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qEEG AND Neurofeedback in mTBI -European Neuro Convention 2017

So called Mild Traumatic Brain Injury (mTBI) has been highlighted particularly in relation to head injuries as it is hard to quantify the severity of the injury and predict the likelihood of significant long term consequences. Whilst this has been in the news in relation to professional sport it is a significant clinical issue for the population at large. Diagnostic imaging has typically not proved reliable in identifying mTBI. We have known for a very long time that the EEG signal reflects the collective electrical activity of neurons firing in the brain even if the functional implications were not understood. Recent work with so called qEEG (Quantitative EEG) is showing promise as a way to correctly discriminate the brain injured person from ‘normals’. This presentation will look at some recent research in this area and the approaches to signal processing that make this area promising.

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qEEG AND Neurofeedback in mTBI -European Neuro Convention 2017

  1. 1. qEEG and Neurofeedback in Mild Traumatic Brain Injury Derek Jones PhD MBA Anatomical Concepts (UK) Ltd Fixxl Ltd
  2. 2. Can we distinguish brain injured from ‘normals’ based on their qEEG? Can we use neurofeedback to improve function? mTBI
  3. 3. … Not Just About Sport … •Initial damage may seem minimal .. but … •Chronic effects in the longer term •Significant cognitive, sensory and psychiatric dysfunction
  4. 4. EEG Bioelectric potential recorded at the surface of the head using electrodes and instrumentation. Arising from the brain cells in the cerebral cortex epiphenomenon
  5. 5. EEG Signal Acquisition •80 year + Experience •Good hardware •Care needs to be taken
  6. 6. qEEG = Quantitative Electroencephalography •Frequency domain representation •Normative databases •Coherence
  7. 7. Data Acquisition • Microvolt level signals • Sensitive to error & protocols • Standardised electrode positions
  8. 8. moment-to-moment brain function is directly linked to EEG oscillations. Trauma should be reflected in the EEG pattern but needs to be quantified - you can’t do this subjectively
  9. 9. Frequency Spectrum Representing the EEG as consisting of several “classical” frequency bands Delta - 0 to 4 Hz Theta - 4 to 7 Hz Alpha - 8 to 13 Hz Beta1 - 15 to 21 Hz Beta2 - 21 to 30 Hz Gamma - 30 to 100 Hz SMR 12-15 Hz
  10. 10. Frequency Domain
  11. 11. Classify.. Group A Group C Group B “mTBI” “normal”
  12. 12. Coherence • Coherence (correlation) between regions tends to be high due to high level of connectedness • Connectivity reflects the amount of processing that the brain is devoting to particular activities • Could look at magnitude and phase of FFT
  13. 13. Human Connectome Mapping Structure and Function A wiring diagram of the brain
  14. 14. Normative Database individual
  15. 15. Identify mTBI Kirtley Thornton 
 “A QEEG activation methodology that obtained 100% accuracy in the discrimination of traumatic brain injured from normal and does the learning disabled show the brain injury pattern?”.
 Neuroregulation, Vol. 1(3-4):209-218, 2014
  16. 16. 10-20
  17. 17. Neurofeedback • Signals from the brain are “revealed” to the trainee • Brain processes new information and learns • Allows conditioning and signage to occur • System needs to be intuitive and relatively simple • There is engagement - but not “trying” • EEG changes may occur but what matters is clinical outcomes
  18. 18. Conceptual view of Neurofeedback EEG Brain Events Behaviour Thought Externalised Internalised Perceived as Thoughts Perceived as Behaviour Perceived as Neurofeedback
  19. 19. Derek Jones PhD MBA Anatomical Concepts (UK) Ltd Fixxl Ltd