Feasibility and potential of a bedside mini-EEG for diagnosing delirium superimposed on dementia

Viona J M Wijnen, Letty Oudewortel, Gilles van Luijtelaar, Joost Witlox, Arjen J C Slooter, Willem A van Gool

Onderzoeksoutput: Articlepeer review

Samenvatting

Objective: Delirium superimposed on dementia (DSD) is difficult to diagnose because symptoms of delirium might be interpreted as symptoms of dementia. To improve diagnostic accuracy, we investigated the potential of a brief point-of-care EEG measurement. Methods: Thirty older patients were included, all with Major Neurocognitive Disorder (i.e. dementia) according to DSM-5 criteria. EEG was registered at right prefrontal and right temporal site, with eyes either open or closed for three minutes, simultaneously with the Discomfort Scale for Dementia of Alzheimer Type. The Confusion Assessment Method for the Intensive Care Unit was administered to determine the presence of symptoms of a delirium at the time of EEG administration. Video registrations were reviewed independently by two delirium experts. Results: Higher activities of delta and theta1, and lower activities of theta2, alpha, and beta activity, were found in DSD when compared to dementia only. The ratio of delta and theta power during eyes-open conditions had the highest accuracy (AUC = 0.80 [0.63–0.94]; p <.001) to distinguish DSD from dementia alone. All subjects were on benzodiazepines and half on clozapine, thus the effects of psychotropics on EEG cannot be fully excluded. Conclusions: A brief point-of-care EEG at two sites of the head has the potential to aid in the detection of DSD. Significance: The diagnostic accuracy of EEG in recognizing or excluding delirium in patients who already have dementia is of large potential given the lack of proper diagnostic tools.

Originele taal-2English
Pagina's (van-tot)181-189
Aantal pagina's9
TijdschriftClinical Neurophysiology
Volume142
DOI's
StatusPublished - okt 2022

Bibliografische nota

Funding Information:
We would like to acknowledge the Weston Brain Institute for funding of this project. We thank Evi Berendrecht, Floor Enters, and Emmie van den Dobbelsteen for their contributions to this study, and Prof. Dr. J.K. Vermunt for his helpful advice on the statistical analyses.

Publisher Copyright:
© 2022 International Federation of Clinical Neurophysiology

Copyright:
Copyright 2022 Elsevier B.V., All rights reserved.

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