Sigla - ANT Neurodownload.ant-neuro.com/brochures/Sigla brochure 2013.pdf · Sigla software Sigla’s web-based software can be accessed via the Internet through a normal web browser.

General practice and memory clinicsIdeal for Alzheimer’s centres and smaller facilities, as well as larger practices, Sigla supports the diagnostic protocol, with early detection and differential diagnosis. It can also assist with monitoring disease progression (before and after clinical signs appear) and efficacy of treatment with cholinergic inhibitors.

University hospitalsSigla can be used to evaluate and re-evaluate existing EEGs, helping to confirm diagnoses. Supporting the clinical diagnostic workup for dementia patients, it can also be useful in clinical and pharma-cological studies.

Tel. +354 530 [email protected]

©Copyright Mentis Cura January 2013 [Version 1.0]

Following more than ten years of intensive research and investment, a new and highly efficient diagnostic aid has become available to clinicians specialising in the detection and treatment of dementia.

Sigla from Mentis Cura provides what is essentially the first ‘biomarker’ for dementia. Using EEG, a widely available and simple

technology, clinicians can access individual, evidence-based reports detailing two critical perspectives – the potential cause of cognitive impairment/dementia; and current levels of cholinergic activity, which act as a benchmark for systematic monitoring of progression of the disease and responsiveness to treatment.

Previously, the diagnostic accuracy of EEG recordings in determining Alzheimer’s disease was thought to be about 80%. However, the method has been lacking in key areas; sample size is limited, for example, and there are restrictions in terms of EEG feature selection.

Mentis Cura has developed a sophisticated database of EEG measurements taken from more than 4000 subjects, classified and diagnosed independently by at least two Medical Doctors. Analysing over 1,100

EEG features, the Sigla software applies modern multivariate statistical methods to determine how well the patient fits specific groups in the database. When the results are used in combination with current clinical best-practice methods for diagnosing dementias, Sigla demonstrates accuracy levels in the region of 90%.

“Sigla is a welcome and reliable tool for diagnosing the causes of cognitive impairment and dementia. It plays a key role in our diagnostic protocol for dementia and is an important part of our follow up on disease progression and treatment efficacy.” Jón Snædal , Chief Doctor, Memory Clinic, University Hospital of Iceland

An exciting breakthrough

Sigla The advanced diagnostic aid for dementia

EARLY | ACCURATE | EFFECTIVE

· early detection · accurate diagnosis · effective monitoring

This new diagnostic aid may transform the approach to dementia and as a consequence, transform the quality of life for many patients and their families.

Mentis Cura is an established medical research company, which benefits from a powerful and expert team with wide- ranging capabilities. It collaborates with a number of leading university hospitals and research organistions. Specialising in EEG statistical pattern recognition, the company has developed a unique neurodiagnostic aid that helps to identify objective physiological evidence, shedding new light on the detection, diagnosis and progression of various dementias.

“Dementia is overwhelming, not only for the people who have it, but also for their caregivers and families. There is a lack of awareness and understanding of dementia in most countries, resulting in stigmatisation and barriers to diagnosis and care.” (WHO)

To date, the effective diagnosis of dementia has proved challenging and time-consuming. A major challenge has been the prompt and timely detection of the disease. While all major pathological changes in the brain occur early on, diagnosis is rarely clear until a time when most of the damage has already been done. With only cognitive test results and the subjective evaluation of clinical symptoms as a basis for diagnosis, the need for an accurate biomarker that can support early detection is more urgent than ever.

Sigla softwareSigla’s web-based software can be accessed via the Internet through a normal web browser. Registered users receive a log-in ID and password enabling them to enter the analysis environment and upload EEG files*. Within a few minutes, the user receives the Sigla report (DementiaGram and Cholinergic Index – see left), which can be saved and printed as required.

*Uploaded EEG files do not include any patient information.

EEG Cholinergic IndexTM

Drugs used in the treatment of Alzheimer’s disease and other dementias are mainly cholinesterase inhibitors, which are thought to enhance the function of the cholinergic system. The pharmacodynamic effects of these medicines have traditionally been measured only by cognitive tests and care-givers’ reports, and, until now, there have been no direct biological means of evaluating the effects of any treatment.

The EEG changes seen in Alzheimer’s disease and other dementias reflect the cholinergic dysfunction very well, and are therefore a logical way of measuring the cholinergic response of the drugs in the brain. Using a Cholinergic Index based on EEG recordings, Sigla offers an objective method to evaluate and monitor the effects of cholinergic drugs, helping to support appropriate and effective ongoing treatment.

A challenging disease

An advanced and highly effective diagnostic aid for dementia, Sigla offers valuable support to those engaged in this challenging field. Using a simple electroencephalogram (EEG), clinicians can now access individual, evidence-based reports detailing two critical perspectives:

The pathologies of different dementias vary greatly, but they all affect the electro-physiology of the brain, which is reflected directly in the electroencephalogram (EEG). Sigla focuses on the EEG as a basis for early and accurate differential diagnosis of dementias, and for monitoring progress of the disease effectively.

The diagram below demonstrates the different factors that steadily contribute to cell death in the brain, reflecting clear bio-markers for the presence of dementia before clinical symptoms present themselves.

With the number of aging populations increasing worldwide, dementia is fast becoming a critical healthcare issue. Its impact on individuals and families is devastating and the economic implications are also becoming clear – dementia is already the world’s 18th largest economy, with an estimated cost in excess of EUR 450 billion (2010).

PUBLIC HEALTH PRIORITY

The World Health Organisation (WHO) has identified dementia as a public health priority and encourages governments worldwide to take action in order to control this threat to global health.

The DementiaGramTM

The underlying pathology of conditions such as mild cognitive impairment (MCI), depression (DPR), Alzheimer’s disease (AD) and Lewy bodies-Parkinson’s dementia (L-P) produce a reliably different signature in the EEG signals compared with normal (NRM), healthy subjects.

The DementiaGram adds insight to these separate indications, allowing clinicians to diagnose early and, more importantly, to differentiate between them. In the report top right, for example, the ‘DementiaGram weight’ (DGW) shows a clear match with the AD signals for Alzheimer’s.

The impact on physical and psychological health, not to mention the economy, is massive.

The advanced diagnostic aid for dementiaIntroducing Sigla

• Thepotentialcauseofcognitive impairment and dementia – helping the professional to differentiate between degenerative disorders of the brain

• Cholinergicactivity–anaccurate snapshot or index that acts as a bench-mark for systematic monitoring of progression of the disease and respon-siveness to treatment

Recording protocol

- Standard 10-20 system- Five-minute recording- Patient at rest, eyes closed

NON-INVASIVE

AFFORDABLE

ACCESSIBLE

Abnormal

Bio

mar

ker

mag

nitu

de

Normal

Aß

Tau-mediated neuronal injury and dysfunction

Brain structure

Memory

Clinical function

Onset of symptoms (clinical disease)- Middle stage dementia - MCI

Late stage dementia

Asymptomatic disease - Early stage dementia - Cognitively normal

Dementias originate in different parts of the brain cortex or in sub-cortical parts of the brain. These abnormalities manifest early in the electrophysiology of the brain and make the electroencephalogram (EEG) a sensitive measurement of these changes.

Within minutes of a new EEG recording being presented, Sigla is able to compare and analyse the data and deliver its report directly to the clinician.

0 20 40 60 80 100 120 140

Cholinergic index: 48

AD NRM

1.69

80.58

NRM

0.01 0.00 0.36 99.63 0.00DGW

NRM

MCI

DPR

AD

L-P

MCI DPR AD L-P

14.58 35.27 99.97 43.77

85.42 73.75 99.98 3.53

64.73 26.25 98.31 19.42

0.03 0.02 0.20

56.23 96.47 99.80