An objective and sensitive electrophysiological marker of word semantic categorization impairment in Alzheimer's disease

Objective: Combining electroencephalographic (EEG) recording and fast periodic visual stimulation (FPVS) to provide an implicit, objective and sensitive electrophysiological measure of semantic word categorization impairment in Alzheimer's Disease (AD).

Methods: Twenty-five AD patients and 25 matched elderly healthy controls were tested with a validated FPVS-EEG paradigm in which different written words of the same semantic category (cities) appear at a fixed frequency of 4 words per second (4 Hz) for 70 seconds. Words from a different semantic category (animal) appear every 4 stimuli (i.e., 1 Hz).

Results: Frequency domain EEG analysis showed a robust response objectively identified at specific 1 Hz harmonics over the left occipito-temporal cortex for healthy controls, indexing automatic semantic categorization. However, only a negligible response, less than 25 % of healthy controls', was found in AD patients, this response being inversely correlated with the amount of Tau protein in the cerebrospinal fluid. The significant group difference was maximal when including an additional left central region, with only 2.5 min of testing providing a significant group difference.

Conclusion: A reduced semantic word categorisation EEG amplitude rapidly differentiates AD patients from healthy controls.

Significance: FPVS-EEG provides a valuable electrophysiological index of semantic categorization impairment in AD.