Not shown in this view is the blue to purple right subgenual orbital-frontal lobe. As Drevets (Drevets et al 1999), showed, this area, when below normal, is common to bipolar disorder and depression (Ito et al. 1996). The right orbital-frontal area, a gateway between cortex and the limbic system, seems to provide cortical control of emotion. Such control is lacking in bipolar disorder. In this emotional vein we have yet to see a bipolar patient who has a good relationship with her mother.
This study (Fig 4) was completed after 23 HEG sessions, 7/21/2000. As of this writing this patient, previously a rapid cycler, has not experienced a manic episode. At the time of this SPECT study she was depressed. That this is to be expected is shown by the below normal blue area in her left frontal cortex.
At present she is coping competently with her mother's newly diagnosed metastasized breast cancer. She is a nurse and is too busy to feel depressed. This is interesting since she has never before been able to live peacefully with her mother.
Literature study examines brain areas involved in ADD/ADHD, Schizophrenia, and Autism.
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Fig. 5
The National Library of Medicine search turned up many imaging studies of Autism, Schizophrenia and ADD/
ADHD disorders (Andreason et al.). The citation frequency for hypoperfused brain modules is illustrated here.
It is clear that hypoperfused frontal cortex dominates the fi eld. Knowledge of the distribution of hypoperfused areas is useful in determining brain areas to be treated.
The dominance and importance of frontal hypoperfusion fi ts our experience in dealing with Depression (Drevets et al 1999), Toxic Encephalopathy (Heuser et al. 1994), Epilepsy and Schizophrenia (Andreason et al. 1997) as well. The importance of the frontal lobes cannot be over emphasized (Ito et al. 1996). These areas are particularly easy to reach from the forehead with the spectrophotometer headband.
Disorders with Abnormal Regional Blood flow:
- ADD Senile Dementia
- Aging Memory Loss Dyslexia
- Alzheimer's Disease Epilepsy
- Anorexia /Bulimia Lupus Erythematosus
- Aspberger's Migraine
- Autism Multiple Sclerosis
- Chronic Fatigue Schizophrenia
- Depression Toxic Encepathalopathy
Test of Variables of Attention. (T.O.V.A.) A computerized test that measures response time, consistency, inattention, and impulsivity.
The TOVA is useful in tracking patient recovery. Frontal cortex, the executive part of the brain is most often compromised in any brain disorder. The TOVA indicators, speed of response and stability of the prefrontal cortex, are a useful index of improvement of brain function following HEG neurotherapy. Many brain studies have validated the proposition that healthy brains respond to problem solving and other stimuli more rapidly than compromised brains. Thus working memory problems are suitably tracked with TOVA to determine the most appropriate dose for ADD/ADHD children.
Each study in the following graph used TOVA scores as a pre-post training measure. The graph shows the gains for all published studies with TOVA scores as the dependent variable
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Fig. 6
Treatment TOVA gains per session vs. initial TOVA scores for various treatments reported in the Neurofeedback literature. There are EEG, Audio-Visual Stimulation (AVS), and HEG studies presented. The number of sessions ranged from 10 to 40 in these studies.
The TOVA gains per session of these published studies (Kaiser 1997, Kaiser Othmer 1997, Thompson & Thompson 1998, Joyce & Siever 1997, Rossiter 1995 1996, Joyce, 1997) present some very counterintuitive information.
These results fall naturally into two groups:
1) Studies done by the most accomplished providers gained 0.52 TOVA points per session.
2) Studies done with home, school, or average providers cluster about 0.37 TOVA points per session.
2) Studies done with home, school, or average providers cluster about 0.37 TOVA points per session.
That the per session scores cluster so closely about either 0.52 or 0.37 is completely unexpected since the number of reported sessions ranged from 20 to 40 and each provider had a favorite set of parameters and procedures. It is also unexpected that the initial scores that measure the degree of dysfunction of the patients had no effect on the gains per session.
