Linking EEG markers of oscillopathy and default mode network dysfunction in Alzheimer's disease

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and multifaceted neuropathology. Although fluid biomarkers cerebrospinal fluid (CSF) amyloid-β and tau and imaging biomarkers positron emission tomography (PET) have substantially advanced AD diagnostics, electroencephalography (EEG) remains a comparatively underutilized tool despite its unique potential. EEG biomarkers capture oscillatory abnormalities (oscillopathies), providing a dynamic window into network-level dysfunction in AD pathophysiology that is not accessible through static molecular or structural measures. Of particular interest are EEG indices linked to dysfunction in the default mode network (DMN), a large-scale intrinsic network increasingly recognized as an epicenter of AD vulnerability. This review synthesizes evidence for key EEG oscillopathy markers in AD-including spectral slowing, gamma deficits, and reduced long-range synchrony-and maps these alterations onto DMN dysfunction within a hierarchical cascade spanning molecular pathology to cognitive impairment. We further explore how frequency-specific transcranial alternating current stimulation (tACS) may both mechanistically interrogate and therapeutically target the oscillopathy-DMN link, drawing on causal evidence from combined EEG-fMRI studies and emerging clinical trials. Finally, we discuss how artificial intelligence (AI), applied to large-scale multimodal datasets, may transform oscillopathy markers into tools for personalized diagnosis, prognosis, and closed-loop neuromodulation. By integrating EEG, network neuroscience, and targeted stimulation, this narrative review positions oscillopathy as a central and clinically accessible feature of AD-related network dysfunction.