He was very happy to have a second chance in life to make up for some of the things he may have missed out on in the first half of his life. He made it clear to me that I should never let my work overcome my involvement in my family life. He once told me to be sure to appreciate the joys of fatherhood – as you really only have one chance at it. Wise words from someone with plenty of life experience.

I am very happy I had the opportunity to call Hershel my friend and learn from such a wonderful person. Hershel truly cared about people. Hershel will be sorely missed. Rest in peace my friend.

Biofeedback uses physiological measures of muscle tension (EMG), skin perspiration (GSR), temperature , respiration and heart rate variability. Neurofeedback, or EEG biofeedback assesses unhealthy brainwave (EEG) patterns to determine if an athlete is anxious, in the peak attention zone or over-focused and trains their brain to be able to maintain the optimal pattern required for peak performance. The Mind Room combines biofeedback and neurofeedback measures with game video that can be used to train several athletes at one. In addition, using the Mind Room concepts, players are less like to suffer severe injuries and recover from these injuries, including concussions, more quickly and with better long-term results. These training benefits result in greater player performance and durability, often resulting in Olympic Gold Metals and Team Championships.

The use of biofeedback and neurofeedback are becoming more frequent in sport psychology, especially in the area of concussion assessment (using QEEG assessment) and treatment. Athletes in contact sports, especially hockey and football are increasingly experiencing concussions which not only can significantly interfere with their teams success (i.e. Sidney Crosby in the NHL), but also negatively affect their future sport success and life health.

Additional information is available in a book to be released in June 2001 called “Applications of Biofeedback & Neurofeedback in Sport Psychology” edited by Ben Strack, Ph.D. and Michael Linden, Ph.D., published by the Association of Applied Physiology and Biofeedback (www.aapb.org).

Dr. Linden is a Clinical Psychologist and Nationally Certified in Neurofeedback and Biofeedback. He is the director of The Attention Learning Center, which has offices located in San Juan Capistrano, Irvine and Carlsbad, California.

Shifted frequencies cause a background coherence pattern to be mis-read by the database as an aberant pattern, when it may be prefectly normal for the rhythm if it were tuned (frequency adjusted) properly… altering the coherence is not the NF fix in this situation, but rather a re-tuning of the aberrantly shifted frequency.

The coherence needs to be understood… and whether to feed it back or not picked based on a real coherence issue, not a distortion due to aberrant tuning or a focal event issue.

Obviously there still needs to be a sea-change in the attitude of football players when too many believe that they will “just be replaced” if they suffer a brain injury and need treatment or recovery time before returning to the game… so they suffer and the brain injury worsens with repetition, and “substance Tau” builds up and up, ruining brain function in the process. In a game where millionaires are playing for billionaires, this should not be an issue.

Our ability to see the brain function and dysfunction associated with white matter or gray matter injuries has advanced over the last decade, and now we have technologies that can measure even small changes in function associated with brain injury. The structural imaging will catch the gross issues, like a cortical contusion or a bleed, but functional imaging is needed to see the subtle impacts on neural networks. The addition of Event Related Potentials to the evaluation has allowed our approach using ICA analysis to show the subtle impacts on neural processing of head injuries.

The ICA approach initially was used in research in Trondheim Norway on know TBI and normal clients done by Professor Dr Juri Kropotov, and subsequently in funded research in Switzerland this is being replicated in a much larger study paid for by the insurance industry.

The offshoot of the work shows that the EEG alone does a poor job of seeing TBI, with a weak discrimination ability. The ERP however appears to be a robust and sensitive metric that also has high specificity. Together the EEG and ERP provide uniquely powerful imaging which can not be matched by any other medical imaging approach with respect to temporal resolution. We have millisecond time domain resolution using these electrographic EEG and ERP approaches, whereas the functional MRIs and PET/SPECT approaches are “smeared” across time, with 100 to 1000 times less resolution.

It is a shame that human tragedy seems needed to move opinions and practices after-the-fact. I am encouraged that these modern imaging tools are providing us with tools that allow insight into these physiological processes.

The neuroscience is moving ahead, and older approaches have been shown to be unreliable, but superior methods are now available and are being proven in solid neuroscience research internationally.

Jay

As a symptom, this sensory loss points to the severity of the TBI, and it
immediately makes the case something other than a mild traumatic brain
injury, as the effect is not mild.

The loss of sense of smell is not something that has an EEG signature,
though often the severity of the TBI will have caused some cortical issue,
which may be seen as a temporary loss of rhythmic faster content (see
previous postings for the spectral impact of gray matter injury and the
time-course for those changes).

The new American Academy Of Neurology paper suggests that in MOST mild
traumatic brain injuries there is no long term effect. This does not speak
to the cases that look mild until they looked with better imaging technology
than human sight, like CT scans or MRI to see bleeding (see the post of the
paper regarding my father’s mild TBI and large subdural hematoma removal),
or better clinical workup which can reveal things like the loss of sense of
smell associated with the TBI. The circular logic of changing the
definitional diagnosis of a case as “mild TBI” as soon as a “real” finding
is identified to a TBI (note the lack of the term “mild” now?) has never
seemed like a real good clinical practice, but it is the current situation,
given the pre-defined nature of MTBI as being “benign”.

If the MTBI were really benign, then a series of them should also be
benign… and this logical fallacy reveals the difficulty at the heart of
the AAN position on MTBI. A series of these MTBI events is known to cause
an exponential increase in the likelihood of seeing a finding which is not
normal.

Repetitive TBIs have a developing literature showing increased levels of a
substance “Tau” with repeated injury, which is much like the amyloid plaque
of Alzheimer’s Dementia.

The AAN position on this is obviously undergoing an acute change, and even
more change is expected, since the neuroscience is getting better and as the
politics of evaluation of the MTBI in court starts to dissolve with the use
of better neuroscience tools, including the ERP and the EEG/qEEG.

The failure of MTBI discriminants to be both sensitive and specific should
not discourage professionals from using EEG and ERP to characterize their
client’s brain function, as these tools can and do show a head trauma’s
impact on brain function, and without the discriminant, can often get
admitted into court along with good neurocognitive testing as valid evidence
of brain function/dysfunction. Even in the absence of litigation or severe
findings (like a subdural), the data can help direct neuromodulatory
treatment options such as Neurofeedback to help in thee remediation.

I personally prefer the path of remediation to that of diagnostic
specificity and litigation, and find the EEG and ERP invaluable in
optimizing the design of an individual’s remediation.

Jay