Society for Applied Neuroscience May 5, 2011 – Thessaloniki, Greece

Validation of a global live z-score protocol:

mechanism, within-subject results, and a randomized controlled study

Society for Applied Neuroscience May 5, 2011 – Thessaloniki, Greece

Thomas F. Collura, Ph.D., QEEG-D

BrainMaster TechnologiesThe Brain Enrichment Center

Bedford, Ohio(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown

University

Acknowledgement

Elena Festa, Ph.D. William Heindel, Ph.D. Department of Cognitive, Linguistic,

and Psychological Sciences Brown University, Providence, Rhode

Island Alzheimer’s Association, USA

(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown

University

Validation Principles

Controlled Conditions Record physiological & behavioral

variables Demonstrate physiological change Demonstrate behavioral change Confirm principles of operation


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Validation Specifics

Metric based upon QEEG parameters Live feedback of derived

computations Operant learning of brain Demonstrable expected EEG changes Demonstrable clinical / behavioral

changes(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown

University

Live Z-Score Principles

Normalization of QEEG-based parameters

Resulting change in brain function “Normal” reference database Anatomy, Physiology, Logic Activation AND Connectivity changes “First Order” Changes – “expected” Secondary / Compensating Changes


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Possible Changes – “Phenotypes”

Normalize aberrant process Focal or Global abnormalities Depression , Anxiety, Attention

Normalize coping/compensating mech. Denial, Masking, Hyperconnection

(injury) PTST, chronic pain, chronic anxiety

Normalize “Peak performance” mechanism “High” SMR, “Fast” Alpha Hypercoherence, Hypocoherence


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Validation Stages

Single subject – Within Session Single subject – Across Sessions Across subjects – Within Session Across subjects – Across Sessions Physiological AND Behavioral

observations


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Single Subject - Within Session

Individual Z-Scores


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Single Subject – Within Session

Aggregate (All) Z-Scores


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Subjective Change

“More aware of my pain” (Chronic Pain) Normalization of abnormal alpha Removal of coping mechanism


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Single Subject – Across Sessions(Guan)


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Clinical Changes - Guan

Reduction of Anxiety Reduction of Depression Improved ability to study Improved ability to return to work


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Single Subject – Across Sessions(Lambos)


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Clinical Changes - Lambos

ADHD / Defiant / Violent Reduction in violent outbursts Improved ability to pay attention Increased compassion with others Ability to transfer to regular class


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Controlled Study

Aging Population Normal and Mild Alzheimer’s N=79 Real NF: 4-channels: Cz C4 P3 P4 Percent Z Scores (PZOK): 248 Z-

Scores Cognitive / Behavioral Measures


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NFT Study in AD and Aging

Train posterior sites to: enhance cortical processing within posterior systems relieve burden of anterior systems to moderate

deteriorated posterior system

Investigate the short-term effects of NFT on neurocognitive measures of attention and sensory integration in healthy elderly and patients with early stage AD

Compare performance of true-NFT vs. mock-NFT subjects


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Experimental Design

Healthy elderly and AD patients assigned to either mock or true-NFT group Each mock-NFT subject demographically matched to a

true-NFT subject

8 NFT sessions 1-2 sessions/week over 4-6 weeks

Assessment battery pre & post NFT Within 2 weeks of NFT sessions


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Healthy Elderly Participants

GROUP N (m,f) AGE ED MMSE RBANS

NFT 20 (5,15)

71.6(8.1)

16.0(3.3

)

28.8(1.1)

108.2(12.2)

Mock NFT

19 (3,16)

72.2(8.3)

16.0(2.6

)

28.8(1.2)

108.5(13.1)

MMSE: Mini-Mental State ExaminationRBANS: Repeatable Battery for the Assessment of Neuropsychological Status


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Mild AD Participants

GROUP N (m,f) AGE ED MMSE RBANS

NFT 18 (8,10)

78.0(5.0)

14.0(3.1

)

24.4(1.1)

74.7(13.1)

Mock NFT 12 (6,6)

77.5(6.4)

14.0(2.6

)

25.4(1.2)

79.3(9.7)

MMSE: Mini-Mental State ExaminationRBANS: Repeatable Battery for the Assessment of Neuropsychological Status


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NFT sessions Electrode sites: C3, C4, P3, P4 10 min. % z-score ok training 5 min. baseline (eyes closed) pre & post

Brainwave activity recorded with Atlantis I (4+4) system (BrainMaster Technologies, Inc.)

Real-time z-score neurofeedback training provided by using the Z score DLL (Applied Neuroscience, Inc.) in conjunction with Brainmaster 3.21 software (BrainMaster Technologies, Inc.)

Methods


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Training Regimen Sessions 1-4

75% of z-scores within 1 STD of normative range Sessions 5-8

80% of z-scores within 1 STD of normative range

Audiovisual feedback provided through continuous modulation of the picture contrast of an IMAX nature movie and organ tones when reward criterion sustained for 500 ms

Mock-NFT subjects received feedback in each NFT session based on the recorded brainwave activity across each NFT session of the matched true-NFT subjects

Methods


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Assessment Battery

Several standardized neuropsychological tests of cognitive functions and emotional well-being (RBANS, CAD, GDS)

Resting brainwave activity 64-channel EEG recording (eyes closed)

Behavioral and EEG measures of neurocognitive tests assessing specific component attentional processes

Methods


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Neurocognitive Measures

Alerting, Orienting, & Executive Control Spatial Orienting/Simon Interference

task

Selective Attention & Sensory Integration Visual Search task


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Visual Search:Selective Attention and Sensory

IntegrationSet Size 1 Set Size 3 Set Size 5


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Visual Search and Sensory Integration:Healthy Elderly


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Visual Search and Sensory Integration:Mild AD


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Results: Visual Search

Healthy Elderly Real NFT decreased RTs for both sensory binding

conditions

Mock NFT had no effect on RTs for either binding conditions

Mild AD Real NFT had no effect on RTs for either binding

conditions

Mock NFT had no effect on RTs for either binding conditions


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Simon Interference

Congruent

Covert Orienting/Simon Interference

LEFT

LEFT Incongruent


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Orienting

Alerting

Double

Invalid

LEFT

LEFT

LEFT

Valid

No Cue

LEFT


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Effects of NFT on Simon Interference

Healthy Elderly Mild AD


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Results: Simon Interference

Healthy Elderly Real NFT had no effect on RTs for either Congruent or

Incongruent trials

Mock NFT increased RTs for both Congruent and Incongruent trials

Mild AD Real NFT had no significant effect on RTs for either

Congruent or Incongruent trials

Mock NFT had no significant effect on RTs for either Congruent or Incongruent trials


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Effects of NFT on Spatial Orienting



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Results: Spatial Orienting

Healthy Elderly Real NFT reduced RTs for both Valid and Invalid Cue trials

Mock NFT increased RTs for both Valid and Invalid Cue trials

Mild AD Real NFT selectively reduced RTs for Invalid Cue trials

Mock NFT had no effect on RTs for either Valid or Invalid Cue trials


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Effects of NFT on Alerting



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Results: Alerting

Healthy Elderly Real NFT had no effect on RTs for either Double or No

Cue trials

Mock NFT selectively increased RTs for No Cue Cue trials

Mild AD Real NFT reduced RTs for both Double and No Cue Trials

Mock NFT increased RTs for both Double and No Cue Trials


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Summary: Real NFT Healthy Elderly

No effect on cross-cortical sensory integration, but enhanced selective attention in the visual search task

Generalized enhancement of response times in spatial orienting

No effect on either alerting measures or response inhibition in Simon interference

Mild AD No effect on either cross-cortical sensory integration or

selective attention measures in the visual search task

Selective improvement in disengagement in spatial orienting

Enhanced phasic and tonic alerting No effect on response inhibition in Simon interference(C) 2011 Thomas F. Collura,

Ph.D. &/or E. Festa, Brown University

Summary: Mock NFT Healthy Elderly

No effect on cross-cortical sensory integration or selective attention in the visual search task

Generalized slowing of response times for spatial orienting, alerting and Simon interference measures

Mild AD No effect on cross-cortical sensory integration or

selective attention in the visual search task

No effect on response times for spatial orienting or Simon interference measures

Generalized slowing of response times for the alerting measures


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Non-Memory Impairments in AD Attention

Cognitive operations involved in the detection and selection of sensory information

Automatic (stimulus-driven) Voluntary (controlled, goal-directed)

Different attentional processes mediated by distinct neural subsystems

Sensory Integration The “Binding Problem”

Moment-by-moment ability to combine distinct sensory inputs related to a single object into a coherent, unified representation

Dependent upon effective interactions across cortical areas (C) 2011 Thomas F. Collura,

Ph.D. &/or E. Festa, Brown University

Non-Memory Impairments in AD (and Aging)

Posterior Cortical Processing Systems Alerting (cortical tonus) Orienting Sensory Integration

Inefficient cortical processing in Aging Corticocortical disconnectivity in AD

Anterior Executive Control Processes Changes in frontal cortex with age and AD results in less

efficient controlled attentional processes Greater demands placed on anterior executive processes

to moderate deterioration in posterior attentional and sensory systems


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Documents

Society for Applied Neuroscience May 5, 2011 – Thessaloniki, Greece