What's New in Neurofeedback

A Monthly Summary of News and Events

Vol. 6 No. 7 - July 2003

This newsletter is sponsored by EEG Spectrum International Intl, Inc.,
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Copyright (C) 2002 by EEG Spectrum International Intl, Inc. All rights reserved.


  • Announcements  - News
  • In the Spotlight     - Theory of Mind Tests
  • News & Reviews - Books & journal papers
  • Events & Locations - Conferences, Courses
  • Last Word               - EEG & FMRI databases online

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    Announcements


     

    In the Spotlight

    Theory of Mind Tests

    In the past (February 2001 of this newsletter), I've written about how I found slower sleep spindles in two autistic individuals (out of only two tested) plus a past report also showing slow spindle bursts. Having an autistic child increasing the likelihood of having another 10- to 20-fold, so I tested both of my younger sons and found their sleep spindles to be normal (the most recent is pictured, left). Normal sleep spindles are from 12 to 15 Hz; abnormal ones are slower (say, peaking at 10.5 Hz). Although it's not yet certain whether slower sleep spindles indicate autism, they probably do indicate motor system immaturity or some lack of integrity in the various sleep processes, so it should be useful for many conditions. And it has three advantages -- simplicity, early detection, and simplicity! Well, sounds like two but you can never be too simple. (As Einstein said, Everything should be made as simple as possible, but not one bit simpler.) This is not simpler. We can test gross motor function before an infant can roll over. The mechanisms underlying sleep spindle appears to mature rapidly, attaining adult levels by 3 months. In comparison, the alpha rhythm, an electrophysiological measure of sensory processing, takes another decade to reach such heights.

    The three advantages (over existent and currently non-existent evaluative techniques):
    1. A single-channel EEG system can perform sleep spindle evaluations.
    2. An infant can be checked as early as 3 months of age.
    3. Sleep spindles are not subtle. They are hard to miss. Quick and distinct bursts. They become the dominant frequency for a sec or two; then that slower nonsense seeps back into the record.
    And one good corollary of #2: Perfect sleep subjects! Sleep is the primary function of infants as far as I can tell. Sleep mixed with noise and smell. If an infant isn't asleep when the electrodes go on, wait a minute or three.

    And if you cannot capture the raw data or spectral output like I have in figure 1 above, you can analyze sleep spindle frequencies by simply adjusting filters to adjacent bands, 9-12 Hz, 10-13 Hz, 11-14 Hz, and 12-15 Hz and note the magnitude of each filter's output. As you see from my example, my 4 month old son shows maximal amplitude in the 12-15 Hz band -- completely normal, except for that noise and smell... (The two autistic children I mentioned earlier showed maximal amplitude at 9-12 Hz and 10-13 Hz, respectively.)

    Simon Baron-Cohen has accumulated a healthy list of theory of mind (TOM) tests, ordered by severity (failing earlier tests indicates generally more severe TOM deficits) which can be used to evaluate the presence of autistic spectral behaviors in (generally older) children:

    1. The Mental-Physical Distinction
    2. Understanding the Functions of the Brain
    3. The Appearance-Reality Distinction
    4. First-order False Belief Tests
    5. Seeing Leads to Knowing
    6. Recognising Mental State Words
    7. Mental State Words in Spontaneous Speech
    8. Spontaneous Pretend Play
    9. Understanding Causes of Emotion
    10. Inferring from Gaze-direction when a Person is Thinking, or what a Person Might Want
    11. Monitoring One's Own Intentions
    12. Deception
    13. Understanding Metaphor, Sarcasm and Irony
    14. Pragmatics
    15. Imagination
    16. Correlation with Real-life Social Skills
    17. Second-order False Belief Tests

    I must have a neurologist's bent because I prefer very simple diagnostic tests over complex ones, the simpler the better, as long as they reasonably differentiate. The famed Russian neurologist Luria tested motor function in patients using a solitaire version of Rock-Paper-Scissors -- make a fist, then place your palm flat on a surface, now the edge of the hand. Repeat quickly. In seconds he has delved deeply into his patient's motor (and attentional/cognitive) condition.

    The EEG sleep spindle assessment is complex, I grant you, but I cannot get my 4 month old to play Rock-Paper-Scissors... not that this would reveal autistic brain organization. The EEG measure might not either, but it does look at gross motor organization, and may indicate autism or a variant. (I'm currently of the opinion that autism is fundamentally a failure of the motor system to mature. The reward systems involved in motoric maturation inhibit development of typical sensory, and thus linguistic/social, processing, perhaps.)

    Most of the TOM tests require some verbal ability, but not all. We tried a gaze-direction test on my 4 month old and it worked fine. When an infant is focused on you, turn your head to the left and stare. Does s/he eventually turn to look in that direction as well? Now counterbalance the test and turn to the right. Does s/he eventually follow your look again? If so, the infant realizes how the eyes are a communication device (or the head to be scientifically correct at this level of riger -- but that is a start).

    Here is a subset of evaluative tests for TOM deficits:

  • The Mental-Physical Distinction
    A child listens to stories in which one character has a mental experience, another a physical experience. Can the child judge appropriate actions by the character. E.g., Sam thinks about a dog, Sally is holding a dog. Ask: who can stroke the dog? Three-to-four-year-old normal children can readily make such judgements whereas children with severe autism have difficulty.

  • The Appearance-Reality Distinction
    Presented a candle shaped like an apple or other item. Children with autism may say the object really is an apple or really is a candle, but not capture the object's dual identity in their spontaneous descriptions.

  • First-order False Belief Tests


    Does the child realize different people can have different thoughts about the same situation? One can test with stories or objects. Normally developing four-year-olds will say in response to a picture of Little Red Riding Hood at her grandmother's bed that LRRH thinks the person in bed is her grandmother, but really it's the wicked wolf! Or place marbles inside a box of raisins. Ask the child what s/he thinks is in the box -- "raisins!" -- then show the trick (marbles), close up the box, and ask what his or her brother/sister/mother will think is in the box. "Marbles!" says the normal 2-3 year old, until they get more TOM into their heads.

  • Recognising Mental State Words


    By four years of age children can pick out words from a word list that refer to what goes on in the mind, or what the mind can do.

  • Mental State Words in Spontaneous Speech


    Track word use in a child. Children with autism produce fewer mental state words in their spontaneous descriptions of picture stories involving action and deception, compared to normal counterparts.

  • Spontaneous Pretend Play


    Do they take toy soldiers and arrange them in neat rows, or grab one in each hand and stage a revision of the Battle of the Bulge? Do they take teacups and become a budding socialite amid a circle of dolls, or do they stack them, or spin them?

    For more info, see www.autism.net/html/baron-cohen.html

    -DK

     

    News & Reviews NEW BOOKS

    Clinical and Neuropsychological Aspects of Closed Head Injury
    by John T. E. Richardson
    Reviews the epidemiology, causes, and structural neuropathology of closed head injury and its impact on cognitive function. --www.amazon.com/exec/obidos/ASIN/0863777511/top100

    Psychiatric Management in Neurological Disease
    by Edward C. Lauterbach
    Psychiatric management of neurological conditions. --www.amazon.com/exec/obidos/ASIN/0880487860/top100

    Pediatric Brain Injury: A Practical Resource
    by Carole Wedel Sellars, David Wedel Guard
    Practical guide for treating brain injury in children. --www.amazon.com/exec/obidos/ASIN/0890799628/top100

    Philosophical Foundations of Neuroscience
    by MR Bennett, PHacker
    Implicatons of state of the art neuroscience research. --www.amazon.com/exec/obidos/ASIN/140510838X/top100

    Children With Traumatic Brain Injury: A Parent's Guide
    by Lisa Schoenbrodt
    Comprehensive resource for families and professionals working with children who have sustained a traumatic brain injury. Discusses coping and adjustment, effects on cognition, speech, and language, educational needs, and legal concerns. --www.amazon.com/exec/obidos/ASIN/0933149999/top100

    Cognitive Neuroscience: Essential Readings
    by Marie Banich, Neil Cohen
    Introduction to this multi-disciplinary field that draws from neuropsychology, cognitive science, neurophysiology, and computer science. --www.amazon.com/exec/obidos/ASIN/1841690015/top100

    Treatment-Resistant Mood Disorders
    by Jay D. Amsterdam, Mady Hornig, Andrew A. Nierenberg
    The clinical problem of treatment-resistant mood disorders, followed by discussion of the biological basis, including psychoneuroendocrine aspects, role of estrogen for women, sleep abnormalities, brain imaging, and immunologic factors. --www.amazon.com/exec/obidos/ASIN/0521593417/top100

    Handbook of Cognitive Neuropsychology: What Deficits Reveal About the Human Mind
    by Brenda Rapp
    Reviews cognitive domains that have benefited from the study of deficits, including language, memory, attention, and various cognition. --www.amazon.com/exec/obidos/ASIN/1841690449/top100

    Clinical Neuropsychology
    by Kenneth Heilman, Edward Valenstein
    A definitive text on all major neurobehavioral disorders of adults, including aphasia, alexia, agraphia, agnosia, apraxia, amnesic disorders, dementia, and others. A required reference. --www.amazon.com/exec/obidos/ASIN/0195133676/top100

     

    JOURNAL PAPERS

    Quantitative EEG and the Frye and Daubert standards of admissibility. : Shows how Quantitative EEG meets all Daubert standards of scientific knowledge and how science and technical aspects of QEEG also match recent Supreme Court standards of "technical" and "other specialized" knowledge. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12784902

    Neurodevelopmental liabilities of substance abuse. : Even elevated levels of estrogens and corticosteroids in the pregnant mother can act as neuroteratogens. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12829418

    ERPs of methylphenidate in children with and without ADHD. : P300a amplitudes are lower in non-medicated ADHD patients than in healthy children during a continuous performance task; but not for methylphenidate-treated hyperactive children. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12811642

    Longitudinal study of cognitive dysfunction in multiple sclerosis : Mild cognitive impairment in MS patients is consistent with slowing information processing over time. Cognitive dysfunction appears to be related to disease peculiarity and not time course. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12810771

    Individual differences on neural circuitry underlying sadness. : Individual differences may be responsible for inconsistent research findings in affective neuroscience. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12814585

    Metabolic changes after rTMS of the left prefrontal cortex: a sham-control : Rapid transcranial magnetic stimulation may act via stimulation of glutamatergic prefrontal neurons. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12814378

    Autism and auditory brain stem responses. : Auditory brain stem response abnormalities were found in 58% of a small group of autistic children, with also abnormal left-right differences in 18% of the cases. Brain stem lesion or cochlear dysfunction are probable causes. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12799542

    Early Cognitive and Affective Sequelae of Traumatic Brain Injury : TBI patients were best classified by poor performance on measures of affect disturbance and impaired awareness. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12802243

    Brain activation in PTSD with hyperarousal and impulsive aggressiveness. : Some PTSD symptoms, especially impulsive aggression, may be associated with increased regional cerebral blood flow in the projection area of nucleus accumbens. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12799745

    Neural substrates of decision making in adults with ADHD : Activation in ADHD individuals is less extensive in prefrontal cortex and does not involve the anterior cingulate and hippocampus as it does in normals. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12777263

    Cerebral blood flow in OCD : Severity of OCD correlated positively with rCBF in the right thalamus. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12787854

    Frontal brain hypoactivity in anxiety with panic disorder. : Patients with panic disorder have greater decrease in activation of a left frontal avoidance-withdrawal system in situations with a negative valence. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12759561

    Quantitative EEG analysis in obsessive compulsive disorder. : Relative theta powers were increased and alpha powers were decreased in OCD patients, particularly in the frontotemporal region. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=12775347

     

     

    Events & Locations

    Upcoming Courses

    A Pathway to Brain Regulation - Neurofeedback helps improve neuroregulation. It's used by health care professionals for ADHD, depression, anxiety disorders, LD, mood disorders, and behavioral problems. This 4-day course, Neurofeedback in a Clinical Practice, provides the basis for using Neurofeedback clinically. - *28 CEs

      4-Day Comprehensive Course Dates
    • San Fran Aug 14-17
    • Greenwich CT Sep 11-14
    • Portland OR Oct 23-26
    • Alexandria VA Nov 13-16
    • Woodland Hills, CA Dec 11-14

    Our course is a hands-on experience right from the start. Attendees consistently say this format is a very good way to learn Neurofeedback.

    "Neurofeedback should be viewed as one of the three essential or primary forms of intervention - psychotherapy, psychopharmacology, and Neurofeedback. In my experience, Neurofeedback is every bit as important and powerful as the other two forms of treatment." - Dr. Laurence Hirshberg of Brown University Medical School, a psychologist specializing in Developmental Disorders and Autism.

    Contact Karie Kramer, our training coordinator, for more information 818-789-3456 ext 847 or see www.eegspectrum.com/Training

    *EEG Spectrum International, Inc. is approved by the APA to offer continuing education to psychologists. ESII maintains responsibility for the program.

    Conferences for Neurofeedback Clinicians & Researchers

    CONFERENCELOCATIONDATES
    SNR - http://www.snr-jnt.orgHouston, TXSep 18-21

     

    Last Word

    EEG & fMRI databases online

    An international research consortium, led by UCLA's Laboratory of Neuroimaging (LONI), has gathered into a database 7,000 digitized scans (fMRI, PET). Mainly adults between the ages of 20 and 40, healthy as well as clinical patients (e.g., Alzheimer's, autism, schizophrenia and fetal alcohol syndrome).

    "What scientists do is take things apart and study one little thing at a time ... This atlas allows us to put it all together again," said Dr Toga of UCLA.

    The atlas is available at http://www.loni.ucla.edu/ICBM.

    To significantly less fanfare, and after wanting to put an eyes closed EEG database online for years, I finally got around to it. Links and information at http://www.skiltopo.com/. I may eventually post a relative EC db, as well as making the current format easier to use (pre-set graphs, etc), perhaps this winter.