Subclinical white matter lesions and medial temporal lobe atrophy are associated with EEG slowing in a memory clinic cohort

•Standard clinical EEG is still of relevance in a memory clinic.•Subclinical white matter lesions (WML) are a common finding in a memory clinic population, but their impact remains unknown.•Association of subclinical WML with EEG is evident with simple visual assessment methods.

ObjectiveThe aim of the study was to describe the relationship between electroencephalographic (EEG) findings obtained by standardized visual analysis, subclinical white matter lesions (WML) and brain atrophy in a large memory clinic population.MethodsPatients with Alzheimer's disease (AD, n = 58), mild cognitive impairment (MCI, n = 141), subjective cognitive impairment (SCI, n = 194) had clinical, MRI based WML severity and regional atrophy assessments, and routine resting EEG recording. Background activity (BA) and episodic and continuous abnormalities were assessed visually in EEG.ResultsWML (p = 0.006) and atrophy in medial temporal regions (MTA) (p = <0.001) were associated with slower BA in all diagnoses. WML were associated in SCI with total episodic EEG abnormalities (p = 0.03).ConclusionsEEG is associated with subclinical WML burden and cortical brain atrophy in a memory clinic population.SignificanceEven the standard visually assessed EEG can complement a memory clinic diagnostic workup.