Excerpts from qEEG Articles
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BIOPHYSICAL LINKAGE BETWEEN MRI AND EEG AMPLITUDE IN CLOSED HEAD INJURY
By: Robert W. Thatcher, Ph.D.
Typically the severity of closed head injury is judged by: (1) Length of loss of consciousness (LOC) and/or (2) Length of Posttraumatic Amnesia (PTA) and/or (3) The Glascow Coma Score (GCS). It is known that the GCS is often not obtained by emergency personnel. Accurate measures of PTA require a trained professional to administer tests, and LOC is often unknown by the patient themselves. Thus, estimates of severity of head injury are prone to error.
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ELECTROENDEPHALOGRAPHY AND MILD TRAUMATIC BRAIN INJURY
By: Robert W. Thatcher, Ph.D.
Evaluation of the sensitivity and specificity of qEEG with a reduced number of EEG Channels offers the feasibility of real-time monitoring of the EEG using Bluetooth technology inside of a football helmet so that immediate evaluation of the severity and extent of brain injury in athletes can be accomplished. Finally, qEEG biofeedback treatment for the amelioration of complaints and symptoms following TBI’s is discussed. Quantitative EEG studies of the diagnosis of TBI typically show quite high sensitivity and specificity, even for mild head injuries. For example, a study of 608 mild TBI patients and 103 age matched control subjects demonstrated discriminant Sensitivity = 96.59%; Specificity = 89.15%, Positive Predictive Value= 93.6%...and Negative Predictive Value= 97.4%...in four independent Cross-Validations.
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CONCUSSIONS IN ATHLETES PRODUCE BRAIN DYSFUNCTION AS REVEALED BY EVENT-RELATED POTENTIALS
By: Dupuis F.
Moreover, the degree of impairment was strongly related to the severity of post-concussion symptoms. Our data suggest that concussions cause objectively measurable changes in the electrophysiological markers of brain activity and hence in the functions of the structures from which they originate.
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THE USEFULNESS OF QUANTITATIVE EEG (qEEG) AND NEUROTHERAPY IN THE ASSESSMENT AND TREATMENT OF POST-CONCUSSION SYNDROME
By: Jacques Duff, MAPS, AMACNEM, MAAAPB.
qEEG studies reviewed by Hughes and John have found similar patterns of frontal deficits in TBI as in ADHD. Thornton used Neurotherapy to remediate memory deficits by applying EEG biofeedback to qEEG correlates of the memory function…Thornton presented 3 case examples that indicated the successful use of Neurotherapy in subjects with Brain-Injury, with improvements ranging from 68% to 181% in relation to baseline measures as a result of the intervention. Hoffman et al., reported that in around 80% of cases, TBI patients were able to achieve a minimum 70% improvement in symptoms. Good clinical results were also obtained with chronic patients years post-injury.
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IMPACT OF qEEG – GUIDED COHERENCE TRAINING FOR PATIENTS WITH A MILD CLOSED HEAD INJURY
By: Jonathan E. Walker, MD
Posthuma and Wild (1988) reported that neuropsychological assessment may miss up to 50% of the more subtle symptoms of mTBI, which adversely limits neuropsychological intervention. In addition, small sample size, lack of statistical significance, and poor matching of samples are some of the other weaknesses associated with using a neuropsychological approach to treat Posttraumatic symptoms (PTS). This study focused on Neurofeedback Therapy for the treatment of PTS in patients with Mild Closed-Head Injury (MHI) to be included in this study, the patient had to have had PTS for at least three months. Further, PTS symptoms had to interfere significantly in the lives of the patients. It appears that qEEG -guided NFT was an effective treatment. Eighty-eight percent of the patients reported GIS (Global Improvement Score) of 50% or greater. Not only was there improvement, but the positive change occurred most frequently for headaches and memory loss or confusion, two of the most debilitating PTS.
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DIAGNOSIS AND TREATMENT OF HEAD INJURY
By: Daniel A. Hoffman, M.D.
Mild traumatic brain injury causes a great deal of angst for the diagnostic clinician as well as the legal system. Traditional methods of evaluation consist of history, neurological exam, CAT scan, MRI, standard EEG, and neuropsychological testing. Although patients complain of significant neurocognitive dysfunction's, not uncommonly most of these standard tests are normal. In March 1979, Robert Thatcher, Ph.D. began work on a normative or reference database… The normative database provides a statistical analysis in which a patient’s EEG can be expressed as a deviation from the normative group in Z score units, i.e., standard deviations from the mean. The EEG norms were replicated in several places… The advent of such databases allows a patient’s EEG, when digitalized (quantitative EEG, or computer enhanced EEG), to be compared with a reference population. Since the end of the 1960’s, Barry Sterman demonstrated the ability to control brain wave rhythms through operant conditioning and biofeedback techniques (neurofeedback) in the epileptic population through suppression of SMR… Dr. Joel Lubar and Sterman have continued this work, discovering patients demonstrated increased attentiveness, focus and concentration during feedback. Lubar went on to find improvements in distractibility and attentional gains in academic settings resulted in increased performance and grades. Our clinical experience in using this treatment is that 80% of patients learn neuronal control and attain a minimum of 70% improvement in self-reported symptoms.
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Articles Related to Concussion, Authored by Dr. Thompson
1. Thompson, James (2005). Thompson2005_EEGPosturepostMTBI.pdf
2. Thompson, James (2006). Thompson2006_MTBIBookChapter.pdf