neurofeedbacksa

"NORMAL" ROUTINE EEG's ARE NOT ALWAYS NORMAL

2011-12-01T16:11:00.005+02:00

“NORMAL” ROUTINE EEG’s ARE NOT ALWAYS NORMAL

EEG SEVERITY INDEX OF TRAUMATIC BRAIN INJURY

Robert Thatcher (Neuro-scientific research)

Routine EEG’s do not always show brain damage although we know that a person might have suffered brain injury after trauma. We refer for EEG investigations with high expectancy and often the EEG shows no abnormality.

The severity of traumatic brain injury in patients is normally judged by emergency hospital admission records, the Glasgow Coma Scale and duration of coma and amnesia. The accurate measuring of the GCS may be in doubt where as the present EEG severity index may facilitate accurate diagnosis of the extent of brain injury by providing an objective and independent measure of the severity of TBI.

There are often reports of headaches, fatigue, impaired memory, reduced concentration and attention, reduced information processing capacity, depression, aggression, anxiety, irritability, sleep disturbances, sexual dysfunction, posttraumatic personality changes, temper outbursts, self centered behaviour, emotional lability and reduced social awareness which are thought to be associated with frontal and temporal lobe damage. The presence thereof can be measured by psychometric assessment but the severity level of the brain damage is still unclear.

Although the Glasgow Coma Scale, the duration of loss of consciousness and duration of posttraumatic amnesia, are valuable clinical predictors of the severity of TBI, there are limitations. The GCS is often not measured in emergency rooms. The duration of loss of consciousness and posttraumatic amnesia is often only a prediction and not necessarily correct.

The routine EEG and MRI are also not sensitive enough to predict the severity level or difference between mild, moderate or severe level of TBI.

A study done by Dr Robert Thatcher had the purpose of developing an objective and quantitative metric of the severity of brain injury by using EEG obtained in the long term post-acute period from 15 days to 4 years post injury. For the purpose of this article, the method of study will not be discussed. (The Journal of Neuropsychiatry and Clinical Neurosciences 2001;13:77-87)

There were significant correlations between emergency admission measures, EEG discriminant scores and 7 neuropsychological tests: Wechsler Adult Individual Scale Revised, Boston Naming Test, Word Fluency Test, attention tests, Wisconsin Card Sorting Test, Wechsler Memory Scale revised and California Verbal Learning Test. (Robert Thatcher et al)

The results of Thatcher’s research indicate that TBI has a long lasting effect on cognitive functioning and that the Q EEG provides a measure of persistent neurological reorganization resulting from the injury.

Patients who present with persistent cognitive and neuro-phychological deficits many months after the injury, do not have access to accurate estimates of the severity of the TBI. The EEG severity index may facilitate accurate diagnoses of the extent of brain injury and provides an objective and independent measure of the severity of TBI. (The Journal of Neuropsychiatry: Patients included in the research: From the Bay Pines Veterans Affairs Medical Center, Bay Pines, Florida and Defense and Veterans Head Injury Program, Washington DC. By Dr R Thatcher).

The TBI Severity Index is an estimate of the neurological severity of injury and should be viewed as an adjunct to the evaluation of the patient. It does not serve as a primary basis for diagnosis.

How do we derive a TBI Severity Index?

STEP 1: Routine EEG

Routine EEG recordings are performed to measure brainwaves and the most prominent purpose of performing EEG’s is to diagnose epilepsy and brain damage. These recordings do not always offer enough information.

STEP 2: Quantitative EEG
The Q EEG can be compared to observing light through a prism. Detail is accentuated which cannot be seen with the naked eye on a routine EEG recording. The Q EEG provides information regarding brain functioning and cognition as compared to a normative or reference database (Thatcher Neuro-Guide). We get information from the Q EEG regarding absolute and relative power, ratio of different frequencies in the brain, coherence or connectivity of the brain, phase lag scores and asymmetry scores.

STEP 3: Derive discriminant scores by importing into NeuroGuide (Dr R Thatcher)

Discriminant scores were accomplished through mathematical procedures described by Thatcher et al.

So a “normal” EEG might be an abnormal Q EEG.

For more information:
Dr. Annemie Peché

0823356133 / 011 6756138 / 0164549302

COHERENCE: IS YOUR CHILD CONNECTED?

2010-08-22T14:35:00.003+02:00

IS YOUR CHILD’S BRAIN CONNECTED?

If our brains are not connected, we cannot function effectively.

What does that mean?

All brain activity is coordinated by neuronal networks. If there is a dysfunction or disruption of one or more neuronal circuits or there is some slowing in the timing of neuronal transmission, a person will have some trouble thinking, learning, remembering, understanding, integrating new information and coping with life.

A person may suffer from over connectivity in the brain or under (poor) connectivity. The following symptoms are indications of poor connectivity of certain brain areas:

• speech problems: leaving out words and phrases: in stead of “I will take the dog for a walk” a person would say “walk dog”; “defily” for “definitely”; battling to find the correct word to describe something;
• general word finding or “lost vocabulary” -“the word is on the tip of my tongue” but the person is unable to utter it. The person may understand a concept but is unable to verbalize thoughts or get a message across.
• What is the disconnection syndrome?
• Asperger and Autistic children can not imitate others because their mirror neurons are not connected.
• When connections in the brain are poor, learning becomes a problem.
• One may not be able to follow instructions through because the information gets lost on the way.
• Poor motivation and procrastination may be due to hypo coherence or poor connectivity.

When a person is over connected or suffers from hyper coherence one can present with the following symptoms:

• A person repeats his actions. Tourette syndrome is a good example – they will repeat a word and or a swearword uncontrollably.
• Obsessive compulsiveness (i.e repeated hand washing) is an example of hyper coherence or over connectivity of certain areas of the brain. They feel forced or driven to repeat actions or have repetitive thoughts.
• Stuttering is another example of hyper coherence. In other words the person is over connected and cannot control his actions.

Hyper or hypo coherence in other words, overly connected or poor connectivity may be found with:
• Traumatic Brain Injury
• The 5 learning disorders
• Stroke
• Autism
• Memory Impairment
• And various psychiatric disorders
• Memory impairment

Remediation
Neurotherapy is a tool utilized to remediate these problems and thereby normalizes brain functioning. Before neurotherapy can be utilized to remediate hyper (over connectedness) or hypo coherence (disconnection), a quantitative EEG (Q EEG) should be performed which shows how much of each frequency range the brain produces in different brain areas relative to a world wide norm. It also indicates hyper and hypo coherence. According to the Q EEG results a program is identified to train the brain to operate more effectively.

Dr Annemie Peché

SLEEPING DISTURBANCES

2009-11-10T17:39:00.000+02:00

Our brains and specific associative areas in the brain are responsible for cognitive, mental, emotional, social functioning in human beings as well as sleep.

There are 5 normal stages of sleep. Sleep is cyclic through the night beginning at stage 1-5 and REM sleep, before beginning the cycle again, each cycle, between 80-120 minutes.

In wakefulness with the eyes closed, alpha activity (a range of brain waves between 8-12 hz) dominates and is highest in the occipital areas or at the back of the head and with beta dominating over the frontal areas.
1. stage 1: alpha attenuates, becomes irregular and the slower rhythms start to dominate in the EEG. The person becomes very calm and even drowsy.
2. stage 2: this light sleep phase is characterized by sleep spindles or V shape waves over the back (posterior) regions of the brain. These waves are called theta (4-7 hz). The person becomes very drowsy.
3. stage 3: in this stage high amplitude delta waves begin to appear and the person falls asleep.
4. stage 4: more than half of the brain waves are in the delta range (1-2 hz) and the person is fast asleep.
5. REM: rapid eye movement phase in which the subject is usually dreaming and may recall the dreams on awakening.

There are about 200+ diagnosable sleep disturbances of which sleep apnea, narcolepsy, sleep onset problems, sleep maintenance problems and REM sleep disturbances are the most common.

Sleep disturbances are common with ADD (increase in theta activity). There are several reasons for suffering from sleep disturbance such as a reduction of oxygen flow during the day and night. The latter may be due to sleep apnea caused by closing of the airway and although it is less common with children, a family history of sleep apnea may precipitate sleep apnea even with children. Stress and tension, depression, situational circumstances such as problems at home, school and social life and an over aroused right brain may cause sleep onset and sleep maintenance problems. Teeth grinding, sleep walking and sleep talking as well as night mares and night terrors are some of the sleeping disturbances experienced.

A disturbed EEG pattern may also cause sleep disturbances which can be addressed by neurotherapy, through which the brain is trained to produce effective frequencies of brain waves.

THE HIGHLY SENSITIVE CHILD

2009-11-10T17:28:00.001+02:00

THE HIGHLY SENSITIVE CHILD

Highly sensitive individuals are people born with a tendency to notice more in their environment, who reflect deeply on everything before acting, who cried lots as newborns and suffered from cholics.

Although their ears, eyes, sense of smell and taste buds may not be better, their way of sensing their environment is more sensitive. Their brains seem to process information more thorough. They seem more affected by pain, medication and stimulants and their immune systems are more reactive and they are more prone to allergies, stomach aches, head aches and upset tummies. Food is normally too spicy and place smells weird. Their whole body is designed to detect what is happing in the outside world. Therefore they get overwhelmed by much more stimulation than their systems allow. They have to create a defense mechanism to protect them from over stimulation and often they are reactive in a less sociable tolerant manner. They won’t enjoy camps, partying and sometimes dating. They avoid being irritated or overwhelmed by resisting new situations and will throw a temper tantrum, have rages and melt downs to protect themselves to these situations.

Many well meaning parents cause tremendous pain not understanding these “difficult children” and treating them totally wrong, causing serious adverse reactions, which snow balls. With gentle and sensitive guidance they can be very cooperative.

As a result of their sensitivity they tend to be empathic, smart, intuitive, creative, careful and conscientious but on the down side they are easily overwhelmed by high volume or large quantities of input experiencing at once. They get over stimulated and are easily upset. Restaurants are too noisy and birthday parties are too busy. They would rather engage in chess, which requires deep cognitive engagement. They will ponder on social dilemmas; focus on “what would happen if..” ; imagining their cat’s thoughts.

They will notice when the bed sheets have been changed. They feel stronger and more intense emotions but they also suffer more when others suffer. They are bestowed with rich inner lives and are normally very conscientious for their age

About 15-20 % people are born highly sensitive and traditionally these people become scientist, counselors, theologians, historians, lawyers, teachers, artists and people in the healthcare profession.

Answer to the following statements to determine whether you or your child is highly sensitive:
Gets startled easily; complains about scratchy clothing (seams in socks or labels in T-shirts); does not enjoy big surprises; learns better from a gently correction than strong punishment; doing mind reading; use mature big/sophisticated words for their age; sensitive to the slightest uncommon odors; has a clever sense of humor; seems intuitive; battles with sleep onset after excitement; does not adjust easily to changes; needs to change wet or dirty clothes often; very inquisitive; tends to be perfectionistic; notices distress in others; prefers quite play; asks provoking and deep questions; sensitive to pain; irritated by noise; notices subtleties (notices changes in appearance or routine); cautious (won’t engage unless situation or safety is checked); feeling of uneasiness with strangers; experience deep routed feelings.
13 or more statements answered yes: probably highly sensitive
No psychometric test is accurate enough to guarantee this diagnosis, however even a few positive statements may assume highly probability of being highly sensitive.

WHAT CAUSES ADD?

2009-07-25T14:05:00.000+02:00

WHAT CAUSES ADD?

Theories have ranged from silly to scientific. Let’s look at a few popular theories:

The bad child

In 19120 Still published an article in the British medical journal Lancet and described children who exhibited symptoms of moral control, mischievousness and destructiveness. These children were born bad. The theory of genetic offer some credibility to this theory. Some children live with a genetic predisposition which is passed down. Regardless of genetics it is important to keep in mind that if the parent does not teach, the child will not learn. Parents cannot change the genetic code but good teaching can alter the behaviour.

The role of the family

Stability at home, predictability, an element of constancy, happiness in the home, marital stability, the parents’ attunement with the child are all important factors. When chaos in the family reaches a certain level, the child is likely to tune it out. They slow down the brain, so that it is less alert, less awake and less aware to environmental stress. The same pattern is followed when a child is yelled at constantly or when parents are verbally abusive. Slow frequency ranges are the essence of ADD. So slowing down the brain is very functional as a defense mechanism.

ADD does not exist

“There is nothing wrong with him, he just needs discipline.” The denial of a syndrome, which needs to be spanked out of a child, is not only offensive but ludicrous. In 1979 Schmitt was of the opinion in his book “The Minimal Brain Dysfunction Myth” was of the opinion that ADD is a fabrication by distressed parents, teachers and physicians.

Poor parenting

ADD kids come from various homes good and bad. Poor parenting can however cause ADD to be like a runaway train. Inadequate parenting may make things worse but good parenting can dramatically alter the course of the ADD child. Poor parenting may result in uncontrollable, disrespectful, undisciplined and neurotic children. The dysfunctional behaviour may be the result of the way the children interpret the world based on how it was presented by dysfunctional parents. There for poor parenting dramatically affect the outcome of ADD children in a negative way, but it is highly unlikely to be the cause of ADD.

Environmental influences

Due to zenobiotic toxins, synthetic substances and pollution in the environment a theory that ADD is caused by environmental factors developed and can not be ignored. It will take a long time to collect all data to get a new understanding of molecular biology, toxicology and human sensitivities and hopefully lead to deeper insight. We are just scratching the surface regarding the influence of sugar, food additives, dyes, preservatives, lead, dioxin, mercury etc and don’t exclude eating habits.

Genetics

Clinicians, teachers, the remedial fraternity and parents have experience of the theory of genetic transmission, which is supported by a number of twin studies by Goodman and Stevenson and Comings. The idea that ADD is agenetic disorder is well grounded in the scientific literature. Meeting with the parents of an ADD kid, it is often obvious were it is coming from and that the parents are undiagnosed.

Brain injury

Brain injury can be structural, when the brain is physically damage and shows up on MRI’s or, or functional where is does not show structural damage but a dysregulation of brain waves cause functional problems. The latter may be more prominent in ADD. When EEG or brainwaves are broken down I specific sites on the head, we see abnormal patterns in ADD patients. Slower frequencies vary from 0,5 to 7 hz and faster frequencies from 15-18 cycles per second. Functional injuries relate to the timing of the brain. Certain functions require production of brainwaves within certain bandwidths. If we go to sleep, the brain should produce slower frequencies. If we write exams we need to produce faster frequencies. A child who needs to concentrate in class will not succeed if he produces slower delta/theta frequencies. The structure of the brain may be good, but on functional level the person will not succeed in finishing the task if the brain is not alert. The term MBD or minimal brain dysfunction was changed to ADD to describe e the nature of the dysfunction.

Brain injury can occur from many different factors. Children suffering from ADD may not report major head injury but jolts, hits, bangs, whip lash could be sufficient to alter the rhythm of the brain. Toxins and nutritional deficiencies, anoxia or interruption of the flow of oxygen to the brain, encephalitis, severe infections, high fever or damage during pregnancy or birth complications may cause brain injury. Heavy metals result in brain injury.

The role of stress

People under stress tend to produce high ranges of beta activity. Although the higher beta ranges are important for vigilance, alertness, concentration and focus, the brain needs to go back to an idling mode to relax, which is the alpha range. Should the brain not adapt or its state flexibility does not bring about relaxation, the brain learns to be hyper vigilant, over sensitive and highly stressed. Children with ADD may zone out if stress or demands are too much and become lethargic and passive as a defense.

Genetic brain injury

Genetic brain injury is carried over from the one to another generation and may play a role in behaviour, personality and cognition.

The main reason for ADD is inefficient brain waves that are produced by the ADD child. One way of treating ADD is to alter the brain waves from too slow frequencies (delta, theta) which cause under arousal and poor concentration and focus as well as too high frequencies, causing tension and hyper activity to frequencies that will help with concentration and other cognitive functions such as sensory motor rhythm.

UNDERSTANDING MEMORY

2009-07-15T20:38:00.002+02:00

UNDERSTANDING MEMORY

A common misconception of what memory is is that the mind has the ability to make a photograph of experiences. In fact memory is more than what we consciously recall about events from the past. It is the way past events affect future functions.

The brain is composed of spider web neural networks that fires patterns, called a neural net profile. When the neurons in our brain make connections, they fire. If they fire repeatedly, these connections between the neurons strengthen and enhance the possibility of learning. So memory is the repetition of firing of certain neuronal networks. In other words, experience shapes the brain and learning is experience dependent.

The infant brain has an over abundance of neurons with few synaptic connections at birth. The brain learns from implicit memory, which is the first impressions a baby makes from the first day of his life and those remain available to us through out our lives. Implicit memory happens automatically. The baby does not say “oh yes, I remember that toy, it made a loud noise before”, when he has a fright as it happens again.

The brain constantly scans the environment and tries to determine what comes next. It distinguishes between familiar and new information which is the mind’s attempt to “remember’’ the future. When the next moment is anticipated, the brain is ready to handle the environment and helps us to plan for the future.

By the second birthday toddlers have developed a new skill. They talk about recollections of the day’s events. This kind of memory includes knowledge of their world. This development is experience dependent. This kind of memory is called explicit memory.

Working memory is what we are thinking of at a specific moment. Remembering the phone number of a shop you need to call once only, is an example of working memory. You hold on to those digits just long enough to dial the number. There is no rehearsal of the information. Unfortunately information for exam papers is stored as working memory and the information is held onto till after the exam only. There is a time limit to working memory. If working memory persists, you are bombarded with irrelevant information from the past.

How do items become part of long term memory? An example of long term memory is remembering a close friend’s phone number, which should be placed in long term storage. How does this happen? New associations link up with existing memory traces and form new clusters. The new clusters depend on REM sleep stage, which is an attempt to make sense of the day’s activities.

Information has to be encoded into long term explicit memory to last longer but may be affected by trauma. For example, if someone had been in an accident in January. He may retrieve information from October to December, but after that he can’t remember, which is called retrograde amnesia. Why? Retrograde amnesia is information which did not have a chance to be integrated and encoded into the long term explicit memory. The patient involved in the accident will be able to remember old info that had been encoded before the accident.

Remembering and forgetting: Forgetting is an essential aspect of explicit memory. If we remember everything we encoded, our working memory would be flooded and normal functioning will become impaired.

Emotions also play a role in memory. Information with a moderate or high degree of emotional intensity is labeled as important and has a greater chance to be remembered but when we are overwhelmed by emotions and terror, we inhibit because we feel bombarded and confused. If the degree of emotional intensity is too high, we rather forget traumatic information.

Sleep plays an important role in memory. The brain sometimes tries to recollect blocked memory during REM sleep and therefore we have nightmares in order to reorganize traumatic information. Sleep and more important REM sleep, is crucial for memory consolidation.

Memory can also be enhanced by a technique called neurotherapy.

For more information : Dr Annemie Peche’ 0823356133

BORDERLINE PERSONALITY DISORDER

2009-07-15T10:06:00.003+02:00

BORDERLINE PERSONALITY DISORDER (BPD)

The popular description of the borderline personality disorder (BPD) focuses on individuals who cannot tolerate routine, are incapable of insight, who are inclined to lead chaotic lives and who have little to no empathy with others. Friends and family suffer with them as they (the people around them) are the targets of rage. They show unpredictable mood shifts and behaviour and the BPD blame people close to them for deliberately causing them pain.

Key characteristics of BPD are
affect dysregulation; which refers to an unusual intensity of emotional responses and a slow return to baseline. The affect is highly variable and they show intense response to environmental triggers. They react to non verbal cues and are quick to read threat. Moods may change from hour to hour. There is a greater possibility of experiencing anger, anxiety and shame. Their moods do not include all emotions equally. Their experience of fear and anxiety reflects a double message, which involves fear of abandonment and rejection on the one hand and fear of merging and getting too close to people on the other hand. They experience an intense need for love vs an intense fear of abandonment. These fears may flow from a history of poor attachment and memories of abandonment. The role of brain functioning is very important, as the memories reactivate the amygdale which is involved with emotional memory. Feelings of losing control, causes regression to memories of rejection. They experience themselves as defective, bad and worthless. This feeling is not built on conscious memories but they are felt and these are created thoughts and feelings of shame. Uncontrolled aggression is the most common defense mechanism to hide behind painful experiences. So, should a BPD become ashamed or tensed, he will project aggression and show rage. Depression is experienced but short lived. They don’t experience continuous low mood. Their coping skills are characterized by acting out behaviour (destructiveness, sexual perverse activity, self destructiveness, cutting themselves, suicide attempts); regression to prior childhood patterns (being late or forcing someone to phone them to wake up in the morning, despite of being able to set an alarm). They often suddenly withdraw and seem inhibited. Passive-aggression such as manipulation and sarcasm occur. They often dissociate from themselves – they may deny that they ever had a feeling of love for someone, whilst they are cross with the person. They tend to project their own feelings onto others – why do you hate me so much?
Impulsivity or disinhibition: sudden outbursts of rage, uncalled for; self destructive behaviour such as substance abuse, promiscuity, addictions (anorexia, bulimia, gambling, shoplifting and excessive spending, self-mutilation) may occur. Self-mutilation or inflicting pain is an attempt to relieve mental pain by inflicting emotional anesthesia. The sight of their own bleeding, bruises or burns allow for an almost orgasmic release. The endogenous endorphins are released into the bloodstream and the brain.
Identity diffusion and interpersonal problems: BPD individuals feel dissociated, empty, bored, lonely which suggest identity disturbance and which impacts all kinds of relationships. Intimate relationships begin with intense emotion, an over connectivity and later brake op the same way with rage and impulsivity. Extreme bonding may also occur – they may invite themselves to a quick cup of coffee, after which one can’t get rid of them or connect with an acquaintance as if they were life long friends.
Cognitive functioning: their thoughts may become distorted. They may experience paranoia. On a different level they may also justify unacceptable behaviour such as stealing.

BORDERLINE DISORDER IN CHILDREN

Borderline pathology in childhood is associated with the same neurophychological abnormalities as seen in adult BPD, showing defects in executive functioning, associated with:
· Impulsivity: They easily become overwhelmed by inner and external pressure and with minimal provocation or anxiety will through fits of rage, loose control and bite others, be destructive and show paranoia. Their life style seems erratic – they are in either hypo- or hypertonic states.
· Anxiety: they show free floating and chronic anxiety; they fear separation; they fear their own disorganization and aggression and need a caring adult to help them regulate their feelings.
· Depression: the negative self image cause negative affect
· Defense mechanisms include fantasy, projection, denial, ritualistic behaviour to ward off negative feelings such as anxiety.
· Disturbed sense of self includes an unstable self-concept including feelings of emptiness and nothingness.
· Interpersonal relationships: they are clinging and focus on adults to gratify basic needs such as love, since they have not introjected love during development , mainly due to an attachment problem. They seem socially isolated and don’t make friends easily.
· Their cognitive functioning is characterized by short attention span, poor spatial orientation and impaired memory. They are capable of logic, although their reality testing is distorted by their expectancy or anticipation of emotional pain or abandonment.

ETIOLOGY – HOW DOES IT ALL START?

This disorder is experience dependent and interactions may play a more important role than dramatic life events. Children can be resilient even in the face of such events. Genetics do play a role so does neurologically based vulnerability. An individual may be born with impaired brain circuitry for modulation of moods and impulsivity. So, psychologically adverse events could amplify personality traits. The quality of attachment is regarded the most important factor. A child’s brain links up to the mother’s brain to learn self-regulatory capacities. Joy, laughs or anger, distancing, early neglect are all experiences that the child internalizes and engraves in his brain (anterior cingulated in the prefrontal cortex that organizes social, emotional and cognitive functions). Absence, lack of attachment or sexual/physical abuse, result in miss-attunement between the child and mother or caretaker. No feedback on the baby’s smiles cause an inner emptiness and leaves the child with no mirror image from which he should experience a self or introject feelings.

The role of the brain: the amygdale involves emotional memory: the insula and anterior cingulate are associated with self image. The insula associate with love or rejection and connects with self awareness. Should a child experience neglect, abuse, abandonment, or sees disgust or despair in the eyes of the caretaker or parent, the insula associates the experience with shame, pain, discomfort and rejection. Should these situations repeat, a post traumatic flashback is engraved in the neuronal loop and the uncomfortable emotion is learnt and becomes part of the daily experience as well as the personality.

TREATMENT PLAN

As BPD accompany symptoms of bipolar disorder, depression, post traumatic stress disorder, ADHD, psychosis, dissociative disorder, eating disorders and substance abuse, it is important to differentiate in order to follow the correct treatment plan. The wrong medication for instance prescribing anti depressants not keeping in mind that their depression is short lived, may make them worse.

The treatment plan should be on multi disciplinary level including psychotherapy, in certain cases medication may play a role, as well as neurotherapy , during which the brainwaves are monitored. Neurotherapy is non-invasive in other words, no impulses go into the brain. How does the training work? Through operant conditioning: this is a process through which the brain gets visual and auditive feedback when it produces productive and effective brain frequencies. When the brain produces ineffective frequencies, in other words, if the brain is either over or under aroused, problems are experienced on behaviour level, cognitive and emotional as well as interpersonal levels. The level of arousal of the brain is normalized or stabilized in order to ward off tension and other negative feelings. Specific focus is placed on the cingulated and amygdale mentioned before.
Annemie Peche’
For more information please phone: 0823356133

ASPERGER'S SYNDROME: MIRROR NEURON DYSFUNCTION AND UNDERSTANDING OF EMOTIONS ON THE AUTISTIC SPECTRUM

2008-09-04T22:15:00.002+02:00

ASPERBERGER’S SYNDROME: MIRROR NEURON DYSFUNCTION AND UNDERSTANDING OF EMOTIONS ON THE AUTISTIC SPECTRUM

Mirror neuron activity in the inferior frontal gyrus (which is in the social domain of the brain), is evident in individuals who show emotional appropriate reactions to others or to emotional stimuli; who understand other peoples’ feelings and emotions; who experience theory of mind and social communication.

A dysfunction in the mirror neuron system may underlie the social deficits observed on the autistic spectrum.

Research (Vol 9 nr 1 Jan 2006 Nature Neuroscience; Vol 7 Dec 2006 ) proved that mirror neurons fire in the pars inferior frontal gyrus (area F5) when goal directed actions are performed by the individual as well as when the individual watches the same actions performed by others. This is described as an observation-execution matching system that provides a neural mechanism by which others’ actions and intentions can be understood. Adequate functioning of mirror neurons is required for imitation, action observation and intention understanding. The mirror neuron system should be in concert with activity in the limbic centers to support our understanding of the emotional states of other people. Interface between the mirror neurons and the limbic system enables the translation of an observed or imitated facial expression or a social or emotional experience.

A typically developed individual’s neural network will activate the striate and extra striate cortices; the primary, motor and pre-motor regions; limbic structures (amygdala, insula and ventral striatum), cerebellum, visual cortices and Brodmanns’ area with more prominence over the right hemisphere.

Research indicates that the autistic spectrum disorder group, showed no activity in the mirror neuron area in the pars opercularis.

Individuals on the autistic spectrum show deficits in understanding emotional states of others; they have a problem imitating emotional expressions and also when they merely observe emotions displayed by others. They seem unable to read others’ emotions and sometimes appear odd or dumbfounded not knowing how to react.

So there seems some ground to the hypothesis: that a dysfunctional mirror neuron system may underlie the social deficits that are characteristic of the individual on the autistic spectrum. The greater the activity in the mirror neuron system during imitation, the higher the individual’s level of functioning in the social domain. The mirror neuron system seems to be a key neural system for social cognition.

The area targeted by neurotherapy during treatment of autism and Aspergers’, is the right anterior parietal region which is in the area, where the mirror neurons are situation.

Although neurotherapy can’t “cure” autism and Asperger’s, according to research and feedback from the patients’ family, the patients normally communicate more effectively, they feel better in them selves and eye contact and even vision improve.

Dr Annemie Peche’ 0823356133

ADD and TELEVISION - UNSUSPECTED BEHAVIOURAL INFLUENCE IN CHILDREN

2008-04-20T14:49:00.000+02:00

ADD AND TELEVISION –UNSUSPECTED BEHAVIOURAL INFLUENCE IN CHILDREN (Published in ROODEPOORT RECORD , January 30, 2005

Attention Deficit Disorder (ADD) is not only a problem of inattention in the classroom, but manifests throughout life.

It reflects in poor school performance and ADD sufferers show a higher
likelihood of ending up with less education than non-ADD’s. The lives of ADD sufferers are often characterized by failed marriages, less job success, more auto accidents, unstable interpersonal relationships and more trouble with the legal system.

Ritalin might ease living conditions for the ADD sufferer and his family and friends in the short term but does not fix or cure the problem and Ritalin may have side effects.

Consequences of long term use are still unknown.

In general, ADD sufferers experience hyperactivity, aggressiveness, violence, substance abuse due to dysregulation of the brain, which makes the ADD sufferer unable to access and utilize their inherent abilities and talents.

Neurofeedback is perhaps the biggest breakthrough in non invasive medicine in the past 50 years. It is a self regulating process that stabilizes and rewires the brain in order to control and regulate bodily functions more effectively.
Television has found its own way into our bedrooms, kitchens and lounges.

The brain produces certain frequency brain waves during certain conditions and certain states of awareness.

The slowest waves are called delta activity, which ranges between 0,5 and 3.5 hz. Production or appearance of delta is normal during stages three and four of sleep in adults and children and also occurs with new born and young babies.

Occasional delta activity is also expected in wake states up to more or less four years. Occurrence of delta activity with adults and children of about four to five and older suggests pathology.

The second range between 4 and 7 hz is called theta activity, which is a slow wave and occurs during stages two and three of sleep in children and adults and suggests hypnagogical states or twilight states during which a person is half awake and half asleep.

In wake stages in adults, the occurrence of theta is not normal and could suggest the possibility of underlying epilepsy. It could also refer to emotional instability.

There are quite a few types or ranges of brain wave activity but for the purpose of this article only alpha and beta activity is mentioned other than delta and theta rhythm.

Alpha activity ranges from 8 to 11/12 hz and suggests awake but relaxed states during which the brain is not occupied with complex cognitive processes. Alpha activity is produced during meditation.

The alpha craze during the 60‘s and 70’s promoted transcendental mediation.

Acid was the party drug and production of alpha activity promised nirvana or a state of euphoria.

Beta activity ranges from 12-15 hz (sensory motor rhythm) and 15 to 18 hz which is a faster beta rhythm. Beta activity of 22-30/40 hz causes tension, obsessive compulsive disorder, bipolar disorder and other anxiety disturbances.

Slow brain wave activity is the core of ADD.

Your brain is like a car, with faulty timing, it needs a tune up. Ritalin is a stimulant and speeds up the brain. It is, however, only a temporary treatment. Remove the stimulant and the brain slows down again.

Watching TV causes the brain to slow down. The brain produces a constant pattern of low frequency brain waves.

A drop in alpha activity and production of theta activity is consistent with ADD behaviour. The dominant brain wave of ADD is 7 hz. A problem solving brain may be operating in the 15-18 hz range with intense bursts up to 40 hz.

Children with ADD cannot speed up the brain when they need to. The brain is parked in the lower frequencies. The low frequency theta activity (4-7 hz), reduces the brain’s capacity for higher thought processes and excessive television viewing by younger children causes the brain to miss some of the early developing stages, which results in inadequate brain functioning.

The brain becomes limited in creating higher levels of cognitive functioning such as abstract thinking. Watching television , forces the brain into inactivity and a barely concentrating brain, which resembles hypnosis.

Questions are raised concerning television viewing and video game playing being the culprit in worsening ADD and even causing ADD.

Generations that missed television as a child, may not even recall classmates during the 60’s and 70’s suffering from ADD.

Maybe creating klei-osse and playing with paper dolls and lappoppe kept the brain functioning on 12-15 hz sensory motor rhythms.

Literature confirms, that excessive TV viewing, particularly in young children causes neurological damage.

TV watching causes the brain to slow down, producing constant patterns of the low frequency brain waves.

DR Annemie Peche’ 0823356133

CONTROLLED BY TV?

2008-04-20T14:27:00.000+02:00

CONTROLLED BY TV?

How much time do we spend in front of the TV? According to dr Aric Sigman, if you spend four hours a day watching TV, TV takes up more than one full 24 hour day a week. A six year old child will have watched TV for nearly one full year of his life. By the age of 75, you will have spent more than twelve and a half years of 24 hour days, doing nothing but watching TV. Most children have more eye contact with TV characters than with their parents. TV becomes the main shared activity, which is passive in stead of active time sharing. TV watching enhances selective deafness. How often do you have to repeat yourself to a person watching TV. In order to counteract his selective deafness, the news has to be shocking or devastating. That teaches people to thrive on negative attention, in order to get any. Life is short and with TV it is shorter, needless to say that TV has not only become the favourite pastime, but it is our prime time that we spend in front of the TV.

TV has an influence on us regarding psychological well being, on political neurological and even metabolical level.

Harvard Medical School has found that TV watching slows down a child’s metabolism, and increases body fatness. They describe TV as an independent factor for obesity. It numbs us and lulls the brain into a theta brainwave range, the frequency which we should be producing while falling asleep, not while trying to attend and focus.

The American Medical Association hypothesizes that TV is responsible for 50% of violent crimes. It also influences our political views.

The American Academy of Pediatrics made it clear in 1999 that although ADHD is a genetically based disorder, TV watching enhances idling of a brain that is already under active regarding controlling of impulses. ADD children have a problem with inner awareness, mental control and inner directed attention. The wiring of the brain is formed by repeated firing of neurons by continuous focus on a task, so learning takes place. In other words, experience shapes the brain and learning is experience dependent.

With TV watching there is constant shifting of attention (images keep on changing), which causes mental and cognitive chaos in the child’s brain. TV watching therefore conditions short attention span and distractibility.

Taking in account, the basic effects TV watching has on our mental social cognitive, emotional performance and sleeping patterns, it should also have far reaching consequences for adult health.

TV has in many households the role of an electronic babysitter, which may arrest development.

To counteract slowing of the brain and raise the level of arousal in order to enhance concentration and be focused, neurotherapists implement a therapeutic technique called neurotherapy.

Dr Annemie Peché

LIFE AFTER STROKE

2008-04-17T13:33:00.002+02:00

LIFE AFTER STROKE

The infant brain has an overabundance of neurons with few synaptic connections at birth. The brain learns from implicit memory, which is the first impressions a baby has from the first day of his life and those remain available to us throughout our lives. Implicit memory happens automatically. The baby does not say “O yes, I remember that toy, it made a loud noise before, it might happen again’’, the baby reacts with a fright instantly.

The brain constantly scans the environment and tries to determine what comes next. It distinguishes between familiar and new information which is the mind’s attempt to “remember’’ the future. When the next moment is anticipated, the brain is ready to handle the environment and helps us to plan for the future.

By the second birthday toddlers have developed a new skill. They talk about recollections of the day’s events. This kind of memory includes knowledge of their world. This development is experience dependent. This kind of memory is called explicit memory.

Neurons that fire together, wire together.
Cells that are repeatedly together will associate.
These neural associations involve metabolic changes for short term memory.
And more structural changes involve long term memory.
The alteration of synaptic connections, changes the probabilities of neuronal firing.
Memories are based on the binding together of neuronal patterns.
or neurons firing in specific ways.
People’s recollections differ and depend on the way the brain creates representations.
If you were bitten by a dog during the time visiting the Eiffel tower, you may begin to feel pain or fear when you think of the Tower.
The brain is an anticipation or scanning machine that constantly scans the environment and tries to determine what comes next.
How do we anticipate: prior experiences shape our anticipatory models. The mind attempts to “remember’’ the future.
When the next moment is anticipated, the brain is ready to handle the environment. It depends on implicit memory.
Working memory is a recollection of items from the immediate sensory process and lasts half a minute, if there is no rehearsal.
Working memory is the chalkboard of the mind and involves what we are thinking of at the time.
An example of long term memory is remembering a close friend’s phone number, which should be placed in long term storage.
Remembering the number of a shop you need to call once only, is working memory. You hold on to those digits just long enough to dial the number. Afterwards the number vanishes.
If working memory persists you are bombarded with irrelevant information from the past – so forgetting is important for memory build up.
Long term memory does not last for ever.
For items to become part of long term memory, a process called cortical consolidation has to occur.
How does this happen? by rehearsing existing memory traces which link with new associations, new associations link up with existing memory traces and forms new clusters.
The new clusters depend on REM sleep stage, which is an attempt to make sense of the day’s activities.
This cortical consolidation can take months or years. For example, if someone had been in an accident in January. He may retrieve information from October to December, but after that he can’t remember, which is called retrograde amnesia.
Why? Retrograde amnesia is information which did not have a chance to be integrated and encoded into the long term explicit memory. He will be able to remember old info that had been encoded before the accident.
There is a difference between observer recollection and participant recollection.
The observer recollection is a situation which we observe from a distance and the participant recollection is a recollection where we are a participant, which is more emotional intense.
We will recall experiences easier where sights, sounds, smells or your state of mind, like emotions played a role.
Why do we remember events so intensely of which the recollection is not accurate? Because of the personal experience that had been influenced by sound, smell and emotions

How is it possible that a person who suffered brain injury or a stroke can improve cognitive functioning?

Neurons that fire together, wire together and synaptic connections cause neural firing, which involve metabolic changes for short term memory and long term memory. Neurons firing in specific ways repeatedly and new synaptic connections that are created and enhance learning and memory.

NF is an alternative therapy through which brain functioning can be improved after a patient suffered a stroke

Brain waves are monitored by placing sensors or electrodes on the scalp, which register the electrical signals inside of the brain over specific associative areas. Brainwaves carry messages to and from all parts of the body through the nervous system. Breathing, heartbeat, muscle coordination, metabolism, blood sugar levels, memory, attention, learning, emotions and all cognitive functioning or mental activity are controlled by brainwaves.

During NF the brainwaves are monitored, it is non-invasive in other words, no impulses go into the brain. How does the training work? Through operant conditioning, the brain is taught to produce productive and effective brain frequencies, in order to enhance emotional stability and cognitive functioning and specific functions or problem areas can be addressed.
For more information: Dr A Peche’ 0823356133

BEHAVIOUR DISTURBANCES: INDICATION OF VARIOUS PROBLEMS

2008-04-14T12:44:00.001+02:00

Behaviour disturbances are not always indicative of naughtiness or disciplinary problems only. It could be suggestive of brain dysfunctions causing:
Epilepsy: an epileptic patient may present with mood swings, uncontrolled aggression, social problems, seizures and learning disabilities.
Behaviour problems are seen in conduct disorder and manifest in lying, steeling, uncontrolled aggression, manipulating people and severe social problems. Children diagnosed as ADD/ADHD, show a lot of behaviour problems regarding self control, control and of their personal environment. Their cognitive behaviour and ability to learn and attend, reflect in uncontrolled behaviour. There are six types of ADD, each diagnosed by specific trends.
Tourette syndrome and Asperger syndrome are other syndromes reflecting severe behaviour problems where rigidity regarding routine boundness, focused preferences, recurring behaviour and unsocial behaviour, occur.
Behaviour disturbances also indicate social impairment and emotional problems which could be a reflection of parental or sibling conflict.
Behaviour disturbances also occur with sleep disturbances. Sleep deprivation or a problems with sleep initiation or maintenance, can result in behaviour disturbances
One of the most subtle syndromes is the highly sensitive child syndrome. These children experience sensory motor integration problems, so tags in a T-shirt may irritate them so much that they may tear it out. These children may appear spoilt. They seem to complain about everything.
Ihibitory control is the inability to control instinctive or immediate actions, the ability to exchange uninhibited behaviour in favour for appropriate or thought through behaviour. These children appear naughty.
Children having a problem to execute appropriate behaviour, well meant behaviour, or applicable knowledge or excellent plants, but don’t get so far as to project these thoughts, plans, ideas or knowledge, suffer from a prefrontal cortex deficit and can not express good functions. Once they try, confusion or chaos sets in and they mess up.

So, if your child presents with behaviour problems, don’t tag him as naughty, undisciplined or difficult. His behaviour may just be indicative of a depression or other more serious problems. Have him assessed by a psychologist. Therapy may suggest a multidisciplinary approach including remedial treatment, speech and or occupational and psychotherapy and or chemical treatment.

Neurotherapy is another form of supportive therapy addressing problems referring to the central nervous system and all the above mentioned problems can be addressed by neurotherapy.

WHAT ABOUT AN ALTERNATIVE TO RITALIN?

2008-04-14T11:41:00.000+02:00

At some intitutions and schools, the prescription of Ritalin is a given, it goes with the syllabus. Is this the only treatment?

ADD is not only a problem of inattention in the classroom, but manifests throughout life. It reflects in poor school performance and ADD sufferers show a higher likelihood of ending up with less education than non ADD's. ADD reflects over life skills behaviour patterns and general interpersonal relationships, such as failed marriages, less job success, more auto accidents, unstable inerpersonal relationships and more trouble with the legal system.

Ritalin might ease living conditions for the ADD sufferer and his family and friends in the short term, but does not fix or cure the problem and Ritalin has side effects. Consequences of long term use are still unknown.

In general ADD sufferers experience hyperacvtivity, aggressiveness, violence, substance abuse, due to dysregulation of the brain, which makes the ADD sufferer unable to access and utilize their inherent abilities and talents.

NF (neurofeedback) is perhaps the biggest breakthrough in non invasive medicine in the past 50 years. It is a self reguolating process that stabilizes and rewires the brain in order to control and regulate bodily functions more effectively.

To get a better understanding of ADD we have to distinguish between 6 sub types of ADD. When most people think about attention deficit disorder, they notice the classic type. Amongs the most common symptoms of the classic ADD type are the following: Inattentiveness, distractbility, being disorganized, inabiliy to sustain attention span, trouble listening and follwing through instructions, difficulty in keeping an organized area (room, suitcase), problem with general time management, restlesness, forgetfulness, being fidgity and noisy, being talkative and impulsive. The other ADD types are the inattentive ADD type, Overfocused ADD, Temporal lobe ADD, Limbic ADD, Ring of Fire ADD.

The problem with ADD is the level of arousal. The Central feature of ADD is poor regulation of the brain's state of arousal in other words how sleepy or awake the brain is.

Research has shown that hyperactive children have low levels of arousal. They tend to seek new stimulation and Ritalin speeds up their level of arousal. It appears to be a paradoxical effect: a hyperactive child is given a stimulant, actually: the stimulant is used to wake up the sleepy brain. Ritalin increases the dopamine activation and reduces the norepinephrie arousal.

If the brain is over aroused, we are jumpy, hyper or anxious, nervous or upset. We are trying too hard, paying attention to everything at once. If the brain is under aroused we may appear sleepy, lethargic or disinterested.

The chronic under aroused brain seeks stimulation. Stimulation seekers are frequently hyperactive, therefore they show purposeless movements and out of control behaviour. They are risk takers, thrill seekers in order to increase the level of arousal of the brain. We have all experienced fiighting low arousal level: driving long distances - we open the window, turn on the radio. The ADD kid taps with a ruler on the desk, while doing homework, trying to stay in this world and wake up. The same is true with criminal behaviour - exitement wakes the brain up.

NF as an alternative treatment for ADD, shows good results concerning the following symptoms: Symptoms overlapping with ADD such as oppositional defiant disorders , spaciness, daydreaming, poor concentration or inattentiveness, lack of motivation, hyperactivity and self stimulation, impulsivity, distractibility, hyperactivity - the driven type, racing thoughts and memory impairment.

Amongst other deficiencies such as Tourette's, Asperger's, autism, conduct disorder, obsessvie compulsiveness, dysthemia, bipolar disorder, specific learning disabilities, sleep disorders, disorganized laterality, head aches and depression are also treated succesfully by means of NF.

It is however important to follow the correct diet and to carry on with other therapies such as psychotherapy, speech therapy, occupational therapy, physiotherapy. Neurotherapy helps the brain to be receptive to other stimulation and stabilizes the brain. After sufficient training it is possible to decrease medication, but not without the concent of the the medical doctor involved as well as neurological assessment. There is hope, medication is not the only form of treatment.

ADHD:RESEARCH PROVES EFFICACY OF NF TRANING

2008-04-14T11:38:00.000+02:00

ADHD: RESEARCH PROVES EFFICACY OF NEUROFEEDBACK TRAINING

Substantial empirical evidence has been compiled by a number of editors, on research done by neurofeedback clinicians, psychiatrists, clinical technologists, clinical and neuropsychologists, regarding the efficacy of neurofeedback (L M Hirshberg, Sufen Chiu and J A Frazier: CHILD AND ADOLESCENT PSYCHIATRIC CLINICS OF NORTH AMERICA. Saunders Publ, January 2005 Volume 14 Nr 1)

During the past three decades electroencephalographic biofeedback or neurotherapy, has emerged as a nonpharmacologic treatment for ADHD (attention deficit/hyperactivity disorder). This intervention derived form operant conditioning studies, which resulted in noninvasive neurotherapy.

Research findings published, indicate positive clinical response in 75% of ADHD children, treated in controlled group studies. In Gruzelier and Egner’s studies, where different protocols such as alpha-theta, sensory motor rhythm and beta protocols were applied, an improvement of attention, memory and music performance were validated. To strengthen the efficacy of neurotherapy scientifically, remarkable improvements in artistic aspects of music performance were shown in conservatory students.

Research indicates functional brain abnormalities associated with depression, anxiety and obsessive-compulsive disorder. Research proves high validity of the use of neurofeedback, of the above mentioned disorders, also including posttraumatic stress disorder, treatment of substance abuse and self defeating disorder.

Thornton did research on traumatic brain injured and reading disabilities and the effect of neurofeedback, and found a statistical significant improvement on verbal skill, attention and IQ measures, reading and auditory memory and general cognitive improvement.

Except for Vagus nerve stimulation therapy, which has also proven safety, tolerability and efficacy in the treatment of epilepsy, Walker and Kozlowski did research on neurofeedback treatment of epilepsy, by down training brain frequencies which are responsible for causing epilepsy. The brain is trained to de-emphasize rhythms that lead to generation and propagation of seizures.

Neurotherapy as an intervention, holds promise as a potential treatment of epilepsy, ADHD, emotional instability, headaches, traumatic brain injury, depression, sleep instabilities, behavioural disorders, stroke, patients on the autistic spectrum and other symptoms related to the central nervous system.

For more information: Phone Dr Peché on 0823356133 / 016 4549302

ADHD : NEUROTHERAPY – AS PART OF THE MULTI DISCIPLINARY APPROACH.

2008-04-13T16:16:00.000+02:00

Daniel Amen describes six types of ADD: classic ADD, they meet the criteria for both inattentiveness and hyperactivity-impulsivity. The hyperactive-impulsive sufferers are inattentive, distractible, disorganized, hyperactive, restless, impulsive and bouncing off the walls. Inattentive ADD, where sufferers are inattentive, sluggish, slow moving with low level of motivation, daydreaming, the couch potato, who quietly slip into daydreaming. Overfocused ADD where suffers have trouble shifting attention. They frequently get stuck in recurrent negative thoughts or behaviour. They are inflexible and obsessive, worry excessively and tend to be oppositional and argumentative. Temporal lobe ADD sufferers are inattentive, irritable, aggressive, they have dark thoughts are moody, impulsive and unstable. Limbic ADD, they are inattentive, experience low grade depression, are negative, experience low energy levels and have feelings of hopelessness and worthlessness. Ring of fire ADD sufferers are inattentive, extremely distractible, angry, irritable, overly sensitive, oppositional and experience cyclic moodiness.

This is not were ADHD ends. The problem doesn’t go away with adulthood as 80% of children with ADD take their disorder into adulthood.

Keeping in mind that ADD/ADHD is a matter of poor regulation of the level of arousal of the brain, treatment should focus on stabilizing the brain. The brain is either too under aroused in other words slowed down, causing sleepiness, being lethargic, disinterested and not taking in what’s happening around him OR too over aroused, causing the child to be jumpy due too a revved brain, that capture everything at the same time. So nothing gets absorbed or done.
Neurotherapy (NT) for ADHD offers an effective alternate for patients whose treatment is limited by side effects, poor medication response and in cases where the patient or parents refuse to consider medication.

What does NT do? Using computerized feedback, the brain learns to increase brain frequencies that are too slow, causing under arousal and decrease the frequencies that are too fast, causing over arousal. NT normalizes the unstable brain which is either over or under aroused. NT results in a healthier better regulation. Over time the new behaviour is “learnt” through operant conditioning

Dr A Peché 0823356133

ADD: A MATTER OF AROUSAL NOT ATTENTION

2008-04-13T15:56:00.000+02:00

How to rectify through Neurotherapy

The efficacy with which a person’s brain functions depends on the level of arousal, which is the central feature of ADD. The core problem with ADD is poor regulation of the brain’s state of arousal. In other words, the level of arousal of the brain is how sleepy or awake the brain is.

Although it borders on a contradiction, Robert Hill, a well known neurotherapist in the USA, stresses the fact that the hyper active child has low states of arousal and they habituate to sensory stimulation. They seek stimulation to speed up the sleepy brain and therefore they appear hyper active. They turn on their brains by causing turmoil and then get addicted to the turmoil. This kind of behaviour gets conditioned.

What is the problem? One can compare brain arousal with a dimmer switch that adjusts the light levels in a room. The dimmer switch in the brain is located in the thalamus and adjusts the intensity of arousal that’s needed for the task at hand. This should happen automatically. This switch, or thermostat in most ADD sufferers’ brains is set on dim, which causes them to have low levels of arousal. The brain battles to stay on task and they can’t stay focused. In order to compensate, they seek stimulation which often ends up in hyperactivity, risk taking, thrill seeking behaviour, living on the edge, daring actions such as bunngy jumping and speeding. The excitement that is needed to activate the brian sometimes results in excessive spending, lying and steeling. So the low level of arousal of the brain accounts for both the hyper and hypoactive (slowed down) person. Every task requires a specific level of arousal. Listening to music requires a lower level of arousal than doing arithmetic. The thermostat in the thalamus should automatically switch over from one to another level of wakefulness. In the case of many ADD’s the switch stays on dim. They therefore lack adequate level or arousal and can not stay focused, so they move from one thing to the other to stay aroused. They try to pay attention to all the stimuli that goes through the prefrontal cortex or right frontal gateway, at the same time. Therefore nothing gets absorbed or learnt.

Arousal is the basic problem with ADD, but attention plays a major role in the person’s dysfunction. If the child can’t attend, boredom is a major complaint. Boredom is always a result of inattention.
ADD children can spend hours engrossed in cartoons or video games, because the scene is forever changing. The poor teacher who has to rely on chalk and a blackboard only, can’t compete with the quick changes of video games. Once the brain learns to accommodate and deal with video games, learning stops and the brain relaxes into a coast or idling mode, requiring only a small part of the brain to be used to manipulate the game. So video games tend to drive the brain deeper into low arousal.

WHAT DOES MEDICATION DO?

Medication such as Ritalin is prescribed for hyperactive children to speed up the low level of arousal. It appears to be a paradox: a stimulant is prescribed for a hyperactive child. In fact, the stimulant is used to wake up the sleepy brain. Ritalin increases the dopamine activation over the left hemisphere and reduces the norepinephrine arousal over the right hemisphere.

HOW TO RECTIFY THROUGH NEUROTHERAPY

Neurotherapy enhances a self regulating process in order to stabilize the level of arousal. Right brain over arousal is decreased and left brain under arousal is increased. The brain is trained by computerized programs to regulate it’s own light and dim switch. Unlike medication, this has a long term effect.
Dr A Peche 0823356133 /0116756138 / 0164549302

NEUROFEEDBACK AS AN ALTERNATIVE FORM OF TREATMENT OF ASPERGER SYNDROME

2008-04-13T15:28:00.000+02:00

What is Neurofeedback?

The brain is powered by electricity and produces electrical patterns called brainwaves, which determine the level of arousal of the brain. The more aroused the brain is, the more effective is the functioning. The lesser the level of arousal, the less effective is the activity and thought processing of the brain. If the brain is too aroused, we experience, hyperactivity, high tension levels, aggression and panic. If the brain is under aroused, we suffer from under activity ( the typical couch potato), we can’t focus or concentrate, we feel depressed and lethargic.

Brain waves are monitored by placing sensors or electrodes on the scalp, which register the electrical signals inside of the brain over specific associative areas. Brainwaves carry messages to and from all parts of the body through the nervous system. Breathing, heartbeat, muscle coordination, metabolism, blood sugar levels, memory, attention, learning, emotions and all cognitive functioning or mental activity are controlled by brainwaves.

During neurofeedback the brainwaves are monitored, it is non-invasive in other words, no impulses go into the brain. How does the training work? through operant conditioning, which is a process, through which the brain gets visual and auditive feedback, when it produces productive and effective brain frequencies.

When the brain produces ineffective frequencies, in other words, if the brain is either over or under aroused, problems are experienced such as :

ADD/ADHD Learning disabilities Depression
Bipolar disorder Anxiety disorder Panic attacks
Aggression and rage Conduct disorder Chronic pain
Cognitive impairment Chronic pain Traumatic brain injury
Stroke Sleep dysregulation Epilepsy
Post traumatic stress Dissociative disorders Autism and PDD
Reactive attachment disorder Migraine and headaches Exam stress

Noticeable results occur normally during the first ten sessions. Since neurofeedback is a process, this form of treatment requires a significant number of sessions to ensure consistent and lasting benefits. The brain learns a new pattern. Like learning to play an instrument, one needs a lot of practice. Changes are normally seen with symptoms disappearing as well as identifiable abnormalities in EEG recordings such as epileptiform activity. Typical EEG patterns seen with ADD kids also change from generalized slowing to normal frequencies. The most common effects reported: improved sleep, better focus and concentration, less anxiety, improvement of academic abilities and more stable emotions.

Since a multidisciplinary approach should be followed with Asperger syndrome and the Autistic spectrum, it is important to check the individual’s brain activity to start with.

Pet scans show specific brain abnormalities in autistic patients that are responsible for the higher order functions such as memory, attention, language, auditory information processing and conceptual reasoning ability which are all compromised to some degree on the autistic spectrum. There are indications of stunting of the dendritic tree (or hindrance of normal growth and development) in the limbic system, the associative area which controls emotions. Since the brain is responsible for normal cognitive, motor and emotional functioning, neurofeedback-therapy addresses brain functioning.

Through neurofeedback-therapy also known as EEG training, brain waves that are of too low frequency causing under arousal and are also on the epilepsy range (0,5-7 hz) are inhibited through operant conditioning done electronically on cellular level. Brain waves of a 22-40 hz, that are of too high frequency and causing over arousal, aggression and hyperactivity, are inhibited. Through neurofeedback-therapy the brain gets strengthened. Neurotherapy calms the brain, improves stability, stimulates blood flow, stimulates dendritic connections as well as the function of neurotransmitters and metabolism. It improves the ability to carry out cognitive tasks. The brain is trained to regulate and manage itself, neurotherapy rewires the brain.

Brain growth is experience-dependent. Experiences lead to an increased activity of neurons which enhances the creation of new synaptic connections, which is enhanced by NF.

With Asperger’s and Autism the patients suffer from hyper expressive right brain activity, which is a good place to start training with the purpose of down training delta/theta activity (depending on the person’s age and appropriate age related brain waves) and up training of the AC or SMR.

The main aim for Aspergers and Autistics is to end therapy with more life skill.

Summary: neurotherapy enhances the individual’s ability to maintain different states of arousal from hyper vigilence to calmness. From narrowly focused activity to broad and inclusive focus. Treatment addresses cognitive, emotional, neurological, immune and sleep disregulation.

Symptoms on the autistic spectrum that can be addressed by neurotherapy include epilepsy, motor and vocal tics, emotional instability, cognition, communication skills and language, sensory instabilities, motor skills, eye contact, vocalizations, a sense of being engaged more steadily, hyper activity, attention problems, anxiety, sleep disorders, obsessive compulsive behaviours and general cognitive behaviour.

According to Pennington (1991) the core deficit in Asperger’s / Autism is the inability to imagine what is going on inside another person in terms of thoughts, feelings and images. It seems important that one has to discriminate and be able to represent these internal states to oneself before one can imagine what internal states another person might be experiencing.
The duration of NF with these children is about 40 sessions per year over 2-4 years

NEUROFEEDBACK AND REWIRING OF THE BRAIN

2008-04-13T15:24:00.000+02:00

FOX TERRIER CHILDREN

2008-04-13T15:04:00.000+02:00

IS YOUR CHILD AMONGST THE CHILDREN CALLED FOX TERRIER CHILDREN?

I spoke to a headmaster of a school recently about neurotherapy as an alternative form of treatment for ADD/ADHD, referring to these children’s restlessness. His reaction was: O YOU MEAN THE FOX TERRIER CHILDREN!, referring to the activity level of a Fox Terrier, forever barking, stirring, being energetic, running around in circles purposelessly, chasing nothing.

Does you child…..

Irritate the teacher and other children in class?
Throw classmates with pieces of rubber and paper?
Climb up the roof and fences to test your nerves?
Wheelie on his back wheel whilst turning around to see your reaction?
Play with the other siblings until they cry, with the excuse that it’s just a game?
Or scare people and watch their reaction?
Picks a fight or set other children’s anger alight so that they start to fight about something they don’t really understand, and then he walks off innocently?
Acts as the class clown or wise crack?
Focus on being sarcastic and sometimes mean?
Make noises and hum inappropriately?
Show activities that could describe him as being a daredevil testing the limits?
Get exited by exercises such as bungee jumping and other activities that can get him into serious trouble?
Engage in activities where he obviously did not do any forethought?

Why do they engage in conflict seeking activities, are hyperactive, restless and irritate others?

This is a way to stimulate the inactive or sleeping brain, which means that they normally suffer from an under arousal. They don’t plan to do these things. They have this unconscious need for stimulation. They try to keep the brain awake.

People with ADD/ADHD turn on their brains, causing turmoil. To get their parents or spouses to yell, may increase the activity in their own prefrontal lobes and help them to feel more tuned in.

If you stop to provide the stimulation (in other words react to their stimulus by shouting, yelling or over reacting) their negative behaviour will decrease. So, don’t react to their message “ let’s have a problem”.

How do we stop this game playing and auto-reaction? Psychotherapy with both parent and child is one way of managing the problem. Neurotherapy though, addresses the basic problem. The lower frequencies that the ADD brain produces are inhibited and the more productive frequencies that help us to concentrate, attend, focus and being alert and more calm, are rewarded, so that we produce more effective brainwaves.

DR A Peche’ (0823356133 / 011 6756138)