CURRENT SCIENCE AND UNDERSTANDING€¦ · • Brainwave activity (electrical activity) of the brain has been tested for hundreds of years with groundbreaking research starting in

All contents © 2016 by Youth Villages, Inc. with all rights reserved

QUANTITATIVE EEG

AUGUST 2016

QEEG

CURRENT SCIENCE AND UNDERSTANDING

All contents © 2016 by Youth Villages, Inc. with all rights reservedAll contents © 2016 by Youth Villages, Inc. with all rights reserved

INTRO / OBJECTIVES

Presenter – Chris Raines, EMBA, BCN-A (Board Certified in Neurofeedback)- Worked in the mental health and QEEG field for 11 years- Diverse Education Background in Education, Religion, Psychology, and

Business- Specifically trained and certified in QEEG/EEG acquisition and

interpretation, Neurofeedback, and other Neuroscience modalities by BCIA (Biofeedback Certification International Alliance)

Objectives:• Learn the basics of QEEG/Brainmaping• Understand QEEG/Brainmapping and how it is useful• Explore some science behind QEEG/Brainmapping• See examples of QEEG/Brainmapping results• Explore how QEEG/Brainmapping can be used in research


Marc R Nuwer of the UCLA Brain Research

Institute defines EEG as a paperless acquisition

and recording of the EEG via computer-based

instrumentation, with waveform storage in a digital

format on electronic media, and waveform display

on an electronic monitor or other computer output

device. Further he describes QEEG as a

mathematical transformation of standard EEG.

According to the American Academy of Neurology:

Quantitative EEG (QEEG) is the mathematical

processing of digitally recorded EEG in order to

highlight specific waveform components, transform

the EEG into a format or domain that elucidates

relevant information, or associate numerical results

with the EEG data for subsequent review or

comparison.

Layman's Terms – Electrical activity that is at the

scalp of the head is recorded using an EEG

acquisition device through a PC. The recording is

then edited, examined, and subjected to a

computer software that allows many different

measurements to be analyzed through colorful

brainmaps and statistical data.

QEEG - Definition


QEEG

• Brainwave activity (electrical activity) of the brain has

been tested for hundreds of years with groundbreaking

research starting in the late 1800s.

• Quantitative Analysis of human EEG has been studied as

early as 1930s (Berger, 1931).

• Digital EEG (as technological ability) has grown and

expanded and greatly accelerated the potential of

quantitative analysis of human EEG.

• In the hands of qualified practitioners with the skill,

knowledge, ability, training, and experience

QEEG/Brainmapping is highly accurate (a statement

supported by American Academy of Neurology,

Biofeedback Certification International Alliance, EEG and

Clinical Neuroscience Society, and other leading

Neuroscience organizations after looking at the overview

of countless research within the field of QEEG)


QEEG

• Involves standard EEG recording + Quantitative analysis• Uses normative reference databases (will look at in more detail)

• Involves Neurometric Analysis (science in measuring brain electrical activity pioneered by E.

Roy John, former professor of psychiatry at NYU)

• Can be used to help/aide in appropriate diagnosis by qualified clinicians• Used to assess overall brain function• Can be used to help/aide clinicians in medication efficacy• Used as a research instrument across many fields• Compliments standard treatment and therapeutic modalities

NOTE: The terms QEEG and Brainmapping can be used interchangeably. However, do not confuse with other types of brainmaps such as MRI, fMRI, SPECT, or PET imaging. Out of all imaging techniques QEEG has much more benefit in testing brain activity. EEG's can detect changes within a millisecond timeframe and track single neurons, depending on the type of neuron. Other methods of looking at brain activity, such as SPECT, PET, and fMRI can only detect change in seconds and minutes. Additionally, EEG measures the brain's electrical activity directly, while other methods record changes in blood flow (SPECT, fMRI) or metabolic activity (PET), which are indirect markers of brain electrical activity.


STEPS TO COMPLETING QEEG

1. Setup a client/individual by placing electrodes (most often electro-caps that are pre-measured) on the head.

2. Place electrodes on the ears of client/individual. (Ensures proper grounding and references, just like any normal electrical device – to ensure recording is accurate, the brain must be grounded properly.

3. The head is then prepped with Electro Conductive Gel – to amplify electrical signal.4. The electro cap is plugged into the EEG acquisition device and a signal is generated onto

the computer screen to see the standard EEG.5. EEG (Electrical activity) is then captured and recorded through the PC.6. A standard EEG recording time is 2-5 minutes Eyes Open and 2-5 minutes Eyes Closed to

see brain activity when both eyes are opened and closed.7. At the end of recording the client/individual is complete and can easily clean the gel out

of their hair. (Steps 1-7 takes between 30-45 minutes)8. The data is then inspected, edited, and examined. This is done through Neuroguide

software – a comprehensive QEEG editing and assessment software that includes a normative database. It is then at Youth Villages – Inner Harbour Campus put through another an additional Database and QEEG assessment software offered through New Mind Maps. (Step 8 needs to be assessed carefully and time can vary depending on the severity of each QEEG/brainmap – Most assessments are completed with reports within 72 hours)


QEEG BASIC

QEEG in simplest terms correlates with the Brodmannareas. The Brodmann area’s of the brain correlate with what the different regions of the brain actually “do” and provide function for. This is based on research that has been on-going and refined since 1909 when the initial research was completed.Brodmann area’s correlate with the anatomy of the brain and their known function(s).


WAVELENGTH & FREQUENCIES

Understanding the different frequencies are crucial to understanding the results of a QEEG/Brainmap. The above chart shows what they help to “control” in each individual.• Delta is mostly associated with sleep• Abnormalities in Theta are associated with the most common form of ADD/ADHD• Alpha helps humans relax, abnormalities are associated with anxiety and depression• Beta is associated with another form of ADD/ADHD, Mood Disorders, PTSD, and Emotional Trauma.

Beta is usually divided into SMR, Lo-Beta, and High Beta and have their on respective associations.• Gamma is commonly used in sports performance building and is not usually measured by common

QEEG systems/software.


DIFFERENT MEASUREMENTS OF A QEEG

THESE MEASUREMENTS ARE INCLUDED IN THE DIFFERENT MAPS THAT ARE GENERATED BY QEEG ANALYSIS SOFTWARE:

Relative Power – Who’s in Charge? Measurement helps determine whether a particular brain frequency is overpowering other brain frequencies. EXAMPLE: Theta waves dominant over Alpha waves in the frontal cortex may indicate attention issues.

Absolute Power – How much power is available? Measurement helps determine the amount of brainpower in a particular frequency range at each recording site (using 10/20 system)

Dominant Frequency – What is the dominant power of each frequency. Most often combined with Absolute Power.

Connectivity (also called Coherence) – How efficient is the brain working to connect and disconnect different parts of itself to accomplish a particular task? Helps indicate traumatic injury, learning deficits, and arousal.

Asymmetry – What is balanced? Are parts of the brain overtired? Are cells firing enough to maintain proper function? Frontal asymmetry in the Delta Frequency has been known to correlate with head injury

Discriminants Analysis – statistical predictions based on variables and data collected over many years. These analyzed variance and categorizes by age, gender, and other conditions.

OTHER AREAS OF MEASUREMENT:(be able to see some of these in scales and examples later in the Presentation)

Emotional AnalysisCognitive AnalysisMidline AnalysisSuggested Supplements


NORMATIVE REFERENCE DATABASES

Normative reference databases serve as a vital and important function in modern clinical science and patient evaluation.

Numerous clinical Normative reference databases that aid in evaluation of a wide range of clinical disorders. They are used with MRI, fMRI, PET scans, QEEG, and other non-brainmapping instances such as blood pressure, nerve conduction velocity, bone density, ultra sound, and many others. A comprehensive survey of existing clinical normative datasbases can be obtained through the National Library of Medicine’s database at http://www.ncbi.nlm.nih.gov/sites/entrez

QEEG Normative Databases include a common set of statistical and scientific standards that have evolved over the years.The standards have been established by leading Neurobiological experts within the field and have been validated through peer reviewed publications, tests of reliability, cross-validation testing, adequate sample sizes, and other criteria.

A distinguishing feature of Normative databases that is crucial to using QEEG/Brainmapping as a clinical tool and research instrument is comparing a single individual to a population of “normal” individuals in order to identify the measures that are deviant from “normal.”

http://www.ncbi.nlm.nih.gov/sites/entrez


Statistical Support through the Software and Database:

NeuroStat and NeuroBatch seamlessly allow for pre vs. post treatment or pre vs

post medication statistical analyses with a few mouse clicks. Individual statistics

for analyses such as pre vs post treatment and group statistics for comparative

statistics include ANOVA, independent t-tests and paired t-tests. Group

statistics include descriptive statistics such as group means and standard

deviations, paired t-tests and ANOVA. LORETA 3-dimensional individual and

group statistics including descriptive statistics, paired t-tests and individual t-

tests. From Dr. Robert Thatcher, Applied Neurosciences


The main Neurometrics and normative database that is used is called Neuroguide and can be found to be used by Psychiatrists, Neurologists, Psychologists, Neuro-psychologists, Mental Health Providers, Researchers and Students. NeuroGuide is a "Tool Set" that a Clinician or Researcher can apply to help link symptoms and behavior to functional networks in the brain. One of the tools is EEG Neuro Imaging to evaluate Brodmann Areas and nodes and connections of functional networks in the brain likely linked to symptoms, statically or in real-time. It is based on individuals from 2 months of age to 82 years who meet specific clinical standards of no history of neurological disorders, no history of behavioral disorders, performed at grade level in school, etc. Most of the subjects in the normative database were given extensive neuropsychological tests. Details of the normative database are published at: Thatcher, R.W., Walker, R.A. and Guidice, S. Human cerebral hemispheres develop at different rates and ages.

Science, 236: 1110-1113, 1987; and

Thatcher R.W., Biver, C.L., North, D., Curtin, R. and Walker, R.W. Quantitative EEG Normative Databases:

Validation and Clinical Correlation. Journal of Neurotherapy, 2003, 7(3/4): 87-121.



The New Mind Normative Data Information – ONE DATABASE USED BY YOUTH VILLAGES –INNER HARBOUR CAMPUS)

New Mind Maps has bio-psycho-social data on over 15,000 individuals. Presently it has a normative sample of N=372 ranging in age from 5 years to 90 years of age. These individuals were screened for normal scores using the Test of Variables of Attention (TOVA), MicroCog, and the Beck Depression and Anxiety Inventories as references with respect to inclusion/exclusion criteria. This insures the population meets the functional criteria for “normal” rather than a purely historical interview as well as insuring content and predictive validity of the database. The sample was drawn from over 300 clinics around the U. S. and is comprised of a wide variety of male and female professionals as well as students, academics, and athletes which provides a rich demographic content. The chart to the right shows the sample distribution of the age of the population by decade.


NEUROMETRIC ANALYSIS

In 1977, John, E. Roy, et al. proposed that the Neurometric Method may aid in the differential diagnosis of a variety of subtle brain dysfunctions. The frequency composition of the normal healthy EEG recorded from every brain region is predictable and changes systematically with normal development and aging. Normative values have been statistically described and independently confirmed by researchers in Barbados, China, Cuba, Germany, Japan, Korea, Mexico, the Netherlands, Sweden, Venezuela, and the United States. Statistically significant deviations are found in individuals with psychiatric illnesses and brain abnormalities.

Mathematical discriminant equations that characterize the EEG of normal individuals and various clinical groups have been constructed and independently replicated. Practitioners can now use Neurometrics to objectively assess the statistical similarity between the individual patient and these statistically-defined distinctive group profiles. The Neurometric Analysis System (AAS) was cleared for medical use by the U.S. Food and Drug Administration for the post-hoc statistical evaluation of the EEG under FDA 5 1 0(k) K974748 in July of 1998. It presently is the only objective measure for many neurologically based disorders.

This process is used in select hospitals, clinics and research centers around the world.

Neurometrics provides a sound, extensively tested data selection and analysis method, rigorously defined and accurate statistical evaluations relative to validated norms, and the largest clinical QEEG database in the world.

(Taken from: Neurometric Analysis System - Demonstration Program, NxLink, Ltd, Copyright, 1999)(Further explained by Dr. David Cantor – leading Neuropsychologist in the field of QEEG and EEG Neurofeedback)


QEEG – VARIOUS APPLICATIONS

PHARMACO – EEG offers the possibility of establishing specific biomarkers for successful treatment (As observed through 7 different research publications from 1995-2007 that include researchers such as Suffin and Emory who studied Neurometric subgroups in attentional and affective disorders and their association with pharmacotherapeuticoutcomes.

QEEG guided Neurofeedback (EEG Biofeedback) offers the ability to define deviations of brain function within a normally distributed measurement set and can target those deviant measures to “normalize” using computer guided games thus improving brain function, negative symptomologies, and negative behaviors.

DIAGNOSIS – Used by qualified clinicians as a guiding tool can offer major insight to appropriate diagnosis of Neurodevelopmental Disorders. In July 2013 the FDA approved and permitted the first QEEG based systems to solely diagnose ADHD. This has been heavily studied by Dr. Joel Lubar from the University of Tennessee for close to 60 years.

FORENSICS – QEEG is used as evidence for civil cases in brain injury by competent and trained QEEG experts. Forensic QEEG is most often considered a separate field and requires specific recording and reporting guidelines.


QEEG – VARIOUS APPLICATIONS

AVE THERAPY (Auditory Visual Entrainment) – Can decrease symptoms of ADHD, Depression, Anxiety, Migraines, and many other negative symptoms. QEEG has been used extensively to show changes in the brain when AVE Therapy is applied. Countless studies have shown statistical and brainmap observational changes in improved Alpha Rhythms (which correlate with improved anxiety and depressive symptomologies). You can find out more about Dave Siever and his research at http://mindalive.com

TOOL FOR MONITORING THERAPEUTIC OR EVIDENCE BASED INTERVENTIONS:One of the benefits of using Neurometric QEEG measurements is to not only clarify brain dysfunction, but also using QEEG as a tool to identify and predict intervention strategies. QEEG provides a clinical means to validate intervention strategies. (Cantor, D., as included by Budzynski, T., Evans, J., and Abarbanel A.).

http://mindalive.com/


QEEG – Example in Assessing changes and validating intervention strategies.

This client completed 24 Neurofeedback sessions. This map shows the Theta changes and asymmetry changes after those 24 sessions.

This same principle and study design can be replicated and expanded to assess any treatment, therapeutic, educational modality.

Youth Villages – Inner Harbour Campus has used this same principle to study the effects of drumming on the brain, Neurofeedback efficacy of individual youth and groups (milieus).

These results come with many other possibilities and results pages, as follows in this presentation on the following slides.


QEEG – Example in Assessing changes and validating intervention strategies.

Drumming Study

This is one of nine subjects that participated in a YV pilot investigation to show the long-term effects on therapeutic drumming.This is one observational piece that shows improved good alpha and improved delta asymmetry.

QEEG has already proven Therapeutic Drumming as an evidence-based practice


PIECES TO THE QEEG DATA – Overall Summary

A summary of all maps from a single QEEG/Brainmap


PIECES TO THE QEEG DATA – Initial Technical Data

To ensure reliability and validity the QEEG record can be analyzed before any further assessmet by using the split-half and test-retest quotients which act as reliability co-efficients and ensure the best quality EEG recording.

80 and above is accepted by most clinical standards. However, the goal is to be above 90 for best and most accurate results.

This also ensure QEEG validity as a measurement tool.


Z-Scored Values in single hertzIncluded for Absolute and Relative Values

PIECES TO THE QEEG DATA – Single Hertz Maps


Probability of membership in a TBI Population

PIECES TO THE QEEG DATA – TBI Probability


Probability of a client falling into a general learning disability population

PIECES TO THE QEEG DATA – Learning Disability Probability


Clinical view of measuring various mental process

PIECES TO THE QEEG DATA – Functional Measures









Client View of various measurement process(The measures the client usually see’s)


Client View of various measurement process(The measures the client usually see’s)



OTHER QEEG DATA

NeuroStat and NeuroBatch takes these maps and further analyzes statistical data and can easily import into other statistical analysis software.


TAKEAWAYS / CLOSING THOUGHTS

QEEG is highly effective and can help validate evidence-based practices through research studies.QEEG has endless possibilities in what it is able to report. QEEG is highly accurate and valid.QEEG has many uses in the mental health field for the counselor, psychiatrist, educator, and researcher.

Presentation by Chris Raines, EMBA, BCN-ABoard Certified in NeurofeedbackContact at 770-852-6400 or [email protected]

mailto:[email protected]

Documents

CURRENT SCIENCE AND UNDERSTANDING€¦ · • Brainwave activity (electrical activity) of the brain has been tested for hundreds of years with groundbreaking research starting in