The Role of Electroencephalography in Alzheimer’s Disease Drug Development

The clinical value of EEG in Alzheimer’s disease (AD) trials is increasingly recognized, offering a practical, patient-friendly assessment of neurophysiological response to novel treatment. Its non-invasive, task-independent, and relatively straightforward mode of operation make it a suitable candidate for longitudinal trials in patients with cognitive impairment. The visual analysis in EEG has led to the well-described process of diffuse oscillatory slowing in AD. It is complemented by advanced quantitative analysis methods, giving a more accurate and diverse overview along the AD disease course, such as loss of functional connectivity and functional network structure. Many of these neurophysiological changes are linked to AD pathology and cognitive decline, and recent trials have implicated the practical feasibility and potency of EEG-based markers. In this chapter, we discuss what EEG analysis techniques are most useful for AD research, the hallmark EEG changes in AD, and insights from recent trials assessing the effect of new compounds on EEG activity. We offer a practical view on the most essential elements for obtaining consistent data quality in multi-center trials.