Neurofeedback

EEG Complexity as a Biomarker for Autism Spectrum Disorder Risk

William Bosl1,2*, Adrienne Tierney3,4, Helen Tager-Flusberg5, Charles Nelson1,4

Abstract


Background: Complex neurodevelopmental disorders may be characterized by subtle brain function signatures early in life before behavioral symptoms are apparent. Such endophenotypes may be measurable biomarkers for later cognitive impairments. The nonlinear complexity of electroencephalography (EEG) signals is believed to contain information about the architecture of the neural networks in the brain on many scales. Early detection of abnormalities in EEG signals may be an early biomarker for developmental cognitive disorders. The goal of this paper is to demonstrate that the modified multiscale entropy (mMSE) computed on the basis of resting state EEG data can be used as a biomarker of normal brain development and distinguish typically developing children from a group of infants at high risk for autism spectrum disorder (ASD), defined on the basis of an older sibling with ASD.
Methods: Using mMSE as a feature vector, a multiclass support vector machine algorithm was used to classify typically developing and high-risk groups. Classification was computed separately within each age group from 6 to 24 months.

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Technical Details in EEG Diagnosis of Autism

Many have heard experts in the neurofeeback field state vehemently that the “ICA deartifacting ruins the EEG”, and that “remontaging to a Laplacian montage ruins coherence”. There are internet tutorials attempting to support these opinions. This self-publication on-line on a commercial site is not the same as peer review, and many publish bad opinions without an alternative approach even considered.

Rather than engage in the meaningless back and forth of mere opinions, I thought it was better to wait for the decision of the jury.. a jury of our peers inherent to the peer reviews in professional publications seen in the field of neuroscience. I comfortably accept the judgment of the field’s journal’s editors.

Harvard’s famous Electroencephalographer, Frank Duffy M.D. just published a large scale well designed study. Some of the key aspects in the paper are highlighted and discussed below:

“Remaining eye blink and eye movement artifacts, which may be surprisingly prominent even during the eyes closed state, were removed by utilizing the source component technique [42, 43] as implemented in the BESA (BESA GmbH, Freihamer Strasse 18, 82116 Gräfelfing Germany) software package”

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The Effects of QEEG-Informed Neurofeedback in ADHD: An Open-Label Pilot Study

Martijn Arns • Wilhelmus Drinkenburg • J. Leon Kenemans

Abstract In ADHD several EEG biomarkers have been described before, with relevance to treatment outcome to stimulant medication. This pilot-study aimed at personalizing neurofeedback treatment to these specific sub-groups to investigate if such an approach leads to improved clinical outcomes. Furthermore, pre- and post-treatment EEG and ERP changes were investigated in a sub-group to study the neurophysiological effects of neurofeedback. Twenty-one patients with ADHD were treated with EEG-informed neurofeedback and post-treatment effects on inattention (ATT), hyperactivity/impulsivity (HI) and comorbid depressive symptoms were investigated. There was a significant improvement for both ATT, HI and comorbid depressive complaints after QEEG-informed neurofeedback. The effect size for ATT was 1.78 and for HI was 1.22. Furthermore, anterior individual alpha peak frequency (iAPF) demonstrated a strong relation to improvement on comorbid depressive complaints. Pre- and post-treatment effects for the SMR neurofeedback sub-group exhibited increased N200 and P300 amplitudes and decreased SMR EEG power post-treatment.

This pilot study is the first study demonstrating that it is possible to select neurofeedback protocols based on individual EEG biomarkers and suggests this results in improved treatment outcome specifically for ATT, however these results should be replicated in further controlled studies. A slow anterior iAPF at baseline predicts poor treatment response on comorbid depressive complaints in line with studies in depression. The effects of SMR neurofeedback resulted in specific ERP and EEG changes.

Read the full text here The Effects of QEEG-Informed Neurofeedback in ADHD:
An Open-Label Pilot Study – This article is published with open access at Springerlink.com Applied Psychophysiology and Biofeedback. doi: 10.1007/s10484-012-9191-4

QEEG-guided Neurofeedback: New Brain-based Individualized Evaluation and Treatment for Autism

by James Neubrander, MD, Michael Linden, PHD, Jay Gunkelman, QEEGd, and Cynthia Kerson, PHD

QEEG-guided neurofeedback is based on normalizing dysregulated brain regions that relate to specific clinical presentation. With ASD, this means that the approach is specific to each individual’s QEEG subtype patterns and presentation. The goal of neurofeedback with ASD is to correct amplitude abnormalities and balance brain functioning, while coherence neurofeedback aims to improve the connectivity and plasticity between brain regions. This tailored approach has implications that should not be underestimated. . . . Clinicians, including the authors, have had amazing results with ASD, including significant speech and communication improvements, calmer and less aggressive behavior, increased attention, better eye contact, and improved socialization. Many of our patients have been able to reduce or eliminate their medications after completion of QEEG-guided neurofeedback.

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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

What Happened to the Reporter at the Grammys?

Recently during a post-Grammy interview, the on-air report had some serious difficulties in getting her words out. You can read about it and see the video here .

The reporter in this article likely had a TIA… a Transient Ischemic Attack… the temporary insufficiency of vascular flow dynamics to a cortical area providing insufficient local glucose and oxygen for function. This can happen from just flow dynamics due to vasoconstriction, such as seen in hyperventilation or gross over-arousal. This can also happen when blood consistency is not appropriate to allow flow, such as seen with hyperglycemia in diabetics when their blood sugar rises too high.

You may think “what does this have to do with EEG?”… well it is an important EEG area, and not without controversy.

The mid-temporal sharp-slow transients that are seen in EEG are considered neurologically non-specific, and many neurologists do not even comment on them. This is a mistake, as these nonspecific changes are a harbinger of vascular issues, including ischemia (as seen in migraine ischemia and the current discussion of TIAs), or vascular insufficiency, commonly in the vertebro-basillar artery and posterior vascular distributions supplying the hippo-campus (which has a huge metabolic demand load).

No less than Ernst Neidermayer chastises the neurologists doing EEG interpretations for under-reading of these findings. He clearly shows in his paper that these non-specific findings are important.

Recently I had a client who sent in the EEG of his wife, who had experience some word-finding and fluency issues, and it had these “nonspecific” temporal findings on the left… we suggested an MRA (magnetic resonance angiography), and though they had already done the MRI (which was normal), the MRA was done. The MRA showed a 9 millimeter AV malformation, and surgery was done to patch this area so it didn’t burst, saving her life.

These are the sort of waveform distortions that require an experienced EEG interpretation, and preferably an expert with Board qualification in EEG, not just someone licensed to read EEGs. These controversial findings make all the difference, and it is exactly these areas that provide the large difference between interpretation in studies looking at inter-reader visual EEG reliability.

Jay

Historical Archives: The Beginning of Neurofeedback . . .

PART I – The Beginning – from the latest issue of the Journal of Neurotherapy introduces a new feature of the journal, the Historical Archives. In any profession it is important to be aware of the historical origins of the field. The field of neurofeedback was conceptualized a long time ago, and in this section we want to share some of the first works so the interested reader can get an idea of where our field came from and how it all started. As with most psychiatric treatments, the field of neurofeedback started as serendipity . . . .

In the early 1940s several studies already demonstrated that the human EEG could be classically conditioned (Jasper & Shagass, 1941a; Knott & Henry, 1941). These studies investigated in great detail the occipital alpha-blocking response and whether alpha blocking with visual stimulation could be conditioned to an auditory stimulus. In addition a range of classical conditioning principles have been successfully applied, and all of the Pavlovian types of conditioned  responses could be demonstrated (Jasper & Shagass, 1941a). In a follow-up study, Jasper and Shagass (1941b) investigated further whether participants could also exert voluntary control over this alpha-blocking response. In this study they had participants press a button, which would turn the lights on and off, and use subvocal verbal commands when pressing the button (e.g., ‘‘Block’’ when pressing the button and ‘‘Stop’’ when releasing the button).

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New Study Shows – The increase in theta/beta ratio on resting-state EEG in boys with attention-deficit/hyperactivity disorder is mediated by slow alpha peak frequency

References and further reading may be available for this article. To view references and further reading you must purchase this article.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) was found to be characterized by a deviant pattern of electrocortical activity during resting state, particularly increased theta and decreased beta activity.

The first objective of the present study is to confirm whether individuals with slow alpha peak frequency contribute to the finding of increased theta activity in ADHD. The second objective is to explore the relation between resting-state brain oscillations and specific cognitive functions. From 49 boys with ADHD and 49 healthy control boys, resting-state EEG during eyes open and eyes closed was recorded, and a variety of cognitive tasks were administered. Theta and beta power and theta/beta ratio were calculated using both fixed frequency bands and individualized frequency bands. As expected, theta/beta ratio, calculated using fixed frequency bands, was significantly higher in ADHD children than control children. However, this group effect was not significant when theta/beta ratio was assessed using individualized frequency bands. No consistent relation was found between resting-state brain oscillations and cognition. The present results suggest that previous findings of increased theta/beta ratio in ADHD may reflect individuals with slow alpha peak frequencies in addition to individuals with true increased theta activity. Therefore, the often reported theta/beta ratio in ADHD can be considered a non-specific measure combining several distinct neurophysiological subgroups such as frontal theta and slowed alpha peak frequencies.

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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