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Take a test drive – download a FREE NeuroGuide Demo at: www.appliedneuroscience.com. [email protected] 727-244-0240 NeuroConnections ISNR Co-editor: Merlyn Hurd, PhD [email protected] AAPB Neurofeedback Division Co-editor: Roger H. Riss, PsyD [email protected] Managing Editor: Cynthia Kerson, PhD 2007 Research Fund Awardees Mario Beauregard, PhD Robert Coben, PhD Bojana Knezevic, BA [email protected] Estate Sokhadze, PhD $ $ $ $ Be Involved | Support Neurofeedback Research Help the Field of Neurofeedback Grow Look for news about 2008 Fund Raisers

ISNR 2008 Become an ISNR Member! Crowne Plaza Riverwalk Membership Advantages San Antonio, Texas Journalist for MindFull: David Kaiser, PhD August 28 – 31, 2008 Subscription and online access to the W/additional Pre- and Post-Conference Workshops Journal of Neurotherapy Subscription to NeuroConnections joint newsletter with the AAPB Neurofeedback Division Listing your Member Profile on our Site Discounts to book and DVD purchases Discounts to the annual conference registration Submission process begins early 2008 [email protected] http://www.isnr.org for fees and application www.isnr.org (800) 847-4986 Publisher: International Society for Neurofeedback and Research [email protected] Design: Rosalie Blazej [email protected] Contents

Letter from ISNR President...... 4 International Society for AAPB Neurofeedback Division Neurofeedback and Research 2011-2013 Board Letter from AAPB Neurofeedback Division President. . . . 5 2010-2011 Board President President Siegfried Othmer, PhD Letter from ISNR Co-Editor...... 6 Leslie Sherlin, PhD [email protected] [email protected] Past President Letter from AAPB Co-Editor ...... 6 Past President David Kaiser, PhD Thomas Collura, PhD [email protected] Letter from AAPB Executive Director...... 6 [email protected] Secretary/Treasurer President Elect Networks: A Compelling Rationale for Combining Richard E. Davis, MS Richard Soutar, PhD [email protected] [email protected] Neurofeedback, Biofeedback and Strategies...... 8 Secretary Board Members Joy Lunt, RN Rex Cannon, PhD Brodmann Montage...... 18 [email protected] [email protected] Treasurer Jeffrey Carmen, PhD BCIA Mailbag...... 20 Anne Stevens, PhD [email protected] [email protected] Alicia Townsend, PhD Working with Athletes with ADHD and Sergeant at Arms [email protected] Autistic Spectrum Disorder (ASD)...... 23 Noland White, PhD Web Site Coordinator [email protected] David Kaiser, PhD sLORETA Neurofeedback— Member at Large [email protected] Deborah Stokes, PhD First Clinical Results...... 27 [email protected] Research Committee Representative Member at Large Tom Budzynski ...... 30 Rex Cannon, PhD Kirtley Thornton, PhD [email protected] [email protected] Understanding LORETA ...... 32 Int’l Member at Large Martijn Arns, MSc [email protected] Research Foundation Workshop in Phoenix...... 38 Membership & Conference Coordinator Research Foundation Donations...... 38 Ann Marie Horvat [email protected]

NeuroConnections is published four times a year and will consider all materials pertaining to the practice and/or promotion of neurofeedback. Copyright © 2011 International Society for Neurofeedback and Research and the AAPB Neurofeedback Division. All rights reserved. No part of this publication may be reproduced with- out written permission from ISNR and AAPB. Direct all correspondence and inquiries, including commercial advertising information and classified ads to: NeuroConnections 1925 Francisco Blvd. E. #12 San Rafael, CA 94901 Phone: (415) 485-1344 Fax: (415) 485-1348 Email: [email protected] ISSN 2151-6987 (print) ISSN 2151-6995 (online)

NeuroConnections is the official publication of the International Society for Neurofeedback and Research and the AAPB Neuro- feedback Division. Opinions expressed herein are those of the respective authors and do not necessarily reflect the official view of ISNR or AAPB. ISNR and AAPB are not responsible for the products or programs of private companies advertised herein.

 NeuroConnections SUMMER 2011

Letter from ISNR President

Greetings col- and through the efforts of the International In- and then unanimously approved by the ISNR leagues. This is stitutional membership category. By the time Board of Directors. This document repre- now my third letter this issue makes it to your mailbox our mem- sents an official position of the organization, to you as president, bership could easily exceed 1000+ members and consequently, it is an official statement which brings me to for the first time in our organization’s his- of ISNR, but also, like any such organiza- the awareness that tory. Martijn Arns, our international member tional position paper, it will be periodically my tenure is over at large has led the board through significant reviewed, updated, and modified following half way complete. considerations for making this program a relevant input from the membership and ap- While this year reality. As I write this letter I am en route to proval by the Board. Especially at this early has been exhaust- Greece to fulfill and invited visit with our Eu- stage of release of the Standards paper, con- Leslie Sherlin, PhD ing in many ways I ropean colleagues and the Society for Applied cerns and comments from ISNR members am more than ever Neurosciences (SAN) conference to discuss who have carefully read the document are invigorated and excited for the future of the continued efforts to truly represent an interna- requested and welcomed. You have no doubt organization. I hope you’ll take a few min- tional effort to promote neurofeedback. Upon likely seen considerable discussion among the utes to continue through this letter as I have invitation, I will also visit our Australian members and even outside our membership some very important updates, acknowledge- colleagues during the Applied Neuroscience regarding our standards committee’s recent ments and news to share with the community. Society of Australasia (ANSA) conference in publication. This discussion has been very If you had the opportunity to read the state- August to continue to develop and strengthen collegial and has risen to an academic level ments that I hoped to achieve as during my the collaborations and support from ISNR. that I am very proud of. It is through the pro- board term, any of the previous presidential During this very exciting growth period it has fessional discussion and debate that we carve letters, or board of directors’ updates sent out caused the board to pause to make sure that out documents that are representative of who by email you’d know that our organization is we have adequately developed structures and we currently are but also provide a vision of making progress on some very important and systems that support ISNR’s governance. who we achieve to become. I urge you to find significant advances. Rather than immediately hire a replace- the full discussion and invitation for commen- Before I can go any further explaining ment executive director, under the leadership tary instructions for members in the archives our future I have to acknowledge our imme- of president-elect Richard Davis, the board of our members list serve. diate past. As you likely have become aware has investigated and determined to receive In other developments I am very excit- Cynthia Kerson, PhD, who has been our ex- services from an interim executive director ed to announce that our website and shopping ecutive director since 2006, left this position program. The LaSalle University Non-Profit cart are under development. Over the next 2- at the beginning of May. I especially want to Center in the School of Business will provide 3 months the www.ISNR.org website will be acknowledge the dedication and passion Cyn- a comprehensive evaluation of our organi- having a complete overhaul. This was one of thia has given to the organization. She has zation’s needs as well as provide significant my primary objectives as president in order made significant efforts to many facets of the documentation including job description, du- to be able to reach the public in a more user organization and she has truly helped us grow ties and procedures for our next permanent friendly and understandable manner as well as to where we are today. I wish her every suc- executive director while also being our inter- be a service to our membership. Our profes- cess in her continued endeavors in our field. im executive director. The interim executive sional content will largely remain unchanged While her roles may be changing I’m pleased director should begin in the middle of May however the PR committee (chaired by Sarah that her talents and skills will still be utilized and we are hopeful that we will have a search Prinsloo) has the vision to additionally have to promote and contribute to the field of neuro- for the permanent position before the 2011- a public and lay person portal to have more feedback. She will continue to be very active year ends. basic information describing our field, our in the neurofeedback community and notably Recently the standards committee members and the services that may be provid- remains the Executive Director for the ISNR members, representing a diverse cross-sec- ed. This overhaul will bring our web design to Research Foundation and you’ll notice that tion of neurofeedback providers, authored a a more current look and have increased ease she currently continues to be managing editor Standards of Practice paper that was produced in user interface and navigability. for this very newsletter. Thank you Cynthia through a very lengthy process of weighing I wanted to also take this time to intro- and I look forward to the future. the issues involved, after which it was unani- duce some very exciting developments for our Our membership continues to grow mously approved by the standards committee Continued on page 7

ISNR Mission Statement AAPB Neurofeedback Division To promote excellence in clinical practice, educational applications, and Mission Statement research in applied neuroscience in order to better understand and enhance To improve human welfare through the pursuit of its goals. The specific brain function. Our objectives are: goals are: • Improve lives through neurofeedback and other brain regulation • The encouragement and improvement of scientific research and clinical modalities applications of EEG technology and neurofeedback. • Encourage understanding of brain physiology and its impact on behavior • The promotion of high standards of professional practice, peer review, • Promote scientific research and peer-reviewed publications ethics, and education in neurofeedback. • Provide information resources for the public and professionals • The promotion of neurofeedback and the dissemination of information to • Develop clinical and ethical guidelines for the practice of applied neuro- the public about neurofeedback. science • The division is organized for the purpose of carrying on educational and scientific objectives and is not to be operated for profit.

 NeuroConnections SUMMER 2011

Letter from AAPB NFB DIV President

This is my first col- in the tenor of our discourse toward one of reproduction, which brings different genetic umn in NeuroCon- greater mutual acceptance and tolerance of resources into combination. Just as biological nections as President differences. This obligates me to model the systems are most productive of change at the of the Neurofeed- behavior I hope to see, which involves some interface between different communities, so back Division of the degree of sacrifice on my part. I must retreat our intellectual growth is promoted by the en- AAPB. I too will from opportunities to engage in verbal con- gagement of divergent perspectives. Instead miss seeing David frontation, which I have traditionally relished, we tended to have the active resistance to any Kaiser’s columns ap- and I invite others to do the same. Ours is an new initiatives. The result is that the field has pear regularly in this intrinsically multi-disciplinary enterprise, and fragmented into sub-disciplines divided by the Siegfried Othmer, PhD space. My topics will no one has the right to shout another perspec- instrumentation being utilized. This is a direct likely have a different tive off the stage. No profession has squat- analogy to the fragmentation in the original flavor. I come to this task with an unrelieved ters’ rights here. None has a perpetual lease, biofeedback discipline according to the physi- sense of urgency about the societal signifi- or title to intellectual property with respect to ological variable being trained. To an extent, cance of our work. Yet my personal optimism the core tenets of our discipline. our pathology is shared by the field of neu- about the import of neuromodulation tech- Over the twenty-two years that I have rophysiology as a whole. Said neuroscientist nologies is tempered by pessimism about the been attending meetings, I have always been Christof Koch, “People are more likely to use state of our larger society. With our methods amazed at the degree to which the Balkaniza- each other’s toothbrush than they are to use we are in a position to redress many of so- tion of the biofeedback field sustained itself in each other’s protocols.” ciety’s critical ills. But our methods need to the face of the obvious unitary quality of our When a new finding is brought to the be better known, on the one hand, and made regulatory regime. Those who practiced EMG attention of our community, the typical re- more accessible, on the other. The barriers to training considered themselves so distinct sponse is to ask whether the aspirational such progress are sociological and political from the whole that eventually they spun off “claim” is already supported by the literature. rather than technical or scientific. into a separate organization from the AAPB. But if we limited ourselves to living within the Right now a preoccupation with rising Those who continued to pursue alpha training comfort zone of published science it would be medical costs is roiling our politics and frac- eventually found themselves so unwelcome at like driving while looking in the rear view turing our society. The piece that is entirely the AAPB that they too spun off to form their mirror. As Daniel Siegel has said, “If you had missing from educated discourse on these own organization. Years later, the EEG bio- to have the science first, we would never get topics is the domain of ‘mind-body therapies,’ feedback contingent also decamped to form anywhere in science.” First comes the ob- namely applied psychophysiology. It has been the SSNR in 1993. servation; then comes the discernment of a a step-child in research, from Hans Berger Unfortunately, the virus of compart- pattern of occurrences; and then we already working alone to search for the EEG signal to mentalized thinking migrated with the daugh- have the obligation to share what we have Barry Sterman seeing his research funding for ter organizations into their new institutional observed with colleagues. Anecdote is not a neurofeedback dry up in 1985. It has also been settings. Right belief needed to be promoted, pejorative. Sometimes even a single observa- derided in practice by self-appointed experts. and heresies expunged. Certainty was claimed tion rises to significance. When I first heard And yet our methods can likely bend the med- for propositions which did not deserve it. from Dan Chartier of a 40-point improvement ical cost curve all by themselves, and they can Fruitful discourse was aborted. And so here in IQ score, from 72 to 112, in one of his early do so quickly. Missing is an articulation of the we are, with no end in sight for the basic rifts clients, it was already sufficient to loosen the perspective that many medical challenges are within the field. The answer, of course, lies in moorings on the belief that the IQ was essen- the tragic end points of a long-term trajectory reaching across the breaches in support of our tially invariant. Something had been accom- of progressive disregulation, combined with common objectives. plished that had no trivial explanation. the realization that the timely implementation The underlying reality of our discipline In the sometimes lengthy progression of a self-regulation strategy can forestall or is that our regulatory regime functions as an from mere conjecture toward solid scientific avoid many of these adverse outcomes. integrated whole. Autonomic regulation is not status, our community should at least benignly One has the sense that we are close rigorously separable in the discussion; the di- tolerate, if not affirmatively value and support, to a tipping point at which there will be a vision into central and peripheral regulation the innovators. The constraints of peer review shift toward more general acceptance of our is not realistically sustainable. Hence the di- are often detrimental to the tender shoots of claims, much like what happened when evi- vision into separate agendas for biofeedback new initiatives. Peer review tends to censor or dence for the generation of new neurons first and neurofeedback is going to be increasingly dismiss anything too far from the beaten path. made brain plasticity respectable for polite limiting. It is not that our prior understandings This is a fact of life in mainstream science discussion. We can only marginally influence were false. It is rather a question of whether that will not change. But that is all the more such a tipping point. We can, however, posi- they remain useful. As the integrative nature reason for our community of professionals to tion ourselves for that occurrence. Right now of our regulatory hierarchy is coming to be provide a buffer to the harsher judgments of there is one factor above all others that mili- understood, the latter perspective is simply the world at large, a safe harbor for innova- tates against our being seen as scientifically going to be more fruitful. Our organizational tion within its orbit. While the world at large mature, and that is the compartmentalization arrangements should accommodate to this is bidding us to make harsher judgments, for of thinking and the high level of internal dis- shift, if not at the formal organizational level, example with respect to evidence-based cri- sension it brings in train. then at least at the conceptual level. We now teria, within our own organization we should In the brief talk I gave at the recent need to reach across the boundaries we our- be moving in the opposite direction, toward AAPB Neurofeedback Division meeting when selves have established. softer judgments and greater openness to di- I assumed my duties, I highlighted two themes Some while ago I heard a program on vergent perspectives. for my two-year tenure in this position. One is TED which talked about the advantage of the conceptual re-unification of biofeedback having lots of different ideas contend with Siegfried Othmer, PhD and neurofeedback, and the other is a change one another. He drew the analogy to sexual  NeuroConnections SUMMER 2011

There are two articles about LORE- tivity at the targeted location and frequency. Letter from TA, one on LORETA itself and the other on Rather than simply altering current density sLORETA. Both will increase your under- selectively in the training region and in the ISNR Co-Editor standing of this very powerful analysis and trained frequency, LNFB seems to engage, and training programming. Do take the time to enhance the functioning of a broader network Dear Neuro read them and think about adding them to your of functional connected cortical units physi- Connections readers, practice. I can attest to the power of both. ologically related to the training regions, and First, this issue has a The Brodmann issue is beautifully often involving several frequencies (in addi- contributory article handled by the Thompsons: Michael, Linda tion to the trained frequency) associated with regarding the passing and James and David Hagedorn, all (PhDs) in the functioning of the network (Cannon, Lu- of our esteemed friend their Network Rational article as Part 1 of this bar, Congedo, Thornton, Hutchens & Towler, Tom Budzynski. issue. Also David Kaiser, PhD again gives us 2007). This effect aligns well with a shift in This summer the definitive discussion of Brodmann and the neuroscience away from simple localization edition started out to implications in analysis and training. Again, models, towards an understanding of the role be focused on LO- hope you take the time to read both articles. of dynamic neural assemblages functionally Merlyn Hurd, PhD RETA and along the Finally Thought Technology in their se- engaged during task performance. way had more information about Brodmann ries of articles is providing us with a look at ath- Thank you to co-editor Merlyn Hurd issues in the writings. Sort of like all of neu- letic personal and ADHD. Very informative! and the many talented contributors to this roscience. Think we are looking at one thing Have a wonderful summer!! issue. We hope that the material within will and it turns out there is even more information Merlyn Hurd, PhD, BCN Fellow provide a glimpse into neurofeedback’s fu- lurking in the wings. ture, and challenge you to expand your cur- rent clinical approaches. limited to differing densities of scalp, skull Roger Riss, PhD Letter from and brain tissue, and discrepancies in shape between actual individual brains and that of Koles Z. (1998). Trends in EEG source localization. Electro- AAPB Co-Editor an idealized model. Indeed, these and other enceph Clin Neurophysiol;106:127–37. Cannon, R., Lubar, J., Congedo, M., Thornton, K., Hutchens, challenges led skeptics to describe the so- The theme of the cur- T. & Towler, K. (2007). The effects of Neurofeedback in called EEG inverse problem as ill-posed, the cognitive division of the anterior cingulate gyrus. In- rent issue reminds ternational Journal of Neuroscience. 117 (3) 337 – 357. underdetermined, and subject to multiple pos- us, at once, not only sible solutions (cf. (Koles, 1998)). of neurofeedback’s These hurdles led some to shift their promising future, but attention to alternative functional brain imag- Letter from also of our continued ing/training techniques such as fMRI neuro- debt to the rich intel- AAPB ED feedback, for their ability to provide more di- lectual lineage of its rect observations in three-dimensional space. founding pioneers. In If You Missed the Boat, However, despite its superior 3-D spatial the second of a 2-part There is Next Year! localization abilities, fMRI (and fMRI neu- Roger Riss, PhD series, we continue an rofeedback) is inherently limited, telling us exploration of 3-D source localization meth- only about the where, but nothing about the This year’s annual ods in neurofeedback, including low-resolu- what, of neural communication associated conference in New tion electromagnetic tomography (LORETA) with various cognitive/emotional processes in Orleans was an ex- neurofeedback, (reflecting the brilliant work 3 dimensional space. cellent example of of Dr. Joel Lubar and highly gifted students By contrast EEG (and EEG neuro- biofeedback and neu- Congedo, Cannon, Sherlin and others) and the feedback) provides us with the capacity to rofeedback profes- SKIL-Brodmann area mapping method de- simultaneously observe and modify both the sional networking at veloped by David Kaiser (reflecting the field’s what of cognitive processes (in the form of its best! There were continued indebtedness to Dr. Barry Sterman specific oscillatory signatures associated with plenty of highlights and his students). various cognitive/emotional processes), as with the keynote A major limitation of neurofeedback David L. Stumph well as the where (in the form of localized presentations, sym- relates to the limited information provided by and long distance activation and connectivity posia, short courses, a single or small number of electrodes placed patterns) associated with the function of the and pre-conference workshops. But, when the on the scalp. To address this limitation vari- brain, with millisecond temporal resolution; planning for the conference began, President ous “inverse solution” techniques such as LO- all from a relatively cheap and non-invasive Carmen Russoniello, PhD, said, “Let’s make RETA and the SKIL Brodmann Montage seek technique. Among current functional brain it fun!” And we did just that. to translate observed electric field activity at imaging/training technologies, only magne- First, it is hard to be in New Orleans at the scalp into meaningful estimates of current toencephalography (MEG) can make similar the time of Marti Gras and not have some fun. source density at depth, providing a window claims, albeit at costs approaching 20X great- A new offering this year of the Foundation for into the operation of functional neural net- er than EEG, despite similar spatial resolution Education and Research in Biofeedback and works in three dimensional space. (given equivalent sensor density) for the two Related Sciences (FERB) was the Saturday The importance of 3-D source local- technologies. evening fundraiser on the Creole Queen Riv- ization to the future of neurofeedback, while Research to date appears to support the erboat, the Riverboat Jamboree, which was obvious to observers today, could not readily promise for more rapid and specific outcomes the networking event of the year for AAPB have been predicted a decade ago. Attempts for LORETA neurofeedback (LNFB) train- members. directed at mathematically relating known ing as compared to traditional neurofeedback So, what is in store for next year? Well, EEG traces recorded at the scalp to the ana- methods. However this effect does not appear plans are at the beginning stage for the 2012 tomical locations of their cerebral generators to reflect a simple modification of brain ac- meeting to be held on March 8-10 in Balti- have been fraught with technical hurdles, not more, Maryland. We have a very enthusiastic  NeuroConnections SUMMER 2011

local chapter, the Mid Atlantic Society of Bio- ISNR President ety of topics and the quality of all our high- feedback and Behavioral Medicine (MAS- Continued from page 4 lighted speakers. You can find a full list of BBM) that is helping to put together some- keynote and invited speakers on our website thing different that will highlight the wonders conference in September that will take place www.ISNR.org. Still on the topic of the con- of Baltimore. in Carefree, Arizona (just outside Phoenix). ference is a different schedule format. Many Although the special event is not deter- The conference committee and Ann Ma- individuals reported wishing they had more mined yet for next year, here are a few clues: rie Horvat have been working diligently to time with our plenary speakers. By your re- history abounds everywhere you look in Bal- bring exciting speakers, innovative devel- quest speakers will have more time in slots timore, the Chesapeake Bay is the crab capital opments and a schedule that maximizes the of either 30 or 60 minutes. Also there will of the US with outstanding seafood and other opportunities for learning and networking. be no evening sessions with the exception options, it is home to a number of outstand- Our membership has increasingly expressed of our traditional receptions with poster ses- ing museums including the B&O Railroad, interest in integrative approaches to neuro- sions and banquet dinner allowing attendees Legions of Sports, Edgar Allan Poe, and Babe feedback. In response to this I was excited to maximize their time networking or taking Ruth museums, and many more. Baltimore’s to call specifically for talks and workshops advantage of the beautiful desert and resort Inner Harbor, literally across the street from that are focused on neurofeedback in combi- amenities. the hotel where you will be staying, is full of nation with other “peripheral” measures. We I’ll respect your time and conclude by great shopping, an excellent array of restau- had a great response and you’ll find a number expressing my continued appreciation to the rants, and fun entertainment options. Whatev- of such talks in this year’s program. To high- board of directors, staff, committee chairs er event FERB decides to offer next year, it is light this effort one of our invited speakers and members and members who continue to important to remember that your participation will be our colleague, Dr. Richard Gevirtz, promote and advance our field through col- will help to raise funds to support education who will speaking on recent research in heart laboration, collegial debate and professional and research in biofeedback and neurofeed- rate variability and EEG along with provid- actions. ISNR truly is a membership organi- back and the future of your profession. ing a workshop on the topic. Other notable zation and it is through your dedication and Come to Baltimore next year for the speakers include keynotes, Paola Arlotta, passion that we will continue to grow and education! And enjoy all that Baltimore has to PhD from Harvard, Scott Makeig, PhD from have a positive impact. Be well I hope to see offer while you are there! the University of California San Diego and you in September! Robert Pascual-Marqui, PhD from the Key

David L. Stumph, IOM, CAE Institute. I am very excited about the vari- Leslie Sherlin, PhD

 NeuroConnections SUMMER 2011

Networks: A Compelling Rationale for Combining Neurofeedback, Biofeedback and Strategies

A Parsimonious Evidence Based Approach to Training

Michael Thompson, MD, Lynda Thompson, PhD James Thompson, PhD & David Hagedorn, PhD

Background: lead of Joel and Judith Lubar who used those derives both from others’ research and our placements for ADD (Lubar, 1991). own evidence based practice. QEEG data Back in 1995 at one of the early meetings of the With today’s perspective and the (either single channel or 19-channel) con- newly formed Society for the Study of Neuro- knowledge gleaned from sixteen additional tinues to provide the basis for planning all nal Regulation, Lynda and Michael Thomp- years in the field, how do we account for our interventions. The 19-channel data, when son presented a paper entitled, “Exceptional early success? This paper will allude to how available, is combined with LORETA analy- Results with Exceptional Children.”The cases our practices developed over these years. It sis for source localization and then we apply presented were children with severe behavioral will emphasize, with its discussion of net- knowledge of Brodmann areas, functional disorders who had not responded to traditional works, an overview of what we hypothesize networks, and the client’s symptoms. Our treatments such as medications, behaviour to be a reasonable answer to the question of observation is that symptoms and functional modification, and extensive psychotherapy. why our original, admittedly rather simple neural networks are mutual among many of With parental consent they tried a new, purely approach, was successful. The explanation the disorders we are working with in general experimental approach for which there was lit- is based on a theoretical framework that practice. tle research support and no way of explaining why neurofeedback (NFB) might work, except to cite outcomes of increased attention span in Figure 1 children with Attention Deficit Disorder who Central Midline Structures (CMS) were treated using neurofeedback. Despite our limited knowledge and equipment that recorded only single chan- nel EEG and basic biofeedback (Autogen- ics A620 and Focused Technologies F1000), these difficult cases made remarkable im- provements regarding both behaviour and medication reduction. A dramatic example was a 13-year-old boy with Autism who ini- tially just screeched and flailed his arms when seated in front of the computer. By the time he finished 85 sessions he had been demitted from the MID class (for children with mental retardation) and had moved on to high school where he was enrolled in regular classes ex- cept for mathematics, in which he took an advanced class. Additionally, he was being invited to parties by his peers. Eight years later, when we called to invite him back for follow-up, his father declined, explaining that his son was doing well in college and did not want anyone to know that anything had ever Drawing from Neurofeedback Book (AAPB.org) & ADD Centre Brodmann Areas Booklet (ISNR.org) been wrong with him. Artwork by Amanda Reeves & Bojana Knezevic What were the procedures that pro- Central Midline Structures (CMS): • SACC = supragenual anterior cingulate cortex duced these results? We had done single An Anatomical and Functional Unit (BA 24, 32); channel assessments and training, placing the (Northoff, 2006) • DMPFC =dorsomedial prefrontal cortex (BA active electrode over Cz, referenced to the left In broad general terms the CMS cortical areas 9); ear in most cases, or in some cases (especially includes the following: • MPC = medial parietal cortex (BA 7,31); when EMG artifact was a problem, as with the • MOFC = medial orbital prefrontal cortex (BA • PCC = posterior cingulate cortex (BA 23, 31); autistic lad), we used a sequential placement: 11, 12); • RSC = retrosplenial cortex (BA 26, 29, 30). FCz and PCz. Both referential (old term: mo- • VMPFC = ventromedial prefrontal cortex (BA We suggest that in thinking about the CMS and its nopolar) and sequential (old term: bipolar) 10, 11); importance in networks that one consider including • PACC = pre- and subgenual anterior cingulate other structures that directly connect to these areas. training were successfully used with very dif- cortex (BA 24, 25, 32); These might reasonably include the hippocampus, ficult cases in the early years, following the the entorhinal/uncus area, and the insula.  NeuroConnections SUMMER 2011

Mechanisms that May areas of the cortex. It may also be reasonable bar’s principles that worked for ADD and we Underlie Treatment to hypothesize that there are more changes in thus chose the central location(s) for a num- Changes: the brain (both amplitude and phase) in rel- ber of reasons: CZ reflects activity of both Given the overlap in symptoms across many evant networks if we use sequential training. the frontal cortex and the sensorimotor strip; disorders and, by extension, overlap in the Sequential placement, in addition to the ad- relative to other sites, because of its distance neural networks involved, it is logical to vantage of common mode rejection lessening from the ear(s) that are used as a reference, postulate that many of the disorders suc- the effects on the EEG due to certain artifacts, it has higher amplitudes(due to less common cessfully treated using neurofeedback (NFB) may produce improvements related to ampli- mode rejection); because of its distance from may have underlying mechanisms in com- tude changes at either (or both) site(s) and, in the jaw, shoulder and neck muscles there is mon. For the most part, there appears to be addition, may encourage phase and coherence less EMG artifact; because of distance from dysfunction, to different degrees, in only a changes. (When the two sites are in phase for the eyes there is less eye movement artifact. few basic networks. Many of the disorders, a particular bandwidth, amplitudes will de- The frequencies trained were based on single for example, have in common difficulties in crease - as is seen with an artifact that is com- channel QEEG data measured at CZ. Typi- attention (executive network) and/or anxiety mon to both sites. Whereas if they become cally we were decreasing bandwidths in the (affect network). A few disorders include dif- less in phase, amplitude will increase.) If the theta range, increasing low beta (either senso- ficulties in monitoring of self and self in rela- distance between two sites is lengthy, they rimotor rhythm [SMR] in the 12 [or 13] – 15 tion to others (default network). The autistic may largely be connected through a loop that Hz range along the motor strip or beta in the spectrum disorders (ASDs) have major diffi- is cortex-to-basal ganglia-to-thalamus-back- 15 – 18 Hz range) and had an inhibit on fre- culties in at least these three major networks. to-cortex, rather than simply cortical-cortical. quencies above 20 Hz. Those beta frequencies The majority of our patients, regardless of di- This, in turn, suggests that our NFB training above 20 were assumed, with the equipment agnosis, appear to have difficulties related to likely affects functional networks and not just available at that time, to reflect muscle (EMG) these networks with just a different “balance” direct connections between two sites. artifact. Now we realize 20-36 Hz may reflect of involvement of the three networks across On the other hand, if only a single site is excess high frequency beta, including spin- clients and diagnostic categories. These three clearly outside your data base norms, then am- dling beta. In some patients this high ampli- networks can all be influenced by neuro- plitude training for a specific frequency range tude, high frequency beta may correlate with feedback at the sites over the central midline at that site may be more logically done with dysfunction. However, this beta may also structures (CMS) (See Figure #1). They are a referential montage. With amplitude training correlate with high IQ and multi-tasking, so also altered by means of biofeedback and, in and referential placement you have a clearer care must be taken in making any interpreta- particular, by Heart Rate Variability (HRV) idea of what has changed at a particular site. tion (Thompson & Thompson, 2005). More training, which will influence the same CMS (M. Barry Sterman [personal communication] recently we have observed that, in patients through afferents to the brain stem (medulla) often used sequential placements in his earliest where the differences from the data base z- and from these nuclei to the basal ganglia and research but switched to referential placement scores appear to correlate with dysfunction the cortex (Thompson & Thompson, 2009). after a grant reviewer insisted on more speci- (such as anxiety or ruminating) rather than Central training near Cz (Jasper, H., ficity about what was being changed during high functioning, LORETA often shows the 1958) with referential placement (ear reference) operant conditioning of brainwaves.) source of this dysfunction to be in the cingu- should have an effect on the affect network (the Combining NFB with BFB late cortex (Thompson & Thompson, 2010). emotional brain) as shown in Figure # 2. to influence Central In nearly all cases we used some bio- The loops that involve connections from feedback, initially just finger temperature and cortex to basal ganglia to thalamus and back Midline Structures electrodermal response (EDR). We also taught to cortex may affect many functionally related With these early clients we were applying Lu- diaphragmatic breathing and encouraged dropping the shoulders as a simple relaxation technique to decrease anxiety as well as EMG Figure 2 artifact. We always worked 1:1 with quiet en- The Affect Network couragement, modeling, and teaching the chil- dren learning strategies (emphasizing active reading, listening, and organization skills) dur- ing part of each neurofeedback session when the EEG indicated they were calm and focused (Thompson & Thompson, 1998). To determine which biofeedback mo- dalities to train, we now use a stress assess- ment that demonstrates changes during stress- ors (STROOP color test and mental math) and recovery after stress for peripheral skin tem- perature, electrodermal response, muscle ten- sion, heart rate, and breathing frequency. Heart rate variability training (HRV) is now taught in virtually all training sessions with adolescents Drawings by Amanda Reeves from The Neurofeedback Book and adults (Thompson & Thompson, 2007). Much of the NFB training done at our Affect Information Flow Centre, both now and in the early days, begins In simplest terms, information related to ‘affect’ traverses from the orbital frontal cortex (OFC), medial at a central location. Increasingly in the neu- frontal cortex, anterior cingulate gyrus (ACG), hippocampus (HC), amygdala, and entorhinal (ERC) / uncus area to basal ganglia, including the nucleus accumbens and ventral pallidum, and from there to roscience literature central midline structures specific functionally related areas of the thalamus such as the medial-dorsal and anterior nuclei of the are being investigated due to their involve- thalamus. The thalamus then connects back to areas of the cortex including the anterior cingulate, which ment in the default network. has functions related to control of the affect network. The result is regulation of mood and emotional reactions (after Kropotov, 2009). Continued on page 10

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Networks connections to a ‘set’ of functionally related, sary. This is because symptoms related to the Continued from page 9 even though distant, areas of the cortex. Less functions of that area, such as difficulty read- Cortex-Basal Ganglia- important pathways continue to be inhibited by ing non-verbal cues, had resolved through the Thalamus-Cortex Circuit other nuclei in the globus pallidus. initial CMS training. An example of the above is that activa- There are always exceptions. We do One key to understanding why NFB applied tion of the motor cortex, such as when a hy- not, for example, begin our training over the over an appropriate site along the CMS, such as peractive child is moving his or her feet under CMS if the main problem is a reading disor- FZ, FCZ, CZ or PZ, may have such a profound the school desk,will stimulate the putamen, der or a seizure disorder. With dyslexia, if that effect on different, but functionally related, areas which in turn inhibits an area of the globus is the primary complaint and not a comorbid- of the brain is to recognize the key importance pallidus, which will then no longer inhibit the ity with a bigger problem such as ADHD, we of the cortex-basal ganglia-thalamus-cortex cir- functionally related area of the thalamus. In usually follow the QEEG, which typically cuit that affects functionally-related areas. In this manner the ventro-lateral nucleus within shows inactivity over Wernicke’s area near simplest terms both the putamen and the globus the thalamus stops producing the oscillations the angular gyrus in the dominant hemisphere. pallidus are inhibitory. When cortical activity (oscillations with the reticular nucleus of the With seizure disorders we may alternate SMR stimulates a specific area of the caudate or pu- thalamus) that would produce theta in the cor- enhancement at C3 and C4 while decreasing tamen (components of the striatum within the tex and the student stays awake and alert. slow wave activity (2 – 5 Hz) near the focus corpus striatum) then those nuclei will inhibit a Every Brodmann Area (BA) site has of the epileptiform activity. We may also train functionally related, specific area of the globus functions that overlap with the functions down slow wave activity at the homologous pallidus. Lateral inhibition of other areas of the of many other sites (Thompson, Thompson site in the opposite hemisphere (Hammond, ‘striatum’ will stop other functional areas of, & Wu, 2007). In no way is this CMS train- Hunt, Harper, O’Brien, & Dogris, 2011). for example, the putamen from inhibiting the ing overview meant to decrease the impor- Traumatic brain injury (TBI) is another globus pallidus. The firing rate of the globus tance of training over other cortical areas if exception since head injury types, such as mo- pallidus is very high and is constantly inhibit- such training is indicated by the 19-channel tor vehicle accidents, IED (improvised explo- ing the thalamus. Thus the one area of the puta- QEEG findings. It does, however, help us sive device) blast exposure, and sport related men (or caudate) that is activated will inhibit understand why beginning with NFB train- deceleration injury can differ. IED comprises and stop the rapid inhibitory firing of a specific ing over the CMS has truly profound positive several types of injury – the pressure wave area of the globus pallidus. In this manner only effects in many different disorders. We have that passes through tissue damages neurons one specific functional area of the thalamus is often been surprised, for example, that, after in different ways. One way is the axon will released from the inhibition of the globus pal- training at FCz and simultaneously doing, shear off or twist and break.This renders the lidus allowing functionally related areas of the relaxation training, HRV training and incor- pathway that utilized those axons somewhat cortex to be activated. It can be thought of as porating metacognitive strategies with clients hindered.Another type of injury is caused by a opening a ‘gate’ to the cortex, which can inten- with Asperger’s Syndrome, further training at secondary neurochemical cascade (increased sify a specific selected program of action. Thus other sites such as T6 (which often shows de- extracellular potassium, calcium influx and the one site where there is no inhibition allows viations from database norms in people with decreased magnesium) and associated inflam- activation of that one area’s thalamo-cortical Autistic Spectrum Disorders) is not neces- mation which also damages neurons.The EEG and measurements of event related potentials (ERPs) help locate the different locations and Figure 3 degree of dysfunction, such as hypo- or hy- Cortical-thalamic loops involving motor activity. per-sensitivity of the region.TBI patients, of- ten functionally hindered by 1-½ times slower processing speed, appear to benefit from mul- tiple and overlapping brain function assess- ment methods that include analysis of event related potentials (ERPs).The multi-factorial approach offers a more dynamic window into the interconnected brain systems.Advancing hardware and software applications, such as those used by Evoke Neuroscience (Hage- dorn & Thompson, 2011) permit one to iden- tify areas hindered by diffuse axonal injury resulting in delayed motor output and also to measure the extent this output is hindered by additional network dysfunction. The sites trained using NFB are therefore specific to the assessment findings. Drawings by Amanda Reeves from The Neurofeedback Book Nevertheless, beginning training over Cortex—Basal Ganglia—Thalamus – Cortex the CMS is a reasonable starting point with Motor information goes from the somato-sensory cortex (SSC), premotor cortex (PMC), and the majority of our patients due to the network supplementary motor area (SMA) to the putamen and then to internal globus pallidus and to the properties of the structures that underlie the substantia nigra and pars reticularis. From these basal ganglia centers it is routed to the ventro-lateral CMS mid-line sites. Note that the goal with and ventro-anterior nuclei of the thalamus. These nuclei send axons to functionally related areas of the our client population is typically to improve cortex (After Kropotov, 2009). self-regulation of attention and emotion and Basal Ganglia to optimize performance in the following The corpus striatum lies adjacent to the lateral wall of the diencphalon (thalamus) and comprises the disorders: ADHD, seizure disorders, ASD, lentiform nucleus, caudate, amygdala, claustrum and nucleus accumbens. The lentiform comprises movement disorders, age related mild cogni- the putamen laterally, globus pallidus medially, and at its base the innominate substance inferiorly (containing the anterior perforated area). (Note that some neuroanatomy texts label caudate + putamen as tive impairment, and TBI. We do not often the “striatum” and this is a different term than “corpus striatum.”) deal with addictions or personality disorders. 10 NeuroConnections SUMMER 2011

A Few Important Networks Figure 4 (Affect and Distress, Networks Involved in Depression Executive, Default, Salience, and Placebo networks) and Why We Combine NFB with BFB Our working definition of a network, for pur- poses of doing NFB & BFB, is a “net” of in- terconnected, functionally related, groups of neurons. We refer the reader to talks by Dirk De Ridder, such as his ISNR presentations in 2009 and 2010, for neuroanatomical de- tails (De Ridder, 2009, De Ridder, 2010). We give here only a very basic overview. This is a rapidly evolving area and much will become more clearly delineated in the next few years. In terms of applicability to work using NFB + BFB, the ventral anterior portion of the ante- rior cingulate cortex (ACC) is a key structure in the affect network. The ACC connects with the medial and orbital prefrontal cortex and the entire limbic system. In addition, it receives in- put from the brain stem that, important to our work, includes vagal afferents from the heart Drawing from The Neurofeedback Book & ADD Centre Brodmann Areas Booklet to the nucleus solitarus in the medulla, which Artwork by Amanda Reeves & Bojana Knezevic connects to the locus coeruleus (noradrenaline The three coloured boxes highlight aspects of the Executive & Affect networks involved in depression production) (Porges, 2007) and then to the lim- (after De Ridder, 2010): bic system including the ACC. The ACC has Executive / Cognitive Aspects of Network = GREEN (BA 9 & 46, 24, 31, 40) direct links to the hypothalamic-pituitary-ad- Affect / Vegetative Aspects of Network = ORANGE (BA 25, anterior insula, hippocampus, hypothalamus) renal (HPA) axis. The reader can immediately Integration and connection of Cognitive and Vegetative = RED (BA 24, 9, 10, 11) see the role of these connections in the human stress response and hence the importance of concurrent treatment with both NFB and heart age perception, attention, selection, decision treatment that combines HRV training with rate variability BFB is indicated and arguably making, inhibition, memory, planning, prob- NFB to control stress (Thompson & Thomp- essential. Thus, regardless of the site of inju- lem solving, logical thinking (deductive / in- son, 2007). A distress network, as described ry, it is still important that one consider the ef- ductive), sequencing; and to monitor, evalu- in Dirk De Ridder’s work concerning tinnitus, fects of that injury on all the major functional ate, and self-correct outputs; and to respond is similar to that for pain and involves the fol- networks, for example: attention, executive, verbally / non-verbally, motorically and/or lowing areas: orbital frontal cortex, anterior affect and salience networks, and combine socially for the purpose of the attainment of cingulate, amygdala, hypothalamus, posterior NFB+ BFB + strategies that will effect posi- defined goals. The frontal lobes are crucial for insula, primary motor cortex, and frontal pole tive changes in these networks in order to help all executive functions (Knezevi, Thompson (De Ridder, 2009; Kulkarni, 2005). the patient recover. & Thompson 2010; Kouijer, Jan, de Moor, The distress network is possibly a com- We have many good examples that Berry, Gerrits, Congedoet al., 2009). Good ponent of the affect network. It highlights the emphasize the importance of attending to examples of improved executive functioning interconnection between the central and au- dysfunction in all relevant networks in pa- can be found in our own case series publica- tonomic nervous systems. Patients who have tients with TBI but one stands out. Before tions on 111 ADHD (Thompson & Thomp- brain injury due to blast or motor vehicle acci- his automobile accident he had been a bril- son, 1998) and on 150 Asperger’s and 9 ASD dents can also demonstrate symptoms of acute liant student. After the accident he had lost all (Thompson, Thompson, & Reid, 2010). The anxiety disorders and even more chronic con- ability to do his graduate studies. His memory average IQ gain in these two case series were ditions like PTSD (Post Traumatic Stress Dis- was severely affected. He was unable to read 12 and 9 points respectively. Significant aca- order).In such cases, the electrocardiograph and recall a simple page of information. He demic and other changes were also recorded data, namely the R-R interval variability, was understandably anxious and somewhat in these publications. is a frequently observed marker of both the depressed. All hospital related rehabilitation A good example of a complex network brain injury and the stress disorder.The stress therapies over more than a two-year period is one that is involved in depression (Fig- disorder symptoms in IED injuries and other had had little effect. After 8 months of NFB ure #4) as described by De Ridder (2009). mechanisms of TBI may correlate with hy- + BFB + Strategies (memory strategies, or- Logically, it does involve many of the same per-activation of amygdala-hippocampus for ganizational skills, time management, written structures as were listed above for the dis- IED injuries and perhaps more cingulate gy- language skills) he returned to work on his tress network.He notes that in depression rus involvement in motor vehicle accidents. thesis concerning artificial intelligence and, the vegetative / autonomic affect network However, in both types of injury, it is prob- two years later, graduated withhis PhD in symptoms involve a ventral compartment able that a distress network will be activated. computer science... (e.g., sleep disturbance, loss of appetite and Additionally, in these injuries, the patients The same ACC structure, but the libido), which includes the hypothalamic- also have other sympathetic nervous system more dorsal aspect, is a central structure in pituitary-adrenal axis, hippocampus, insula hyper-activation symptoms (e.g., insomnia, the executive network and it connects with (BA 13), subgenual (SG) cingulate (BA 25), temporomandibular joint disorder (TMD), all functionally related structures including and the brainstem.The executive components muscle tension, and so on). the dorsolateral prefrontal cortex. Executive In head injury patients the addition of functioning is the overall capacity to man- Continued on page 12 11 NeuroConnections SUMMER 2011

Networks Figure 5 Continued from page 11 Placebo Network for Pain Management of the affect network in depression are found in the dorsal compartment, which modulates attentional and sensory-cognitive symptoms (e.g., apathy, attentional and executive defi- cits). This includes the dorsolateral prefrontal cortex (BA 9 & 46), the dorsolateral anterior cingulate (area 24b), posterior cingulate (BA 31), the inferior parietal lobe (BA 40), and the striatum. The dorsal prefrontal components, including the ACC, are also involved in the cognitive control of emotion including reap- praisal, evaluation, and explicit reasoning concerning emotional stimuli. Information concerning cognition and emotion from the two compartments (dorsal & ventral) is in- tegrated by the rostral anterior cingulate (BA 24), medial frontal cortex (BA 9 & 10), orbital NAcc = nucleus accumbens RACing = rostral anterior cingulate cortex, DLPFC = dorsolateral frontal cortex (BA 11), and frontopolar areas. prefrontal cortex, Ins = insula (From De Ridder, 2010 after Benedetti, 2005) In addition, recall that selection of activation of particular pathways must involve the cor- tex—basal ganglia—thalamus to cortex con- Figure 6 nections, as was previously shown in a brief Placebo Network for Treating Substance Abuse overview in Figure #1. Another important network is called the default network. It comprises a number of central midline structures including the ven- tral-medial prefrontal cortex, anterior cingu- late cortex, lateral parietal cortex for spatial self-reference, cuneus and precuneus and the posterior cingulate. These areas are concerned with understanding and constant monitoring of self and self in relation to others (Supekar et al, 2010). It is therefore involved in self- referential processing and understanding oth- ers’ intentions. These functions are important in our work with autistic spectrum disorders (ASD). The default network becomes active when the brain is not engaged in specific cog- nitive or motor tasks. Another network subsumes an addi- tional important function not fully covered by the previously mentioned networks. This is De Ridder used the following diagram to help show the difference in activation between rTMS and sham the salience network (Seeley, 2007). Its func- rTMS (placebo) in work with substance abuse. tion is to determine the salience (relevance) of Adapted from De Ridder (2010) after Koob (2010) information. This salience network includes Index: AMG = Amygdala; Hippo = Hippocampus; OFC = Orbital Frontal Cortex; MPFC = medial the dorsal and anterior cingulate gyrus (BA prefrontal cortex; AC = Anterior Cingulate; AMG = amygdala 24 & 25), insula, middle superior frontal area, DS = (dorsal striatum, includes caudate and putamen) VS =(ventral striatum, includes olfactory cubicle and the para-central area (BA 4, 5, 6) the sub- and nucleus accumbens) mPFC (also ACC) = Medial Prefrontal Cortex; OFC = Orbital Frontal callosal gyrus, entorhinal area (BA 28), uncus Cortex;GP = Globus Pallidus;Thal = thalamus;BNST = The bed nucleus of the stria terminalis (BA 34), parahippocampal gyrus (BA 35), (BNST) is a basal forebrain structure involved in many motivational processes. It is closely linked to and fusiform gyrus (BA 36). The right dorsal stress regulation. A part of the corpus striatum called the amygdala connects via the stria terminalis to other cells below the thalamus called the hypothalamus and they attach ACC to an outgrowth that anterior cingulate (dACC) and the right insula controls hormones in the Pituitary to Adrenal (AHPA axis). For a more complete description of pathways act as a switch between the frontoparietal ex- in the stress response see The Neurofeedback Book by Thompson & Thompson (2003) and Thompson & ecutive network and the default network when Thompson (2007). determining salience. However, for each net- work there are always other networks that subsume similar functions but in a different stimulus/task information from frontal (P3a) ADHD symptoms.. Another example of a dif- context. One example might be a salience net- to temporal-parietal (P3b) locations. It is pos- ferent salience network is a salience map (or work, which we postulate could be related to sible that P3a stems from the initial inhibitory network) to rank items in the visual field for evoked potentials. For example, P3a and P3b activation elicited by focal attention to a dis- locus of attention (Bisley & Godberg, 2006). (positive approx. 300 ms responses to audito- tracting stimulus and P3b indexes subsequent The lateral intra-parietal area (LIP) connects ry or visual stimuli) involve a circuit pathway inhibition related to memory (Polich, 2007). to the frontal eye field (FEF) (as does the up- between frontal and temporal/parietal brain This is the process of determining salience of per auditory cortex), superior colliculus, pul- areas. They reflect rapid neural inhibition of the stimulus in a GO – NoGO task, such as the vinar nucleus, and inferior temporal area (BA ongoing activity to facilitate transmission of continuous performance tests used to evaluate Continued on page 14 12

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Networks improvement. This activity will involve hippo- detti (2005) to show areas involved in placebo continued from page 12 campus to orbital frontal cortex (OFC) connec- effect for pain. tions. De Ridder gives an example of placebo Discussion: 20) (visual pattern recognition). This network network action during a sham treatment versus determines the significance of information real repetitive transcranial magnetic stimula- When reviewing the pivotal position of the (salience). However, the use of the informa- tion (rTMS) treatment over a central area that anterior cingulate gyrus in many networks the tion will then depend on the specific functions should influence the ACC in depression and reader can see why we postulate that our origi- of areas that receive projections from this net- addiction. The improvements associated with nal success with such a simple placement as Cz, work and its central component, the LIP. the placebo network in depression seem to in- which lies over the ACC and thus over a key The Placebo Network: volve different cortical connections but a com- area in the central midline structures, was so ef- mon final destination as compared with im- fective. Plus combining this with biofeedback It is possible that this network is always a fac- provements that result from rTMS. The rTMS increased the efficacy because of the indirect tor in any success that we observe with NFB has been shown to decrease 22- 23 Hz beta links via the brainstem to the ACC, A number training. Our favourite way of thinking about activity with its source in the anterior cingu- of networks can be affected by both neuronal placebo effects is Benson’s definition of pla- late (ACC). The ACC is connected to the OFC. firing patterns from different areas within the cebo as remembered wellness.Rather than On the other hand, De Ridder demonstrated ACC and by vagal input to the nucleus solita- downplaying the placebo effect, it makes sense that the sham rTMS does not work through the ris. Vagal tone can be improved with diaphrag- to recruit it. Working one-to-one with clients ACC but rather, it involves the parietal cortex matic breathing at about 6 breaths per minute. and acting as their coach, with praise and en- to the OFC and the placebo network described (Now we can be more precise by doing HRV thusiasm evident while they perform the brain- above (De Ridder, 2010). Thus the placebo re- training.) These networks involve feedback computer interface tasks, doubtless helps acti- sponse with sham rTMS shows the parietal to loops to the brainstem with connecting links vate the placebo network. Placebo will activate OFC link and not the ACC to OFC pathway to the limbic cortex. Knowing this helps us the posterior cingulate cortex (BA 23, 31) and (Figure # 6). understand the effectiveness of our combined its connections to the inferior parietal cortex The placebo effect for other disorders NFB and BFB work. for cognitive feature analysis. These areas con- may involve additional areas. For pain relief, The Cz site may not feed directly into nect to the orbital frontal cortex. They can, in for example, the placebo effect also incor- the placebo network outlined by De Ridder part, involve passive mental states with inter- porates the nucleus accumbens and, to some but our 1:1 trainer/trainee work and the fam- nally directed thoughts that are independent of degree, the ACC, insula, and dorsolateral ily’s positive expectations may be assumed stimuli. These include recollection of the past prefrontal cortex, which are involved in the to indirectly trigger this network. We find it and thinking about the future and are a part salience, executive, and affect networks.De helpful clinically to think of placebo as “re- of the default network functions. The placebo Ridder shows the diagram below from Bene- network is closely linked to memory-based Continued on page 16

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Networks influence through NFB combined with BFB, Conclusion continued from page 14 we remind the reader to always combine this work with appropriate other assessments and For treatment, there now exists an array of neu- membered wellness.” Herbert Benson’ coined interventions. It is not a stand-alone treatment. romodulation tools. When and how we can best this term, which explains the involvement of For example, patients who have correct nutri- use the various combinations of neurofeedback, memory through the hippocampus to orbital- tional and supplemental interventions based biofeedback, evoked potentials, z-score train- frontal cortex connection, on good lab data can be expected to respond ing, LORETA neurofeedback, (tDCS), balance Given this general understanding of better to NFB (Hagedorn & Thompson, 2011: board assessments and training, virtual reality, networks, it seems sensible to combine NFB Scheltens, Kamphuis, Verheyc, Olde, Rikkert, HRV training, sound and light entrainment and BFB. We almost always use both and find Wurtman,et al, (2010).). (AVE), SAMONAS sound therapy, LENS, this a parsimonious approach: even though This paper attempts to introduce the cranial electrical stimulation CES, pIR , HEG you are dealing with more parameters when concept of networks. Under the salience and , advanced blood and urine analysis, medica- you combine the approaches. It is also par- affect network discussions we mention more tion, education, counseling, and other avail- simonious because the training results with than one function and more than one network. able methodologies can only be determined by BFB may be seen more quickly and this will By doing this we are attempting to suggest that extensive research. Until more is published on keep your client motivated to train for enough the reader should understand that each network newer techniques and combined interventions, sessions to get lasting NFB results. Heart rate group (attention, salience, affect, executive, our experience suggests that practitioners can variability, for example, can be learned in placebo) is just a starting point for understand- still begin to do excellent work with quite ba- half a dozen sessions, which is a shorter time ing that our work at different cortical sites with sic single channel EEG assessments (with 19 frame than is needed for reduction in excess EEG feedback (or tDCS or pIRS, for that mat- channel QEEG and ERP being used in more theta or an increase in low frequency beta. ter), combined with peripheral BFB such as complex cases). Single channel training com- Metacognitive strategies are also incorporat- HRV training, will affect more than single ar- bined with basic biofeedback, especially HRV, ed into the training during periods when the eas and single functions. Our work will always may often be best. client is in a receptive state for learning (as affect networks, usually through cortex-basal Two last notes of caution, however: indicated by EEG parameters). Medications ganglia-cortex connections. It is even possible First,by focusing initially on training appro- can also be used with this combination, often that the specific tasks we ask the patient to do priate networks you should avoid the risk of with the dose being reduced as self-regulation during the feedback, such as reading or listen- incorrectly downtraining unpredicted posi- skills improve. Although the emphasis of this ing tasks, may influence which of a number of tive compensatory mechanisms, or of training paper is on neural networks which we can networksare stimulated. down activity at sites that involve specific high

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16 NeuroConnections SUMMER 2011

functioning behaviors. Training at a single lo- and Physiological testing and training techniques. autism spectrum disorders. Research in Autism Spectrum cation can often have an effect on many symp- His doctorate studies focused on novel assessment Disorders 3, 145–162. metrics of brain injury using electrophysiological Kropotov, Juri (2009). Quantitative EEG, Event Related toms due to the influence the training has not Potentials and Neurotherapy. San Diego, CA: Academic measures. Dr. Thompson has specialized in the Press/Elsevier. only on the structure beneath the site (such as field of neural functioning for over a decade. Dr. the anterior cingulate when you train at Fz or Kulkarni, B., Bentley, D.E., Elliott, R., Youell, P., Watson, Thompson is a leader in the field of technological A., & Derbyshie, S.W. (2005). Attention to pain local- Cz) but on the entire network(s), of which that developments and clinical applications of assess- ization and unpleasantness discriminates the functions of site is a part. And, second, when you move to ment metrics for brain injury. Dr. Thompson is the the medial and lateral pain systems. European Journal of other sites not over the CMS be sure you un- Chief Science Officer of DJ Technologies, a com- Neuroscience, (21)11, 3133-3142. Langguth, B. & De Ridder, D. (2011). Transcranial Mag- derstand the functional neuroanatomy underly- pany specializing the development and deployment of functional biometric assessment and rehabilita- netic Stimulation for Tinnitus. In Robert Coben & James ing that site (such as Wernicke’s area relating R. Evans (Eds) Neurofeedback and Neuromodulation tion equipment. Dr. Thompson was formerly the Techniques and Applications,Elsvier/Academic Press to dyslexia) and can correlate the site with the Director of Brain Injury Research Programs at the 293-318. presenting symptoms of your patient. International Brain Research Foundation and the Lubar, J. F. (1991). Discourse on the development of EEg We hypothesize that the approach of us- Neurophysiology Program Director at the Com- diagnostics and and biofeedback for attention-deficit/hy- ing NFB plus BFB & strategy training with suf- prehensive Neuroscience Center in New Jersey. peractivity disorders. Biofeedback and Self Regulation, Dr. Thompson has worked with many high level 16(3), 201-225. ficient sessions (at least 40) and careful moni- athletes including the Penn State Football, Rugby Northoff, Georg, Heinzel, Alexander, de Greck, Moritz, toring of changes at a central location is the Bermpohl, Felix, Dobrowolny, Henrik, & Panksepp, and Hockey programs, Canadian Junior Alpine Ski Jaak (2006). Self-referential processing in our brain - A reason we achieved excellent results early on at Team and consultation to the scientific coordinator meta-analysis of imaging studies on the self. NeuroIm- our centre, as reported in our 1995 presentation, of the UEFA (Union of European Football Associa- age, 31, 440 – 457. Exceptional Results in Exceptional Children tions) 2007 League Champions, AC Milan, and to Polich, J. (2007). Updating P300: An Integrative Theory Thompson & Thompson, 1995) , and why we the Sport Science team at Chelsea Football Club of P3a and P3b. Clinical Neurophysiology, 118(10), in London, England. Dr. Thompson holds level 4 2128–2148. continue with that basic approach, augmented technical coach certification in sailing and level 3 Porges , S. W. (2007). The Polyvagal Perspective . Biologi- cal Psychiatry , 74 , 116 – 143. with some newer techniques, today. in alpine skiing. Scheltens, P., Kamphuis, P. J.G.H., Verheyc, F.R.J., Olde Dr. Thompson has been an invited speaker at inter- Rikkert, M. G.M. , Wurtman, Richard J., Wilkinson, Biographies national conferences in the United States, Canada, D., Twisk, J.W.R., Kurz, A.,(2010). Efficacy of a medi- Mexico and Europe, has published multiple articles cal food in mild Alzheimer’s disease: A randomized con- trolled trial. Alzheimers and Dementia, 6, 1-10. Michael Thompson, MD and book chapters in the areas of EEG, Traumatic Seeley, W., Menon, V., Schatzberg, A., Keller, J., Glover, G., Michael Thompson, MD devotes his time to the Brain Injury, Sports Related Concussions, and Peak Kenna, H., Reiss, A., & Greicius, M. (2007).Dissociable administration of the Biofeedback Institute and to Performance & biofeedback, and is considered one Intrinsic Connectivity Networks for Salience Processing teaching. When formerly practicing medicine he of the top experts in the world in the specialized field and Executive Control. The Journal of Neuroscience , was Associate Professor and head of post-graduate of electrophysiological assessment and training. (27)9, 2349-2356. education in Psychiatry, University of Western On- Supekar, K., Uddin, L.Q.,,Prater, K.,, Amin, H,.,Greicius, David Hagedorn, PhD, BCN MD, Menon,V., (2010). Development of functional and tario, examiner for the Royal College of Physicians structural connectivity within the default mode network (Canada) and chairman of their examinations com- David Hagedorn, PhD, BCN has worked in various in young children, J. Neuropimage 52, :290-301. mittee in psychiatry. Numerous professional publi- clinical and private practice settings for 20 years Thompson, J., Sebastianelli, W. & Slobounov, S. (2005). cations include A Resident’s Guide to Psychiatric and is currently a neuroscience and mental health EEG and postural correlates of mild traumatic brain in- Education. While Associate Professor, University of instructor for U.S. Navy Family Medicine Physician jury in athletes. Neuroscience Letters (3), 158-163. Toronto, he was psychiatric consultant to The Hos- Residents. He is president of DJ Technologies, Inc., Thompson, L., & Thompson, M., (1995). Exceptional Re- pital for Sick Children’s neurology department. sults with Exceptional Children. Procedings of the So- an Associate Professor for the U.S. Military Medical ciety for the Study of Neuronal Regulation, 3rd Annual Lynda and Michael Co-authored The Neurofeed- School, Uniformed Services University of the Health Meeting, Scotsdale, Arizona. back Book: An Introduction to Basic Concepts in Sciences and serves as an international neuroscience Thompson, L. & Thompson, M. (1998) Neurofeedback Applied Psychophysiology, Association for Applied and biofeedback research consultant and instructor. Combined with Training in Metacognitive Strategies: Psychophysiology, Wheat Ridge, Colorado, 2003. Dr. Hagedorn consults with several military and Effectiveness in Students with ADD.Journal of Applied civilian traumatic brain injury and post traumatic Psychophysiology and Biofeedback, (23), 4, 243-263. stress research and treatment facilities. Thompson, M. & Thompson, L. (2003). The Neurofeedback Lynda Thompson, PhD Book: An Introduction to Basic Concepts in Applied References: Psychophysiology, Wheat Ridge, CO: Association for Lynda Thompson, PhD is a Psychologist who has Applied Psychophysiology. Benedetti, F., Mayberg, H. S., Wager, T. D., Stohler, C. S., done teaching, clinical psychology, school psychol- Thompson, M. & Thompson, L.(2006) Improving Attention ogy and owned learning centers. She became Ex- & Zubieta, J-K. (2005). Neurobiological Mechanisms of the Placebo Effect. Journal of Neuroscience, (25)45, in Adults and Children: Differing Electroencephalograhy ecutive Director of The ADD Centre in Toronto in 10390-10402. Profiles and Implications for Training. Biofeedback, Fall, 2006. 1993 after discovering the world of neurofeedback Bisley, J. W. & Godberg, M. E. (2006). Neural Correlates and deciding to specialize in that intervention. Her of Attention in the Lateral Intraparietal Area. Journal of Thompson, M. & Thompson, L. (2007). Neurofeedback for doctoral dissertation (1979) dealt with hyperac- Neurophysiology, ( 95), 1696-1717. Stress Management. Chapter in Paul M. Lehrer, Robert L. Woolfolk and Wesley E. Sime (Eds.) Principles and tive children treated with methylphenidate. She is De Ridder, Dirk (2009). An evolutionary approach to brain Practice of Stress Management, 3rd Edition. New York: co-author with William Sears of The A.D.D. Book: rhythms and its clinical implications for brain modula- Guilford Publications. tion. Journal of Neurotherapy, (13)1, 69-70. New Understandings, New Approaches to Parent- Thompson, M., Thompson, J., Wenqing, W. (2007). The ing Your Child. De Ridder, Dirk (2010) Alcohol Addiction: A Clinical Patho- ADD Centre Brodmann area booklet. San Rafael, Ca: physiological Approach. Procedings of the ISNR 18th ISNR Publications. James W.G. Thompson, PhD, BCN Annual Conference, Denver, Colorado. Thompson, M. & Thompson, L., (2009). Systems Theory of Dr. James Thompson holds a both a Masters and Hammond, C., Hunt Harper, S., O’Brien, J., & Dorgris, N. Neural Synergy: Neuroanatomical Underpinnings of Ef- Doctorate degree in Kinesiology (specializing in (2011). Advancement in Lens Treatment Protocols. Neu- fective Intervention Using Neurofeedback plus Biofeed- sports related brain injury and electrophysiology, roConnections Newsletter, December, 19-23. back.Journal of Neurotherapy,(13)1, 72-74. Hagedorn, D. & Thompson, J. (2011). Evoked Neuroscience Thompson, M. & Thompson, L., (2010). Functional Neuro- Pennsylvania State University) and a B.Sc. in Hu- website www.evokeneuro.com. man Kinetics (athletic training & rehabilitation) anatomy and the Rationale for Using EEG Biofeedback Jasper, H., (1958). Report of the committee on methods of for Clients with Asperger’s Syndrome. Journal of Ap- and a minor in Business and Marketing (University clinical examination in electroencephalography. EEG plied Psychophysiology and Biofeedback, (35)1, 39-61. of British Columbia). While practicing in Canada and Clinical Neurophysiology, 10, 374-375. Thompson, L., Thompson, M., Reid, A., (2010). Neurofeed- he was a Certified Kinesiologist with the Canadi- Knezevic, B., Thompson, L., & Thompson, M. (2010). Us- back Outcomes in Clients with Asperger’s Syndrome. an Kinesiology Association. He has been certified ing the Tower of London to assess improvement after Journal of Applied Psychophysiology and Biofeedback, in electroencephalography (EEG) since 2002, is Neurofeedback training in clients with Asperger’s Syn- (35)1, 63-81. Board Certified in Neurofeedback, and is an Asso- drome. Journal of Neurotherapy, (14)1, 3-19. Uddin, L. Q, Iacoboni, M., Lange, C. & Keenan, J.P. (2007). ciate Fellow of the Biofeedback Certification Insti- Koob, G. F. & Volkow, N. D. (2010). Neurocircuitry of ad- The self and social cognition: the role of cortical midline structures and mirror neurons. Trends in Cognitive Sci- tute of America. diction.Neuropsychopharmacology, (35)4, 217-238. Kouijzer, E.J., Jan M.H., de Moor, Berrie, Gerrits, J.L., Con- ences, (11)4, 153-157. Dr. Thompson specializes in the use of Neurological gedo, Marco, & van Schie, Hein T. (2009). Neurofeed- back improves executive functioning in children with

17 NeuroConnections SUMMER 2011

Brodmann Montage

David A Kaiser, PhD

Beware of his false knowledge: Too tight or too loose a defi- structural mosaic at multiple It is more dangerous than ignorance nition or measurement makes scales of size and Brodmann —GB Shaw (1856-1950) for unreliable data, even non- was interested in the cerebral sensical. So we often want to cortex in particular. He sub- In science we have to decide how best to mea- measure the middle ground divided the cortex on features sure a phenomenon. We can easily sample a of a definition, and this is such as the presence or absence phenomenon too tightly or too loosely. One how I developed the Brod- of cellular layers in the cortex of our goals in science is to figure out how to mann montage, in light of and the distributions of Betz, measure a phenomenon so it best captures its well-known structural and stellate, granular, and other cell nature, allowing maximal analysis and com- functional variability across people. types. Using cytoarchitectural criteria he munication of results. Let me explain with an Our hands are designed for grasping identified 52 areas in monkey and 47 in hu- example. and our feet for motion and balance; a member man brains (Brodmann 1909) (see Table 1). Suppose we want to estimate the num- of an alien species could discern the role and His divisions were initially criticized by other ber of people who are baseball fans and we actions of our hands and feet from a cadaver, experts in the field, as other anatomists fo- make our sample very tight chronologically. without ever seeing a person take a step. Dif- cused on myelination patterns (Vogt & Vogt, We measure a single day or even at a single ferent structures allow different functions, 1919) and other features (von Economo & game and those who attended the game or at- and this is true for the brain on many scales. Koskinas, 1925; von Bonin & Bailey, 1925) tended any baseball game during this day are Korbinian Brodmann (1868-1918), a pioneer but Brodmann’s designations have stood the considered baseball fans and those who did and synthesizer of neuroanatomy, divided the test of time, despite the fact that the pattern not are considered non-fans. Obviously this is human neocortex into areas much as other of convolutions varies considerably from one too tight a sample by most people’s standards. neuroanatomists divided the brain stem and individual to the next and the irregularity and However if we loosen our definition and con- limbic system into functional systems based variability of these convolutions pose major sider anyone who has ever attended a major on structural commonalities and differences, challenges in analyzing neuroimaging data league game a fan, or anyone in the greater and his divisions have stayed with us for more including source EEG.We can model current Boston metropolitan area, we include many than a century (Brodmann, 1905; 1909). distribution within the human cortex from people who do not consider themselves fans. The human brain is a functional and scalp potentials using a variety of promising

18 NeuroConnections SUMMER 2011

source solutions, also called inverse solutions, Marqui, Gonzalez-Andino, Valdes-Sosa & also suggested that the variability of classical known by a variety of acronyms including Biscay-Lirio (1988) to pinpoint energy dif- maps of Brodmann (1905), von Economo and VARETA, LAURA, MUSIC, BESA, with the ferences at the surface, along with functional Koskinas (1925), and Sarkissov (Sarkissov, most popular being LORETA. To this list I and structural data from Van Essen & Drury Filimonoff, Kononowa, Preobraschenskaja, add the Brodmann montage, a solution based (1997), Nielsen (2003), and others. The La- & Kukuew, 1955) may have been due to nor- on different assumptions. placian solution also needed adjustment as it mal variation among the brains they analyzed, In addition to anatomical designations had artificial symmetry embedded in its num- a reconciliation of brain atlases not widely based on gyri and sulci, the ridges and folds of bers, which anyone can see in the matrix of recognized. the brain, we can also impose a 3-dimensional weights. For instance site F3 values matched A histological evaluation by Fischl coordinate system that relates all points within P3 values exactly, indicating a symmetrical et al (2008) revealed that association cortex the brain to an arbitrary axis, plane, or point in spheroid where the fronts of our heads are as (higher order cortical areas) exhibits more space. The Talairach (Talairach & Tournoux, wide as the backs of our heads, which is rarely variability than primary and secondary ar- 1988) and Montreal Neurological Institute the case. A tape measure and a dozen willing eas across individuals. For instance, primary (MNI) (Collins, 1994) coordinate systems are skulls revealed a better, slightly less symmet- visual cortex (BA 17) was determined to two popular approaches, measuring all action rical estimate of ideal head geometry. be the most predictable of all areas, with a points in the brain in terms of their distance We’ve been aware of individual dif- mere 2.7mm median variability in boundary from the midline of the anterior commis- ferences in “localization” of brain function location across individuals. Primary motor sure, an arbitrary point to start our measure- ever since this paradigm emerged (Bouillaud, areas(i.e., BA 2 and 4) showed slightly more ments, point (0,0,0) in 3-dimensional (xyz) 1825, Broca, 1865).Because of this functional variation, a median of 3.7mm uncertainty on space.Stereotaxic coordinates for an ideal variability, functional correspondence across surface-based coordinates, whereas areas 44 head (x,y,z-space e.g., Talairach or MNI) can individuals is uncertain at the level of mm-di- and 45 showed twice the inter-individual vari- greatly aid our investigations, but we need to ameter voxels, and probably even at the level ability of the motor areas, and three times that be aware how functional and structural het- of cm-diameter voxels. Rajkowska and Gold- of the primary visual cortex, up to 9mm me- erogeneity is the rule across humans and other man-Rakic (1995) were early to characterize dian uncertainty, with the greatest variability higher species, not homogeneity.Akin to the the considerable variability of Brodmann ar- in the right hemisphere. Heisenberg principle, the tighter we localize eas across individuals. They focused on BA 9 Neuroanatomical variation is substan- activity of a single voxel in someone’s head, and 46 in 7 human left hemispheres and they tial between healthy individuals (Kennedy, the less certain can we be of its function and argued that inconsistency in functional neuro- Lange, Makris, Bates, Meyer, et al, 1998; also that this voxel serves the same function in imaging findings across studies may likely be Thompson, Schwartz, Lin, Khan & Toga, another head. With this in mind, in November due to morphological variability -- e.g., an ef- 1996), even in identical twins (Thompson, 2006 I created the Brodmann montage while fect reported in area 9 based on Talairach co- Cannon, Narr, van Erp, Poutanen, et al, 2001). developing the new SKIL 3 analysis software, ordinates in one individual was as likely to be For example, everyone possesses Heschl’s relying on the Laplacian solution by Pascual- in areas 45 or 46 in another individual. They Continued on page 21

Edited by: Benjamin W. Strack, PhD; Michael Linden, PhD; and Vietta Sue Wilson, PhD

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19 NeuroConnections SUMMER 2011

I’m pleased to see there has been some movement towards the integration of peripheral measures with neurofeedback training and assess- ment. Last year, out of personal revelations, I created the “Are You Only Looking at the Tip of the Iceberg” ad, where I urged you to not only look at EEG, but to at least observe changes in peripheral measures, such as SC, fingertip temperature, heart rate, and heart rate vari- ability and respiration. Even though this sounds like some additional work, in the over 150 sessions I personally did with Dr. Ray Pavlov, setup took less than five minutes. Pavlov reported, “In 2001, I started using Thought Technology’s Infiniti products to add simultaneous multi-monitoring and training ton euro- feedback. I discovered I could clearly see if clients try too hard to accomplish a task, since they usually produce changes in other physiological signals. These changes often include a rise in SC, SEMG, heart rate or respiration and a drop in peripheral temperature. Now I always have my clients observe and/or train all parameters. It is part of my permanent arsenal, since it has led to faster training and client satisfaction.” I can attest to the power of having one or more of these signals available. When I initially trained to enhance the SMR/theta ratio, I found I was gradually succeeding, but felt stressed at the end of the sessions. When we reviewed one session with the added peripheral measures, it was clear I was breathing too quickly (14 breaths/min) and had activated sympathetic arousal, evidenced by decreasing fin- gertip temperature and increasing SC and heart rate over the 5-minute training trial. With the added peripheral measures visible on the training screen, the SMR/theta training task became much easier, as I kept my breath in the range of 6-8 breaths/min and my SC, HR and temperature readings stable. Even if you don’t use the peripheral measures to provide feedback, I’m certain you will reap benefits by ob- serving what covaries when clients succeed or fail. It might even turn out that much of this super low frequency training is primarily due to changes in sympathetic arousal. I would certainly like to see this studied.

Hal Myers, PhD

BCIA Mailbag

Fred Shaffer, PhD, BCIA Chair

Why does BCIA feel it I am required to complete please do add text that includes is important to promote ethics hours to maintain my the Biofeedback Certification certification standards professional license.May I use International Alliance (BCIA). outside of the US? those hours to complete the We urge you to search in all There is a growing interest 3-hour CE requirement? the places where your name is in biofeedback and neurofeedback interna- Yes, you may and you should. listed and to update the creden- tionally.Some of the best research is coming Your licensing body plays a stronger role in tial to include BCB, BCN, or BCB-PMD. from outside our borders.BCIA certification the regulation of your professional standards; This includes, but is not limited to, any web- is one way to standardize proficiency to use therefore, course work sponsored by them site listings, presentations, memberships, or the modality, gaining respect from the entire would be an important educational tool. You publications. health care field. may also read three ethics articles that are How do I teach my clients about this new How are the exams performing among people listed on our website and then complete on- credential? where English is not their first language? line quizzes to satisfy our ethics CE require- As always, we encourage you to spend a BCIA is delighted to report a high level of ment for a nominal fee. Go to the Certificants little time during the initial intake letting new success in our exams outside of the US, menu, select Recertification, and then choose clients know who you are professionally and and in fact, they often meet or exceed the How Can I Earn Continuing Education Cred- including information about your certifica- North American pass rate.Our international its By Reading Articles? tion.This could be a great promotional tool as partners have well-developed education and Why do some BCIA-certified professionals have well by adding a line that says “I am the only training programs that promote hard work more information listed with their name from BCIA-certified professional in this area” as and mastery of the scientific foundations of the Find a Practitioner directory at www.bcia. is appropriate.Many clients may be too em- biofeedback and neurofeedback. org? barrassed to ask you to explain what these Why has BCIA recently taken a stronger interest We encourage all BCIA-certified profession- letters mean.This is also a good opportunity in ethics education? als to update their profiles to provide more to explain any of the other professional des- ignations you may list.Don’t assume that With our field gaining so much attention, we detailed information. Go to the Certificants clients know what all of those letters mean! realize that it is important for our certificants menu, select Market Your Practice, and then to uphold rigorous standards that would be choose Update Your Professional Listing. May I use the logo on my website or my business acceptable across all health care guidelines. Think of this listing as a free Yellow Pages card? Because biofeedback and neurofeedback are advertisement for your practice. Yes.We encourage you to use the logo on all used across so many different professions, I know that we are encouraged to use BCB, professional correspondence as is appropriate there isn’t one common board to set policy BCN or BCB-PMD after our names to signify with the Logo Usage Guidelines posted at and address concerns.Practitioners must first our board certification.But, what if I want to www.bcia.org. answer to their state licensing boards and continue to use BCIA? May I link to my website from www.bcia.org? their national professional organizations. It We encourage everybody to consider the Yes, and the best way to do that is to expand is our goal to uphold the highest standards to best way to educate people who will be see- the profile listing as described above. protect the consumer and elevate the field. ing your credentials.If you have room for it,

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Ever since its foundation (Netherlands,1992), Mind Media has been ­creating leading edge products for Psychophysiology, Neuroscience, Biofeedback and Neurofeedback. After the launch of the revolutionary NeXus-10 in 2004, NeXus quickly became recognized as the best Biof­eedback and 4 analog AUX inputs 4 analog EXG inputs Medical Grade ­Neurofeedback technology in the world, setting new standards for others for a wide range of with up to 8192 Connectors for to follow. The products of Mind Media are now used world-wide and sensors samples/sec. higher reliability ­distribut­ ed through a network of resellers in over 50 countries.

If you are interested in the new NeXus-10 Mark II (available spring 2011) or in our limited time competitive upgrade program, then feel free to ­contact Active Noise us, or one of our resellers. We’ll be happy to help you. Organic LED display ­Cancelation for for s­ ystem status pristine signal information quality

CORPORATION Leading Suppliers of Biofeedback Technology Integrated Wireless Lithium Polymer Bluetooth for more ­battery pack for freedom to move 24h + recording About Stens Corporation The Stens Corporation, incorporated in 1976, is internationally recognized as the #1 provider of Biofeedback and Neurofeedback training in the United States, Canada, and abroad. Over the past 35 years Stens has trained and introduced more than 14,000 new people into our industry! President and C.E.O., Stephen Stern, was honored with the AAPB Presidential Award in Ultra high 24 bit AD Stand alone recording 2005 for his role in fostering the growth of the Biofeedback/Neurofeedback resolution for on SD flash cards industry over the past 3 1/2 decades. greater precision Stens is proud of its excellent reputation of providing service and carrying the finest systems available. We are extremely proud to be the exclusive Wow! It seems that in the land of Biofeedback and Neurofeedback, distributor of the NeXus for the U.S. & Canada; truly the finest system that is technology has not evolved since the 90’s. What’s going on? Digital Event and Trigger Digital Sensor input creating a new face in the world of physiological monitoring and Feedback! input for high precision Fast USB 2.0 wired link for up to 16 extra Why would you pay thousands of dollars for a product design from the 80’S, that looks like (and sometimes performs like) synchronization for higher samplerates channels For the USA and Canada: For the rest of the world: an outdated computer modem, and comes with complicated software that should have a disclaimer like: ”WARNING this software is for engineers ONLY!” Stens Corporation Mind Media BV 3020 Kerner Blvd. Suite D. Schepersweg 2B The developers of the NeXus and Biotrace+ software believe that those times are behind us. PERIOD. It is time for a change. San Rafael, CA 94901, USA Roermond, Netherlands Today, professional Bio and Neurofeedback systems should offer the same level of quality and ease of use that you expect Call free 800.257.8367 Call +31-475-410123 from electronicsGET today, THE like professional BIOCLUNKTEC audio-systems, digital cameras, 2000... camcorders or HD television. ... and experience why NEXUS is the ultimate ▲ 9:00 am to 5:00 pm (PST) 9:00 am to 5:00 pm (CET) Why would you settle for anything less? Bio- and neurofeedback platform! OR STEP OUT OF THE 80’s www.stens-biofeedback.com www.mindmedia.info AND WITNESS EVOLUTION. Better Design: better Construction More power: Lithium Polymer technology

The new design of the NeXus-10 Mark II does not just impact ­the Because only the best is good enough, Mind Media integrated a state outside. Its cutting edge electronics inside and its sturdy ­mecha­nical of the art Lithium-Polymer battery pack into the Mark II, offering over design make it one of the most reliable Bio- and Neurofeedback 24 hours of operation on a single charge. A built-in supercapacitor ­platforms ever, created for demanding users. The Mark II comes with buffers the power, while you switch battery packs for uninterrupted an optional 3 year warranty on the encoder. recording. Now isn't that smart?

Better signals: Better Sensors, better Connectors Better software: active noise cancelation more reliability more flexibility and ease of use

Signal quality is key! Working with microvolt level physiological signals­ If the NeXus, metaphorically speaking, was a 20+ megapixel digital The BioTrace+ software offers unmatched versatility for clinicians and means that great care must be taken to ensure effective artifact camera, what about the lens quality? Having lots of megapixels with unmatched power for researchers. If flexible feedback and ­frequency ­reduction and rejection. NeXus uses proprietary carbon technology a poor lens, won’t get you very far. This is why the NeXus engineers settings, easy configuration, programmable data processing and in its EXG sensor cables in combination with active noise cancella­ tion spent a lot of R&D on the sensors and carbon technology. It is also the graphic display sound rather daunting, then you may be interested to technology. Instead of ‘hiding’ noise and artifacts with a classic filt­ er, reason why we use heavy duty, brushed metal connectors that lock know that it is easier than ever to get started with NeXus! Our easy we simply measure the external noise and subtract it. Not unlike ­those in. Less worries about poor contact, bent pins or connectors breaking point-and-click Biofeedback and Neurofeedback protocol suites are smart headphones you see people using in noisy airplanes. Cleaner when someone inadvertently ‘yanks’ a cable. included in the standard price. BioTrace+ software updates are free. signals, less artifacts. we are proud THE NEXUS-10 to present MARK II The Ultimate Neuro and Biofeedback Platform Better resolution: 24 bit Digital Sensors: better interfacing, ultra high precision more channels NeXus is a family of systems

In a digital world, resolution is everything. When you buy a These are digital times and Mind Media is proud to introduce the new NeXus** was introduced in 2004 and now consists of a series of ­digital ­camera, it makes no sense to get anything with less than­ series of NeXus digital sensors as an industry first. Digital sensors ­instruments from 4 to 32 channels. With thousands of systems in 10 ­megapixels. A two megapixel camera would show ­pixelated, blocky have a multi-channel design and extend your NeXus with 1 to 16 the market and many leading universities and clinics using NeXus, images as soon as you zoom in or start looking at any ­detail. The channels of physiology using a single connector. They provide su­ pport we have set new standards for others to follow. Need more EEG same principle applies to physiological signals. In our opinion s­ ystems for precise event recording, P300, ­reaction time measurement, ­channels? Take a look at our NeXus-32F system. Besides a wide range with less than 16 bit AD resolution are simply outdated. NeXus uses ­oxygen saturation, multi-axis ac­ celeration and more. Whether you of Neuro- and Biofeedback functions, it is also a (wireless) 21 channel 24 bit technology, resulting in ultra high resolution and a huge are a clinician or a researcher, the digital sensor will have something digital EEG system with QEEG export and real time neuromapping. ­ dynamic­ range. in store for you. Its sensors are compatible with NeXus-10.

Ultra wide band amplifiers: Better connectivity: ** NeXus is manufactured in an ISO 13485 certified facility (TMSI BV, Netherlands), FDA registered and certified as a medical CE class IIa for the EU. more cost effective wireless design

4.5 inch Because of its unique amplifier design and carbon technology, you We believe that having only a cable connection to your PC can ­really not only get better signals, you save money! For the typical price of a be limiting. That is why the Mark II, like its predecessor, comes with single (1 channel) active sensor, the NeXus EXG sensor cable gets you built-in Bluetooth. It is a fully ambulatory system that can work 2 channels of EEG, or DC-EEG, sEMG, ECG, EOG or a combination. stand-alone and store sessions on SD flash memory for more than When you take sensor price into account, you will be amazed about 24 hours. In addition we added a USB 2.0 wired link for those of you EEG • DC-EEG • SCP • ERP • P300 • EOG • HEG • VEP • EMG • RSP • ECG HRV • Temp. • SpO2 • BVP • SC/GSR • ACCEL • FORCE how cost effective NeXus is! wanting higher sample rates. Better Design: better Construction More power: Lithium Polymer technology

The new design of the NeXus-10 Mark II does not just impact ­the Because only the best is good enough, Mind Media integrated a state outside. Its cutting edge electronics inside and its sturdy ­mecha­nical of the art Lithium-Polymer battery pack into the Mark II, offering over design make it one of the most reliable Bio- and Neurofeedback 24 hours of operation on a single charge. A built-in supercapacitor ­platforms ever, created for demanding users. The Mark II comes with buffers the power, while you switch battery packs for uninterrupted an optional 3 year warranty on the encoder. recording. Now isn't that smart?

Better signals: Better Sensors, better Connectors Better software: active noise cancelation more reliability more flexibility and ease of use

Signal quality is key! Working with microvolt level physiological signals­ If the NeXus, metaphorically speaking, was a 20+ megapixel digital The BioTrace+ software offers unmatched versatility for clinicians and means that great care must be taken to ensure effective artifact camera, what about the lens quality? Having lots of megapixels with unmatched power for researchers. If flexible feedback and ­frequency ­reduction and rejection. NeXus uses proprietary carbon technology a poor lens, won’t get you very far. This is why the NeXus engineers settings, easy configuration, programmable data processing and in its EXG sensor cables in combination with active noise cancella­ tion spent a lot of R&D on the sensors and carbon technology. It is also the graphic display sound rather daunting, then you may be interested to technology. Instead of ‘hiding’ noise and artifacts with a classic filt­ er, reason why we use heavy duty, brushed metal connectors that lock know that it is easier than ever to get started with NeXus! Our easy we simply measure the external noise and subtract it. Not unlike ­those in. Less worries about poor contact, bent pins or connectors breaking point-and-click Biofeedback and Neurofeedback protocol suites are smart headphones you see people using in noisy airplanes. Cleaner when someone inadvertently ‘yanks’ a cable. included in the standard price. BioTrace+ software updates are free. signals, less artifacts. we are proud THE NEXUS-10 to present MARK II The Ultimate Neuro and Biofeedback Platform Better resolution: 24 bit Digital Sensors: better interfacing, ultra high precision more channels NeXus is a family of systems

In a digital world, resolution is everything. When you buy a These are digital times and Mind Media is proud to introduce the new NeXus** was introduced in 2004 and now consists of a series of ­digital ­camera, it makes no sense to get anything with less than­ series of NeXus digital sensors as an industry first. Digital sensors ­instruments from 4 to 32 channels. With thousands of systems in 10 ­megapixels. A two megapixel camera would show ­pixelated, blocky have a multi-channel design and extend your NeXus with 1 to 16 the market and many leading universities and clinics using NeXus, images as soon as you zoom in or start looking at any ­detail. The channels of physiology using a single connector. They provide su­ pport we have set new standards for others to follow. Need more EEG same principle applies to physiological signals. In our opinion s­ ystems for precise event recording, P300, ­reaction time measurement, ­channels? Take a look at our NeXus-32F system. Besides a wide range with less than 16 bit AD resolution are simply outdated. NeXus uses ­oxygen saturation, multi-axis ac­ celeration and more. Whether you of Neuro- and Biofeedback functions, it is also a (wireless) 21 channel 24 bit technology, resulting in ultra high resolution and a huge are a clinician or a researcher, the digital sensor will have something digital EEG system with QEEG export and real time neuromapping. ­ dynamic­ range. in store for you. Its sensors are compatible with NeXus-10.

Ultra wide band amplifiers: Better connectivity: ** NeXus is manufactured in an ISO 13485 certified facility (TMSI BV, Netherlands), FDA registered and certified as a medical CE class IIa for the EU. more cost effective wireless design

4.5 inch Because of its unique amplifier design and carbon technology, you We believe that having only a cable connection to your PC can ­really not only get better signals, you save money! For the typical price of a be limiting. That is why the Mark II, like its predecessor, comes with single (1 channel) active sensor, the NeXus EXG sensor cable gets you built-in Bluetooth. It is a fully ambulatory system that can work 2 channels of EEG, or DC-EEG, sEMG, ECG, EOG or a combination. stand-alone and store sessions on SD flash memory for more than When you take sensor price into account, you will be amazed about 24 hours. In addition we added a USB 2.0 wired link for those of you EEG • DC-EEG • SCP • ERP • P300 • EOG • HEG • VEP • EMG • RSP • ECG HRV • Temp. • SpO2 • BVP • SC/GSR • ACCEL • FORCE how cost effective NeXus is! wanting higher sample rates. Better Design: better Construction More power: Lithium Polymer technology

The new design of the NeXus-10 Mark II does not just impact ­the Because only the best is good enough, Mind Media integrated a state outside. Its cutting edge electronics inside and its sturdy ­mecha­nical of the art Lithium-Polymer battery pack into the Mark II, offering over design make it one of the most reliable Bio- and Neurofeedback 24 hours of operation on a single charge. A built-in supercapacitor ­platforms ever, created for demanding users. The Mark II comes with buffers the power, while you switch battery packs for uninterrupted an optional 3 year warranty on the encoder. recording. Now isn't that smart?

Better signals: Better Sensors, better Connectors Better software: active noise cancelation more reliability more flexibility and ease of use

Signal quality is key! Working with microvolt level physiological signals­ If the NeXus, metaphorically speaking, was a 20+ megapixel digital The BioTrace+ software offers unmatched versatility for clinicians and means that great care must be taken to ensure effective artifact camera, what about the lens quality? Having lots of megapixels with unmatched power for researchers. If flexible feedback and ­frequency ­reduction and rejection. NeXus uses proprietary carbon technology a poor lens, won’t get you very far. This is why the NeXus engineers settings, easy configuration, programmable data processing and in its EXG sensor cables in combination with active noise cancella­ tion spent a lot of R&D on the sensors and carbon technology. It is also the graphic display sound rather daunting, then you may be interested to technology. Instead of ‘hiding’ noise and artifacts with a classic filt­ er, reason why we use heavy duty, brushed metal connectors that lock know that it is easier than ever to get started with NeXus! Our easy we simply measure the external noise and subtract it. Not unlike ­those in. Less worries about poor contact, bent pins or connectors breaking point-and-click Biofeedback and Neurofeedback protocol suites are smart headphones you see people using in noisy airplanes. Cleaner when someone inadvertently ‘yanks’ a cable. included in the standard price. BioTrace+ software updates are free. signals, less artifacts. we are proud THE NEXUS-10 to present MARK II The Ultimate Neuro and Biofeedback Platform Better resolution: 24 bit Digital Sensors: better interfacing, ultra high precision more channels NeXus is a family of systems

In a digital world, resolution is everything. When you buy a These are digital times and Mind Media is proud to introduce the new NeXus** was introduced in 2004 and now consists of a series of ­digital ­camera, it makes no sense to get anything with less than­ series of NeXus digital sensors as an industry first. Digital sensors ­instruments from 4 to 32 channels. With thousands of systems in 10 ­megapixels. A two megapixel camera would show ­pixelated, blocky have a multi-channel design and extend your NeXus with 1 to 16 the market and many leading universities and clinics using NeXus, images as soon as you zoom in or start looking at any ­detail. The channels of physiology using a single connector. They provide su­ pport we have set new standards for others to follow. Need more EEG same principle applies to physiological signals. In our opinion s­ ystems for precise event recording, P300, ­reaction time measurement, ­channels? Take a look at our NeXus-32F system. Besides a wide range with less than 16 bit AD resolution are simply outdated. NeXus uses ­oxygen saturation, multi-axis ac­ celeration and more. Whether you of Neuro- and Biofeedback functions, it is also a (wireless) 21 channel 24 bit technology, resulting in ultra high resolution and a huge are a clinician or a researcher, the digital sensor will have something digital EEG system with QEEG export and real time neuromapping. ­ dynamic­ range. in store for you. Its sensors are compatible with NeXus-10.

Ultra wide band amplifiers: Better connectivity: ** NeXus is manufactured in an ISO 13485 certified facility (TMSI BV, Netherlands), FDA registered and certified as a medical CE class IIa for the EU. more cost effective wireless design

4.5 inch Because of its unique amplifier design and carbon technology, you We believe that having only a cable connection to your PC can ­really not only get better signals, you save money! For the typical price of a be limiting. That is why the Mark II, like its predecessor, comes with single (1 channel) active sensor, the NeXus EXG sensor cable gets you built-in Bluetooth. It is a fully ambulatory system that can work 2 channels of EEG, or DC-EEG, sEMG, ECG, EOG or a combination. stand-alone and store sessions on SD flash memory for more than When you take sensor price into account, you will be amazed about 24 hours. In addition we added a USB 2.0 wired link for those of you EEG • DC-EEG • SCP • ERP • P300 • EOG • HEG • VEP • EMG • RSP • ECG HRV • Temp. • SpO2 • BVP • SC/GSR • ACCEL • FORCE how cost effective NeXus is! wanting higher sample rates. PLUG INto THE FUTURE WITH THE Ns eXu -10 Mark II About Mind Media

Ever since its foundation (Netherlands,1992), Mind Media has been ­creating leading edge products for Psychophysiology, Neuroscience, Biofeedback and Neurofeedback. After the launch of the revolutionary NeXus-10 in 2004, NeXus quickly became recognized as the best Biof­eedback and 4 analog AUX inputs 4 analog EXG inputs Medical Grade ­Neurofeedback technology in the world, setting new standards for others for a wide range of with up to 8192 Connectors for to follow. The products of Mind Media are now used world-wide and sensors samples/sec. higher reliability ­distribut­ ed through a network of resellers in over 50 countries.

If you are interested in the new NeXus-10 Mark II (available spring 2011) or in our limited time competitive upgrade program, then feel free to ­contact Active Noise us, or one of our resellers. We’ll be happy to help you. Organic LED display ­Cancelation for for s­ ystem status pristine signal information quality

CORPORATION Leading Suppliers of Biofeedback Technology Integrated Wireless Lithium Polymer Bluetooth for more ­battery pack for freedom to move 24h + recording About Stens Corporation The Stens Corporation, incorporated in 1976, is internationally recognized as the #1 provider of Biofeedback and Neurofeedback training in the United States, Canada, and abroad. Over the past 35 years Stens has trained and introduced more than 14,000 new people into our industry! President and C.E.O., Stephen Stern, was honored with the AAPB Presidential Award in Ultra high 24 bit AD Stand alone recording 2005 for his role in fostering the growth of the Biofeedback/Neurofeedback resolution for on SD flash cards industry over the past 3 1/2 decades. greater precision Stens is proud of its excellent reputation of providing service and carrying the finest systems available. We are extremely proud to be the exclusive Wow! It seems that in the land of Biofeedback and Neurofeedback, distributor of the NeXus for the U.S. & Canada; truly the finest system that is technology has not evolved since the 90’s. What’s going on? Digital Event and Trigger Digital Sensor input creating a new face in the world of physiological monitoring and Feedback! input for high precision Fast USB 2.0 wired link for up to 16 extra Why would you pay thousands of dollars for a product design from the 80’S, that looks like (and sometimes performs like) synchronization for higher samplerates channels For the USA and Canada: For the rest of the world: an outdated computer modem, and comes with complicated software that should have a disclaimer like: ”WARNING this software is for engineers ONLY!” Stens Corporation Mind Media BV 3020 Kerner Blvd. Suite D. Schepersweg 2B The developers of the NeXus and Biotrace+ software believe that those times are behind us. PERIOD. It is time for a change. San Rafael, CA 94901, USA Roermond, Netherlands Today, professional Bio and Neurofeedback systems should offer the same level of quality and ease of use that you expect Call free 800.257.8367 Call +31-475-410123 from electronicsGET today, THE like professional BIOCLUNKTEC audio-systems, digital cameras, 2000... camcorders or HD television. ... and experience why NEXUS is the ultimate ▲ 9:00 am to 5:00 pm (PST) 9:00 am to 5:00 pm (CET) Why would you settle for anything less? Bio- and neurofeedback platform! OR STEP OUT OF THE 80’s www.stens-biofeedback.com www.mindmedia.info AND WITNESS EVOLUTION. PLUG INto THE FUTURE WITH THE Ns eXu -10 Mark II About Mind Media

Ever since its foundation (Netherlands,1992), Mind Media has been ­creating leading edge products for Psychophysiology, Neuroscience, Biofeedback and Neurofeedback. After the launch of the revolutionary NeXus-10 in 2004, NeXus quickly became recognized as the best Biof­eedback and 4 analog AUX inputs 4 analog EXG inputs Medical Grade ­Neurofeedback technology in the world, setting new standards for others for a wide range of with up to 8192 Connectors for to follow. The products of Mind Media are now used world-wide and sensors samples/sec. higher reliability ­distribut­ ed through a network of resellers in over 50 countries.

If you are interested in the new NeXus-10 Mark II (available spring 2011) or in our limited time competitive upgrade program, then feel free to ­contact Active Noise us, or one of our resellers. We’ll be happy to help you. Organic LED display ­Cancelation for for s­ ystem status pristine signal information quality

CORPORATION Leading Suppliers of Biofeedback Technology Integrated Wireless Lithium Polymer Bluetooth for more ­battery pack for freedom to move 24h + recording About Stens Corporation The Stens Corporation, incorporated in 1976, is internationally recognized as the #1 provider of Biofeedback and Neurofeedback training in the United States, Canada, and abroad. Over the past 35 years Stens has trained and introduced more than 14,000 new people into our industry! President and C.E.O., Stephen Stern, was honored with the AAPB Presidential Award in Ultra high 24 bit AD Stand alone recording 2005 for his role in fostering the growth of the Biofeedback/Neurofeedback resolution for on SD flash cards industry over the past 3 1/2 decades. greater precision Stens is proud of its excellent reputation of providing service and carrying the finest systems available. We are extremely proud to be the exclusive Wow! It seems that in the land of Biofeedback and Neurofeedback, distributor of the NeXus for the U.S. & Canada; truly the finest system that is technology has not evolved since the 90’s. What’s going on? Digital Event and Trigger Digital Sensor input creating a new face in the world of physiological monitoring and Feedback! input for high precision Fast USB 2.0 wired link for up to 16 extra Why would you pay thousands of dollars for a product design from the 80’S, that looks like (and sometimes performs like) synchronization for higher samplerates channels For the USA and Canada: For the rest of the world: an outdated computer modem, and comes with complicated software that should have a disclaimer like: ”WARNING this software is for engineers ONLY!” Stens Corporation Mind Media BV 3020 Kerner Blvd. Suite D. Schepersweg 2B The developers of the NeXus and Biotrace+ software believe that those times are behind us. PERIOD. It is time for a change. San Rafael, CA 94901, USA Roermond, Netherlands Today, professional Bio and Neurofeedback systems should offer the same level of quality and ease of use that you expect Call free 800.257.8367 Call +31-475-410123 from electronicsGET today, THE like professional BIOCLUNKTEC audio-systems, digital cameras, 2000... camcorders or HD television. ... and experience why NEXUS is the ultimate ▲ 9:00 am to 5:00 pm (PST) 9:00 am to 5:00 pm (CET) Why would you settle for anything less? Bio- and neurofeedback platform! OR STEP OUT OF THE 80’s www.stens-biofeedback.com www.mindmedia.info AND WITNESS EVOLUTION. NeuroConnections SUMMER 2011

Broadmann an advance over the original two-dimension continued from page 19 (or infinitely-distant source) Laplacian model (Hjorth, 1975; 1980). If humans exhibited no gyrus as part of our primary auditory cortex, structural or functional variability across indi- but the geometry and size varies considerably viduals, we could cut up the brain into an infi- across individuals (Rademacher,Morosan, nite number of voxels and accurately resolve Schormann, Schleicher, Werner, et al., 2001), functional activity in all individuals, but this a variability observed in every cortical region is not the case. The cortex folds and unfolds studied so far (Ono, Kubik & Abernathey, differently across individuals and it exhibits 1990; Amunts, Malikovic, Mohlberg, Schor- amazing diversity of structure and function mann & Zilles, 2000). Folding and functional for the same brain areas across individuals, differences also vary by a factor of two or ranging from reverse dominance (speech more between individuals in terms of BA size, motor centers in the right hemisphere), dif- shape, and location (Van Essen, Drury, Dick- ferences associated with handedness, gender, son, Harwell, Hanlon, & Anderson, 2001) age, maturation, history of injury, and other Morphological variability plays a more factors. Accordingly the Brodmann montage minor role in compact or symmetrical BAs, has only 55 sources or mega-voxels unlike the Figure 1 but it can be devastating in how we interpret thousands of other solutions so as to improve A schematic representation of gray matter orientation activation patterns in elongated BAs such as the reliability of each source estimation. in a sulcus and gyrus (modified from Van Essen et al., 1998). BA 4 (Fischl et al., 2008). Gender and age dif- Most EEG source solutions are isomor- ferences also factor in when it comes to struc- phic, cutting the brain into equally-sized vol- tural variability. In a small study of brain area umes (voxels) evenly distributed across the volume, 4 of 5 males had comparable BA 45 cortex. For instance LORETA (low- resolution volume in the left and right hemisphere but all EEG tomography) relies on 2,394 relatively the women (5 of 5) had a larger BA 45 in the evenly-spaced voxels. But the Brodmann left hemisphere (Uylings Rajkowska, Sanz- montage compensates for individual variabil- Arigita, Amunt &, Zilles., 2006). Age-based ity by leveraging what we know about brain neuron loss can also alter BA boundaries organization. It is a heteromorphic solution, with time (e.g., Simic, Bexheti, Kelovic, Kos, dividing the cortex along cytoarchitectural Grbic, Hof & Kostovic, 2005). distinctions. Each source is positioned in the The Brodmann montage was developed center of gravity of a Brodmann area instead with these limitations in mind, in an attempt of in relation to an artificial grid or coordinate to be as accurate as possible for use in norma- systems. Not every BA is included the solu- tive EEG assessment, neuropsychology ap- tion; only those Brodmann areas of sufficient plications, and neurotherapy (Kaiser, 2007). size and proximity to the scalp were selected, The Brodmann montage is an advance on the amounting to 94% of the neocortex. This spherical harmonic expansion model of ener- limits the possibility of EEG activity being Figure 2 gy distribution (Pascual-Marqui et al., 1988), inaccurately assigned to other BA areas due A surface-based warping of the left hemisphere is a weighted-average solution, which itself was shown (modified from Van Essen et al., 1998). Continued on page 22

Figure 3 The same EEG data is shown from surface and source montages.

21 NeuroConnections SUMMER 2011

Broadmann An analysis of the geometry and functional organization of continued from page 21 the human neocortex reveals a total surface area of 1570 square cm with an average spatial uncertainty for activation sources of to structural and functional variance. In fact I am not the first to caution 1 cm (Van Essen & Drury, 1997). Divide 2,394 voxels into 1570 investigators about dividing the brain too finely and arbitrarily. Uylings square cm and we find ourselves within the error range (1 cm) of and colleagues (2005) argued that a specification of Brodmann areas via our localization technique and in need of smoothing to minimize the Talairach atlas is ill-advised given the large interindividual differences the possibilities of false source estimations. This is not to say that in 3-D location of primary visual cortex as well as heteromodal associa- LORETA and similar inverse solutions are not exceedingly useful, tional areas (prefrontal cortex), even after correction for differences in as 367 current publications in Medline attest to, but that we may brain size and shape. develop a false confidence in their accuracy, especially in terms of This center-point approach of the Brodmann montage also address- their voxel-BA correspondences. es the issue of electrical source orientation. Cortical tissue contours in The Brodmann solution cautions on the side of fewer sourc- every direction and nearly 70% of all human cortex is buried in sulci (Van es in order to increase the reliability of these sources.The voxel Essen & Drury, 1997). Scalp electrodes are limited to measuring those 9, -53, 14, which refers to x, y, z coordinates in millimeters, falls electrical potentials projecting towards the scalp (as opposed to parallel to in the right posterior cingulate gyrus for most people, but not all, the scalp). Given the many folds of the brain, we can see how little of the in Talairach space, and in the white matter above this gyrus in cortex actually contributes significantly to surface EEG signals. With this MNI space, and it may serve emotional perception in one person knowledge, it seems prudent to limit our number of potential sources, as and somato-emotional processes in another. By limiting activity the Brodmann montage does. to Brodmann areas instead of sub-area sections of a Brodmann area (i.e., small voxels), we also have reasonable correspondence Table 1 to neuropsychological evaluation data. Further division of Brod- BA names are locations, prominent cell types in the area, or both. mann areas may be reliable for larger areas such as BA 10 or 6, but Frontal Lobe Temporal Lobe any division should be determined by neurophysiology or neuro- 4 - gigantopyramidal- “huge 20 - inferior temporal anatomy, in response to the presence of different cell distributions pyramids (cones)” 21 - middle temporal 6 - agranular frontal- “lacking 22 - superior temporal or types within an area and not be isomorphic divisions. grains” 28 - entorhinal In the Brodmann montage all 55 sources or “mega-vox- 8 - intermediate frontal 34 - dorsal entorhinal els” are assumed to be constantly chattering away (i.e., generat- 9 - granular frontal-“composed of 35 - perirhinal grains” 36 - ectorhinal ing electrical dipoles), with amplitude equal to their area, with the 10 – anterior prefrontal (or 37 – occipitotemporal surface EEG being a composition of this chatter. As you can see in frontopolar) 38 - temporal pole Figure 3, this approach appears to work. A sinusoidal burst lost in 11 - prefrontal 39 – angular gyrus the composite surface signal, and not fully emergent in the Hjorth 12 - prefrontal 41 – anterior transverse temporal 25 - subgenual- “below the knee” 42 – posterior transverse temporal or Spherical Harmonic Expansion Laplacian montages, appears 44 - opercular“little lid” 48-retrosubicular clearly in the Brodmann montage. A sinusoidal burst is unlikely to 45 - triangular 52 - parainsular be generated by random noise, so its appearance with this source 46 - middle frontal 47 - orbital solution, along with its absence in the other montages, starts to validate the accuracy of this new signal triangulation technique. Parietal Lobe Limbic Lobe Since its development in 2007, an estimated 10,000 EEG records 1 – intermediate postcentral 13 - insula 2 – rostral postcentral 23 - ventral posterior cingulate from dozens of neurotherapists and scientists have been analyzed 3 – caudal postcentral 24 - ventral anterior cingulate using the Brodmann montage, with promising results. For more 5 - preparietal – “in front of the wall” 26 - ectosplenial information about the SKIL software containing the Brodmann 7 - superior parietal “on top of the 29 - granular retrolimbic wall” 30 - agranular retrolimbic montage, see http://www.skiltopo.com. For those who want 40 – supramarginal gyrus 31 - dorsal posterior cingulate to consider Brodmann area centers of gravity without SKIL soft- 43 - subcentral 32 - dorsal anterior cingulate ware, Tables 2 and 3 lists electrode sites nearest each Brodmann 33 - pregenual area, and vice versa. Occipital Lobe 17 - striate - “stripes” Continued on page 36 18 – parastriate - “near the stripes” Areas 14-16, 27, 49-51 reported in 19 - peristriate - “enclosing the nonhuman primates only. stripes” Table 3 Closest Brodmann area to each 10-10 electrode

Table 2 ELECTRODE SITE ELECTRODE SITE ELECTRODE SITE FP1 ba10L FC3 ba06L CP4 ba40R Closest 10-10 Electrode position to the center of each Brodmann area in the FPz ba10L FC1 ba06L CP6 ba40R Brodmann montage FP2 ba10R FCz ba06R TP8 ba21R AF7 ba46L FC2 ba06R P9 ba20L Area LEFT RIGHT HEMISPHERE Area LEFT RIGHT HEMISPHERE AF3 ba09L FC4 ba06R P7 ba37L ba01 C3 C4 ba21 T7 T8 AFz ba09L FC6 ba44R P5 ba39L ba02 C3 C4 ba22 T7 T8 AF4 ba09R FT8 ba47R P3 ba39L ba03 C3 C4 ba23 Pz Pz AF8 ba46R FT10 ba20R P1 ba07L ba04 C3 C4 ba24 F1 F2 F7 ba47L T7 ba42L Pz ba07R F5 ba46L C5 ba42L P2 ba07R ba05 C1 CP2 ba31 Pz Pz F3 ba08L C3 ba02L P4 ba39R ba06 FC3 FC4 ba32 F1 AFz F1 ba08L C1 ba05L P6 ba39R ba07 P1 P2 ba37 P7 P8 Fz ba08L Cz ba05L P8 ba37R ba08 F1 F2 ba38 FT9 FT10 F2 ba08R C2 ba05R P10 ba37R ba09 AF3 AF4 ba39 P5 P6 F4 ba08R C4 ba01R PO7 ba19L ba10 FP1 FP2 ba40 CP3 CP4 F6 ba46R C6 ba41R PO3 ba19L ba11 AF7 FPz ba41 C5 T8 F8 ba45R T8 ba21R POz ba17L ba17 O1 O2 ba42 T7 C6 FT9 ba20L TP7 ba21L PO4 ba19R ba18 O1 O2 BROCAF5 FT7 ba47L CP5 ba40L PO8 ba19R ba19 PO7 PO4 ba44 FC6 FC5 BROCA* CP3 ba02L O1 ba18L CP1 ba05L Oz ba17R ba20 FT9 FT10 ba45 F8 (*BA 44L BA45L) CPz ba05R O2 ba18R ba46 AF7 F6 CP2 ba05R ba47 F7 F8

22 NeuroConnections SUMMER 2011

Working with Athletes with ADHD and Autistic Spectrum Disorder (ASD)

Michael K. Linden, PhD

An estimated 15 to 20 percent of professional psychologist who is experienced with ADHD. a sport psychologist who is experienced with athletes have attention deficit-hyperactivity An athlete may be performing inconsistently ASD are if they have difficulty with unfair or disorder (ADHD), compared to 4-8% of the or be streaky. They may perform well in prac- incorrect official/referee calls. They also of- general population of adults. Many undiag- tice but not in games, or be bored or unmoti- ten have difficulty with lack of structure, such nosed athletes with Asperger’s excel at tech- vated in practices. They have breakdowns in as overtime or extra innings. Athletes with nical positions such as pitcher, goalie, surfing, concentration, such as taking their eyes off the Asperger’s will have difficulty socially bond- running, and martial arts. ball, and may be forgetful (e.g., outs, plays, ing with other players and end up playing Since 2000, subtypes of AD/HD are time outs remaining). Athletes with ADHD positions that are more individualized, such identified with QEEG,, including an over- may be late to or miss practices, which can as goalies, relief pitchers, or field goal kick- focused type that often becomes worse with lead to conflicts with coaches and teammates. ers. Finally, they may remain over-focused on activating treatments (i.e., stimulant medica- They may become easily frustrated and act techniques, even if these techniques are un- tion) (Chabot, 1996). impulsively, throwing equipment or getting successful — for example, a quarterback’s or Asperger’s Syndrome is the most un- into a fight. They often have problems go- relief pitcher’s throwing motion. der-diagnosed of ASD because often these ing to sleep because they cannot stop their Assessment of ADHD/ASD individuals are very bright and articulate and thoughts or calm down at night and may use can over-focus intensely on technical aspects prescription medications or drugs/alcohol to The following steps and tests are recommend- such as goalie saves, pitching techniques, help them sleep. ed to accurately assess ADD/ADHD/ASD. and golf swings. However, since 2004, we Some of the advantages of having For additional information, please refer to have utilized QEEG brain mapping patterns Asperger’s in sports are being able to over- www.attentionlearningcenter.com. to confirm not only diagnoses of autism and focus on technical aspects, such as throwing 1-Clinical Interview Asperger’s but to determine specific subtypes a curveball, three-point shooting, making the 2-Behavior Rating Scales of ASD for more individualized and success- perfect jump in skiing, turning in surfing, or ful treatments (Linden, 2004; Coben, Linden, goalie save techniques. They are able to hy- 3-Continuous Performance Tests & Meyer, 2010). We have been using QEEG- per-focus on their techniques and practice for 4-Personality Tests (MMPI) guided neurofeedback with individuals with long periods of time. The most successful ath- 5-QEEG Mapping Evaluation ASD to specifically target improvements in letes can increase their hyper-focusing when communication, socialization, anxiety, obses- necessary, such as a pitcher in a full pitch Professional Athletes siveness, and overactive behavior. count or a goalie in a shootout. In addition, with ADHD Many athletes who have mild to mod- athletes with Asperger’s have a greater ability erate ADHD or autistic spectrum disorder are to stay calm in high-pressure situations and MLB player with ADHD and Anxiety able to excel in sports if they find the right when they make a mistake, as a result of hav- Randy (name changed to protect his confiden- fit. Some individuals and athletes have both ing less emotional responsivity. tiality) was diagnosed with ADHD and anxi- ADD/ADHD and Asperger’s. If their ADHD Some of the reasons to refer athletes ety. He was prescribed the stimulant medica- or Asperger’s symptoms are severe, most of with Asperger’s or high-functioning autism to them will need to be treated. However, the use Continued on page 24 of medication is not allowed in most profes- Figure 1 Pre-QEEG relative power maps for Randy sional sports. What are some of the individual sport advantages of having ADHD? Some sports do not require intense concentration for long periods but rather short periods of attention (15 seconds) or short shifts as in football or hockey. Athletes with ADHD perform bet- ter in individualized or fast sports; they have quick speed and reaction time if they can control their impulsivity. Athletes with ADHD have a heightened awareness of their environment. They have the ability to do well under pressure and under chaotic situa- tions, for example, a quarterback rolling out to avoid a rush and completing a pass across the field. Athletes with ADHD have unique and creative problem solving abilities and can make a novel play out of a problem situation. Because their impulsivity leads them to often live in the present, they also may have a lack of concern about losing at the moment. On the other hand, sometimes athletes with ADHD will need to be referred to a sport

23 NeuroConnections SUMMER 2011

Athletes with ADHD book, Biofeedback & Neurofeedback Appli- Monastra, Lubar, Linden, et. al. (1999). Assessing ADHD Via Quantitative electroencephalography: An Initial continued from page 19 cations in Sports Psychology, published by Validation Study. Neuropsychology, August the Association of Applied Psychophysiology Monastra, V., Lubar, J. & Linden, M., VanDeusen, P., Green, tion Adderall but had side effects. Randy un- and Biofeedback (AAPB), Wheat Ridge, Col- G., Wing, W., Phillips, A. & Fenger, T (2001).The Devel- LENSware opment of a QEEG Scanning Process for ADHD: Reli- © 2011 OchsLabs, Inc. derachieved in college baseball his first few orado. More information is available at www. ability and Validity Studies. Neuropsychology, January, years. A QEEG map was administered, and aapb.org. Biography the results indicated high theta (daydreaming, Many of the authors of our book train ADHD) and high beta (anxiety) (Figure 1). athletes using Thought Technology hardware Michael Linden, PhD Randy was trained using QEEG guided neu- and Infiniti software (Thought Technology, Dr. Michael Linden is a licensed Clinical Psycholo- rofeedback to enhance SMR (lowers impul- Montreal, Canada), including professional gist and BCIA Certified as a senior fellow in BFB sivity and anxiety, increases relaxation) and golfers, Olympic teams (Canadian Winter and NFB. Dr. Linden has been the director of the inhibit theta (increases focus) and inhibit beta Olympic Skaters, Free Style and Skiers; Ca- Attention Learning Centers and the biofeedback The Neurofeedback system that frees the brain to optimize itself brainwaves (lowers anxiety). nadian Tennis: Indian Olympic archery), and neurofeedback programs at Mission Psycho- Randy also was trained with HRV and logical Consultants in San Juan Capistrano, Irvine, professional soccer (AC Milan), professional and Encinitas California since 1988. He works with GSR biofeedback to decrease anxiety and in- hockey/NHL (Vancouver Canucks), profes- both athletes in general and athletes with ADD and crease batting performance. Furthermore, he sional tennis, college teams (UCLA), Major Asperger’s using biofeedback and neurofeedback to was trained in the use of mental skills such as League Baseball. Several teams have set up enhance performance, increase attention and man- visualization. As a result of Randy’s training, Mindrooms, which include up to 8 systems to age anxiety. He has presented on biofeedback and he became more successful in college base- neurofeedback applications in sport psychology at train groups of athletes simultaneously. The conferences such as Winterbrain, ISNR and AAPB. ball and was drafted by a MLB team. small portable Thought Technology Procomp 2 encoder is well suited for ambulatory sport In 1990, Dr. Linden won the “Outstanding Research Conclusion: Award’ given by the Biofeedback Society of Cali- and wireless applications. It is likely that athletes will become more open fornia and in 1993, Dr. Linden & Associates were to investigating a diagnosis of ADHD or ASD References awarded the “Outstanding Research Award” from Chabot, R., & Serfontein, G. (1996). QEEG profiles of AAPB. Dr. Linden published the first randomized as knowledge of more accurate brain func- children with ADHD. Biological Psychiatry, 40(1), controlled study of neurofeedback with children with tioning assessment, such as QEEG, increases 951–963. ADD in the Journal of Biofeedback and Self-Regu- and more awareness of non-drug treatments Coben, R., Linden, M., & Myers, T. (2010). Neurofeedback lation in 1996; his QEEG assessment studies were for autistic spectrum disorder: A review of the literature. without side effects, such as neurofeedback Journal of Applied Psychophysiology and Biofeed- published in The Journal of Neurofeedback Therapy occurs. This should create alternative options back,35(1), 83-105. in 1996 and in The Journal of Neuropsychology in Linden, M. (2004). Case studies of QEEG mapping and 1999 and in 2001. His current research on QEEG for these athletes to improve their perfor- neurofeedback with autism. Proceedings of the 12th An- Subtypes and neurofeedback with Autistic Spectrum mance and overall functioning. nual Conference of the International Society of Neuronal Regulation, Ft. Lauderdale, FL, Society for Neuronal Disorder was published in the Journal of Applied This article is an excerpt from the Regulation. Psychophysiology and Biofeedback in 2010. Neuroscientists believe that the brain’s defenses against stressors, trauma and functional problems can create neuronal blockages. Addressing the brain in its own electromagnetic language, the LENS seems to open the way for the brain to restore itself. Unobstructed communications flow in the brain’s complex neuronal network allows it to self-adjust. Result: Optimum Functioning.

From anxiety to ADD, central nervous system dysfunctions can be compared to a car that’s stuck in Park. The LENS gets traffic flowing again and your whole system shifts. Many people see broad improvement immediately with better focus, more energy, better sleep, mood, anxiety and depression lifting.

Unlike traditional neurofeedback in which you have to actively regulate your brainwaves, the LENS frees the brain to optimize itself. All you do is sit there, and your brain does the work. It’s quick too! Your brain interacts with the signal on its own and re-regulates. No drugs required.

OchsLabs, Inc. has both purchase and lease programs available. Leasing can include a fully loaded 15” laptop computer and start at only $267.00 per month. Contact our office by calling (707) 823-6225 and we will be happy to assist you.

OchsLabs, Inc. 6683 Sebastopol Avenue Sebastopol, Ca 95472 Tel: 707-823-6225 Fax: 707-823-6266 www.ochslabs.com 24 NeuroConnections SUMMER 2011

LENSwareLENSware © 2011© 2011OchsLabs, OchsLabs, Inc. Inc.

TheThe Neurofeedback Neurofeedback system system that that frees frees the the brain brain to tooptimize optimize itself itself

NeuroscientistsNeuroscientists believe believe that that the the brain’s brain’s defenses defenses against against stressors, stressors, trauma trauma and and functionalfunctional problems problems can can create create neuronal neuronal blockages. blockages. Addressing Addressing the thebrain brain in its in own its own electromagneticelectromagnetic language, language, the theLENS LENS seems seems to open to open the theway way for thefor thebrain brain to restore to restore itself.itself. Unobstructed Unobstructed communications communications flow flow in the in thebrain’s brain’s complex complex neuronal neuronal network network allowsallows it to it self-adjust. to self-adjust. Result: Result: Optimum Optimum Functioning. Functioning.

FromFrom anxiety anxiety to ADD,to ADD, central central nervous nervous system system dysfunctions dysfunctions can can be comparedbe compared to ato a car carthat’s that’s stuck stuck in Park. in Park. The The LENS LENS gets gets traffic traffic flowing flowing again again and and your your whole whole system system shifts.shifts. Many Many people people see seebroad broad improvement improvement immediately immediately with with better better focus, focus, more more energy,energy, better better sleep, sleep, mood, mood, anxiety anxiety and and depression depression lifting. lifting.

UnlikeUnlike traditional traditional neurofeedback neurofeedback in which in which you you have have to activelyto actively regulate regulate your your brainwaves,brainwaves, the theLENS LENS frees frees the thebrain brain to optimize to optimize itself. itself. All youAll you do isdo sit is there,sit there, and and youryour brain brain does does the thework. work. It’s It’squick quick too! too! Your Your brain brain interacts interacts with with the thesignal signal on on its ownits own and and re-regulates. re-regulates. No Nodrugs drugs required. required.

OchsLabs,OchsLabs, Inc. Inc. has hasboth both purchase purchase and and lease lease programs programs available. available. Leasing Leasing can caninclude include a fullya fully loaded loaded 15” 15”laptop laptop computer computer and and start start at onlyat only $267.00 $267.00 per permonth. month. Contact Contact our ouroffice office by callingby calling (707) (707) 823-6225 823-6225 and and we wewill willbe happybe happy to assist to assist you. you.

OchsLabs, OchsLabs, Inc. Inc. 66836683 Sebastopol Sebastopol Avenue Avenue Sebastopol,Sebastopol, Ca Ca95472 95472 Tel:Tel: 707-823-6225 707-823-6225 Fax: Fax: 707-823-6266 707-823-6266 www.ochslabs.comwww.ochslabs.com 25 19 Channel NeuroGuide Neurofeedback Seamless Integration of QEEG and EEG Biofeedback

Available to users of Deymed BrainMaster Discovery Neuropulse Mitsar Neuron Spectrum

Including: Real-Time Z Score Symptom Check List Discriminant Functions Power Coherence Phase JTFA Burst Metrics Phase Reset Statistics Instantaneous Coherence & Phase Reset Phase Lock and Phase Shift Duration 3-D LORETA Z Score Biofeedback.

Take a test drive – download a FREE NeuroGuide Demo at: www.appliedneuroscience.com Contact US at: [email protected] 727-244-0240 NeuroConnections SUMMER 2011

19 Channel NeuroGuide Neurofeedback sLORETA Neurofeedback— First Clinical Results Seamless Integration of QEEG and EEG Biofeedback Susanne Schmid-Grether, MTh

Available to users of This review shows the first results of sLoreta- the QEEG at the beginning 8 sessions with sLORETA Deymed based neurofeedback (LNFB) in the clini- of the training. Neurofeedback cal application in a neurofeedback practice Subjects • ACC left on -5/29/31 BrainMaster Discovery in Switzerland. Patients who trained with 1-, 2- or 4-channel NFB using BioExplorer 1. 14-year-old boy with increased frontal He was the only one of the subjects where we Neuropulse Software (Cyberevolution, USA) also trained midline theta recorded another QEEG after the treatment. with LNFB at the anterior cingulate, intrapa- Figure 4 (page 28) results show a sig- 2. 14-year-old boy with alpha excess in cen- nificant decrease of theta activity in frontal Mitsar rietal sulcus (Brodmann Area 40; P4) and on tral (mu rhythms) and parietal regions Brodmann Area 6 (fronto-central). regions. The patient reported much decreased Neuron Spectrum We analyzed the efficacy of LNFB 3. 57-year-old male with depression, alpha hyperactivity, improved concentration and im- while training on the anterior cingulate (BA excess over whole cortex and alpha asym- pulse control and no more need for treatments 32) as a region that receives inputs from sev- metry at the psychiatrist. The shift is also visible in the ERP eral sensory areas and which therefore plays Results a critical role in information processing, component for impulse control (figure 5): modulation of attention, executive functions, Subject #1 The indicator for the improved impulse control is the P3 supF component, which emotional control and monitoring (error de- 14-year-old boy with increased frontal mid- tection). In addition to BA 32 the patient with shows much more activity after treatment line theta than before. sensory integration deficit was trained at in- The complained symptoms were hy- traparietal sulcus (Brodmann Area 40) and the peractivity, ADHD, problems with sustained Subject #2 patient with depression at Brodmann Area 6 attention and impulse control. The patient (fronto-central). 14-year-old boy with alpha-excess in central Including: showed significant amount of frontal midline (mu rhythms) and parietal regions Real-Time Z Score Method theta in the QEEG. He received the following The QEEG at the beginning of the trainings: Symptom Check List A 19-channel EEG was recorded during treatment showed excessive alpha activity LNFB with Mitsar (St Petersburg, Russia) 36 sessions (1/2 hour) with conventional over central and parietal regions. The com- Discriminant Functions and Braintuner Software (Mitsar, St. Peters- Neurofeedback: plaints of the boy were sensory integration Power burg, Russia). Patients were watching a DVD deficit (proprioception), problems with sus- • ACC trainining on Fz tained attention, hyperactivity andmath prob- Coherence that began jamming when feedback-criteria were not matched. • Hemoencephalography (BioExplorer (Cy- lems mostly in geometry. He was medicated Phase All subjects have been investigated berevolution), Neuroamp and pIRx3 Sen- with 8 mg Dexamin (dexamphetamine) per sor from EEGInfo, Switzerland) on Fp1/ JTFA by a QEEG at the beginning of their treat- day. His trainings were adapted to his alpha ment. We compared QEEG data from the Fpz/Fp2 Burst Metrics LNFB training sessions with the data from Continued on page 28 Phase Reset Statistics Training Protocols Instantaneous Coherence & Phase Reset ACC protocol Brodmann Area 32 left Protocol for intraparietal sulcus right on Training protocol for depression -35/-15/45 Phase Lock and Phase Shift Duration (BA 32) -5/29/31 39/-53/47 and 45/-52/48 (BA 40) (BA 6 left) 3-D LORETA Z Score Biofeedback.

Take a test drive – download a FREE NeuroGuide Demo at: www.appliedneuroscience.com Contact US at: [email protected] Figure 1—Subject 1 Figure 2—Subject 2 Figure 3—Subject 3 Anterior cingulate -5/29/31 Intraparietal sulcus right on 39/-53/47 and BA 6 left -35/-15/45 727-244-0240 45/-52/48 (BA 40) Enhanced were 12-20 Hz and 36-40 Hz, in- Enhanced were 12-17 Hz and 35-40 Hz, in- Enhanced were 14-20 Hz and 36-40 Hz, in- hibited were 4-8 Hz. The duration of a session hibited were 8-13 Hz. The duration of a ses- hibited were 8-12 Hz. The duration of a ses- was 2 x 5 minutes training with 1 min relax- sion was 2 x 5 minutes training with 1 min sion was 2 x 5 minutes training with 1 min ation between the trainings. relaxation between the trainings. relaxation between the trainings. 27 NeuroConnections SUMMER 2011

sLoreta continued from page 27

excess by stopping 8-12 Hz instead of 4-8 Hz in ACC protocol. He got the following trainings: 18 sessions (1/2 hour) with conventional Neurofeedback: • 4 channel training on C3/C4 and P3/P4 al- pha stop and gamma go • Hemoencephalography on Fp1/Fpz/Fp2 14 sessions with LORETA Neurofeedback • ACC left on -5/29/31 with alpha stop • Intraparietal sulcus on 39/-53/47 with al- pha stop Figure 4 The comparison of the QEEG file with a file recorded during a sLORETA neurofeedback Relative power Theta (4 – 8 Hz) and comparison with the database before (dark green bars) and after (light green session shows a significant decrease in the bars) treatment. alpha activity in central and parietal regions. The boy reported improved proprioception and improvements in geometry. He also re- ported improved concentration and planning and also decreased hyperactivity. His Dexa- min dose could be reduced to 2mg/day. Subject #3 57-year-old male with depression, alpha ex- cess over whole cortex and alpha asymmetry The QEEG at the beginning of the ther- apy showed a dominance of alpha rhythms over the frontal, central and parietal regions. The patient complained of depression since 1986 with symptoms such as poor self-image, negative and unhappy, low energy level, prob- lems with socializing, hopelessness about the future and not seeing any positives in life. Figure 5 His ACC training protocol in sLoreta neuro- Event Related Potential component P3 supF (suppression frontal) on Cz feedback was adapted to his alpha excess by stopping 8-12 Hz instead of 4-8 Hz. We also developed an individual protocol for a region in BA 6 in reference to his QEEG data that showed a significant source of his alpha activ- ity in this region. He got the following trainings: 36 sessions (1 hour) with conventional Neurofeedback • ACC trainining on Fz • Alpha-asymmetry training on F3/F4 • Hemoencephalography on Fp1/Fpz/Fp2 8 sessions with sLORETA Neurofeedback • ACC left on -5/29/31 with alpha stop • BA 6 left on -35/-15/45 with alpha stop Figure 8: Relative power Alpha (8 -12 Hz) and comparison with the database before (dark green bars) and after (light green bars) treatment The comparison of the QEEG file with Figure 6 a file recorded during a sLORETA neurofeed- Relative power Alpha (8 -12 Hz) and comparison with the database before (dark green bars) and after (light green back session shows a significant reduction in bars) treatment. Continued on page 28 28 NeuroConnections SUMMER 2011

his overall alpha activity, though it is still too much in comparison with the database in cen- tral regions. The patient reported much less depressive feeling, less problems with social- izing, he is much more energetic and enthusi- astic - he began with a theatre course and with traveling. He also feels much more positive about the future and finds pleasure and enjoy- ment in life. Conclusion Figure 7 LNFB seems to be a very effective way for Relative power Alpha (8 -12 Hz) and comparison with the database before (dark green bars) and after (light green neurofeedback training. The training is stron- bars) treatment. ger than in conventional neurofeedback, so that the training time with twice 5 minutes is long enough. The EEG patterns all showed significant changes and patients all reported improvements. Although the improvements certainly can’t be attributed only to the LNFB, patients reported much stronger improvements when we began to train them with LNFB. The additional time needed for the montage of the full cap is counterbalanced by the shorter training time. This makes LNFB practicable

for clinical application. Biography Susanne Schmid-Grether, MTh, is a neurofeedback therapist and director of the Neurofeedback Center of Excellence “SCHORESCH” in Wetzikon, Swit- zerland that provides an own high level neurofeed- back education. Susanne is also a lecturer at the “Neurofeedback-Akademie Schweiz.” Figure 8 Relative power Alpha (8 -12 Hz) and comparison with the database before (dark green bars) and after (light green bars) treatment

LORETA neurofeedback will work best for areas that are relatively large, for example the cingulate gyrus. We have done and published studies showing that it is possible to learn to change current density in the cingulate and that this is helpful for a variety of problems including ADHD, possibly depression, and may even be helpful in treating chronic pain. One of the areas in which people are very interested is the amygdala. The problem is that the amygdala is a relatively small region and consists of two main divisions one of which receives olfactory input and the other, the basolateral division is involved in a variety of functions. This latter division has at least eight sub nuclei, such as the central, lateral, basal and others. Back in the 1960s Birger & Kaada and later Birger & Kaada and Holger & Ursin published many studies and monographs showing that with stimulation of the amygdala in a variety of species an enormous number of autonomic, emotional, sexual, and repetitive responses could be elicited. These were shown to be precise to specific sub nuclei of the amygdaloid complex. At present LORETA only has a 7 mm resolution confined to 2,394 voxels. Even MRI and fMRI utilizing five and seven Tesla coils cannot get very far below 1 mm resolution, still not sufficient to target in detail the individual sub nuclei of the amygdaloid complex. Another problem is that the Talairach Atlas is based on an average of 305 MRIs and therefore mapping an individual onto that atlas can lead to errors as large as 5 mm which might actually target outside of the amygdaloid complex completely. So the question for me is what happens when you try to train activity using LORETA neurofeedback in the region of the amygdala which has so many different functions. This could be quite dangerous and should be approached with great caution. I also have some concerns about training in the insular cortex. Dirk De Ritter pointed out that the left insular cortex is involved with parasympathetic functions and the right insular cortex with sympathetic functions. All of our internal organs are mapped within the insular cortex so it is not unreasonable that we could impact psychophysiological disorders of internal organ functions such as irritable bowel syndrome as one example. Again the resolution of LORETA is so low that it cannot target the individual regions within the insular cortex representing different organ systems with any degree of precision. Furthermore, for both the amygdaloid complex and the insular region we don’t know which frequency bands or even which individual frequencies are best to train for specific disorders. The point of all this is that we must be very cautious and training these internal structures whether we use LORETA neurofeedback or fMRI neurofeedback. My best advice would be before training these areas and patients

try it on your self and note carefully what kind of experiences take place. Joel Lubar

29

NeuroConnections SUMMER 2011

Understanding LORETA

Roland Verment

LORETA is an abbreviation of ion-channels start to open which the periods of intense firing alternate LOw REsolution TomogrA- too, hence a snowball ef- with rest occurs in the range of the brain wave phy and is an inverse technique fect occurs.The electric frequency bands we commonly as theta, al- whose goal is to map measure- charge will rapidly change pha, etc. Realize that the firing rates of single ments (EEG) on the 2-dimen- from negative state and neurons is much faster, around 1,000 Hz. It is sional plain of the skull into a 3- overshoot into a positive the groupings of firing moments that make the dimensional space of sources of state. On the other side brain rhythms appear. the EEG. To understand how this of the cell the charge will With the EEG we measure the po- technique works we have to look at the physi- change in the opposite way, it will become tentials on a 2 dimensional surface, which ology background of the EEG. The EEG is a more negative. This concept describesis a di- is embedded in a three dimensional space. measurement of the post synaptic potentials pole system. We can think of the head as a grid of small of the pyramidal cells in the brain, the PSPs. In order to measure a scalp electrical cubes (voxels) all with their own position and These potentials can be excitatory or inhibi- signal (EEG), two conditions have to be met. electrical activity. Mathematical equations, tory, respectively EPSPs and IPSPs. The dipoles (pyramidal cells) should all have known as the “lead field equations,” calculate A neuron at rest has a negative charge the same alignment. Otherwise the dipoles how, depending on position and orientation on the inside compared to the outside. This is would cancel out each other’s potentials and of a potential, this is transformed. It is with a called the resting potential; the value of this the net to signal would be merely noise. Na- transformation matrix linked to the locations is -70 mV. The potential is stable. Due to its ture was generous in this case. All the pyrami- of measurement on the scalp of a person. The impenetrable nature, the ions cannot penetrate dal cells are aligned perpendicular to the corti- model used for these equations takes into ac- the wall without the use of normally closed cal layers they are in. This means that from all count the dipole character of the neurons and ion-channels. The ions are prevented from the cortical layers that are aligned horizontal other relevant properties such as conduction. following passively the concentration gradi- to the skull a proper signal can be measured. All the voxels have their own contribution to ent. At the event of an excitatory potential, This is also the reason why EEG is known not the potential as measured on the scalp at each EPSP, Sodium, Na+ enters the cell through to measure a signal from the gyri and sulci electrode site. When the equations are correct the active opening of an ion-channel. This in the brain. For gyri and sulci MEG, magne- opening can be an effect of stimulation of toencephalograhpy, is used, since a magnetic nearby axons or an effect of a change from signal has a perpendicular orientation from an the rest potential. The Sodium ion can then electrical signal. passively follow the concentration gradient A second condition that has to be met through the cellular wall. To a lesser extent is gross synchronized firing of the neurons. Potassium ions, K+ move out of the cell. Due Only the synchronization of at least 10,000 to the following change of the potential other neurons will be measurable. The frequency at

Figure 2 Figure 1 EPSP in a pyramidal cell, forming a dipole , Mechanism of an action potential http://www.uzh.ch/keyinst/TrainingCourses/ http://www.odec.ca/projects/2004/syed4s0/public_html/action.jpg Slides01/01-Talka_frame.htm 32 NeuroConnections SUMMER 2011

and we know the potentials in the voxels, we can calculate one accurate solution of this equation, this is called the forward solution. Unfortunately we have to work backward in the case of source localization of EEG. However, the scalp measurements don’t have enough information to provide a solution to the question, what is the source of this ener- gy? The potentials and orientations can be al- tered in many different ways to give the same result for the scalp measurement. The amount of results is infinite. LORETA is a technique that locates sources of the EEG energy. It makes use of the constraints/condition explained above. LORETA gives probable solutions to the backward (or inverse) problem of the EEG by setting a constraint for the solution. The constraint that is used results from the idea that it is likely that neuronal activity spreads from a source in a fluent way. Since the EEG reports synchronized firing of large groups of neurons oriented in the same way and not randomly. It is presumed, that the EEG activ- Figure 4 ity is highest at the source and that it gradu- a 3-D Grid ally declines as we go further away from it, similarly compared to a source of heat.The LORETA technique looks for the solution in in locating activity of neural activity perpen- being ventrally from the middle and positive which the transition of activity between the dicular to the skull in gyri and sulci. To plot numbers being dorsally from it. As a model voxels is most fluent and calculates this tran- the data in a brain, normally Talairach coordi- for a brain the MNI (Montreal Neurological sition. LORETA favours the equation that has nates are used. This system uses 3 axes from Institute) atlas is used that is based on MRI the lowest total sum of transitions between which the 0(x),0(y),0(z) point is in the middle studies. voxels. Due to the density of the neurons this of the brain.The x-axe corresponds to the An enhanced version of LORETA is condition is largely, but not completely, real- frontal plain, negative number corresponding sLORETA, or standardized LORETA. This ized by the real human brain. For example to the left brain part and positive to the right method is based upon the understanding that gyri and sulci activity abruptly change natu- brain part. The y-axe corresponds to the sagit- activities around a source are distributed in a rally. Also only pyramidal cell activity can be tal plane, negative number being posterior to noisy, Gaussian way and uncorrelated to other localized; the cerebellum for example doesn’t the middle of the brain, positive numbers be- sources.This method has been proven to give have pyramidal cells and hence there is no ing anterior to it. Lastly the z-axe corresponds better results and should ideally have zero er- EEG or a possibility of source localization by to the transversal plane, negative numbers ror. From a clinical perspective it can be said LORETA. LORETA is also not so successful that sLORETA gives better results, which are more in line with knowledge from psycho- physiology. One of its biggest advantages is the increased sensitivity for artifacts. LO- RETA often locates maximal activity near the eyes, since there is almost always some EOG left even in de-artifacted EEG. sLORETA seems to be more sensitive to this, excluding it from the data. Both LORETA and sLORETA are based on finding a transformation matrix that gives the solutions for the given data input. Calculating the matrix is a time and capacity consuming process. But once the calculations are done the LORETA and sLORETA-based transformation matrices can be used as a spa- tial filter, which does not take heavy resources when used with real-time data. On every da- tum, exactly the same transformation matrix is used. When we ascertain voxels of inter- est we can calculate in real-time the activity in these voxels according to the LORETA or sLORETA method. This opens the possibility Figure 3 for neurofeedback, based on activity in vox- Pyramidal cells with aligned axons, http://www.meridianinstitute.com/eamt/files/burns2/68burns2.jpg Continued on page 32 33 NeuroConnections SUMMER 2011

LORETA continued from page 31 els and hence 3-dimensional activ- ity in the brain. Mitsar (St. Peters- burg, Russia) developed software Some advantages for this type of training. of (s)LORETA Additionally, the NeuroGu- ide software and database (Neuro- neurofeedback Guide, St Petersburg, Florida, USA) can be: developed a normative database, which shows deviations from the + Specific training of brain regions based on norm in the shape of maximal nega- measurement and/or theory. tive or positive deviation (z-scores). For every voxel a distribution can + Interesting research tool, what happens be determined after being normal- Achieve Superior deep in the brain with normal or LORETA ized to a Gaussian curve. For each frequency the maximum deviation neurofeedback. is located, whether negative or pos- itive. In addition to seeing the activ- + When several sources seem to have same ity referenced to a normed group, activity (for example alpha), the LORETA the sLORETA is less prone to arte- Neurofeedback Results neurofeedback will only focus on the fact influences. This is because also the normed group will also have ______activity from the given region. a slight amount of artefacts in the Figure 6 EEG. Source-localization of alpha-activity with the use of sLORETA + Less prone to artifacts because artefacts For neurofeedback we can will have another source than the region decide to train a subcortical loca- ing from MRI. A ROI is a sphere around a cer- tain voxel with a radius that is chosen in order that is correctly chosen. tion based on LORETA or sLORETA. This can be the wish to train a brain region that lies to allow a larger or smaller area to be trained. I personally read each QEEG and design deeper in the brain. An example can be theta The radius can be adjusted within a one voxel - Less laborious method than traditional activity from the anterior cingulate, a com- resolution. Aside from the ROI a frequency individualized protocols for your success neurofeedback that is unpleasant for monly seen pattern, and the anterior cingulate band can be chosen, so amplitude changes of client, especially for children. lies deep in the brain, not on the surface. The defined frequencies originating from the ROI decision to train deep in the brain can be based can be trained. ______- Extensive research is necessary to clarify on a finding of activity in a certain structure, LORETA neurofeedback serves good based on theory of ADHD, based on the wish for training locations deep in the brain. Con- if there is a difference in effectiveness to train a certain structure with functionality gedo (2003) trained a small group of partici- between normal and LORETA as described in Brodmann areas, or for exam- pants in decreasing alpha activity. In only five neurofeedback. ple around a location where there has been an sessions there seemed to be a decrease in ac- infarct or trombose. tivity and increased control of this alpha ac- Marco Congedo was the first to develop tivity. Another explanation could be that also and test LORETA neurofeedback. The method surface neurofeedback gives the same control Jonathan Walker, M.D. used is currently available for Deymed (Pay- and decrease, but due to blurring of the signal ette, USA) amplifiers. In this method a region this cannot be measured as well as with the of interest (ROI) is chosen, a method originat- LORETA method. ¥ Board Certified in Neurology and EEG ¥ Published Medical Researcher Continued on page 36 ¥ Published Neurofeedback Researcher ¥ Past President, Neurofeedback Division of AAPB ¥ President of the American Board of QEEG Technology ¥ Practitioner of Neurofeedback for 30 years

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Figure 5 Source localization of frontal theta activity with LORETA at the medial frontal gyrus

34 Achieve Superior Neurofeedback Results ______

I personally read each QEEG and design individualized protocols for your success ______Jonathan Walker, M.D.

¥ Board Certified in Neurology and EEG ¥ Published Medical Researcher ¥ Published Neurofeedback Researcher ¥ Past President, Neurofeedback Division of AAPB ¥ President of the American Board of QEEG Technology ¥ Practitioner of Neurofeedback for 30 years

Contact me. Experience the difference.

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35 NeuroConnections SUMMER 2011

Broadmann continued from page 22

References Amunts K, Malikovic A, Mohlberg H, Schormann T & Zilles K (2000). Brodmann’s areas 17 and 18 brought into stereotaxic space-where and how variable? Neuroim- age, 11, 66-84. Bouillaud JB (1825). Traité clinique et physiologique de l’encéphalite, ou inflammation du cerveau. Paris:J.B. Baillière. Brodmann K. (1905).Beiträge zur histologischen Lokalisation der Grosshirnrinde. Dritte Mitteilung: Die Rindenfelder der niederen Affen. Journal of Psychology and Neurol- ogy (Leipzig), 4, 177–226. Brodmann K (1909). Vergleichende Lokalisationslehre der Grosshirnrinde in ihren Prinzipien dargestellt auf Grund des Zellenbaues, Johann Ambrosius Barth Verlag, Leipzig (reprinted in English, 1994). Broca P (1865) Sur le siège de la faculté du langage articulé. Bulletion of the Society of Anthropology, 6, 337–393. Collins DL (1994). 3D Model-Based Segmentation of Individual Brain Structures from Magnetic Resonance Imaging Data. Thesis, McGill Univ., Canada. Economo, C. von & Koskinas, G.N. (1925). Die Cytoarchitektonik der Hirnrinde des erwachsenen Menschen. Vienna and Berlin: Julius Springer.(reprinted in English, 2008). Fischl B, Rajendran N, Busa E, Augustinack J, Hinds O, Yeo BT, Mohlberg H, Amunts K & Zilles K (2008). Cortical folding patterns and predicting cytoarchitecture. Ce- rebral Cortex, 18, 1973-80. Gerhardt von Bonin & Percival Bailey (DOES THIS INCLUDE FORST NAMES OR IS IT SHORT ON COMMAS?) (1925). The Neocortex of Macaca Mulatta. Urbana, Illinois: The University of Illinois Press. Hjorth B (1975). An on-line transformation of EEG scalp potentials into orthogonal source derivations. EEG and Clinical Neurophysiology, 39, 526-30. Hjorth B (1980). Source derivation simplifies topographical EEG interpretation. Ameri- can Journal of EEG Technology, 20, 121–132. Kaiser DA (2007). Proprietary C++ software application for Microsoft Windows, Ster- man-Kaiser Imaging Laboratory, Inc., Churchville, NY Kennedy, D. N., Lange, N., Makris, N., Bates, J., Meyer, J., et al.(1998). Gyri of the hu- man neocortex: An mri-based analysis of volume and variance. Cerebral Cortex 8, 372-384. (I NEED ALL AUTHORS) Koessler L, Maillard L, Benhadid A, Vignal JP, Felblinger J, Vespignani H & Braun M (2009). Automated cortical projection of EEG sensors: anatomical correlation via the international 10-10 system. Neuroimage, 46, 64-72. Nielsen FA (2003). The Brede database: a small database for functional neuroimaging. Presented at the 9th International Conference on Functional Mapping of the Human Brain, June 19--22, New York, NY. Oishi K, Faria A, Jiang H, Li X, Akhter K, Zhang J, Hsu JT, Miller MI, van Zijl PC, Albert M, Lyketsos CG, Woods R, Toga AW, Pike GB, Rosa-Neto P, Evans A, Mazziotta J & Mori S (2009). Atlas-based whole brain white matter analysis using LORETA continued from page 35 large deformation diffeomorphic metric mapping: application to normal elderly and Alzheimer’s disease participants. Neuroimage, 46, 486-99. Ono, M., Kubik, S. & Abernathey, C. D., 1990. Atlas of the cerebral sulci, Thieme Medi- cal Publishers, Inc., New York. Conclusion Pascual-Marqui, RD, Gonzalez-Andino SL, Valdes-Sosa PA & Biscay-Lirio R. (1998). Current source density estimation and interpolation based on the spherical harmonic sLORETA neurofeedback seems to be a very interesting tool for Fourier expansion. Int J Neuroscience, 43, 237-49. neurofeedback therapy. Due to the facts mentioned above till so Rademacher J, Morosan P, Schormann T, Schleicher A, Werner C, Freund HJ, & Zilles K far in our clinic sLORETA neurofeedback is only chosen as an al- (2001) . Probabilistic mapping and volume measurement of human primary auditor cortex. NeuroImage 13, 669-683. ternative option when traditional neurofeedback isn’t satisfactory. Rajkowska G, & Goldman-Rakic PS (1995). Cytoarchitectonic definition of prefrontal With normal neurofeedback a considerable range of protocols can areas in the normal human cortex: II. Variability in locations of areas 9 and 46 and be tried, that can make a big difference in effect as all experienced relationship to the Talairach Coordinate System. Cerebral Cortex, 5, 323-37. Sarkissov SA, Filimonoff IN, Kononowa FP, Preobraschenskaja IS, & Kukuew LA. neurofeedback therapists know. Some clients that tried the sLORE- (1955). Atlas of the cytoarchitectonics of the human cerebral cortex. Moscow: TA neurofeedback could localize the training very accurately when Medgiz. Simic G, Bexheti S, Kelovic Z, Kos M, Grbic K, Hof PR & Kostovic I. (2005). Hemi- asked, which may validate the method. At least one client with tin- spheric asymmetry, modular variability and age-related changes in the human ento- nitus experienced more effect from the sLORETA neurofeedback rhinal cortex. Neuroscience, 130, 911-25 Talairach J & Tournoux P.(1988). Co-planar Stereotaxic Atlas of the Human Brain: compared to normal neurofeedback. 3-Dimensional Proportional System - an Approach to Cerebral Imaging. Thieme One of our main interests for this method in the future will be Medical Publishers, New York. to give us more insight onto the mechanisms of neurofeedback. Thompson, P. M., Schwartz, C., Lin, R. T., Khan, A. A. and Toga, A. W., (1996). Three dimensional statistical analysis of sulcal variability in the human brain. Journal of Congedo, M (2003). Tomographic neurofeedback; A new Neuroscience, 16, 4261-4274. technique for the self-regulation of brain electrical activity. http:// Thompson, P. M., Cannon, T. D., Narr, K. L., van Erp, T., Poutanen, V. P., et al., (2001). Genetic influences on brain structure. Nat Neurosci 4, 1253-1258. (I NEED ALL www.lis.inpg.fr/pages_perso/congedo/M%20Congedo%20Disserta AUTHORS) tion.pdf Uylings HB, Rajkowska G, Sanz-Arigita E, Amunts K, Zilles K (2005). Consequences of large interindividual variability for human brain atlases: converging macroscopi- cal imaging and microscopical neuroanatomy. Anatomical Embryology (Berl), 210, BIO: 423-31. Van Essen DC, Drury HA (1997). Structural and functional analyses of human cerebral Roland Verment received his master degree in 2005. His thesis studied non- cortex using a surface-based atlas.Journal of Neuroscience, 17, 7079-102. linear dynamics and neurofeedback at the university of Groningen in the Van Essen DC, Drury HA, Dickson J, Harwell J, Hanlon D, & Anderson CH (2001). An Netherlands. From 2006 he is running Neurobics, www.neurobics.nl. Be- Integrated Software Suite for Surface-based Analyses of Cerebral Cortex. J Am Med sides running the clinic he is working on a dissertation about neurofeed- Inform Association, 8,443–459. back. Vogt C & Vogt O. Die physiologische Bedeutung der architektonishcen Rindenfelderung auf Grund neuer Rindenreizungen. J Psychol Neurol 1919;25:399–429. Contact him at [email protected]. Von Bonin G &Bailey P. The neocortex of Macaca mulatta. Urbana, IL: University of Illinois Press; 1947. von Economo C & Koskinas GN (1925). Die Cytoarchitektonik der Hirnrinde des erwa- chsenen Menschen. Berlin: Julius Springer.

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37 NeuroConnections SUMMER 2011

Research Foundation Workshop in Phoenix

David Trudeau, MD

During its two and a half years of Good, The Bad, and The Ugly cessful in educating and motivating attend- existence the RF has attempted (and how to tell the difference) ees. At the conclusion of the workshop, par- many different avenues of defin- and has published more than ticipants will not only understand fundraising ing and executing its mission. 250 articles on fundraising, programs and techniques, they will also have After many attempts and ideas, management and leadership. the tools necessary to incorporate fundraising many not fruitful at all, we have Bill is a Certified Fund Rais- into the organizational strategic plan. To learn narrowed our efforts. Our focus ing Executive and a graduate more about Bill visit www.ITeachFundrais- today is twofold: 1) collaborat- of the Association of Fundrais- ing.com for more information about his edu- ing on projects that gather ideas ing Professionals (AFP) Exec- cational programs. and pilot data to successfully ap- utive Leadership Institute, the This workshop will be open to anyone ply for governmental and non governmental AFP Executive Management Institute, and at the ISNR conference and free of charge. agency research grants either as a coordi- the AFP Faculty Training Academy, and is the If you are interested in learning more about nating or administrating or advising agency, recipient of several important awards, includ- how you can help the RF achieve its long term and 2) raising significant funding from direct ing the 2005 Fundraising Executive of the goals this free workshop is for you. and deferred gifts from ISNR members and Year Award. Over the past ten years, Bill has friends of ISNR to develop grant awards and worked with numerous organizations includ- To help us all learn administration. ing Valley Lutheran Hospital, John C. Lincoln With significant funding there is a lot Hospital, Blood more about long- we can do to facilitate research. Our horizon Systems, Habitat for term fundraising for significant money raising is over decades, Humanity, Chandler not just years. To help us all learn more about Cultural Founda- the RF will sponsor long-term fundraising the RF will sponsor a tion, Goodwill In- workshop at our annual conference in Phoenix ternational, and the a workshop at our that will feature Bill J. Harrison, CFRE. Bill Community Anti- annual conference has 34 years of fundraising experience. For Drug Coalitions of seven years he was an instructor at the Arizona America. in Phoenix that State University Center for Nonprofit Leader- Bill’s interac- will feature Bill J. ship and Management. He’s the author of the tive workshops have award-winning textbook, Fundraising: The proven to be suc- Harrison, CFRE

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38 Thought Technology Ltd. For over 35 years we have pursued the dream of helping people help themselves through biofeedback and neurofeedback

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Thought Technology Ltd. For over 35 years we have pursued the dream of helping people help themselves through biofeedback and neurofeedback

t h a n k y o u f o r m a k i n g t h e d r e a m a r e a l i t y

Tell us your Favorite Thought Technology Thought Technology Ltd. Experience for a chance to WIN a ProComp2! Tel: 1-800-361-3651 • 514-489-8251 Fax: 514-489-8255 http://www.thoughttechnology.com http://on.fb.me/cAl16e MAR971-00