EEG Neurofeedback & Quantitative Electroencephalogram (qEEG)

A Comparative Case Study of a SMTC Resident

Client Background History:Caucasian male; age twelve at the onset of

treatment.Experienced parental neglect and abuse from

birth to age six.Placed in numerous foster homes since age

six.

Presenting Symptoms:Suicidal verbalizations and behaviorsSevere impulsivity and explosive angerSevere defiant, disruptive, or destructive behaviorDangerous, self-injurious, or unsafe behaviorsSevere deterioration of functioningSerious lack of development of age appropriate

functioningSerious depressive symptomsAggressiveness or assaultivenessRecurrent thoughts, impulses, or imagesIrritable or labile moodEnuresis

Admitting Diagnoses:Posttraumatic Stress DisorderAttention-Deficit/Hyperactivity Disorder Oppositional Defiant Disorder History of Reactive Attachment DisorderRule-Out: Mood DisorderRule-Out: Learning Disorder Rule-Out: Intermittent Explosive Disorder Rule-Out: Complex-Partial Seizure Disorder Suspected History of Child Physical and Sexual

AbuseSuspected Fetal Drug and Alcohol Exposure

Treatment History: Multiple inpatient admissions to North Star

Behavioral Health System between May and August 2013, with a brief period spent at Palmer Residential Treatment Center in the beginning of August 2013.

Transferred to San Marcos Treatment Center on October 1, 2013.

Has also been receiving outpatient counseling services from a local counselor for approximately three years

Neuropsychological Evaluation Results: May 18, 2013

Within Normal Limits:Full Scale IQ (SS=90)

Verbal Comprehension (SS=88)

Perceptual Reasoning (SS=94)

Working Memory (SS=94)

Processing Speed (SS=97)

Visual Spatial ProcessingSocial PerceptionLanguage SkillsSensory Motor Integration

Below Normal Limits:Sustained Attention and

ConcentrationExecutive Functioning

(patterns, sequences, cause & effect relationships)

Memory/Learning

Quantitative Electroencephalogram (qEEG)

The qEEG is a painless and non-invasive procedure which begins with data collection. The scalp is prepared and measurements are calculated.

Quantitative Electroencephalogram (qEEG)

A stretchable elastic electrode cap is slipped onto the head, and the recording electrodes filled with a water soluble contact gel.

Quantitative Electroencephalogram (qEEG)

Brain waves are then recorded onto the computer while the client relaxes with eyes closed and with eyes open.

EEG Spectral Analysis: Pristine Pattern

Brain Wave Frequencies:

Brodmann Areas of the Brain:

qEEG Recommended Protocols:Suppress

frequency activity 8 - 10 Hz at O2.

Suppress frequency activity 9 - 10 Hz at F3.

Reinforce EEG coherence at 8 – 12 and/or 15 - 18 Hz between FP2 and F8.

Completed Treatment Protocols:

From October 2014 to May 2015:SMR 12-15 Hz @ C4 (27 sessions)Suppress 8-10 Hz @ O2 (14 sessions)Suppress 9-10 Hz @ F3 (14 sessions)Suppress 15-18 Hz @ FP2 (12 sessions)Suppress 8-12 Hz @ FP2 (10 sessions)Suppress 15-18 Hz @ F8 (12 sessions)Suppress 8-12 Hz @ F8 (10 sessions)

Absolute Power (Linked Ears):February 4, 2014 May 19, 2015

Absolute Power (Linked Ears):February 4, 2014 May 19, 2015

Absolute Power (Laplacian):February 4, 2014 May 19, 2015

Absolute Power (Laplacian):February 4, 2014 May 19, 2015

Amplitude Asymmetry:February 4, 2014 May 19, 2015

Coherence:February 4, 2014 May 19, 2015

Phase Lag:February 4, 2014 May 19, 2015

Predicted Neuropsychological Scores:February 4, 2014 May 19, 2015

Conclusions: Discharged from SMTC in June 2015His caseworker reported that he has shown

significant improvement in many emotional and behavioral domains

He continues to exhibit occasional issues with:Hyperactivity ImpulsivityLack of development of age-appropriate

functioningEnuresis

Conclusions: Adopted by a family in AlaskaEnrolled in regular public school. School is

no longer perceived as a trigger for behavioral issues

Predicted IQ scores from the qEEG suggest an IQ increase near one standard deviation compared to his May 2013 neuropsychological evaluation.