Dementia and Alzheimer’s Disease: LORETA findings

Thanks to Jay Gunkelman who made a very informative post on January 27 on this forum entitled Dementia and Alzheimer’s Disease. There he described the EEG patterns that we should expect and detect when evaluating for AD or other dementias.

I’d like to just throw out there a few other findings that were discovered in a few exploratory investigations while working on some studies with our colleague Alicia Townsend, at the time at Univ. of North Texas. Lexicor funded these projects and now the arrangements are such that I can’t disclose more than was published in the abstracts from our talks at ISNR and AAPB.  I did at least want to point to these very preliminary findings because theoretically they are in concert with your explanations.

First, we explored 10 participants between the ages of 65 and 85 were recruited at the University of North Texas Health Science Center.  Each was diagnosed by the Alzheimer’s Disease Assessment Scale and a medical interview.  The aim of the study was to identify current source density markers in AD.  EEG recording of the eyes closed condition of an AD group was compared to an age-sex matched control group using within-subject multiple t-test procedures. sLORETA difference maps in nine frequency bands were investigated. Interestingly the results showed that there was a significant increase in current source density in the delta and theta bands in the Brodmann Area (BA) 39 of the right temporal lobe and BA 31, the cingulate gyrus respectively.  Additionally there were decreases in alpha in the BA 21 of the right temporal lobe and right inferior parietal lobule (Sherlin, Townsend & Hall, 2006).

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Neurofeedback Foundation Award 2009

In his role as the Managing Director of the Foundation for Neurofeedback and
Applied Neuroscience
John Fisher recently announced the Foundation’s selection of a recipient of the Neurofeedback Foundation Award.

The Foundation gives an award to the author(s) of the publication which has
“contributed the most to furthering the field of neurofeedback” during the
past year. Past recipients have included Drs Rob Coben, John Gruzelier, as
well as Johan Levesque and Mario Beauregard.

This year the Foundation has chosen Professor Dr. Juri Kropotov as recipient
of this years award, based on his book and the body of work Juri has
contributed over the years.

This award selection was announced recently at the EEG Spectrum Clinical
Interchange Conference in Los Angeles.  The award includes a gorgeous plaque
as well as an honorarium.

We salute both the Foundation for helping promote the fiend of NF, as well
as all the award recipients for their publications and the substantial
contributions they all have given to our field.

Letter to APA regarding qEEG

This letter has been sent to the American Psychological Association because they have for so long seemly ignored a growing number of psychologists who provide neurofeedback and QEEGs to people who have many disorders , often, disorders that were”incurable”.

Our organization needs to provide information regarding the types of training/treatment that has been proven  over and over to help clients that have severe impediments to their lives.  If you feel similarly and would like to either sign this letter or write your own, it may cause some movement in APA and the Monitor to recognize the services we provide.

Merlyn Hurd PhD;BCIAC/EEG Fellow
Editor of NeuroConnections the ISNR/AAPB Neurofeedback division

Letter to APA regarding qEEG – March 09 2009

James H Bray PhD, President APA
Rhea K. Farberman, Executive Editor Monitor on Psychology
750 First Street, N.E.
Washington, DC 20002-4242

Dear Drs. Bray and Farberman,

Imagine the excitement of seeing “Brain Imaging” on the front of the Monitor for the March 2009 edition.  Finally, the APA is writing about QEEGs (quantitative electroencephalograms) and the types of work that is being done by thousands of psychologists in the neurofeedback world.

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qEEG Artifacting

The qEEG represents the statistical manipulation of the raw EEG, so an understanding of these manipulations should precede any discussion of the qEEGs clinical indications for protocols. Without such knowledge any given finding may be misinterpreted.

Following the careful recording of the EEG, the quantitative analysis is begun with the sampling of the data to be used in the analysis by the Fourier transform. The Fourier analysis assumes there are no transients (epileptic discharges, episodic voltage changes etc.) or state changes (light sleep, drug effect, mental task, etc.), so these must be avoided when selecting data for analysis in qEEG for eyes closed resting database comparison. There are some eyes open and task databases available more recently (Hudspeth, Sterman, Duffy etc.)

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Why do a qEEG for Neurotherapy?

There are many in the field of Neurotherapy who do not perform qEEGs prior to designing a clinical intervention. These people are currently practicing well within the standard of practice for this rapidly evolving field. Many within this group have standard protocols which are used on all clients, with various alterations to respond to the client’s reported experiences during the treatment.

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Dementia & Alzheimer’s Disease (AD)

I often get questions about Alzheimer’s Disease (AD) and the EEG.

Whenever a client presents with the question of dementia, all other forms of
dementia need to be ruled out before you are left with the diagnosis of AD.
There are many EEG signatures of various forms of dementia, all of which are
helpful in evaluating a client’s presentation of dementia.

Done by experts in EEG in dementia, the EEG and qEEG may be of substantial
additive value in the differential diagnosis puzzle that all cases of
dementia represent clinically.

One EEG pattern seen in dementia is the presence of periodic triphasic
slowing in the EEG, which is actually diagnostic of subacute sclerosing
panencephalitis (SSPE). SSPE is a “spongiform encephalopathy” where the
brain becomes like “Swiss cheese”, with holes scattered throughout. This
periodic triphasic finding is differentiated from MULTIFOCAL triphasics
which are diagnostic of Crutzfeld-Jacob Syndrome (CJD), which in lay terms
is a form of mad cow disease in humans.

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EEG Findings in Traumatic Brain Injury

This brief summary will discuss the various EEG findings seen in head injury when it results in a brain injury, though any given head injury may or may not result in traumatic brain injury.  When an injury is incurred by the brain there are a few varieties of findings seen in the EEG, ranging from spectral changes associated with either white or gray matter damage, to the changes in “connectivity”, seen as changes in coherence or correlation measured across the cortex, or between more distant functionally related areas.

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Introduction to Phenotypes

Identifying subtypes of specific disorders is an attractive exercise, as it expands our understanding of the individual’s response to therapy, but it remains attached to the approach based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is rooted in behavior and frequently does not predict therapeutic response by any individual within the DSM grouping. Phenotypes are an intermediate step between genetics and behavior. These proposed electroencephalography (EEG) phenotypes are semistable states of neurophysiological function. The author proposes a framework allowing one to describe much of the observed EEG variance with a small number of phenotypical categories. These groupings cut across the DSM categories, and unlike the DSM, the phenotypes predict the individual’s response to therapy, for neurofeedback as well as for medication.

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