Three 1-hour lecture with discussion and questions:
The PAST: The history of epilepsy is as long as history itself, and this slowly-unveiling mystery, and the likewise-deligitimizing stigma, has inflicted much destruction, disability, disorder, and isolation, as well as unnecessary mortality, morbidity, and misunderstanding through the centuries.
The PRESENT: After a review of the history of epilepsy and the varied attempts at its understanding, diagnosis, and treatment, this presentation will overview diverse approaches behind many complex, sometimes-confusing, and not-infrequently injurious strategies for diagnosis and treatment of the ‘sacred disease’ of epilepsy.
The FUTURE: Given an understanding of neuro-scientific approaches which exist amidst multi-faceted socio-economic and cultural entities, and how these approaches influence scientific study and application, a slowly-emerging, yet comprehensive model integrating spirit-soul-body medicine (PPPN— Pneumo-Psycho-Physiological Neuroscience) is presented which offers a scientifically-validatable, mechanistically-testable, trans-cultural and trans-ethnic, whole-person medical approach to understanding, testing, and treating seizures, the spectrum of the epilepsies, and related disorders.
Learning Objectives:
Based on the content of this presentation, the participant will be able to:
1. Understand the history of epilepsy (ancient to present) and its importance to the current understanding of the disease.
2. Understand the most current tools for understanding and analysis of seizures and epilepsy.
3. Understand the importance of a comprehensive, health-based approach to working with persons with epilepsy, and what that approach may look like.
WS 3
Integrating Neuroscience Assessments to Inform and Maximize Clinical Outcomes in Neurofeedback
Anne Stevens PhD, Robert Coben PhD
Workshop Level: Intermediate
The field of neurofeedback is changing rapidly. The neurofeedback practitioner has a variety of approaches and modalities to consider when recommending a treatment course. With all of these options, however, the most critical piece in understanding how to proceed with treatment is through and integrated assessment. Clinical experience and research supports an integrated approach when considering treatment of neuropsychological disorders, such as developmental or acquired brain injuries and other psychological disorders. An integrated evaluation process has been found to be superior when compared to single (i.e. history of presenting symptoms) (Coben & Myers, 2010; Surmeli & Ertem, 2011) or dual approaches (i.e. presenting symptoms and QEEG findings), in both the breadth and depth of understanding clinical and neurophysiological processes and determining a best course of treatment.
Therefore, this type of approach amalgamates the presenting symptoms with the clinical understanding of those symptoms, the neuroscientific correlates and objective data from neurophysiological and neuropsychological assessment of those symptoms. Once applied, better diagnostic formulation is afforded, along with superiorly informed neurofeedback treatment strategies.
All assessment procedures have their inherent biases and strengths. For instance, we know that solely based on symptom reporting, diagnostic accuracy has been determined to be between 40–50% accurate in cases of ADHD (Sax & Kautz, 2003). Neuropsychological testing has been shown to be more sensitive to brain changes when compared to CT or MRI studies (De Jager, Hogervorst, Combrinck, & Budge, 2003).
This type of assessment allows the clinician to understand cognitive and or behavioral concerns compared to a normative database and compared to other cognitive and behavioral symptoms. Examining specific neurocognitive functions that are attributed to the case presentation, allows a value to
be placed on that skill based on a normative distribution. This allows for increased understanding of how symptoms are related to function and gives a value or severity for each function assessed. Finally, the QEEG has been determined to be a valuable part of the examination process. This allows the clinician to then get a physiological understanding underlying the presenting concerns adding exceptional value in understanding how the brain is functioning to contribute to the cognitive or psychological deficit or presenting concerns. Combining these different assessment strategies can thus, only serve to make a more accurate understanding of a case, and inform a superior treatment course. Then, as treatment progresses, this approach is re-applied to monitor progress and to inform further treatment recommendations.
The aim of this workshop is to demonstrate specific ways to assess the clinical case and how to integrate these specific assessment strategies in order to produce clear and deliberate treatment regimens. This workshop is designed for the intermediate and advanced professionals to further their clinical skills in these areas, while the more novice practitioner will find the theory of this approach to be important in developing their professional skills.
Learning Objectives:
1. The participant will better understand how to integrate complex information in a case conceptualization.
2. The learner will appreciate how QEEG information can be attended to in such cases.
3. Integrating such information will lead to better neurofeedback recommendations.
References:
Coben, R., & Myers, T.E. (2010). The relative efficacy of connectivity guided and symptom based EEG biofeedback for autistic disorders. Appl Psychophysiol Biofeedback, 35 (1), 13–23.
De Jager, C.A., Hogervorst, E., Combrinck, M., & Budge, M.M. (2003). Sensitivity and specificity of neuropsychological tests for mild cognitive impairment, vascular cognitive impairment and Alzheimer’s disease. Psychol Med, 33 (6), 1039–1050.
Sax, L., & Kautz, J. (2003). Who first suggests the diagnosis of Attention Deficit Hyperactivity Disorder? Ann Fam Med, 1 (3), 171–174.
Surmeli, T., & Ertem, A. (2011). Obsessive compulsive disorder and the efficacy of qEEG-guided neurofeedback treatment: A case series. Clin EEG Neurosci, 42 (3), 195–201.
