Abnormal periodic and aperiodic resting-state electroencephalographic markers in Lewy body and Alzheimer’s diseases with cognitive decline

AI Summary

Both LBCD and ADCD exhibit slowed individual alpha frequency and reduced periodic alpha and beta power, yielding a lower vigilance index, more pronounced in LBCD.
Elevated aperiodic exponent in both groups and increased aperiodic offset in LBCD suggest steeper spectral profiles and heightened inhibitory cortical tone.
In LBCD, poorer cognition linked to higher low-frequency alpha; better cognition to higher high-frequency alpha; reduced vigilance index associated with visual hallucinations.

Geroscience. 2026 May 22. doi: 10.1007/s11357-026-02325-5. Online ahead of print.

ABSTRACT

Lewy body disease (LBD) and Alzheimer’s disease (AD) are the most common causes of cognitive decline and dementia and are associated with characteristic alterations in resting-state electroencephalographic (rsEEG) activity. This multicenter exploratory study investigated periodic and aperiodic rsEEG features in patients with cognitive decline due to Lewy body disease (LBCD) and Alzheimer’s disease (ADCD), compared with cognitively unimpaired older adults (Nold), and examined the clinical relevance of these markers in LBCD. A total of 140 LBCD, 135 ADCD, and 118 Nold datasets from the PDWAVES archive underwent spectral parameterization to decompose rsEEG power spectra (1-30 Hz) into periodic peaks and aperiodic background activity. Both clinical groups showed a significant slowing of the individual alpha frequency (IAF), more pronounced in LBCD, along with reduced periodic alpha and beta power reflected in a lower vigilance index. The aperiodic exponent was elevated in both groups, and the aperiodic offset was also higher in LBCD, suggesting steeper spectral profiles consistent with increased inhibitory cortical tone. Within the LBCD group, poorer cognition was associated with higher low-frequency alpha power, whereas better cognition was predicted by higher high-frequency alpha power. A reduced vigilance index was associated with the presence of visual hallucinations, while no associations emerged for other symptoms. These findings suggest that combined periodic and aperiodic rsEEG features may provide relevant markers of altered vigilance regulation in LBCD. Future studies should evaluate whether these EEG markers can inform targeted interventions, such as neuromodulatory or audiovisual stimulation, to stabilize quiet-vigilance states and improve clinical outcomes.

PMID:42168727 | DOI:10.1007/s11357-026-02325-5

Document this CPD