Topographical Distribution of Consecutive Cholinergic Transmission Deficit in Patients Suspected of Dementia Disease

Abstract

Introduction: The objective of this study is to evaluate topographical differences for Acetylcholine neurotransmission deficit in suspected dementia patients measured with the electroencephalographic Vigilance-index. In order to find the most sensitive and earliest location of Acetylcholine neurotransmission deficit and find patients benefiting from Acetylcholinesterase inhibitor medication, a well-recognized treatment for suspecting Alzheimer’s and Lewy body dementia. Material and Methods: The Vigilance-index for Electroencephalography (EEG) used in the analyses: average peak power for eyes open/eyes closure reflecting Acetylcholinergic status in four locations; anterior Temporal lobe (T3 and T4), posterior Temporal lobe (T5), Parietal lobe (P3), and Occipital lobe (O1) for 30 patients suspected of dementia compared to 30 healthy individuals. The EEG recording positions according to (10-20 EEG system) covering the anterior Temporal left side and the anterior temporal right side (T4) of Cortex. The Vigilance-index average values for the positions of the suspected dementia patients compared to the control group, evaluated by Student’s t-test. To illustrate differences of Vigilance-index for the recording positions, between baseline and follow-up, diagrams comparing the Vigilance-index for the recording sites constructed for the suspected dementia patients. Results: All recording positions at the baseline showed significant increased average Vigilance-index with p-values (***) compared to the healthy controls, the highest average Vigilance-index for T3 and lowest for O1, at follow-up, the T3 increased most and O1 least. The comparison between the left and right anterior temporal regions (T3 and T4) showed different average Vigilance-index and also different Vigilance-index values for the same patient. Conclusion: For the dementia diseases characterized by Acetylcholine Deficit: Alzheimer’s disease, and Lewy body dementia, Vigilance-index can be used for early detection of these diseases. The Temporal anterior region (T3, T4) was most and earliest detected having a cholinergic deficit and least the Occipital region (O1), both at baseline and follow-up examination.