A Monthly Summary of News and Events
Vol. 3 No. 4 - April 2000
This newsletter is sponsored by EEG Spectrum International, Inc.,
a leader in providing clinical service and training professionals.
Past issues are available at www.eegspectrum.com/newsletter/
Information on how to subscribe or cancel a subscription appear at the end.
The opinions related in this newsletter reflect those of the author only.
Copyright (C) 2000 by EEG Spectrum International, Inc. All rights reserved.
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The literature ... which lacks any negative study of substance, suggests that EEG Biofeedback Therapy (EBT) should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used. - Frank Duffy, M.D., Harvard Children's Hospital, Assoc Editor for "Neurology"
EEG and the Sun:
Circadian Effects on the QEEG
As the sun climbs higher into the northern sky each day, the behavior of the inhabitants of this tiny rock changes in mysterious ways: We hide colored eggs on the lawn, we sit in ballparks and snatch at foul balls, the young migrate south to Fort Lauderdale for a week. Not only does the Sun dictate vacation plans, it dominates most processes within a light year of our location. And human EEG is no exception.
About 4.6 billion years ago a not-so-distant star, some 6 to 33 light years away, exploded and sent a formidable shock wave out in all directions. In its path lay a slowly rotating cloud of gas and dust, previously seeded with heavier dust by a blast two billion years before. The shock wave collided with the large cloud, compressing it, which started a process that led to a whole slew of spinning shapes. Local processes soon took over and forged these bodies into familiar forms. Four gaseous planets condensed within a billion miles of the newly-formed star, but as the smaller ones jockeyed with their neighbors, they were slung to the farthest reaches. Nearer the center, two planets failed to miss each other during a pass, and after considerable cooling, an unrivaled satellite system was formed. Four billion years quickly and violently passed on the two-marble system. On the rock which did not lose its spin, electrodes are now commonly placed on various descendants of a strange experiment in information transmission and storage. That this experiment evolved on a spinning surface, within the influence of a nearby celestial fusion reactor, underlies the premise of this essay.
Does our EEG reflect this evolutionary history? Does human EEG exhibit a circadian rhythm, and if so, what relevance may it hold for neurofeedback?
Analyzing EEG from more than 150 subjects at various times of day reveals ample evidence of the Sun's influence on a wide range of frequency activity (Kaiser & Sterman, 1994 - www.eegspectrum.com/articles/kaiser94.htm). Some might questioned my data and suspect that any circadian rhythm apparent in the EEG are probably due to drowsiness or hunger or lunch. Now I agree that these factors play a role -- but only a co-starring one. If the drowsy epochs were clipped out of my data set, some argued, the EEG would remain relatively flat throughout the entire day. Essentially, this argument implies that EEG is the only physiological, biochemical, or endocrinological process in the human which evolved unaffected by the Sun.
What biological processes are influenced by a 24 hour day-night cycle? In short, nearly all of them. A search of the literature reveals thousands of papers which describe circadian rhythms in various biologic parameters: body temperature, heart rate, motor activity -- far too many to relate here. A recent paper on ultradian cycles in event-related potentials (Polich, 1997) found evidence of ultradian rhythms in the background EEG and in the ERP signals themselves. So why do some neuroscientists and psychologists deny the existence or importance of circadian or ultradian rhythms in gross neuroelectric activity? Perhaps the clearer argument would be that such cycles, if they exist, are not relevant to neurofeedback assessment or training. Perhaps... But the following (true) example points to how time of day can be critical in neurofeedback training:
A woman with epilepsy undergoing neurofeedback learned that whenever she was supervised by her regular clinician she performed much worse than when he was out of town and she took her sessions with a substitute trainer. This effect (sometimes called the experimenter effect) is not unusual and could be attributed to numerous factors. With her regular clinician, she averaged around 5 microvolts each session, but when the substitute trainer was in the room it wasn't unusual to record a mean of 7 or 8 microvolts. Well, it didn't take long before both she was convinced that her regular clinician's approach was poor and inferior to the sub's. A logical conclusion, but totally unfounded. You see, the woman met with her regular clinician at 5 pm but the sub couldn't make it at 5 pm and always scheduled their sessions for 7. The change in time of day was altering the EEG baseline from which she worked, not any clinical approach.
There's nothing new under the Sun, so the saying goes. The woman and her new trainer had simply rediscovered what was already known. In November 1983, Gertz and Lavie published a paper in the journal Psychophysiology which should have focused attention on the possible confounding influence of circadian rhythms on EEG biofeedback. The paper was for, some ungodly reason, enigmatically titled: "Biological rhythms in arousal indices: A potential confounding effect in EEG biofeedback" The title alone may explain why few people in EEG biofeedback field seem aware of the problem to this day... Gertz and Lavie recorded EEG from 11 subjects for about 8 hours each. During this time, arousal was evaluated (albeit subjectively) and between EEG recordings subjects underwent a form of EEG biofeedback. They observed significant ultradian rhythmicity in the EEG (at about 200 min/cycle, the Basic Rest Activity cycle). The rhythmicity was also apparent in the arousal measure. They also reported a more prominent circadian rhythm during eyes closed than during eyes open conditions. They correctly concluded that because "the observed ultradian and circadian EEG rhythmicities could be spuriously interpreted as learning curves under a biofeedback paradigm, it is argued that future designs should incorporate continuous baseline controls." Wise advice which has been almost entirely ignored.
In 1995 we reported that absolute magnitudes in all frequencies were similarly modulated across the day. This similar modulation suggested a common organizing influence on the cortical expression of thalamic input. In other words, the Sun had long ago set a timer or two inside the thalamus (as it had everywhere else) and we rediscovered this basic fact. For our efforts, our data and conclusions immediately came under suspicion. Those who should have recognized the obvious role of the Sun in neurophysiology and neurofeedback, who encountered it each and every day, were (predictably) the most obstinate. How many times must America be discovered before it stays discovered? At least five times.... and this is only round two or three for circadian cycles in EEG.
All in all, circadian rhythms are probably not a big problem for neurofeedback training. Most people who see a clinician regularly do so at about the same time of day each time, due to work or school schedules. Time of day is more likely to vary between widely-spaced recording sessions (assessments) than between shortly-spaced sessions (training). And most clinicians nowadays work with reinforcement schedules (e.g., 70% above threshold, 80% above threshold, etc.) more than amplitude values. Assessments (which are usually widely-spaced sessions) are more vulnerable to time of day effects. The best solution adopted by many offices is to test people only at one time during the day, typically around 10:00 am in the morning. But what happens when the client is running late? When they appear at 11:30 am, are they rescheduled for the next day or are they re-tested anyway then and there? In other words, do you let the Sun into your data or not?
-David Kaiser
Dual Diagnosis Recovery Sourcebook: A Physical, Mental, and Spiritual Approach to Addiction with and Emotional Disorder
The Developing Mind: Toward a Neurobiology of Interpersonal Experience
ADHD With Comorbid Disorders: Clinical Assessment and Management
Taming the Troublesome Child: American Families, Child Guidance, and the Limits of Psychiatric Authority
Test-retest reliability of cognitive EEG:
Task-related EEG can be highly reliable within and between sessions; it should prove to be useful in assessing clinical changes in cognitive status. Resting EEG also showed high reliability (though lower than task-related conditions).
Social functioning and emotional regulation in ADHD:
ADHD-C (combined type) children show more aggressive behavior and evidence of emotional dysregulation. ADHD-I (inattentive type) children have normal emotional regulation but are socially passive.
Neuropsychological deficits in sober alcoholics:
Alcoholics were impaired on the Shipley Vocabulary and Abstraction tests and on the Digit Symbol test. Chronicity of alcohol abuse played no factor in these deficits.
Attention deficit-hyperactivity disorder and its deceivers:
There is a myriad of disorders that can mimic ADHD. Children suspected to have ADHD should be approached in a systematic, scientific, and professional manner to determine the best treatment for the child.
An EEG approach to the neurodevelopmental hypothesis of schizophrenia:
Schizophrenics showed lower delta-theta activity centroid frequencies and higher alpha and beta activity centroids than controls. Schizophrenics showed partial similarities in delta-theta and beta reactivity centroids with the 11-year olds and in alpha reactivity centroids with the 13-year olds, which supports some aspects of the neurodevelopmental hypothesis.
Validity of DSM-IV subtypes of attention-deficit/hyperactivity disorder
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ADHD exhibits genetic components, but symptom differences among subtypes appear to be due to nonfamilial, environmental causes.
Transcranial magnetic stimulation induces 'pseudoabsence seizure'.
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Reports a single case of repetitive transcranial magnetic stimulation in a depressed individual which, combined with drugs modulating the norepinephrine turnover, may have contributed to the occurrence of a complex partial seizure.
Risk factors for adolescent substance abuse and dependence: data from a national sample.
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Teens have increased risk for current substance abuse when they have been physically or sexually assaulted, witnessed violence, or had family members with alcohol or drug use problems.
Neurological soft signs and EEG findings in children and adolescents with Gilles de la Tourette syndrome.
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Non-specific EEG abnormalities and neurological soft signs were detected in 57.5 percent of cases of Tourette's syndrome. These findings were associated with low-performance IQ.
Orbitofrontal cortex and human drug abuse: functional imaging.
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Activity in the orbitofrontal cortex and its connections plays a role in the maladaptive behavior of substance abuse, including expectancy, craving and impaired judgment.
| EEG Spectrum International is offering a series of workshops addressing topics of interest to professionals working in the field of neurofeedback. Class size is limited to 25 to allow for informal interaction. | |
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Working with Learning and Behavior Problems in a School Setting
John Anderson Instructor Minneapolis, MN Jun 10-11, 2000 EEG Biofeedback Instrumentation Howard Lightstone Instructor Encino CA July 8-9, 2000 Therapeutic Techniques, Ethics, Research Principles Lisa Cavallaro, Psy.D., Instructor Encino CA Aug 12-13, 2000 Psychopharmacology, Nutrition, and Neurofeedback Bruce Goderez, M.D., Instructor Boston, MA Sep 23-24, 2000 | |
For information, telephone EEG Spectrum International at 818-891-6789 x 810 or email training@eegspectrum.com
Conferences for Neurofeedback Clinicians & Researchers | ||
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| CONFERENCE | LOCATION | DATES |
| SNR | Minneapolis, MN | Sep 20 - 24 |
Sandy Talbott 854 E. Main Street Santa Paula, CA 93060 (805)701-8884 (805)647-0072 fax |
The other day I was playing an online first-person perspective shoot'em-up game with 10 other players. The game's landscape consisted of a series of interconnected hallways and each player appeared in the game as an eyeball that scamped around on tiny feet and sported grenades. When you spotted another player, you tossed a grenade and ran for cover. Part of the fun of the game was that you could not run backwards, so you had to toss the grenade at your target, run past it and the intended victim, and escape down a side corridor before the grenade blew up. The grenade had a two-second delay and would destroy everyone in the hallway. You knew you were a dead man when you saw an eyeball pass your position on the run and turn sharply out of view. I spent the majority of that day watching eyeballs rush past me, ducking into side corridors, just as everything went black.
Now this game may sound boring to those of us who have played Doom, Quake, Duke Nukem, or a hundred other first-person PC games, but the "other day" to which I referred was in 1976, I was in sixth grade, and I was playing at MIT on one of the largest computers in the world at the time. (Even in those days MIT students knew how to put a computer to good use -- hunting down friends in cyberspace.)
The eyeball game was played on "dumb" terminals connected to a central computer which was located half a building away. The central computer was the size of a VW van. It was brand new, cost $4 million, and was cooled by a dozen industrial air conditioners. You had to wear a sweater to stay in that room for any length of time. Despite the cold, throughout the day a dozen or so students and staff vainly tried to keep the damn machine from crashing, which it did every 4 hours like clockwork. Although the machine had less computing power than a Furbie does today, it was state-of-the-art at the time and it intimidated me more than any other creature I've encountered on this planet, before or since. Yet here were students standing three feet below floor level, running wires and connecting terminals to the underbelly of the beast without a second thought. Hard work, but they enjoyed it. This was a world, a campus, a small city in itself, made up entirely of early adopters of computers and technology.
What reminded me of this strange day of computer play, now 23 years forgotten, was a recent email message I received. It was a message from an academic psychologist who had been sent a number of papers on neurofeedback. He replied that until a neurofeedback study was published in the Journal of Clinical Psychology, the General Archives of Psychiatry, or some other major journal, he would not pay attention to any results we found. Regardless of the number of subjects involved! Unless the AMA or some other austere organization told him what to accept, and think, he would remain happy with his dated toolset. (Did Australopithicus think this way? I imagined him crouched over a waning fire, poking his meal with a stick or bone, where off in the distance claypots and spearheads are being fashioned.)
The brain, once thought to be nothing more than a cooling organ, has now grabbed center stage in the world of science. Everyone in psychology and the mental health disciplines should agree on this. And this growing focus on the 3-pound universe cannot help but contribute daily to greater acceptance of technologies that assess and alter the brain's functions such as neurofeedback. As spiritual explanations (demonic possession) were superseded by psychological explanations (id disorders) in the early part of this century, psychological explanations will themselves be superseded by biological and psychophysiological explanations in the early part of the next century (e.g, neural dysfunction). Yet today the world is still populated with stone tool users and the various gods and superstitions they heed. Some days I wonder what can ever change this.
According to some, change will come about in response to public demand. The public, and not academia, does not have careers or stock options at stake in determining what treatments work and what treatments don't. The public seeks out what is best for him or her. They are ready and eager to adopt the newest technologies as long as they prove effective. Public demand is creating supply. At one time it was predicted that the entire world's computational power could be supplied by 5 computers worldwide. But public demand turned that prediction into nonsense. Likewise, the arguments we hear today for eliminating abnormal brain function through rampant medication and surgery, instead of training, will be met by the same derision. We are all early adopters in this field. Early adopters work harder than the rest -- but they also reap the greatest rewards. Early adopters are the explorers and conquerors, institutions are the homesteaders. Early adopters are like all those eyeballs that raced ahead of me in the hallway that day, having already dropped a bomb at my feet. I was stuck in place, and all went quickly black, just as they were turning the corner.