society for applied neuroscience may 5, 2011 – thessaloniki, greece
DESCRIPTION
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 Technologies The Brain Enrichment Center - PowerPoint PPT PresentationTRANSCRIPT
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Validation Stages
Single subject – Within Session Single subject – Across Sessions Across subjects – Within Session Across subjects – Across Sessions Physiological AND Behavioral
observations
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Single Subject - Within Session
Individual Z-Scores
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Single Subject – Within Session
Aggregate (All) Z-Scores
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Subjective Change
“More aware of my pain” (Chronic Pain) Normalization of abnormal alpha Removal of coping mechanism
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Single Subject – Across Sessions(Guan)
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Clinical Changes - Guan
Reduction of Anxiety Reduction of Depression Improved ability to study Improved ability to return to work
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Single Subject – Across Sessions(Lambos)
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Neurocognitive Measures
Alerting, Orienting, & Executive Control Spatial Orienting/Simon Interference
task
Selective Attention & Sensory Integration Visual Search task
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Visual Search:Selective Attention and Sensory
IntegrationSet Size 1 Set Size 3 Set Size 5
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Visual Search and Sensory Integration:Healthy Elderly
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Visual Search and Sensory Integration:Mild AD
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Simon Interference
Congruent
Covert Orienting/Simon Interference
LEFT
LEFT Incongruent
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Orienting
Alerting
Double
Invalid
LEFT
LEFT
LEFT
Valid
No Cue
LEFT
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Effects of NFT on Simon Interference
Healthy Elderly Mild AD
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Effects of NFT on Spatial Orienting
Healthy Elderly Mild AD
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
Effects of NFT on Alerting
Healthy Elderly Mild AD
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University
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
(C) 2011 Thomas F. Collura, Ph.D. &/or E. Festa, Brown
University