Transcript Quantitative Electroencephalogram (qEEG) - Respen-A

Improvement of Symptoms Following
Administration of Respen-A to a
14-Year-Old Boy with Autism
Significant Changes
Demonstrated Using
State-Of-The-Art Brain
Imaging Techniques
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Fred S. Starr, M.D., BCIA-EEG
[email protected]
Quantitative Electroencephalogram
(qEEG)
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qEEG is a technique that
allows a detailed two and three
dimensional electrical picture of a
subject’s brain to be generated
with the help of a sophisticated
statistical computer program.
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Fred S. Starr, M.D., BCIA-EEG
[email protected]
qEEG
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The enormous scientific body of clinical literature is, by itself, a
testament to the high degree of reliability and validity of QEEG as well
as evidence of the general acceptance of QEEG as a reliable,
sensitive and clinically valuable measure.
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There is an extensive body of peer reviewed literature quantifying the
superior reliability (i.e., reproducibility or the ability to repeat a
measurement), validity and specificity of QEEG.
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To date, there have been over 1400 peer-reviewed scientific articles
using qEEG as a clinical research tool.
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There are an estimated 16,000 qEEG practitioners in the US alone.
Fred S. Starr, M.D., BCIA-EEG
[email protected]
Professional Organizations acceptance
of qEEG
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The American Medical EEG Association (AMEEGA) endorses
QEEG as reliable
The EEG and Clinical Neuroscience Society (ECNS) endorses
QEEG as reliable
The American Psychological Association endorses QEEG as
reliable.
The International Society for Neuronal Regulation (ISNR)
endorses QEEG as reliable.
The Association for Applied Psychophysiology and Biofeedback
(AAPB) endorses the QEEG as reliable.
The International Society for Brain Electromagnetic
Tomography (ISBET) endorses QEEG as reliable.
Fred S. Starr, M.D., BCIA-EEG
[email protected]
qEEG Validity
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qEEG has been found to meet the Frye Standards of
admissibility in several federal and state court cases.
In Steif vs. Greyhound Lines, (United States District
Court, Southern District of New York docket # 08 cv
2892 February 10th, 2009), based on professional
testimony, The Hon. Judge Naomi Buckwald ruled,
without a formal hearing, that the qEEG is a
scientifically valid instrument on par with MRI, PET
and CT scans.
Fred S. Starr, M.D., BCIA-EEG
[email protected]
qEEG and Autism
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The qEEG of Autistic Patients has a specific
morphology.
EEG studies of Autism typically show a “U,”
shaped function of power vs. frequency.
Elevated power is seen at low (delta/theta)
and high frequencies (beta/ gamma).
Reduced power is seen in alpha frequency
bands.
(Developmental Neuropsychology, Thatcher et al. June 25, 2009)
Fred S. Starr, M.D., BCIA-EEG
[email protected]
Reading the qEEG
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There are two different types of scans; a two-dimensional scan, and a threedimensional scan (LORETA).
The two dimensional scan is based on surface electrical patterns. The
conventional digital EEG recording is computed as a Fast-Fourier Transform of
power vs frequency.
The FFT function is then compared to an FDA approved Z-Score database that
uses a univariate Gaussian Distribution to compare the subject's electrical
patterns to an age and gender matched group who have been evaluated and
found to be free from psychiatric and neurological disorders.
The maps show the pattern of the sensors that were placed on the head during
the recording, with the top of the map representing the front of the head. Green
indicates areas that match the database. These green areas are considered to
be functioning normally.
Areas of orange and yellow indicate an over abundance of a specific
brainwave, or frequency.
Areas of blue indicate low amounts of a specific brainwave.
Fred S. Starr, M.D., BCIA-EEG
[email protected]
Autistic Patient 1
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The next slide shows the Fast-Fourier
Transform (FFT) of Patient 1 before and after
administration of Respen-A.
The first slide clearly demonstrates the “U,”
shaped power/frequency curve.
The second slide shows a statistically
significant change and normalizing of the “U,”
curve.
Fred S. Starr, M.D., BCIA-EEG
[email protected]
Fred S. Starr, M.D., BCIA-EEG
[email protected]
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Two Dimensional Map
Pre-Post Respen-A
Autistic Subject
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These “cartoon,”
brainmaps are a
representation of the
previous slide.
You are looking down at
the top of the head, with
the nose pointing up.
Green means there is no
significant deviation from
the normal database.
Red means that the brain
activity over that region is
too high, Blue means it is
too low.
Pre-Respen-A is on top,
post Respen-A is on the
bottom.
Fred S. Starr, M.D., BCIA-EEG
[email protected]
Pre-Post Respen-A Administration
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Fred S. Starr, M.D., BCIA-EEG
[email protected]
Loreta Time Domain Analysis
(Low Resolution Brain Electromagnetic
Tomography)
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The following 2 slides use a powerful technique for
3-dimensional brain imaging called Loreta (The KEY
Institute for Brain-Mind Research).
Using the Loreta method, a difference of 8.5
standard deviations is found when comparing the pre
and post Respen-A digital EEGs using a Paired tTest, and Pearson’s Correlation Coefficient.
The possibility of this change due to change alone is
greater then 0.000000002560%
1. Pascual-Marqui RD, International Journal of Psychophysiology 1994, 18:49-65.
2. Pascual-Marqui RD. Review of Methods for Solving the EEG Inverse Problem. International
Journal of Bioelectromagnetism 1999, 1:75-86.
3. Pascual-Marqui RD, Psychiatry Research-Neuroimaging 1999, 90:169-179.
4. Frei E, Human Brain Mapping 2001, 14: 152-165.
Fred S. Starr, M.D., BCIA-EEG
[email protected]
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Fred S. Starr, M.D., BCIA-EEG
[email protected]
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Fred S. Starr, M.D., BCIA-EEG
[email protected]
Conclusion
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There is a specific EEG morphology associated with Autism.
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Respen-A administered to autistic patients with this
characteristic EEG morphology leads to significant alterations
in the EEG, resulting in major changes in the underlying
neuronal activity and are far greater then can be explained by
chance alone.
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The resultant shifts in brain activity that occur when Respen-A
is administered to autistic patients approach a more normal
functioning brain and are associated with an improvement in
the core symptoms of autism.
Fred S. Starr, M.D., BCIA-EEG
[email protected]