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.
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:
Nijmegen, July 16th 2009 – Neurofeedback – also called EEG Biofeedback – is a method used to train brain activity in order to normalize Brain function and treat psychiatric disorders. This treatment method has gained interest over the last 10 years, however the question whether this treatment should be regarded as an Evidence-Based treatment was unanswered until now. Tomorrow a study will be published in the scientific journal ‘EEG and Clinical Neuroscience’ demonstrating that Neurofeedback can indeed be regarded as an evidence-based treatment for Attention Deficit- / Hyperactivity Disorder (ADHD).
Neurofeedback is a treatment where real-time feedback is provided for specific brain activity (most often EEG) in order to learn the brain to suppress or produce specific brain activity. This method was initially discovered for the treatment of Epilepsy and from 1976 investigated further for the treatment of ADHD. This technique has become more popular by clinicians worldwide, and is currently provided for the treatment of several disorders. Critics have often questioned the efficacy of Neurofeedback and whether it can be considered an Evidence Based treatment or not.
In collaboration with researchers from Tübingen University (Germany), Radboud University (Nijmegen, the Netherlands), Brainclinics and EEG Resource Institute a so-called meta-analysis was conducted on all published research about Neurofeedback treatment in ADHD. This meta-analysis included 15 studies and 1194 ADHD patients. Based on this study – which will be published in the July issue of EEG and Clinical Neuroscience – it could be concluded that Neurofeedback can indeed be considered an Evidence-Based treatment for ADHD. The results show that neurofeedback treatment has large and clinically significant effects on Impulsivity and Inattention and a modest improvement of Hyperactivity.
A collection of great videos on the brain from Vilayanur S. Ramachandran MD, PhD
The Boy with the Incredible Brain
This is the breathtaking story of Daniel Tammet. A twenty-something with extraordinary mental abilities, Daniel is one of the world’s few savants. He can do calculations to 100 decimal places in his head, and learn a language in a week. This documentary follows Daniel as he travels to America to meet the scientists who are convinced he may hold the key to unlocking similar abilities in everyone.
Background:
For children with attention deficit/hyperactivity disorder (ADHD), a reduction of inattention, impulsivity and hyperactivity by neurofeedback (NF) has been reported in several studies. But so far, unspecific training effects have not been adequately controlled for and/or studies do not provide sufficient statistical power. To overcome these methodological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite randomised controlled study using a computerised attention skills training as a control condition.
According to the U.S. Substance Abuse and Mental Health Services Administration, addiction is currently one of the most significant health and social problems in America, affecting ~12.5% of the population. Medical costs can be up to 300% higher for an untreated alcoholic than a treated alcoholic. Other costs to society have reached almost $500 billion, taking into account unemployment, lost productivity, increased crime and justice system/incarceration costs, health care system strain, increased insurance costs, child abuse/neglect and even workplace violence. It is estimated that every dollar spent on treatment saves $4–$7 in costs from drug-related crime and can help reduce the spread of infectious diseases.
The ascending reticular activating system stimulates the diffuse thalamic projection system and sets the general arousal level of the brain. With an increase in the CNS arousal level, there is an increase in the mean frequency of alpha and a decreased slowing. With decreases in arousal there is a slowing of the alpha, as well as eventually an increase in diffusely distributed slowing ( a mixture of diffuse lower voltage delta and theta, usually with a weak vertex prominence in linked ear montages).