Alpha rhythm and Alzheimer's disease : has Hans Berger's dream come true?

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Babiloni, Claudio and Arakaki, Xianghong and Baez, Sandra and Barry, Robert J. and Benussi, Alberto and Blinowska, Katarzyna and Bonanni, Laura and Borroni, Barbara and Bayard, Jorge Bosch and Bruno, Giuseppe and Cacciotti, Alessia and Carducci, Filippo and Carino, John and Carpi, Matteo and Conte, Antonella and Cruzat, Josephine and D'Antonio, Fabrizia and Della Penna, Stefania and Percio, Claudio Del and De Sanctis, Pierfilippo and Escudero, Javier and Fabbrini, Giovanni and Farina, Francesca R. and Fraga, Francisco J. and Fuhr, Peter and Gschwandtner, Ute and Güntekin, Bahar and Guo, Yi and Hajos, Mihaly and Hallett, Mark and Hampel, Harald and Hanoğlu, Lutfu and Haraldsen, Ira and Hassan, Mahmoud and Hatlestad-Hall, Christoffer and Horváth, András Attila and Ibanez, Agustin and Infarinato, Francesco and Jaramillo-Jimenez, Alberto and Jeong, Jaeseung and Jiang, Yang and Kamiński, Maciej and Koch, Giacomo and Kumar, Sanjeev and Leodori, Giorgio and Li, Gang and Lizio, Roberta and Lopez, Susanna and Ferri, Raffaele and Maestú, Fernando and Marra, Camillo and Marzetti, Laura and McGeown, William and Miraglia, Francesca and Moguilner, Sebastian and Moretti, Davide V. and Mushtaq, Faisal and Noce, Giuseppe and Nucci, Lorenzo and Ochoa, John and Onorati, Paolo and Padovani, Alessandro and Pappalettera, Chiara and Parra, Mario Alfredo and Pardini, Matteo and Pascual-Marqui, Roberto and Paulus, Walter and Pizzella, Vittorio and Prado, Pavel and Rauchs, Géraldine and Ritter, Petra and Salvatore, Marco and Santamaria-García, Hernando and Schirner, Michael and Soricelli, Andrea and Taylor, John-Paul and Tankisi, Hatice and Tecchio, Franca and Teipel, Stefan and Kodamullil, Alpha Tom and Triggiani, Antonio Ivano and Valdes-Sosa, Mitchell and Valdes-Sosa, Pedro and Vecchio, Fabrizio and Vossel, Keith and Yao, Dezhong and Yener, Görsev and Ziemann, Ulf and Kamondi, Anita (2025) Alpha rhythm and Alzheimer's disease : has Hans Berger's dream come true? Clinical Neurophysiology, 172. pp. 33-50. ISSN 1388-2457 (https://doi.org/10.1016/j.clinph.2025.02.256)

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Abstract

In this “centenary” paper, an expert panel revisited Hans Berger’s groundbreaking discovery of human restingstate electroencephalographic (rsEEG) alpha rhythms (8–12 Hz) in 1924, his foresight of substantial clinical applications in patients with “senile dementia,” and new developments in the field, focusing on Alzheimer’s disease (AD), the most prevalent cause of dementia in pathological aging. Clinical guidelines issued in 2024 by the US National Institute on Aging-Alzheimer’s Association (NIA-AA) and the European Neuroscience Societies did not endorse routine use of rsEEG biomarkers in the clinical workup of older adults with cognitive impairment. Nevertheless, the expert panel highlighted decades of research from independent workgroups and different techniques showing consistent evidence that abnormalities in rsEEG delta, theta, and alpha rhythms (< 30 Hz) observed in AD patients correlate with wellestablished AD biomarkers of neuropathology, neurodegeneration, and cognitive decline. We posit that these abnormalities may reflect alterations in oscillatory synchronization within subcortical and cortical circuits, inducing cortical inhibitory-excitatory imbalance (in some cases leading to epileptiform activity) and vigilance dysfunctions (e.g., mental fatigue and drowsiness), which may impact AD patients’ quality of life. Berger’s vision of using EEG to understand and manage dementia in pathological aging is still actual.

ORCID iDs

Babiloni, Claudio, Arakaki, Xianghong, Baez, Sandra, Barry, Robert J., Benussi, Alberto, Blinowska, Katarzyna, Bonanni, Laura, Borroni, Barbara, Bayard, Jorge Bosch, Bruno, Giuseppe, Cacciotti, Alessia, Carducci, Filippo, Carino, John, Carpi, Matteo, Conte, Antonella, Cruzat, Josephine, D'Antonio, Fabrizia, Della Penna, Stefania, Percio, Claudio Del, De Sanctis, Pierfilippo, Escudero, Javier, Fabbrini, Giovanni, Farina, Francesca R., Fraga, Francisco J., Fuhr, Peter, Gschwandtner, Ute, Güntekin, Bahar, Guo, Yi, Hajos, Mihaly, Hallett, Mark, Hampel, Harald, Hanoğlu, Lutfu, Haraldsen, Ira, Hassan, Mahmoud, Hatlestad-Hall, Christoffer, Horváth, András Attila, Ibanez, Agustin, Infarinato, Francesco, Jaramillo-Jimenez, Alberto, Jeong, Jaeseung, Jiang, Yang, Kamiński, Maciej, Koch, Giacomo, Kumar, Sanjeev, Leodori, Giorgio, Li, Gang, Lizio, Roberta, Lopez, Susanna, Ferri, Raffaele, Maestú, Fernando, Marra, Camillo, Marzetti, Laura, McGeown, William ORCID logoORCID: https://orcid.org/0000-0001-7943-5901, Miraglia, Francesca, Moguilner, Sebastian, Moretti, Davide V., Mushtaq, Faisal, Noce, Giuseppe, Nucci, Lorenzo, Ochoa, John, Onorati, Paolo, Padovani, Alessandro, Pappalettera, Chiara, Parra, Mario Alfredo ORCID logoORCID: https://orcid.org/0000-0002-2412-648X, Pardini, Matteo, Pascual-Marqui, Roberto, Paulus, Walter, Pizzella, Vittorio, Prado, Pavel, Rauchs, Géraldine, Ritter, Petra, Salvatore, Marco, Santamaria-García, Hernando, Schirner, Michael, Soricelli, Andrea, Taylor, John-Paul, Tankisi, Hatice, Tecchio, Franca, Teipel, Stefan, Kodamullil, Alpha Tom, Triggiani, Antonio Ivano, Valdes-Sosa, Mitchell, Valdes-Sosa, Pedro, Vecchio, Fabrizio, Vossel, Keith, Yao, Dezhong, Yener, Görsev, Ziemann, Ulf and Kamondi, Anita;
CORE (COnnecting REpositories)