Introduction to Quantitative EEG and Neurofeedback: Advanced Theory and Applications Second Edition This page intentionally left blank Introduction to Quantitative EEG and Neurofeedback: Advanced Theory and Applications Second Edition Thomas H. Budzynski, PhD Department of Psychosocial and Community Health University of Washington School of Nursing Poulsbo, Washington Helen Kogan Budzynski, PhD, RN Department of Psychosocial and Community Health University of Washington School of Nursing Poulsbo, Washington James R. Evans, PhD Department of Psychology University of South Carolina Columbia, South Carolina Andrew Abarbanel, MD Soquel, California AMSTERDAM • BOSTON • HEIDELBERG • LONDON • NEW YORK • OXFORD PARIS • SAN DIEGO • SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Academic Press is an imprint of Elsevier Academic Press is an imprint of Elsevier 30 Corporate Drive, Suite 400, Burlington, MA 01803, USA 32 Jamestown Road, London NW1 7BY, UK 525 B Street, Suite 1900, San Diego, CA 92101-4495, USA 360 Park Avenue South, New York, NY 10010-1710, USA First edition 1999 Second edition 2009 Copyright © 2009, 1999 Elsevier Inc. All rights reserved No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without the prior written permission of the publisher. 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Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN: 978-0-12-374534-7 For information on all Academic Press publications visit our website at www.elsevierdirect.com Typeset by Charon Tec Ltd., A Macmillan Company. (www.macmillansolutions.com) Printed and bound in the United States of America 09 10 11 12 13 10 9 8 7 6 5 4 3 2 1 Contents Contributors xvii Preface xix Introduction xxi PART 1 QEEG and Neurofeedback: Basics and New Theory 1 Neuromodulation technologies: An attempt at classifi cation 3 Siegfried Othmer, Ph.D. I. Introduction 3 II. Tracing the historical threads of neurofeedback 4 A. The Alpha rhythm and “ felt states ” 4 B. The sensorimotor rhythm and behavioral state 4 C. EEG operant feedback and normalcy patterns 5 D. Stimulation-based treatment 5 III. A classifi cation of neuromodulation technologies 6 A. Slow cortical potential training 8 B. Stimulation-based technologies 8 IV. The evolution of standard reward and inhibit-based neurofeedback 10 V. Resonant-frequency training 13 VI. An attempt to achieve synthesis 14 v vi Contents VII. Alpha/Theta and synchrony training 20 VIII. General self-regulation and specifi c dysfunctions 22 IX. Summary and conclusion 24 References 26 2 History of the scientifi c standards of QEEG normative databases 29 Robert W. Thatcher, Ph.D. and Joel F. Lubar, Ph.D. I. Introduction 29 II. Defi nitions of digital EEG and quantitative EEG (QEEG) 30 III. Simultaneous digital EEG tracings and quantitative EEG 31 IV. Test–retest reliability of QEEG 32 V. History of standards of QEEG normative databases 33 VI. History of inclusion/exclusion criteria and “representative samples ” 33 VII. History of artifact-free data and reliability measures 34 VIII. History of sample size per age group 34 IX. History of age stratifi cation vs. age regression 35 X. History of Gaussian distribution approximation and cross-validation 36 XI. History of the use of the Z-score and QEEG normative databases 37 XII. Cross-validations of normative databases: New York University and University of Maryland 39 XIII. History of amplifi er matching and QEEG normative databases 40 XIV. Content validity of QEEG normative databases 43 A. Neuropsychological correlations 43 B. Example for traumatic brain injury 45 XV. History of three-dimensional current source normative databases 46 XVI. History of three-dimensional source correlation normative databases 48 XVII. History of real-time Z-score normative databases 49 XVIII. Active tasks vs. eyes closed and eyes open QEEG databases 51 XIX. Summary of normative database validation and sensitivity tests 52 XX. Gold standard check list for a normative QEEG database 53 XXI. Problems in combining sub-standard QEEG databases with scientifi cally acceptable databases 53 XXII. Future standardization of QEEG normative databases 54 References 55 Contents vii PART 2 Advancing Neurofeedback Practice 3 Applying advanced methods in clinical practice 63 David S. Cantor, Ph.D. I. Diagnostic considerations—univariate versus multivariate measures 63 II. Pharmaco-EEG 67 III. QEEG—therapeutic applications in neurofeedback 68 IV. Diagnostics—utilization source localization methods 69 V. Case sample employing univariate, multivariate and source localization methods to “diagnosis” of the nature of presenting symptoms 69 A. Case DS 69 VI. Forensic applications 72 A. Case JR 73 VII. AVE therapy 74 A. Case BM 75 VIII. QEEG as a tool for monitoring other “experimental” interventions 77 IX. A comment about the future of QEEG-based neurofeedback 78 References 79 4 Diagnosing and treating brain function through the use of low resolution brain electromagnetic tomography (LORETA) 83 Leslie H. Sherlin, Ph.D. I. Introduction 83 II. Introduction to LORETA 84 III. Software required to perform analyses 85 IV. Utility of segmentation of EEG frequency bands by function 85 V. Localization of the cortical refl ection of voltage 86 A. The location of frequency generators 88 VI. Interpretive examples 94 VII. Case example of pre-post neurofeedback training 96 viii Contents VIII. Advanced intervention—LORETA feedback 99 IX. Conclusions 100 References 101 5 EEG biofeedback training using live Z-scores and a normative database 103 Thomas F. Collura, Ph.D., Robert W. Thatcher, Ph.D., Mark Llewellyn Smith, L.C.S.W., William A. Lambos, Ph.D., BCIA-EEG, and Charles R. Stark, M.D., BCIA-EEG I. Introduction 103 II. Design of the instantaneous Z-score normative database 108 A. Use of Gaussian probabilities to identify “de-regulation ” in the brain 108 B. Application of Gaussian probability distributions to instantaneous Z-score biofeedback, and why JTFA Z-scores are smaller than FFT Z-scores 109 C. Simplifi cation and standardization 109 D. Individualized EEG biofeedback protocols 110 III. Instantaneous Z-scores accessed from inside of NeuroGuide TM 111 IV. Implementation of the Z-score biofeedback 112 V. JTFA complex demodulation computations 113 VI. Z-scores and QEEG normative databases 113 A. Standardization by amplifi er matching and QEEG normative databases 115 B. General method to produce a valid instantaneous Z-score EEG database 116 C. Age groupings of the instantaneous Z-score normative population 118 VII. Case study 1: Jack 118 VIII. Case study 2: John 123 IX. Case study 3: SL 128 A. Eyes-closed condition 129 B. Eyes-open condition 133 X. Conclusions 139 References 140 6 Alpha–theta neurotherapy and the neurobehavioral treatment of addictions, mood disorders and trauma 143 Nancy E. White, Ph.D. and Leonard M. Richards, Th.D. I. Introduction 143 II. The peniston protocol 144 Contents ix III. The effectiveness of alpha–theta neurotherapy 146 A. Autopoiesis and the malleability of memory 147 B. State-dependent memory and retrieval 148 C. Causative properties of consciousness and arousal states 149 D. Neural function in the effectiveness of alpha–theta neurotherapy 150 E. Phase transition and alpha–theta’s effectiveness with trauma 151 F. Importance of the patient–therapist relationship 152 G. Summary of the effectiveness of alpha–theta neurofeedback 153 IV. Alpha–theta neurofeedback in the neurobehavioral treatment of trauma disorder 155 A. A closer look at trauma disorder 155 B. Resolving trauma with alpha–theta neurofeedback: A multi-modality model 158 C. Resolving trauma using alpha–theta in a multi-modality context: A case study 160 V. Conclusion 164 References 164 PART 3 Alternative Treatment Approaches to Neurofeedback 7 Hemoencephalography: Photon-based blood fl ow neurofeedback 169 Hershel Toomim, Ph.D. and Jeffrey Carmen, Ph.D. I. HEG as a form of neurofeedback 169 A. Details of nirHEG development 170 B. Details of pirHEG development 176 C. Cerebral blood fl ow dynamics from the PIR perspective 178 D. Infrared thermography 181 II. A new paradigm 184 A. Human frontal lobes and behavioral pathology 186 III. Basic HEG concepts 188 A. Cautions, precautions, side effects 189 B. Overall training guidelines for both HEG systems 189 IV. Frequently asked questions 190 References 192 x Contents 8 Audio-visual entrainment in relation to mental health and EEG 195 Thomas F. Collura, Ph.D. and David Siever, CET I. Overview 195 II. Evidence of sensory effects of AVE 197 III. Physiological effects of AVE systems 198 IV. Harmonics as a function of entrainment 200 V. Effects of audio-visual entrainment 201 A. Altered EEG activity 203 B. Dissociation/hypnotic induction 203 C. Limbic stabilization 204 D. Improved neurotransmitter production 206 E. Altered cerebral blood fl ow 206 VI. Clinical protocols with free-running audio-visual entrainment 207 A. How AVE protocols (sessions) are designed 207 B. Components of a session 208 C. “Rules of thumb ” 209 D. Session frequency ranges and types 209 E. Special sessions for older adults 216 F. Depression session 217 VII. Applying AVE with neurofeedback 218 VIII.