386 BIOL PSYCHIATRY
1993;34:386-391
Quantified Electroencephalographic Correlates
of Depression in Alzheimer's Disease
Daniel Pozzi, Angel Golimstock, Ricardo Migliorelli, Alejandra Tes6n,
Horacio Garcia, and Sergio Starkstein
While depression is one of the mostfrequent psychiatric problems among patients with probable
AIzheimer' s disease (AD), its mechanism is not well known. We performed quantified EEGs
in a consecutive series of seven patients with mild dementia and depression, six patients with
mild dementia and no depresswn, eight patients with moderate dementia and depression, and
eight patients with moderate dementia and no depression. Regardless of the severity of
dementia, depressed patients had a significantly higher percent theta in posterior brain areas.
Moreover, depressed patients with mild AD showed a similar thetafrequency as non-depressed
patients with moderate AD. These findings suggest that the presence of depression may
contribute to the qEEG changes of AD.
Key Words: Aizheimer's disease, depression, quantified electroencephalography
Introduction
Several studies have demonstrated significant differences
in quantitative electroencephalographic (qEEG) activity
between patients with Alzheimer's disease (AD) and nor.
mal elderly controls (Gordon et al 1968; Gerson et al 1976;
Canter et al 1982; Coben et al 1983; Duffy et al 1984a;
Penttila et al 1985; Visser et al 1985). In mild dementia,
theta activity is increased and beta activity is decreased
(Cohen et al 1983 and 1985), while in more severe de-
mentia alpha also decreases and delta activity increases
(Stigsby et al 1981; Coben et al 1985; Penttila et al 1985).
From the Departments of Ikhaviotal Neurology (DP, AG, RM, AT, SS) and
Neumphysiology (DP, HG, SS), Rail Canea Institute of Neurological Re-
search. Buenos Aires, Argentina.
Address reprint requests to Dr. Sergio Starkstein. Instituto de lnve~igaciones Neu-
ml6gica~ Rail Canea, Ayacucho 2166, Buenos Aires, Argentina.
Received December 4. 1992; revised April 28, 1993.
Primary depression (i.e., depression in the absence of
known brain lesions) is also related to significant qEEG
changes. Decreases in delta and increases in alpha I power
are observed when depressed elderly subjects are com-
pared to non-depressed age-matched controls (Brenner et
al 1986). However, other authors could not find differences
between elderly depressed and non-depressed subjects
(Visser et al 1985).
Depression is a common finding in AD, and about 50%
of cross-sectional samples were reported to have (major
or minor) depression (Loreck and Folstein 1993). While
recent studies suggested the presence of biogenic aminc
changes among patients with AD and depression (Wolfe
et al 1990), the mechanism of depression in AD is still
unknown.
The main aim of the present study was to determine
whether there are specific qEEG changes in depressed and
non-depressed AD patients. We used a 2 × 2 design, with
mood state (depressed or non-depressed) and severity of
dementia (mild or moderate) as main factors.
© 1993 $ergio Starkstein 0006-3223/93/$06.00