Listen to the full podcast here Jay Gunkelman Podcast
This week we’re joined by QEEG Diplomate (yes, that’s a term!) and founder of Brain Science International Jay Gunkelman, to talk Electroencephalography. After analyzing over a half-million EEG scans, Jay has a pretty robust set of human brain data at his disposal… And he uses that body of knowledge to guide the work of psychiatric and other health professionals who make proscriptive recommendations about patients’ brains.
Ronald J. Swatzyna, Gerald P. Kozlowski, and Jay D. Tarnow
Pharmaco-electroencephalography (Pharmaco-EEG) studies using clinical EEG and quantitative EEG (qEEG) technologies have existed for more than 4 decades. This is a promising area that could improve psychotropic intervention using neurological data. One of the objectives in our clinical practice has been to collect EEG and quantitative EEG (qEEG) data. In the past 5 years, we have identified a subset of refractory cases (n = 386) found to contain commonalities of a small number of electrophysiological features in the following diagnostic categories: mood, anxiety, autistic spectrum, and attention deficit disorders, Four abnormalities were noted in the majority of medication failure cases and these abnormalities did not appear to significantly align with their diagnoses. Those were the following: encephalopathy, focal slowing, beta spindles, and transient discharges. To analyze the relationship noted, they were tested for association with the assigned diagnoses. Fisher’s exact test and binary logistics regression found very little (6%) association between particular EEG/qEEG abnormalities and diagnoses. Findings from studies of this type suggest that EEG/qEEG provides individualized understanding of pharmacotherapy failures and has the potential to improve medication selection.
A retrospective study of patients who had in-hospital electroencephalography (EEG) has established that EEG is a valuable tool that could be deployed more widely to identify treatable causes of impaired consciousness in the hospital setting.
The study is published in the April issue of the Mayo Clinic Proceedings.
Altered mental status (AMS) and paroxysmal spells of uncertain origin are common among hospitalized patients. Impaired consciousness can sometimes be linked to metabolic or cardiac causes, but some of these spells may represent seizures or non-convulsive epilepsy, which can be detected only by electroencephalography (EEG). Although EEG is the key test in making these diagnoses, it is relatively underused in the inpatient setting owing to lack of availability and neurologic consultation at many hospitals in the United States.
Nijmegen, March 26th, 2013 – A study published today in Biological Psychiatry sheds new light on the increasing rates (prevalence) of attention-deficit/hyperactivity disorder, known as ADHD. Children with ADHD have problems with inattention, distractibility, disorganization, impulsiveness, and overactivity. This study found that “sunny” regions with high solar intensity, such as the US states of California, Arizona, and Colorado, and countries like Spain and Mexico have lower prevalence of ADHD. An apparent protective effect of sunlight accounted for 34-57% of the variance in ADHD prevalence. The authors speculate that this may be related to sunlight’s effects on preventing circadian rhythm (“biological clock”) disturbances. These results suggest ways to prevent or treat ADHD for a substantial sub-group of patients…
Read the full PDF paper “Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder: The Sunny Perspective” by Martijn Arns, Kristiaan B. van der Heijden, L. Eugene Arnold, and J. Leon Kenemans.
The healthcare guidance body NICE (National Institute for Health and Clinical Excellence (NHS NICE) has published final guidance recommending the use of brain monitoring technology such as the Bispectral Index (BIS, Covidien), E-Entropy (GE Healthcare) and Narcotrend-Compact M (MT MonitorTechnik GmbH & Co). These EEG-based depth of anaesthesia monitors should be considered as positive options in patients receiving total intravenous anaesthesia (TIVA) and in patients who are considered at higher risk of adverse outcomes during any type of general anaesthesia, such as seniors, those with high body mass index, and those with cardiovascular and liver disease.
EEG based Brain Monitoring Systems helps clinicians assess patient consciousness levels through measuring the electrical activity in the brain. This includes patients who are at higher risk of unintended awareness (anesthesia too light) and also those patients who are at higher risk from excessively deep anaesthesia.
Superior surgical outcomes, the low cost of the testing and the ease of use of these technologies all contribute to the recommendations.
You can access these documents through ASET (www.ASET.org)
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.
This last year we lost an old friend, Bill Hudspeth…. William J Hudspeth, PhD. He scientifically contributed to understanding the EEG of maturation, and his multivariate connectivity eigenvector work is still ahead of many others in modeling brain function. We lost a real contributor.
In his later years he was treated for hypertension with Reserpine. I recall Bill’s dehydration in Arizona at an ISNR meeting when I carried him out of the hall during a syncopal spell. He was not well conmtrolled on his diuretic. Reserpine is rarely used in the management of hypertension today, as it is a second-line adjunct agent for patients who are poorly controlled on a diuretic, when cost is an issue. It is an inexpensive and effective antihypertensive, though not without a substantial potential for side-effects, which has it banned in England.
Subclinical electroencephalographic epileptiform discharges in neurobehavioral disorders are not uncommon. The clinical significance and behavioral, diagnostic, and therapeutic implications of this EEG cerebral dysrhythmia have not been fully examined. Currently the only connotation for distinctive epileptiform electroencephalographic patterns is epileptic seizures. Given the prevailing dogma of not treating EEGs, these potential aberrations are either disregarded as irrelevant or are misattributed to indicate epilepsy. This article reappraises the literature on paroxysmal EEG dysrhythmia in normative studies of the healthy nonepileptic general populations, neuropsychiatry,
and in neurobehavioral disorders. These EEG aberrations may be reflective of underlying morpho-functional brain abnormalities that underpin various neurobehavioral disturbances.
Real the full article here – Electroencephalographic Cerebral Dysrhythmic Abnormalities in the Trinity of Nonepileptic General Population, Neuropsychiatric, and Neurobehavioral Disorders
(The Journal of Neuropsychiatry and Clinical Neurosciences 2008; 20:7?22)
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.
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.