Presented by Rex Cannon, Nanja Schorel, and Rianne Schorel: Persistent symptoms after mild traumatic brain injury (mTBI) are often debilitating to the individual. This post-concussion syndrome (PCS) can impact social, emotional and functional domains thereby increasing financial and resource burdens on healthcare systems and individuals. Debate continues concerning the etiology of PCS and how to best diagnose and treat the symptoms that can persist for months to years after the initial injury (D’Souza M et al., 2015; Datta, Pillai, Rao, Kovoor, & Chandramouli, 2009; Duff, 2004; Iverson, 2019; Kennedy, Quinn, Tumilty, & Chapple, 2017; Kenzie et al., 2018; Khong, Odenwald, Hashim, & Cusimano, 2016). Recent data have explored cortisol in relation to mTBI and continued symptoms, with notable differences in these populations. Methods: This study examines data for 17 clients (5 male), mean age 34.88, SD 11.07 with a diagnosis of PCS according to ICD-10 criteria (World Health Organization, 1992) that completed a holistic program with neurofeedback as a primary intervention. LORETA z-score training was conducted twice per day for 10 days in conjunction with other program components (Cannon et al., 2007; Cannon et al., 2014; Thatcher, 2000; Thatcher et al., 2001). Program measures for outcomes were morning cortisol levels, the Dutch version of brief symptom inventory (BSI) and LORETA electrical neuroimaging. We utilized paired comparisons to contrast data across three time points. Nonparametric statistical analyses of functional LORETA images were performed for each contrast using voxel-wise randomization for within subject contrasts (paired t-tests) with a threshold P < 0.05. Results: For this group of clients there was a decrease in morning cortisol levels at 10-days post training and at 30-day follow-up. Clinical scales on the BSI showed significant decreases at both 10 day and 30 day follow up measures. LORETA contrasts showed significant changes in Brodmann Areas (BA) 9, 36, 47, 19 and 6. Cortical-cortisol associations showed significant elevations in delta at BA 9 pre-training. While at post and follow-up there appears to be a more diffuse integration of cortico-cortisol relations. Conclusions: Holistic approaches with neurofeedback may offer the potential to aid individuals in reducing symptoms and improving functional domains, as well as improving approach related behaviors and executive functions as associated with frontal lobes. Larger sample size and randomized controlled trials are goals for future research as well as developing standard procedures for discovery of bio/psychometric combinations to aid in differentiating PCS from other syndromes.
2020: Exploratory Study of LORETA Z-Scored Neurofeedback and Homeostatic Learning (Plenary)
Presented by Rex Cannon, Nanja Schorel, and Rianne Schorel: Persistent symptoms after mild traumatic brain injury (mTBI) are often debilitating to the individual. This post-concussion syndrome (PCS) can impact social, emotional and functional domains thereby increasing financial and resource burdens on healthcare systems and individuals. Debate continues concerning the etiology of PCS and how to best diagnose and treat the symptoms that can persist for months to years after the initial injury (D’Souza M et al., 2015; Datta, Pillai, Rao, Kovoor, & Chandramouli, 2009; Duff, 2004; Iverson, 2019; Kennedy, Quinn, Tumilty, & Chapple, 2017; Kenzie et al., 2018; Khong, Odenwald, Hashim, & Cusimano, 2016). Recent data have explored cortisol in relation to mTBI and continued symptoms, with notable differences in these populations. Methods: This study examines data for 17 clients (5 male), mean age 34.88, SD 11.07 with a diagnosis of PCS according to ICD-10 criteria (World Health Organization, 1992) that completed a holistic program with neurofeedback as a primary intervention. LORETA z-score training was conducted twice per day for 10 days in conjunction with other program components (Cannon et al., 2007; Cannon et al., 2014; Thatcher, 2000; Thatcher et al., 2001). Program measures for outcomes were morning cortisol levels, the Dutch version of brief symptom inventory (BSI) and LORETA electrical neuroimaging. We utilized paired comparisons to contrast data across three time points. Nonparametric statistical analyses of functional LORETA images were performed for each contrast using voxel-wise randomization for within subject contrasts (paired t-tests) with a threshold P < 0.05. Results: For this group of clients there was a decrease in morning cortisol levels at 10-days post training and at 30-day follow-up. Clinical scales on the BSI showed significant decreases at both 10 day and 30 day follow up measures. LORETA contrasts showed significant changes in Brodmann Areas (BA) 9, 36, 47, 19 and 6. Cortical-cortisol associations showed significant elevations in delta at BA 9 pre-training. While at post and follow-up there appears to be a more diffuse integration of cortico-cortisol relations. Conclusions: Holistic approaches with neurofeedback may offer the potential to aid individuals in reducing symptoms and improving functional domains, as well as improving approach related behaviors and executive functions as associated with frontal lobes. Larger sample size and randomized controlled trials are goals for future research as well as developing standard procedures for discovery of bio/psychometric combinations to aid in differentiating PCS from other syndromes.
$30.00
