No abstract

QEEG-electrical neuroimaging has been underutilized in general neurology practice for uncertain reasons. Recent advances in computer technology have made this electrophysiological testing relatively inexpensive. Therefore, this study was conducted to evaluate the clinical usefulness of QEEG/electrical neuroimaging in neurological practice. Over the period of approximately 6 months, 100 consecutive QEEG recordings were analyzed for potential clinical benefits. The patients who completed QEEG were divided into 5 groups based on their initial clinical presentation. The main groups included patients with seizures, headaches, post-concussion syndrome, cognitive problems, and behavioral dysfunctions. Subsequently, cases were reviewed and a decision was made as to whether QEEG analysis contributed to the diagnosis and/or furthered patient's treatment. Selected and representative cases from each group are presented in more detail, including electrical neuroimaging with additional low-resolution electromagnetic tomography analysis or using computerized cognitive testing. Statistical analysis showed that QEEG analysis contributed to 95% of neurological cases, which indicates great potential for wider application of this modality in general neurology. Many patients also began neurotherapy, depending on the patient's desire to be involved in this treatment modality.

A 23-year-old man presented for a neurological evaluation due to cognitive problems restricting him from college education. He graduated successfully from high school but had problems in college, which caused his subsequent withdrawal. He was interested in trying neurofeedback (NFB) for possible cognitive enhancement. His initial computerized neurocognitive testing showed global cognitive standard score (GCS) of 93.1. The information processing speed standard score was 64.5 and was the lowest of scored domains. Quantitative electroencephalography revealed right frontal and temporal increase in delta power and left frontal and temporal beta power excess. Fifteen sessions of 19-electrode Z-score NFB lead to marked improvement of the patient's subjective cognitive perception as well as GCS on computerized neurocognitive testing. His post-NFB GCS was 104.1 and information-processing speed reached 85.2. Also a reduction of the right frontal and temporal delta power expression was achieved, as well as improvement in the left fronto-temporal beta power. This case report illustrates marked increase in cognitive performance achieved by Z-score 19-electrodes NFB training and justifies the initiation of larger studies to confirm these promising findings.

Attention deficit hyperactivity disorder (ADHD) is a disorder of relatively high prevalence and frequently contributes to poor school and work performance. Neurofeedback (NFB) has proven to be an effective therapeutic modality in the treatment of ADHD. Recently introduced z-score LORETA neurofeedback offers promise as a tool, and appears to provide a more efficient therapy than standard two-channel neurofeedback. This advantage is based on the ability to train 19 channels simultaneously, and the ability to directly target an electrically dysregulated area of the brain, which may be more difficult to access with standard neurofeedback therapy (areas addressed with LORETA neurofeedback include the cingulate gyrus and hippocampal structures). This paper presents our experience with Z-score LORETA neurofeedback in the treatment of ADHD.