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A letter to the editor is presented in response to the article about the medical care provided to older people with dementia, which appeared in the previous issue.

New diagnostic criteria for Alzheimer's disease (AD) stress the role of in vivo biomarkers. Neurophysiological markers are usually not considered as such criteria, although theoretical and practical reasons would justify them. In order to assess the value of neurophysiology as an AD biomarker, whole-head magnetoencephalographic (MEG) resting state recordings were obtained from 35 AD patients, 23 mild cognitive impairment (MCI) patients, and 24 healthy controls. The AD group was further split into two groups differing in severity according to the GDS/FAST criteria. A Minimum Norm Estimation procedure was utilized to estimate the cortical origin of slow brain oscillatory activity in the delta band (2-4 Hz). Eight regions of interest (ROIs) discriminated between AD patients and controls. Delta current density (DCD) in all ROIs showed a significant negative correlation with cognitive status (p < 0.001). DCD values in posterior parietal, occipital, prerolandic, and precuneus cortices distinguished reliably between MCI patients, AD patients with different severity scores, and controls. Importantly, an increase of DCD in right parietal cortex and precuneus indexed the transition from MCI to mild dementia and from mild to more severe dementia. MEG delta mapping might be a serious candidate for a 'neural degeneration' marker of AD reflecting dysfunctional synaptic transmission. More importantly, the localization of DCD values is in line with functional imaging markers of AD. However, MEG delta mapping is a totally non-invasive technique that directly measures neural activity. We propose that individuals with enhanced DCD in posterior parietal and precuneus cortices are at risk of progression to full dementia. [ABSTRACT FROM AUTHOR]

New diagnostic criteria for Alzheimer's disease (AD) stress the role of in vivo biomarkers. Neurophysiological markers are usually not considered as such criteria, although theoretical and practical reasons would justify them. In order to assess the value of neurophysiology as an AD biomarker, whole-head magnetoencephalographic (MEG) resting state recordings were obtained from 35 AD patients, 23 mild cognitive impairment (MCI) patients, and 24 healthy controls. The AD group was further split into two groups differing in severity according to the GDS/FAST criteria. A Minimum Norm Estimation procedure was utilized to estimate the cortical origin of slow brain oscillatory activity in the delta band (2-4 Hz). Eight regions of interest (ROIs) discriminated between AD patients and controls. Delta current density (DCD) in all ROIs showed a significant negative correlation with cognitive status (p < 0.001). DCD values in posterior parietal, occipital, prerolandic, and precuneus cortices distinguished reliably between MCI patients, AD patients with different severity scores, and controls. Importantly, an increase of DCD in right parietal cortex and precuneus indexed the transition from MCI to mild dementia and from mild to more severe dementia. MEG delta mapping might be a serious candidate for a "neural degeneration" marker of AD reflecting dysfunctional synaptic transmission. More importantly, the localization of DCD values is in line with functional imaging markers of AD. However, MEG delta mapping is a totally non-invasive technique that directly measures neural activity. We propose that individuals with enhanced DCD in posterior parietal and precuneus cortices are at risk of progression to full dementia. [ABSTRACT FROM AUTHOR]

Abstract: Objective: In this study, we applied a novel procedure to calculate the mean frequency from the Magnetoencephalography (MEG) signals of 22 patients with Alzheimer''s Disease (AD), 22 patients with mild cognitive impairment (MCI), and 21 healthy controls. A significant mean frequency decrease was expected in pathological groups. MCI subjects are expected to show intermediate mean frequency values between AD patients and controls. Methods: MEG signal was obtained from a whole-head 148 channels magnetometer in a resting condition. We estimated the power spectral density from the MEG signal by means of the Fourier transform of the autocorrelation function. Then, we computed the mean frequency for each subject. Results: Mean frequency was higher in controls (12.46±2.00Hz, mean±SD) than in MCI subjects (10.82±2.21Hz) with significant differences (P<0.05). Moreover, mean frequency values in MCI subjects were higher than in AD patients (9.06±2.48Hz, P<0.05). We also detected a decrease of 0.17Hz per year in mean frequency from normal subjects'' MEG (P<0.05) Conclusions: Results demonstrated that the approach adopted for the calculation of a mean frequency score seems to be adequate and sensitive to detect differences between normal aging, cognitive deterioration and AD. In addition, data may contribute to the theoretical discussion on the nature of mild cognitive impairment and its similitudes with Alzheimer''s disease. Significance: This paper may be considered a first step to obtain a reliable measure which summarizes spectral information, and might be of a potential clinical interest. [Copyright &y& Elsevier]

Whole-head magnetoencephalographic recordings were obtained from 10 patients with Alzheimer’s disease (AD) and 10 healthy controls in a resting position. Spectroscopic examinations were performed by means of a 1.5-tesla whole-body scanner in the temporoparietal regions of both hemispheres. The relationship between 1H-MRS-based and magnetoencephalography (MEG)-based measures and their conjoined capability to improve the diagnosis of AD were investigated in this study. Logistic regression analyses were performed. Three separated logistic models were calculated for 1H-MRS-based metabolites, low-frequency magnetic activity, and the combination of both measures. A combined myoinositol/N-acetyl aspartate (mI/NAA)-delta dipole density (DD) model predicted the diagnosis with 90% sensitivity and 100% specificity. Additionally, the combination of temporoparietal mI/NAA and delta DD values explained the variability of individuals’ cognitive status. The results support the notion that a multidisciplinary approach may improve the understanding and diagnosis of AD. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Several studies have shown that memory circuits can be reorganised as a function of age. Brain magnetic activity evoked by a memory task was recorded in 19 healthy elderly subjects divided into two groups, a young-elder group (mean age of 62) and senior-elder group (mean age of 76). The young-elder group showed greater activity over the left medial temporal lobe in the late latency windows (between 400 and 800 ms) than the senior-elder group. The senior-elder group showed an initial increased activity (between 150 and 400 ms) over the complex of motor areas, followed by an increased activity in the left temporo-parietal cortex at the late latency window. These results revealed a reorganization of brain networks supporting memory in the eldest subjects. Furthermore, these circuits are reorganised in a time-dependent manner, meaning the rehearsal articulatory process active in the early time window followed by a phonological storage and recognition process in the late latency window. [Copyright &y& Elsevier]