Clinical Policy Bulletin: Quantitative EEG (Brain Mapping) from Aetna

Recently Released Clinical Policy Bulletin: Quantitative EEG (Brain Mapping) from Aetna

It is no surprise when insurance companies find ways to restrict what they will cover as a service for their clients, whether flood insurance liability insurance, or any other branch of this financial industry.  This is especially true for medical insurance companies, which are always finding reasons to restrict payments.

This decision restricts the payment for a qEEG to be an extension of the analysis of an EEG analysis, which makes the qEEG a medical procedure requiring licensure adequate to provide credentials to do a medical EEG interpretation. If further restricts the payments to applications that match the American Academy of Neurology position paper, which approves the technique in vascular cases, encephalopathies such as dementia cases, or for epilepsy, as well as longer term EEG monitoring, where quantitative analysis allows the selection of segments for review visually, assisting the electroencephalographer in eliminating long time segments from detailed analysis.

Specifically restricted from payment are these applications:

Read moreClinical Policy Bulletin: Quantitative EEG (Brain Mapping) from Aetna

Houston’s Tarnow Center offers solution for service members with PTSD

A friend of qEEGsupport.com ( Dr. Ron Swatzyna) was recently featured on a local news station in the Houston area.

HOUSTON – A Houston doctor is working on something that could help the many service members who return from the battle field suffering from post-traumatic-stress disorder.

By its own admission, The Veterans Administration has had little success treating people who are suffering from both traumatic brain injury and post traumatic stress disorder.

“They end up not having any cognitive strategies to manage the therapy, and they’ll either get out of therapy, or end their lives and that’s what’s happening,” said Dr. Ron Swatzyna, a psychotherapist, neuro-therapist, and biofeedback therapist for Houston’s Tarnow Center. “I’ve been working on this issue for about four years now.”

He said resetting the brain, lining it back up through stimulation, is the key.  And by mapping the brain, he believes he can tell when the patient is ready for therapy.

“Not at the beginning. If you push them too quick that’s a problem. If they are pushed into therapy too quick,” he said.

Swatzyna said the defense department and the VA both realize more research is needed, and if he can get funding, and cooperation from a group in the Texas Medical Center, he would like to open up a research center in Houston.

Vietnam veteran Billy Miller, who one of Swatzyna’s patients, is now helping him pull it off.

“Everyone I had been to before, all 25 doctors had never had military experience, they didn’t know what I was going through,” Miller said.

Swatzyna was a captain in the Air Force, and now many believe he is the best in the country at understanding veterans.

Army soldier Joel Brasier, who suffers from TBI and PTSD, believes Swatzyna is on the right track and is hoping research will lead to better, faster treatment.

“It’s an ongoing process, but eventually they are going to make a breakthrough and get us the help we need,” Brasier said.

Full story from khou.com

Current Research Regarding Blast Injuries in Veterans

This current research from the New England Journal of Medicine  – Detection of Blast-Related Traumatic Brain Injury in U.S. Military Personnel –  shows that Blast Injury is not at all like mild traumatic brain injury, since the mTBI does not involve white matter injuries. The research does show white matter changes during the medical evacuation, done in Germany using Diffusion Tensor Imaging, and also that the white matter changes continue to evolve. They also show that not all symptomatic blast injuries are seen with this technique.

No traditional structural neuroimaging was able to see this damage (like CT or routine MRI). The NY Times recently reported on soldiers injuries evading the M.R.I and CT Scans

The brain areas involved included the orbital surfaces of the frontal lobe and the temporal areas.

These results point to the need for a clinical diagnosis, not a reliance on any given technology to answer the clinical question.

The endocrine changes from supposed pituitary injury, and the presence of micro-emboli due to pressure wave impact on the thorax that are reported in blast injury is not at all dismissible with these findings.

Sports Related Brain Injury aka Chronic Traumatic Encephalopathy(CTE)

It is now almost common to hear about athletes who suffered a number of concussions over their careers having some difficulties later in life. The damage can be very serious.

Chronic Traumatic Encephalopathy(CTE) is associated with repeated head traumas — concussions or sub-concussive hits — that are not allowed to properly heal. It is a progressive degenerative disease found in individuals who have been subjected to multiple concussions and other forms of head injury. A variant of the condition, dementia pugilistica, is primarily associated with boxing. CTE has been most commonly found in professional athletes participating in gridiron football, ice hockey, professional wrestling and other contact sports, who have experienced head trauma, resulting in characteristic degeneration of brain tissue and the accumulation of tau protein. Individuals with Chronic Traumatic Encephalopathy may show symptoms of dementia such as memory loss, aggression, confusion and depression which may appear within months of the trauma or many decades later.

A number of athletes have been affected by the condition with serious consequences. Recently a former NFL lineman committed suicide after serious mental decline. His wife said it started with the nightmares and progressively got worse.

Bob Probert’s brain was examined after his early passing at the age and was found to have CTE (read more here).

Read moreSports Related Brain Injury aka Chronic Traumatic Encephalopathy(CTE)

New Findings on PTSD and Brain Activity

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on November 1, 2010

Researchers have discovered a correlation between increased activity among brain circuits and flashbacks among individuals with post-traumatic stress disorder (PTSD).

University of Minnesota investigators learned that an increased circuit activity in the right side of the brain is associated with the debilitating, involuntary flashbacks that often characterized PTSD.

The ability to objectively diagnose PTSD through concrete evidence of neural activity, its impact and its manifestation is the first step toward effectively helping those afflicted with this severe anxiety disorder.

PTSD often stems from war, but also can be a result of exposure to any psychologically traumatic event. The disorder can manifest itself in flashbacks, recurring nightmares, anger or hypervigilance.

Using a technique called Magnetoencephalography (MEG), a noninvasive measurement of magnetic fields in the brain, researchers found differences between signals in the temporal and parieto-occipital right hemispheric areas of the brain among those with PTSD.

The temporal cortex, in accordance with earlier findings on the effects of its electrical stimulation during brain surgery, is thought to be responsible for the reliving of past experiences.

Read moreNew Findings on PTSD and Brain Activity

The American Academy of Neurology (AAN) Position Statement On Sports Concussion

The American Academy of Neurology (AAN)—an association of more than 22,500 neurologists and neuroscience professionals dedicated to providing the best possible care for patients with neurological disorders—is an advocate for policy measures that promote high quality, safe care of individuals participating in contact sports.

Concussion is a common consequence of trauma to the head in contact sports, estimated by the Centers for Disease Control and Prevention to occur three million times in the United States each year. Among people aged 15 to 24 years, sports are now second only to motor vehicle accidents as the leading cause of traumatic brain injury. While the majority of concussions are self-limited injuries, catastrophic results can occur and the long-term effects of multiple concussions are unknown.

Members of the AAN specialize in treating disorders of the brain and nervous system, and some members have particular interest and experience caring for athletes and are best qualified to develop and disseminate guidelines for managing athletes with sports-related concussion. Based on the clinical experience of these experts, the AAN supports the implementation of policy that supports the following recommendations:


Recommendations

  1. Any athlete who is suspected to have suffered a concussion should be removed from participation until he or she is evaluated by a physician with training in the evaluation and management of sports concussions
  2. No athlete should be allowed to participate in sports if he or she is still experiencing symptoms from a concussion.
  3. Following a concussion, a neurologist or physician with proper training should be consulted prior to clearing the athlete for return to participation.
  4. A certified athletic trainer should be present at all sporting events, including practices, where athletes are at risk for concussion.
  5. Education efforts should be maximized to improve the understanding of concussion by all athletes, parents, and coaches.

Position Statement History
Approved by the AAN Sports Neurology Section, Practice Committee, and Board of Directors
October 2010 (AAN Policy 2010-36).

VA Eases PTSD Claims Process

The Veterans Affairs Department has published a final regulation intended to ease the claims process and improve access to health care for veterans with post-traumatic stress disorder. Under the new rule, VA no longer will require substantiation of a stressor tied to fear of hostile military or terrorist activity if a VA psychiatrist or psychologist can confirm that the experience recalled by a veteran supports a PTSD diagnosis and the veteran’s symptoms are related to the stressor. The Veterans Affairs Department has posted a fact sheet including questions and answers about the new rule governing PTSD claims on the VA website or call VA’s toll free benefits number at 800-827-1000

International Society for Neurofeedback & Research (ISNR) 18th Annual Conference

International Society for Neurofeedback & Research (ISNR) 18th Annual Conference
Denver, Colorado Sept 30-Oct 3, 2010

ISNR invites you to their 18th Annual Conference for Health Professionals, Education Professionals, Researchers & Students. This conference offers workshops by the leading clinicians and researchers in the field of neuroscience. There will be many workshops and keynote talks on clinical as well as theoretical applications in the neuroscience field.

Read moreInternational Society for Neurofeedback & Research (ISNR) 18th Annual Conference

Consciousness: An Emergent Property Of Mind-Brain Interaction

Consciousness: An Emergent Property Of Mind-Brain Interaction – presented by Jay Gunkelman

A model of consciousness will be illustrated with physiological data from EEG and Event related potentials. Using millisecond level time resolution, a working model of the interaction between the mind and the brain will be constructed.

The Slow Cortical Potentials generated by Glial activity and the faster gamma activity reflecting activity of bound neural networks will be used to illustrate this model. The physiological correlates of concepts like intention, attention, memory, perception, awareness, sensory differentiation and conscious awareness will all be discussed within the framework of this model. Advanced concepts like neural network binding, nested rhythms, cross-spectral correlation, and the bispectrum will be discussed.

The DC potentials cause an instantaneous phase resetting and binding of a neural network, which can initiate synchronous activity within these neural networks. Current work using this model in clinical work on severe disorders of consciousness, including work by the International Brain Research Foundation on recovery of consciousness in coma cases will be reviewed. The simplest expression of the model: when the DC potentials reflecting activity of the mind interact with gamma activity reflecting neural activity in the brain, the emergent property of this interaction is consciousness.

[youtube]http://www.youtube.com/watch?v=Pv-msnzTk7o[/youtube]

From The Society for Scientific Exploration (SSE)

First Direct Evidence of Neuroplastic Changes Following Brainwave Training

The scientific and academic press is now considering Neurofeedback as one of the ways neural plasticity can be induced/enhanced. The paper below shows the NF training changing the brain’s plasticity measurably within a single feedback session.

This may not surprise too many old-time NF practitioners, except that it is now being proven with well done studies in the traditional neuroscience literature!  Neurofeedback can induce changes in brain plasticity!

Jay

First Direct Evidence of Neuroplastic Changes Following Brainwave Training

ScienceDaily (Mar. 12, 2010) — Significant changes in brain plasticity have been observed following alpha brainwave training.

A pioneering collaboration between two laboratories from the University of London has provided the first evidence of neuroplastic changes occurring directly after natural brainwave training. Researchers from Goldsmiths and the Institute of Neurology have demonstrated that half an hour of voluntary control of brain rhythms is sufficient to induce a lasting shift in cortical excitability and intracortical function.

Remarkably, these after-effects are comparable in magnitude to those observed following interventions with artificial forms of brain stimulation involving magnetic or electrical pulses. The novel finding may have important implications for future non-pharmacological therapies of the brain and calls for a serious re-examination and stronger backing of research on neurofeedback, a technique which may be promising tool to modulate cerebral plasticity in a safe, painless, and natural way.

Continued at http://www.sciencedaily.com/releases/2010/03/100310114936.htm