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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EEG based Personalized Medicine in ADHD

Neurophysiological studies in ADHD have shown a relatively uniform picture with regards to EEG – QEEG data (based on group data). Most studies find excess slow brain activity (theta) (Hermens et al., 2004; Mann et al., 1992; Chabot and Serfontein, 1996; Clarke et al., 1998, 2001; Lazzaro et al., 1998, 1999) and a decreased fast brain activity (beta) (Hermens et al., 2004; Clarke et al., 1998; Mann et al., 1992; Lazzaro et al., 1998, 1999). Theta EEG activity is often associated with an “inattentive” or a dreamy state, and beta activity is often seen when the brain is very busy with for instance solving a cognitive task. Figure 1 shows an example of this based on the data of the Brain Resource International Brain Database of 275 patients with ADHD. In this example the increased theta and decreased beta can be clearly seen, with a frontal localization.

group data
Theta                              Absolute Beta                     Relative Beta

Figure 1: This figure shows the average brain activity (quantitative EEG – QEEG) of 275 children with ADHD, compared to a control group. On the left the increased theta EEG activity (p<.0001) can be seen, in the middle the absolute beta EEG activity (p<.0001) and on the left the decreased relative beta EEG activity (p<.0001). This deviant brain activity has a fronto-central localization. This pattern is found in almost all ADHD studies.

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Neurofeedback Impacts on Addiction

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.

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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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Patterns seen in the qEEG and their indicated interventions

Diffuse slowing, with slower alpha

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).

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EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy, and Recommendations for Further Research. Part 2

P300 Abnormalities in Cocaine, Methamphetamine, Heroin Addiction, and Alcoholism

The P300 component of the ERP, occurring 300–600 ms post-stimulus, is the most widely used ERP in psychiatry and other clinical applications (Polich et al. 1994; Polich and Herbst 2000; Pritchard 1981, 1986; Pritchard et al. 2004). The amplitude of the P300 reflects the allocation of attentional resources, while the latency is considered to reflect stimulus evaluation and classification time (Katayama and Polich 1998; Polich and Herbst 2000). The P300 is usually obtained in an oddball paradigm, wherein two stimuli are presented in a random order, one of them frequent (standard) and another one rare (target) (Polich 1990). A modification of the oddball task has been used where a third, also rare stimulus (distracter), is presented along with standard and target stimuli. It was reported that these infrequent distracters elicit a frontocentral P300, so called P3a, whereas the rare targets elicit a parietal P300, so called P3b (Katayama and Polich 1996, 1998). The P3a is recorded at the anterior scalp locations and has been interpreted as reflecting frontal lobe activity (Gaeta et al. 2003; Knight 1984). Though the P300 response in general is thought to represent ‘‘context updating/closure,’’ in a three-stimuli oddball task the P3a is interpreted as ‘‘orienting,’’ and the P3b is viewed as an index of the ability to maintain sustained attention to target (Na¨a¨ta¨nen 1990). The anterior P3a indexes the contextual salience of the rare stimuli, whereas the posterior P3b is indexing task-relevance of the stimuli (Gaeta et al. 2003).

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EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy, and Recommendations for Further Research. Part 1

T. M. Sokhadze – email: tato.sokhadze@louisville.edu
Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA

R. L. Cannon – email: rcannon2@utk.edu
Department of Psychology, The University of Tennessee, Knoxville, TN 37996, USA

D. L. Trudeau – email: trude003@maroon.tc.umn.edu
Department of Family and Community Health, School of Health Sciences, University of Minnesota, Minneapolis, MN, USA

Abstract

Electroencephalographic (EEG) biofeedback has been employed in substance use disorder (SUD) over the last three decades. The SUD is a complex series of disorders with frequent comorbidities and EEG abnormalities of several types. EEG biofeedback has been employed in conjunction with other therapies and may be useful in enhancing certain outcomes of therapy. Based on published clinical studies and employing efficacy criteria adapted by the Association for Applied Psychophysiology and Biofeedback and the International Society for Neurofeedback and Research, alpha theta training—either alone for alcoholism or in combination with beta training for stimulant and mixed substance abuse and combined with residential treatment programs, is probably efficacious. Considerations of further research design taking these factors into account are discussed and descriptions of contemporary research are given.

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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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