title: A Novel Application of Multiscale Entropy in Electroencephalography to Predict the Efficacy of Acetylcholinesterase Inhibitor in Alzheimer's Disease.
abstract: Alzheimer's disease (AD) is the most common form of dementia. According to one hypothesis, AD is caused by the reduced synthesis of the neurotransmitter acetylcholine. Therefore, acetylcholinesterase (AChE) inhibitors are considered to be an effective therapy. For clinicians, however, AChE inhibitors are not a predictable treatment for individual patients. We aimed to disclose the difference by biosignal processing. In this study, we used multiscale entropy (MSE) analysis, which can disclose the embedded information in different time scales, in electroencephalography (EEG), in an attempt to predict the efficacy of AChE inhibitors. Seventeen newly diagnosed AD patients were enrolled, with an initial minimental state examination (MMSE) score of 18.8 ± 4.5. After 12 months of AChE inhibitor therapy, 7 patients were responsive and 10 patients were nonresponsive. The major difference between these two groups is Slope 2 (MSE6 to 20). The area below the receiver operating characteristic (ROC) curve of Slope 2 is 0.871 (95% CI = 0.69-1). The sensitivity is 85.7% and the specificity is 60%, whereas the cut-off value of Slope 2 is -0.024. Therefore, MSE analysis of EEG signals, especially Slope 2, provides a potential tool for predicting the efficacy of AChE inhibitors prior to therapy.
authors.affiliation: Neurology Department, National Yang-Ming University Hospital, Yi-Lan, Taiwan ; Neurology Department, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Ping-Huang
authors.initials: PH
authors.lastname: Tsai
authors.affiliation: Division of Pulmonology, Department of Internal Medicine, National Yang-Ming University Hospital, Yi-Lan, Taiwan ; Department of Internal Medicine, College of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Shih-Chieh
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Neurology Department, National Yang-Ming University Hospital, Yi-Lan, Taiwan ; Neurology Department, National Yang-Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Fang-Chun
authors.initials: FC
authors.lastname: Liu
authors.affiliation: Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
authors.forename: Jenho
authors.initials: J
authors.lastname: Tsao
authors.affiliation: Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan ; Research Center for Adaptive Data Analysis, National Central University, No. 300, Jhongda Road, Taoyuan 32001, Taiwan.
authors.forename: Yung-Hung
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan ; Research Center for Adaptive Data Analysis, National Central University, No. 300, Jhongda Road, Taoyuan 32001, Taiwan.
authors.forename: Men-Tzung
authors.initials: MT
authors.lastname: Lo
mesh_terms: D000109:Acetylcholine / Q000737:chemistry; D000368:Aged; D000465:Algorithms; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000473:pathology*; D001921:Brain / Q000473:pathology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D004569:Electroencephalography; D019277:Entropy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D000109:Acetylcholine