Measures of resting state EEG rhythms for clinical trials in Alzheimer's disease: Recommendations of an expert panel

Claudio Babiloni, Xianghong Arakaki, Hamed Azami, Karim Bennys, Katarzyna Blinowska, Laura Bonanni, Ana Bujan, Maria C. Carrillo, Andrzej Cichocki, Jaisalmer de Frutos-Lucas, Claudio Del Percio, Bruno Dubois, Rebecca Edelmayer, Gary Egan, Stephane Epelbaum, Javier Escudero, Alan Evans, Francesca Farina, Keith Fargo, Alberto FernándezRaffaele Ferri, Giovanni Frisoni, Harald Hampel, Michael G. Harrington, Vesna Jelic, Jaeseung Jeong, Yang Jiang, Maciej Kaminski, Voyko Kavcic, Kerry Kilborn, Sanjeev Kumar, Alice Lam, Lew Lim, Roberta Lizio, David Lopez, Susanna Lopez, Brendan Lucey, Fernando Maestú, William J. McGeown, Ian McKeith, Davide Vito Moretti, Flavio Nobili, Giuseppe Noce, John Olichney, Marco Onofrj, Ricardo Osorio, Mario Parra-Rodriguez, Tarek Rajji, Petra Ritter, Andrea Soricelli, Fabrizio Stocchi, Ioannis Tarnanas, John Paul Taylor, Stefan Teipel, Federico Tucci, Mitchell Valdes-Sosa, Pedro Valdes-Sosa, Marco Weiergräber, Gorsev Yener, Bahar Guntekin

Research output: Contribution to journalReview articlepeer-review

64 Scopus citations


The Electrophysiology Professional Interest Area (EPIA) and Global Brain Consortium endorsed recommendations on candidate electroencephalography (EEG) measures for Alzheimer's disease (AD) clinical trials. The Panel reviewed the field literature. As most consistent findings, AD patients with mild cognitive impairment and dementia showed abnormalities in peak frequency, power, and “interrelatedness” at posterior alpha (8-12 Hz) and widespread delta (< 4 Hz) and theta (4-8 Hz) rhythms in relation to disease progression and interventions. The following consensus statements were subscribed: (1) Standardization of instructions to patients, resting state EEG (rsEEG) recording methods, and selection of artifact-free rsEEG periods are needed; (2) power density and “interrelatedness” rsEEG measures (e.g., directed transfer function, phase lag index, linear lagged connectivity, etc.) at delta, theta, and alpha frequency bands may be use for stratification of AD patients and monitoring of disease progression and intervention; and (3) international multisectoral initiatives are mandatory for regulatory purposes.

Original languageEnglish
Pages (from-to)1528-1553
Number of pages26
JournalAlzheimer's and Dementia
Issue number9
StatePublished - Sep 2021

Bibliographical note

Funding Information:
Dr. Petra Ritter is supported by H2020 Research and Innovation Action grants VirtualBrainCloud 826421, Human Brain Project 785907, 945539, and ERC 683049; German Research Foundation CRC 1315, CRC 936, and RI 2073/6‐1; Berlin Institute of Health & Foundation Charité, Johanna Quandt Excellence Initiative.

Funding Information:
Dr. Harald Hampel is an employee of Eisai Inc., serves as Senior Associate Editor for the journal . Before May 2019, he had received lecture fees, travel funding, and research grants from several Pharmacological Companies. Alzheimer's & Dementia

Funding Information:
Dr. Brendan Lucey is supported by the National Institute on Aging (K76 AG054863).

Funding Information:
Dr. Claudio Babiloni is supported by European Committee (H2020‐EU.1.3.1.H2020‐MSCA‐ITN‐ETN‐2016 project with short title “BBDiag”).

Funding Information:
The present paper was facilitated by the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART), through the electrophysiology professional interest area (PIA). EPIA is committed to (1) exploit EEG biomarkers for improving the understanding of neurophysiological mechanisms underlying Alzheimer's disease and age-related dementing disorders at micro, meso, and macro spatial scale and (2) promoting clinical applications. Of note, the views and opinions expressed by authors in this publication represent those of the authors and do not necessarily reflect those of the PIA membership, ISTAART, or the Alzheimer's Association. Furthermore, this manuscript was facilitated by the Global Brain Consortium ( The Global Brain Consortium is committed to achieving the vision of improved and more equitable health outcomes worldwide by strengthening linkages between neuroscientists across borders and disciplines. Quantitative EEG techniques and biomarkers are considered an important resource for brain research and clinical applications in neurologic and psychiatric diseases, especially in lower- and middle-income countries. We thank Prof. Philip Scheltens, Dr. Cornelius Stam, Dr. Wilhelm de Haan, and Dr. Alida Gouw of Center at the VU University Medical Center in Amsterdam for the constructive and helpful revision of an original version of the manuscript. We also thank Dr. Claire Sexton of Alzheimer's Association for the same reasons.

Publisher Copyright:
© 2021 the Alzheimer's Association


  • Alzheimer's disease
  • The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART)
  • biomarkers
  • clinical trials
  • dementia
  • electroencephalography (EEG)
  • eyes-closed resting state condition

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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