ioannis; Taylor, John Paul; Teipel, Stefan; Tucci, Federico; Valdes-Sosa, Mitchell; Valdes-Sosa, Pedro; Weiergraeber, Marco; Yener, Görsev; Güntekin, Bahar
    The Electrophysiology Professional Interest Area (EPIA) and Global Brain Consortium endorsed recommendations on candidate electroencephalography (EEG) measures for Alzheimer's disease (AD) clinical trials. The Panel reviewed the field literature. As most consistent findings, AD patients with mild cognitive impairment and dementia showed abnormalities in peak frequency, power, and "interrelatedness" at posterior alpha (8-12 Hz) and widespread delta (< 4 Hz) and theta (4-8 Hz) rhythms in relation to disease progression and interventions. The following consensus statements were subscribed: (1) Standardization of instructions to patients, resting state EEG (rsEEG) recording methods, and selection of artifact-free rsEEG periods are needed; (2) power density and "interrelatedness" rsEEG measures (e.g., directed transfer function, phase lag index, linear lagged connectivity, etc.) at delta, theta, and alpha frequency bands may be use for stratification of AD patients and monitoring of disease progression and intervention; and (3) international multisectoral initiatives are mandatory for regulatory purposes.
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    Parallel electrophysiological abnormalities due to covid-19 infection and to alzheimer's disease and related dementia
    (2024) Jiang, Yang; Neal, Jennifer; Sompol, Pradoldej; Yener, Görsev; Arakaki, Xianghong; Norris, Christopher M.; Güntekin, Bahar; Hajós, Mihály
    Many coronavirus disease 2019 (COVID-19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acute phase of infection. Resting-state EEG abnormalities include EEG slowing (reduced alpha rhythm; increased slow waves) and epileptiform activity. An expert panel conducted a systematic review to present compelling evidence that cognitive deficits due to COVID-19 and to Alzheimer's disease and related dementia (ADRD) are driven by overlapping pathologies and neurophysiological abnormalities. EEG abnormalities seen in COVID-19 patients resemble those observed in early stages of neurodegenerative diseases, particularly ADRD. It is proposed that similar EEG abnormalities in Long COVID and ADRD are due to parallel neuroinflammation, astrocyte reactivity, hypoxia, and neurovascular injury. These neurophysiological abnormalities underpinning cognitive decline in COVID-19 can be detected by routine EEG exams. Future research will explore the value of EEG monitoring of COVID-19 patients for predicting long-term outcomes and monitoring efficacy of therapeutic interventions. Highlights: Abnormal intrinsic electrophysiological brain activity, such as slowing of EEG, reduced alpha wave, and epileptiform are characteristic findings in COVID-19 patients. EEG abnormalities have the potential as neural biomarkers to identify neurological complications at the early stage of the disease, to assist clinical assessment, and to assess cognitive decline risk in Long COVID patients. Similar slowing of intrinsic brain activity to that of COVID-19 patients is typically seen in patients with mild cognitive impairments, ADRD. Evidence presented supports the idea that cognitive deficits in Long COVID and ADRD are driven by overlapping neurophysiological abnormalities resulting, at least in part, from neuroinflammatory mechanisms and astrocyte reactivity. Identifying common biological mechanisms in Long COVID-19 and ADRD can highlight critical pathologies underlying brain disorders and cognitive decline. It elucidates research questions regarding cognitive EEG and mild cognitive impairment in Long COVID that have not yet been adequately investigated.
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    Treatment effects on event-related EEG potentials and oscillations in Alzheimer's disease
    (Elsevier B.V., 2022) Yener, Görsev; Hünerli Gündüz, Duygu; Yıldırım, Ebru; Aktürk, Tuba; Başar Eroğlu, Canan; Bonanni, Laura; Del Percio, Claudio; Farina, Francesca; Ferri, Raffaele; Güntekin, Bahar; Hajós, Mihály; Ibáñez, Agustín; Jiang, Yang; Lizio, Roberta; Lopez, Susanna; Noce, Giuseppe; Parra, Mario A.; Randall, Fiona; Stocchi, Fabrizio; Babiloni, Claudio
    Alzheimer's disease dementia (ADD) is the most diffuse neurodegenerative disorder belonging to mild cognitive impairment (MCI) and dementia in old persons. This disease is provoked by an abnormal accumulation of amyloid-beta and tauopathy proteins in the brain. Very recently, the first disease-modifying drug has been licensed with reserve (i.e., Aducanumab). Therefore, there is a need to identify and use biomarkers probing the neurophysiological underpinnings of human cognitive functions to test the clinical efficacy of that drug. In this regard, event-related electroencephalographic potentials (ERPs) and oscillations (EROs) are promising candidates. Here, an Expert Panel from the Electrophysiology Professional Interest Area of the Alzheimer's Association and Global Brain Consortium reviewed the field literature on the effects of the most used symptomatic drug against ADD (i.e., Acetylcholinesterase inhibitors) on ERPs and EROs in ADD patients with MCI and dementia at the group level. The most convincing results were found in ADD patients. In those patients, Acetylcholinesterase inhibitors partially normalized ERP P300 peak latency and amplitude in oddball paradigms using visual stimuli. In these same paradigms, those drugs partially normalize ERO phase-locking at the theta band (4–7 Hz) and spectral coherence between electrode pairs at the gamma (around 40 Hz) band. These results are of great interest and may motivate multicentric, double-blind, randomized, and placebo-controlled clinical trials in MCI and ADD patients for final cross-validation.