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INSERT INTO `mdl_lesson_pages` VALUES (1,2,0,2,20,0,1,1,1564057663,1656004604,'Collecting EEG Data','The first item of importance is understanding what the Electroencephalogram is, in a general sense.&nbsp;<br>Here is a very basic explainer video of what an EEG is:<br><a href=\"https://www.youtube.com/watch?v=tZcKT4l_JZk\">Basic EEG Video</a><br>Here is\r\na brief video that covers some fundamentals. Details of what\'s covered here will be further described&nbsp; in the lessons to come.<br><br><a href=\"https://youtu.be/86zIa3pGM50\">Fundamentals of EEG</a><br><br>\r\n<p>There are several software programs that will allow you to collect 19+ channel EEG data. A few of them include EEGStudio, Neuroguide, and NeuroField. This section will cover two platforms for recording EEG: NeuroField and Neuroguide.</p><br>\r\n<h3><b>The 10–20 System and Electrode Placement</b></h3>\r\n<p><span><span>To begin, we first cap up. At present (2019), caps with electrodes placed using the international 10-20 system are popular in clinical neurotherapy. The 10-20 system is an internationally recognized way of placing electrodes on a head that is replicable and verified scientifically. The electrodes pick up the EEG from the cerebral cortex underneath the electrode location.</span></span>\r\n</p>\r\n<p><span><span><img src=\"@@PLUGINFILE@@/10-20%20cap.png\" alt=\"10-20 cap\" width=\"500\" height=\"456\" class=\"img-responsive atto_image_button_left\"><br></span></span>\r\n</p><br>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b><br></b></p>\r\n<p><b>See in this short videos the process of capping in EEG Acquisition.</b><span style=\"font-size: 1rem; text-align: center;\">&nbsp;</span></p>\r\n<div style=\"padding:56.25% 0 0 0;position:relative;\"><iframe src=\"https://player.vimeo.com/video/695265616?h=1eeb6f126b&amp;badge=0&amp;autopause=0&amp;player_id=0&amp;app_id=58479\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen=\"\" style=\"position:absolute;top:0;left:0;width:100%;height:100%;\" title=\"Capping_Shane (1).mp4\"></iframe></div><script src=\"https://player.vimeo.com/api/player.js\"></script>\r\n    <p style=\"text-align: center; \"><span style=\"font-size: 1rem;\"><br></span></p>\r\n        <p><span style=\"font-size: 1rem;\">The “10” and “20” refer to the distances between electrodes, which are either 10% or 20% of the total diameter or radius (transverse and sagittal) of the skull (Figure 1a). The landmarks that are used sagittal are the nasion (the depressed area between\r\n        the eyes on the ridge of the nose) and the inion (the bump at the back of the skull, which can be felt with mild palpitation); landmarks that are used transversely (aka coronally) are the ears (often the tragus of the ear) (Figure 1b).</span></p>\r\n        <ol>\r\n            <br>\r\n            <div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/electrode-placement.png\" alt=\"Figure 1b: The locations of the nasion, inion, and tragus points for measurement purposes.\" width=\"600\" height=\"570\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></div>\r\n            <p style=\"text-align: center; \"><i>Figure 1a. The International 10-20 system of electrode placements.</i></p>\r\n            <p style=\"text-align: center;\"><br></p>\r\n            <div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/tragus-points.png\" alt=\"Figure 1b: The locations of the nasion, inion, and tragus points for measurement purposes.\" width=\"600\" height=\"350\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></div>\r\n            <p style=\"text-align: center; \"><i>Figure 1b: The locations of the nasion, inion, and tragus points for measurement purposes.</i></p>\r\n            <p style=\"text-align: center; \"><i><br></i></p>\r\n            <p style=\"text-align: center; \"><i><img src=\"@@PLUGINFILE@@/Landmarks%20on%20the%20head.jpg\" alt=\"Landmarks on the Head\" width=\"598\" height=\"502\" class=\"img-responsive atto_image_button_left\"><br></i></p>\r\n            <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\">On an EEG cap there are 19 active electrodes, two reference ear electrodes, and one ground electrode.</span></p>\r\n                <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n        </ol>\r\n        <ol style=\"text-align: center;\"><br></ol>\r\n        <ol style=\"text-align: center;\"><br></ol>\r\n        <ol style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/EEG%2019%20CH%20CAP.jpg\" alt=\"19 Channel EEG Cap\" width=\"300\" height=\"204\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></ol>\r\n        <ol>The above image is of a 19 channel cap and the below image is of a 64 channel cap. The more electrodes in a cap the higher spatial resolution of the EEG findings.&nbsp;</ol>\r\n        <ol style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/32%20channel%20cap.jpg\" alt=\"64 channel cap\" width=\"300\" height=\"208\" class=\"img-responsive atto_image_button_middle\"><br></ol>\r\n        <ol><br>\r\n            <h5><b>Electrode Labels</b></h5>\r\n            <p>Each electrode is labeled by a letter or pair of letters.<img src=\"@@PLUGINFILE@@/Electrode%20labels.jpg\" alt=\"Electrode Labels\" width=\"728\" height=\"493\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p>\r\n            <br>\r\n            <p>We will reference 19 channel placements because this, as of 2020, is the most commonly used electrode arrangement in the field of neurotherapy.&nbsp;</p>\r\n            <p>In a 19-channel placement, there are 19 electrodes, the ground, and the reference electrodes (Figure 1c). In a 32, 64, or 128 channel system, there are more electrode names. The additional electrodes are initially placed between the 20% marks\r\n                and are of the “Modified Combinatorial Nomenclature” (MCN) system (Figure 1d). The MCN system adds the following acronyms to designate areas (FC, FT, AF, TP, CP). The MCN system also renames four electrodes in the 10-20 system:</p>\r\n            <ul>\r\n                <li>T3 becomes T7</li>\r\n                <li>T4 becomes T8</li>\r\n                <li>T5 becomes P7</li>\r\n                <li>T6 becomes P8</li>\r\n            </ul>\r\n            <br>\r\n            <p>Even numbered electrodes (2, 4, 6, 8) are on the right hemisphere of the head and odd numbered electrodes (1, 3, 5, 7) are on the left hemisphere of the head.</p>\r\n            <p>A1 and A2 refer to the ear references and M1 and M2 refer to mastoid references.</p>\r\n            <br>\r\n            <div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/inion.png\" alt=\"\" width=\"600\" height=\"473\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n            <p style=\"text-align: center; \"><i>Figure 1c: 19 active electrodes and reference electrodes (A1 and A2).</i></p>\r\n            <p style=\"text-align: center;\"><br></p>\r\n            <div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/mnc-system.png\" alt=\"\" width=\"600\" height=\"567\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></div>\r\n            <p style=\"text-align: center; \"><i>Figure 1d: The electrodes active in the MCN System</i></p>\r\n        </ol>\r\n        <p><br></p>',1),(2,2,1,3,20,0,1,1,1564077340,1656004713,'Prep and Hygiene','<h3><b>HOW DO I INSTRUCT PATIENTS TO PREPARE FOR AN EEG?</b></h3><br>\r\n<p>Before your client comes in for their EEG, you will want to remind them of a few hygiene and self-care tips to ensure you get the best recording possible:</p>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/prep-hygiene.png\" alt=\"\" width=\"800\" height=\"372\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></div>\r\n<div><br></div>\r\n<br>\r\n<ul>\r\n    <li>Don\'t drink alcohol the night before.</li>\r\n    <li>Limit caffeine intake to zero or at most, one cup of coffee.</li>\r\n    <li>Don\'t come in hungry.</li>\r\n    <li>Don\'t come in drowsy.</li>\r\n    <li>Limit hair products.</li>\r\n    <li>Get a good night\'s sleep.<br></li>\r\n</ul>\r\n<br>\r\n<p>The products you will need to prepare your client for EEG acquisition include Nuprep, an alcohol pad or cotton ball + 70% alcohol rubbing alcohol, a blunt tip syringe, and Electrogel. You will need an electrocap, dropped ears (this depend on the amplifier),\r\n    and sponge discs for acquisition.</p>\r\n<p>You can find the links directing you to the prices and descriptions to all these products here:</p>\r\n<br>\r\n<table width=\"100%\">\r\n    <tbody>\r\n        <tr>\r\n            <td align=\"center\"><a href=\"https://bio-medical.com/nuprep-eegecg-skin-prep-gel-3-pack-of-4oz-tubes.html\" target=\"new\"><img src=\"@@PLUGINFILE@@/nu-prep.jpg\" alt=\"\" width=\"200\" height=\"134\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br>NuPrep</a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><br><a href=\"https://electro-cap.com/index.cfm/supplies/\" target=\"new\"><img src=\"@@PLUGINFILE@@/blunt.png\" alt=\"\" width=\"400\" height=\"387\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br>Blunt-tipped needles and syringes</a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><br><a href=\"https://electro-cap.com/index.cfm/supplies/\" target=\"new\"><img src=\"@@PLUGINFILE@@/electro-gel.png\" alt=\"\" width=\"165\" height=\"200\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br>Electrogel </a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><br><a href=\"https://electro-cap.com/index.cfm/supplies/\" target=\"new\"><img src=\"@@PLUGINFILE@@/sponge-disks.png\" alt=\"\" width=\"176\" height=\"200\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br>Sponge Disks </a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><br><a href=\"https://electro-cap.com/index.cfm/caps/\" target=\"new\"><img src=\"@@PLUGINFILE@@/electrocaps.png?time=1564078364483\" alt=\"\" width=\"200\" height=\"255\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br>Electrocaps E1-LEX with drop references </a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><br><a href=\"https://bio-medical.com/ear-drop-clips.html\" target=\"new\"><img src=\"@@PLUGINFILE@@/electrocaps-2.png\" alt=\"\" width=\"200\" height=\"202\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br>Electro-Cap 3 1/2\" DIN Ear Clips </a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><br><a href=\"https://www.amazon.com/gp/product/B001IKKHFO/ref=ppx_yo_dt_b_asin_title_o09_s00?ie=UTF8&amp;psc=1\" target=\"new\"><img src=\"@@PLUGINFILE@@/db-alcohol-swabs.png\" alt=\"\" width=\"480\" height=\"450\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br>BD Alcohol Swabs 100 Each (Pack of 12) </a></td>\r\n        </tr>\r\n    </tbody>\r\n</table>\r\n<br>\r\n<p>To prep a client, place a pea-sized amount of nuprep on an alcohol pad, and scrub the forehead and the ear lobes.</p>\r\n<p>Each hardware/software system differs in the steps you need to take to record. However, whichever system you use, you will need to ensure low impedance. This can be done with a QCheck with the NeuroField System, a Checktrode system, or any built-in impedance\r\n    system, such as EEGStudio’s impedance meter.</p>\r\n<p>To learn how to record in the NeuroField system, watch this short video.</p>\r\n<p style=\"text-align: center; \"><a href=\"@@PLUGINFILE@@/Recording%20in%20Neurofield.mp4?time=1588279301862\">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\"><source src=\"@@PLUGINFILE@@/recording%20in%20Neurofield.mp4?time=1588279357311\">@@PLUGINFILE@@/recording%20in%20Neurofield.mp4?time=1588279357311</video>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</a><br></p>\r\n<p>To learn how to record in the NeuroGuide system, watch this short video.</p>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\"><source src=\"@@PLUGINFILE@@/Recording%20and%20EEG%20in%20Neuroguide.mp4\">@@PLUGINFILE@@/Recording%20and%20EEG%20in%20Neuroguide.mp4</video>&nbsp;&nbsp;&nbsp;<br></p>\r\n<br>\r\n<table width=\"100%\">\r\n    <tbody>\r\n        <tr>\r\n            <td align=\"center\"><a href=\"https://bio-medical.com/catalogsearch/result/?q=checktrode\" target=\"new\"><img src=\"@@PLUGINFILE@@/ufi.jpg\" alt=\"\" width=\"400\" height=\"280\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></a></td>\r\n            <td>1089NP Checktrode EEG &amp; qEEG Impedance Meter\r\n                <br> Use the 1089NP to rapidly check applied electrode contact impedance of multiple EEG electrode configurations. Ideal for electrode configurations found in Cranial EEG caps. This EEG impedance meter has a 25 pin connector for Electro-Cap\r\n                19 channel cap connection. <a href=\"https://bio-medical.com/catalogsearch/result/?q=checktrode\" target=\"new\">Learn More.</a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><a href=\"http://www.neurofield.org/qcheck/\" target=\"new\"><img src=\"@@PLUGINFILE@@/Qcheck%20impedance%20meter.jpg\" alt=\"QCheck Impedance meter\" width=\"400\" height=\"269\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></a></td>\r\n            <td>QCheck (Electrode Impedance Meter)\r\n                <br> The QCheck is a fully software integrated electrode impedance meter, metering 20 channels on your lexicor pinout EEG cap in real time. With a new interface in NeuroField64, the QCheck makes impedance checking simple and quick.\r\n                <a href=\"http://www.neurofield.org/qcheck/\" target=\"new\">Learn More</a>\r\n            </td>\r\n        </tr>\r\n    </tbody>\r\n</table>',1),(3,2,2,404,20,0,1,1,1564079632,1614234307,'Script to Read to Patients','<br><h3>Listen to this script!&nbsp;</h3><p><audio controls=\"true\"><source src=\"@@PLUGINFILE@@/8496094039108007-audio.ogg\">@@PLUGINFILE@@/8496094039108007-audio.ogg</audio><br></p>\r\n<p>Now you are ready to record. You want to minimize the amount of movement in your client’s EEG record, which requires these spoken instructions:</p>\r\n<ul>\r\n        <li>Relax your forehead.</li>\r\n        <li>Soften then muscles around your eyes.</li>\r\n        <li>Relax your jaw.</li>\r\n        <li>Let your tongue fall away from the roof of your mouth.</li>\r\n        <li>Let your teeth slightly part.</li>\r\n				<li><i>Hint—if the client shows frontal eye field when closing their eyes, ask that they lightly place their peace fingers over their eyelids. (Some clinicians opt to use an eye mask when people flutter their eyes.)</i></li>\r\n</ul><p>You will adopt a script that works well for you. Commit it to memory and repeat every time you gather EEG data. With eyes closed, the same script applies with one main difference: <u>Wait 30 seconds before you ask the patient to close their eyes.</u>&nbsp;This allows you to then see the state change from eyes open to eyes closed, clocking the amount of time it takes for alpha to appear (or not appear!)</p>\r\n<br>\r\n<p>It is a standard in the USA that 10 minutes of eyes open and 10 minutes of eyes closed data are collected, this is the minimum length an EEG record must be in order to be held as credible in a court of law.</p><p><br></p><p><br></p>',1),(4,3,0,5,20,0,1,1,1564131050,1564605255,'What Are Artifacts?','An artifact is an alteration of EEG data that is from an extra-cerebral source. The artifacts this section will cover includes: <br><br><ol><li>Electromyographic (EMG) Artifact, AKA Muscle Artifact</li><li>Eye Blink Artifact&nbsp;</li><li>Eye Movement Artifact&nbsp;</li><li>Drowsiness Artifact&nbsp;</li><li>Sweat Artifact&nbsp;</li><li>Pulse and Cardio Ballistic Artifact&nbsp;</li><li>Salt Bridge&nbsp;</li><li>Electrode and Equipment Artifacts</li><li>Environmental Noise Artifact</li><li>Medication “Artifact”</li></ol>',1),(5,3,4,6,20,0,1,1,1564131057,1591200476,'Determining Real EEG vs. Not Real EEG','<p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Real EEG data will have what we call “field” and “phase.” What that means is that any activity we see in the raw EEG data—if it is real brainwave activity—will have a surround. For example, if you are questioning activity coming from T3, you must check to see: Does the activity you see emanating from T3 have a surrounding similar wave pattern\r\nat the neighboring elecetrodes of T5, C3, and F7? If the activity is similar, then you have real brain activity. If it is not, then you have fake activity (called \"artifact\"). Muscle contamination will not share the same phase and field between two or more electrodes. Muscle contamination is one type of artifact in the EEG.</span></p><br>\r\n<div>Often it is necessary to validate data at O1 and O2, as the occipitalis muscle is sometimes the culprit of high amplitude beta activity and sometimes O1 and O2 beta activity is real brainwave activity.&nbsp;</div><div><br></div><div>Listen to this intro for the EEG video!</div><div><br></div><div><audio controls=\"true\"><source src=\"@@PLUGINFILE@@/9213022558190946-audio.ogg\">@@PLUGINFILE@@/9213022558190946-audio.ogg</audio><br></div>\r\n<div><br></div>\r\n<center>&nbsp;<iframe src=\"https://player.vimeo.com/video/358114442\" width=\"640\" height=\"373\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe>&nbsp;<br></center><br>Another way to check for field and phase in your data is to switch to a\r\nmontage that places channels in a sequential order, so that the channels are next to their proximal neighbors. In neuroguide, for example, the deymed montage places channels next to their neighboring electrode sites:<br><br>\r\n<div style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/electrode-pair.png?time=1564134176374\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"760\" height=\"703\"><br></div><br>\r\n<div style=\"text-align: center;\"><i>Figure 1e: A deymed montage in Neuroguide software will place electrodes sequentially, which will allow the reader to check for field and phase in the EEG between neighboring electrode pairs.</i> <br></div>',1),(6,3,5,19,20,0,1,1,1564135308,1602694306,'Ten Types of Artifacts — Type 1: Electromyographic (EMG) Artifact, AKA Muscle Artifact','<br>\r\n<ul>\r\n    <li>The higher the amplitude, with increasing frequency, the greater the chances that its muscle imitating beta.</li>\r\n    <li>Muscle artifact will often occur in one or two channels </li>\r\n    <li>Frontalis muscle artifact arrives at Fp1 &amp; Fp2</li>\r\n    <li>Temporalis and massater muscle artifact arrives at T3/T4, F7 and F8</li>\r\n    <li>Occipitalis muscle artifact arrives at O1 and O2</li>\r\n</ul>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/emg.png?time=1564591360275\" alt=\"Figure 1f: A stray line of high amplitude in the beta frequencies in a spectrum denotes deviant amplitude and is often an indicator that one electrode is picking up EMG.\" class=\"img-responsive atto_image_button_text-bottom\" width=\"453\" height=\"411\"></div>\r\n<p><i>Figure 1f: A stray line of high amplitude in the beta frequencies in a spectrum denotes deviant amplitude and is often an indicator that one electrode is picking up EMG.</i></p>\r\n<br>\r\n<h5><b>Massater Muscle (Chewing) Artifact (50–60 Hz)<br></b></h5>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/massater.png?time=1564140872778\" alt=\"Figure 1g: The massater muscle is responsible for mastication of food and can create high amplitude beta artifact in EEG data.\" width=\"400\" height=\"396\" class=\"img-responsive atto_image_button_middle\"></div>\r\n<p><i>Figure 1g: The massater muscle is responsible for mastication of food and can create high amplitude beta artifact in EEG data.</i></p>\r\n<br>\r\n<p>See a video of massater muscle artifact here (maximize the screen).&nbsp;&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\"><source src=\"@@PLUGINFILE@@/Massater%20Chewing%20Video.mp4\">@@PLUGINFILE@@/Massater%20Chewing%20Video.mp4</video>&nbsp;&nbsp;</p><br>\r\n<h5><b>Occipital Muscle Artifact (Posterior EMG) (20–300 Hz)</b></h5>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/artifact-muscle.gif\" alt=\"Figure 1h: The occipitalis muscles are two rectangular-shaped muscles on the back of the skull, which can give pronounced EMG artifact at the O1 and O2 electrode sites.\" width=\"400\" height=\"400\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<p><i>Figure 1h: The occipitalis muscles are two rectangular-shaped muscles on the back of the skull, which can give pronounced EMG artifact at the O1 and O2 electrode sites.</i></p>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/emg-artifact.png?time=1564141541047\" alt=\"Figure 1i: Summary page of a Quantitative EEG showing occipitalis EMG artifact. Image generated from Neuroguide version 3.0.6.\" width=\"600\" height=\"797\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<p style=\"text-align: center; \"><i>Figure 1i: Summary page of a Quantitative EEG showing occipitalis EMG artifact. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<p style=\"text-align: center;\"><br></p>\r\n<p style=\"text-align: center; \">See a video of occipitalis muscle artifact here.&nbsp;&nbsp;&nbsp;&nbsp;</p><p style=\"text-align: center; \"><video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/Occipitalis%20Artifact.mp4\">@@PLUGINFILE@@/Occipitalis%20Artifact.mp4</video>&nbsp;&nbsp;&nbsp;</p>\r\n<br>\r\n<h5><b>Temporalis Muscle Artifact (40–80Hz)</b></h5>\r\n<p>The temporalis muscle elevates, retracts, and moves the jaw from side to side.</p>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/temporalis.png?time=1564141213287\" alt=\"Figure 1j: The temporalis muscle is a large fan-shaped muscle that covers the sides of the skull.\" width=\"600\" height=\"711\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<p style=\"text-align: center; \"><i>Figure 1j: The temporalis muscle is a large fan-shaped muscle that covers the sides of the skull.</i></p><p style=\"text-align: center; \">The temporalis muscle is responsible for the most common type of artifact, EMG at T3 and T4.</p><p style=\"text-align: center; \">&nbsp;&nbsp;&nbsp;<video controls=\"true\"><source src=\"@@PLUGINFILE@@/temporalis%202.mp4\">@@PLUGINFILE@@/temporalis%202.mp4</video>&nbsp;<span style=\"font-size: 1rem;\">&nbsp;</span><span style=\"font-size: 1rem;\">&nbsp;</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Temporalis artifact at T3 and T4 will create a map that looks like this:&nbsp;</span></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/Temporalis%20Map.jpg\" alt=\"Temporalis Map\" width=\"600\" height=\"492\" style=\"font-size: 1rem;\" class=\"img-responsive atto_image_button_middle\"></p><p style=\"text-align: center; \"><i>Figure 1k: The temporalis muscle can generate artifact in the left or right temporal electrodes, as we see here, with a high amplitude beta artifact arising from T4. Image generated from Neuroguide version 3.0.6.</i></p><p style=\"text-align: center;\"><br></p><br><h5><b>Frontalis (wrinkling forehead) 30–40Hz</b></h5><br><div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/frontalis.png?time=1564141288057\" alt=\"Figure 1k: The frontalis muscle is responsible for much of our expression, wrinkling the forehead and furrowing the brow. Muscle artifact from the frontalis muscle will affect Fp1, Fp2, and Fz electrodes, but may also affect F7, F8 and Fz electrodes.\" width=\"300\" height=\"358\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div><p style=\"text-align: center; \"><i>Figure 1l: The frontalis muscle is responsible for much of our expression, wrinkling the forehead and furrowing the brow. Muscle artifact from the frontalis muscle will affect Fp1, Fp2, and Fz electrodes, but may also affect F7, F8 and Fz electrodes.</i></p><p style=\"text-align: left;\"><span style=\"font-size: 1rem;\">Frontalis muscle artifact is caused by the muscles in the forehead. To check if frontal EEG is real or fake, you will want to</span></p><ul><li>Drop the low pass band filter</li><li>Check for field and phase</li></ul><p>This video is one where we are examining EEG activity in the frontal electrodes to determine if it is real or fake. We examine the waveform and then switch to a deymed montage (in neuroguide software) which shows us the electrodes in sequential order. In this video, the neighboring electrodes have similar field and phase, which means the EEG activity is real! This person has high amplitude frontal beta.&nbsp;</p><p style=\"text-align: center; \">&nbsp;&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/Frontalis%20Video.mp4\">@@PLUGINFILE@@/Frontalis%20Video.mp4</video>&nbsp;&nbsp;<br></p>This is the QEEG Map we would see with this type of high amplitude frontal activity.<br><div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears.png?time=1564141620674\" alt=\"Figure 1l: Summary page of a Quantitative EEG showing frontalis EMG artifact. Image generated from Neuroguide version 3.0.6.\" role=\"presentation\" width=\"712\" height=\"956\"></div><p style=\"text-align: center; \"><i>Figure 1m: Summary page of a Quantitative EEG showing high amplitude frontal beta. Image generated from Neuroguide version 3.0.6.</i></p><p style=\"text-align: center;\"><br></p><div></div><br><p><br>\r\n\r\n</p><br>Sometimes the temporalis muscle affects the electrodes F7 and F8, as we see in this image<br><div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears-2.png?time=1564141695313\" alt=\"Figure 1m: The temporalis muscle can generate artifact in the temporal electrodes (T3, T4, T5, or T6, as well as the left or right frontal electrodes, as we see here, with a high amplitude beta artifact arising from F8. Image generated from Neuroguide version 3.0.6.\" width=\"600\" height=\"796\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"></div><p><i>Figure 1n: The temporalis muscle can generate artifact in the temporal electrodes (T3, T4, T5, or T6, as well as the left or right frontal electrodes, as we see here, with a high amplitude beta artifact arising from F8. Image generated from Neuroguide version 3.0.6.</i></p><p><br></p>',1),(10,3,16,12,20,0,1,1,1564594925,1597382415,'Ten Types of Artifacts — Type 6: Pulse and Cardio Balistic Artifact (EKG)','The below image is of a cardiac artifact (heartbeat) affecting the EEG. You can tells its heartbeat because it happens approximately once per second (the average heartbeat is 72 beats per minute) and it is rhythmic.&nbsp;<br>\r\n<div><img src=\"@@PLUGINFILE@@/cardiac-artifact.png\" alt=\"Figure 1n: A pulse artifact coming from an ear electrode, which contaminates the ear electrode reference and places the cardiac artifact in every channel.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"1784\" height=\"1076\"></div>\r\n<p><i>Figure 1r: A pulse artifact coming from an ear electrode, which contaminates the ear electrode reference and places the cardiac artifact in every channel.</i></p>\r\n<br>\r\n<p>Watch the video here for the case example with the cardiac artifact stemming from an ear electrode.</p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">&nbsp;</span><span style=\"font-size: 1rem;\">&nbsp;&nbsp;&nbsp;<video controls=\"true\"><source src=\"@@PLUGINFILE@@/Cardiac%20Artifact.mp4\">@@PLUGINFILE@@/Cardiac%20Artifact.mp4</video>&nbsp;</span></p>\r\n<p>Often when a global pulse artifact (like this) contaminates the data, the anatomy of the individual is part to play. Often, folks who are stocky, with short large necks, produce artifacts such as this. One possible way to mitigate this artifact is to\r\n    place cottonballs behind the ears. That said, this preventative measure doesn’t work a majority of the time.</p>\r\n<p>Here is another video of a cardiac artifact, only this time it is showing up in only one electrode location.</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/pulse%20artifact%202.mp4\">@@PLUGINFILE@@/pulse%20artifact%202.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<p><b><i>How do I know that its cardiac artifact and not something else?</i></b></p>\r\n<p>A regular heartbeat occurs at 72 beats per minute. So, a bump in the raw data that arrives once per second, approximately, will give away that the source of the artifact is the rhythmic beating of the heart.</p>',1),(12,3,10,14,20,0,1,1,1564596020,1596578387,'Ten Types of Artifacts — Type 7: Salt Bridge Artifact','<br>\r\n<p>A salt bridge is caused when there is too much electrogel in a cap, causing two electrodes to conjoin and destroying the signal. Salt bridge artifact will show up in low amplitude channel (often Fz). Typically Fz and the ground create a salt bridge, since\r\n    they are so close together. Very often the artifact will show up in maps as asymmetry stemming at Fz or a 28Hz artifact (sometimes 16Hz) at Fz, which are subharmonics of an electrical artifact.</p>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears-4.png?time=1564142753887\" alt=\"Image 1p: In this summary map, the salt bridge disrupted the Fz electrode, causing a focal high amplitude artifact, as well as questionable asymmetry and hypocoherence. Image generated from Neuroguide version 3.0.6.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"716\" height=\"921\"></div>\r\n<p style=\"text-align: center; \"><i>Image 1s: In this summary map, the salt bridge disrupted the Fz electrode, causing a focal high amplitude artifact, as well as questionable asymmetry and hypocoherence. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<p style=\"text-align: center;\"><br></p>\r\n<div><img src=\"@@PLUGINFILE@@/fz-electrode.png?time=1564142814872\" alt=\"Image 1q: In this raw recording, the salt bridge disrupted the Fz electrode, causing a low amplitude signal to arrive at the Fz channel, the active electrode in the pain of bridged electrocdes.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"1917\" height=\"1100\"></div>\r\n<p><i>Image 1t: In this raw recording, the salt bridge disrupted the Fz electrode, causing a low amplitude signal to arrive at the Fz channel, the active electrode in the pain of bridged electrocdes.</i></p>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears-5.png?time=1564142905223\" alt=\"\" width=\"700\" height=\"441\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<p><i>Image 1u: Often with a salt bridge, a high amplitude spot at the site of the bridge (commonly Fz) will show up at 28Hz. Image generated from Neuroguide version 3.0.6.</i></p><p>A rare salt bridge artifact will look like what we see in the below recording, high amplitude 16hz activity, stemming from the ground electrode. This is a difficult artifact to spot with the naked eye because it looks real.&nbsp;</p><p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/Salt%20Bridge%202.mp4\">@@PLUGINFILE@@/Salt%20Bridge%202.mp4</video>&nbsp;&nbsp;<br></p>',1),(13,3,14,17,20,0,1,1,1564596675,1597383226,'Ten Types of Artifacts — Type 9: Environmental Noise Artifact','<br>\r\n<p>Environmental noise should always strike the electroencephalograher as strange, due to its fast, rhythmic appearance. When an electrical system is not grounded, when there is poor connectivity between devices, when there is “electro-smog” in the environment,\r\n    as we sometimes see in large cities, these are all situations where environmental noise such as this appears. Its best to check a building for environmental noise before moving in, as sometimes the solution is difficult to arrive at.</p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">&nbsp;&nbsp;&nbsp;&nbsp;<video controls=\"true\"><source src=\"@@PLUGINFILE@@/Environmental%20Noise.mp4?time=1597383179926\">@@PLUGINFILE@@/Environmental%20Noise.mp4?time=1597383179926</video>&nbsp;</span></p>This next EEG is one where the electrical noise is not easy to spot with the naked eye, that is, not until we remove the low pass filter, allowing all frequency activity to enter the recording. Once we remove the filter, we can see that there is environmental noise that contaminates the entire EEG, making it a bad recording--not impossible to interpret, but certainly dirty.<br><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">&nbsp;</span><span style=\"font-size: 1rem;\">&nbsp;&nbsp;&nbsp;<video controls=\"true\"><source src=\"@@PLUGINFILE@@/Electricity.mp4?time=1597383222174\">@@PLUGINFILE@@/Electricity.mp4?time=1597383222174</video>&nbsp;</span></p>&nbsp;<br>',1),(14,3,12,13,20,0,1,1,1564599968,1597383126,'Ten Types of Artifacts — Type 8: Electrode and Equipment Artifact','<br>\r\n<p>Electrode artifacts are brief transients typically at one channel at a time.</p>\r\n<br>\r\n<h5><b>Electrode Pop</b></h5>\r\n<p>A spontaneous discharge of electric potential (because the skin or electrode can act a capacitors and hold electrical charge across the paste).</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/Electrode%20Pops.mp4\">@@PLUGINFILE@@/Electrode%20Pops.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<h5><b>Loose Electrode</b></h5>\r\n<p>Poor contact with varying and disorganized morphology (sharp and slow, high amplitude, etc.).</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/Loose%20Electrode.mp4\">@@PLUGINFILE@@/Loose%20Electrode.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<h5><b>Bad Ear Lead</b></h5>\r\n<p>A bad ear lead will typically distort all of the data—it will appear that all of the data is moving together in synchrony—everything going electro negative and electro positive together. What this will typically produce is a map that shows hypercoherence\r\n    across all channels. Generally a record with a bad ear electrode is immediately suspicious to the eye, even if novice.</p>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears-6.png?time=1564143146857\" alt=\"\" width=\"700\" height=\"934\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<p style=\"text-align: center; \"><i>Image 1v: Coherences such as these, with every frequency showing hypercoherence in every channel, should be questioned as it is always a product of a defective ear electrode. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<p style=\"text-align: center;\">&nbsp;<video controls=\"true\"><source src=\"@@PLUGINFILE@@/Bad%20Ear%20Lead.mp4?time=1597383119548\">@@PLUGINFILE@@/Bad%20Ear%20Lead.mp4?time=1597383119548</video>&nbsp;<br></p>\r\n<p></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">&nbsp;</span><span style=\"font-size: 1rem;\">&nbsp;&nbsp;</span></p>\r\n<hr>\r\n<br>',1),(15,3,18,16,20,0,1,1,1564600493,1597382277,'Ten Types of Artifacts — Type 4: Drowsiness Artifact','<h3><br></h3>\r\n<p>Drowsiness is difficult to see for the untrained eye and would not classify as artifact, however it is data that must be thrown out, unless the quality of someone’s sleep or how quickly they fall asleep are being monitored. In this video, within one minute of closing his eyes, this patient falls asleep, generating beta spindles, high amplitude alpha, K-complexes down the vertex, and low amplitude beta. These findings are part of falling asleep! We see this type of EEG activity in NREM 2 and NREM3 stages of sleep.</p><p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/drowsiness.mp4\">@@PLUGINFILE@@/drowsiness.mp4</video>&nbsp;&nbsp;<br></p>\r\nThe EEG architecture of sleep will be covered further in the chapter on neurophysiology. If you happen to edit a drowsy recording, this is the kind of map you will get! This is not good data, because is it not representative of the patient in normal eyes closed conditions. He is asleep and we see high amplitude central theta (because of the vertex sharp waves) as well as high amplitude frontal beta (because of the beta spindles-the stabilizing mechanism of sleep).<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears-7.png?time=1564143083126\" alt=\"\" width=\"600\" height=\"803\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<p style=\"text-align: center; \"><i>Image 1q: The drowsy EEG was showing vertex slow waves and frontal spindling beta (aka sleep spindles), which show up in a fast fourier transform as high amplitude central theta and high amplitude frontal beta. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<p style=\"text-align: left;\"><br></p><p style=\"text-align: left;\">Sometimes you will catch a patient falling into stage 1 of sleep (aka NREM1). This is the beginning of drowsiness. The video below is what we see when a patient enters stage NREM1, alpha followed by alpha dropout (this coheres to the vigilance stages of A1, A2, A3, and B1). The image below is of the vigilance model and details what we can expect to see as a patient is falling asleep.&nbsp; &nbsp; &nbsp; &nbsp;</p><p style=\"text-align: left;\">&nbsp;&nbsp;<video controls=\"true\"><source src=\"@@PLUGINFILE@@/vigilance%20.mp4\">@@PLUGINFILE@@/vigilance%20.mp4</video>&nbsp;</p><p style=\"text-align: left;\"><div><div><h2>EEG-vigilance algorithm “VIGALL”</h2></div></div><div><div><p>In parallel to the transition from active wakefulness to deep sleep the human brain takes on different global functional states. These functional states are reflected in the spectral composition and topography of the EEG and have been termed vigilance stages. These states correspond to different levels of alertness at the behavioral level. Several stages can be separated during the transition from tense to relaxed wakefulness and further on to drowsiness until sleep onset.</p><p>In 1937, Loomis et al. (1937), later modified by Roth (1961), Bente (1964) and others (e.g. (Klimesch, 1999; Ulrich &amp; Frick, 1986); proposed classifications for vigilance stages occurring during transition from active wakefulness to sleep onset. They are based on the following EEG phenomena during eyes closed, which have been demonstrated in several studies:</p><p><strong>A1)</strong>&nbsp;Posterior alpha mostly seen after eye-closing with a frequency of 8-12 Hz and an occipital focus. This oscillation has been referred to as “idling rhythm” (Niedermeyer, 1997) because it marks a state of relaxed wakefulness, corresponding to vigilance stage A1 according to Bente (1964) and Loomis (Loomis et al., 1937).</p><p><strong>A2-A3)</strong>&nbsp;Alpha power anteriorisation occurs increasingly after several minutes of relaxed wakefulness. Alpha peak frequency shows a slight decrease. This phenomenon is reported to occur during transition to drowsiness (Broughton &amp; Hasan, 1995; Connemann et al., 2005; De Gennaro, Ferrara, Curcio &amp; Cristiani, 2001; De Gennaro et al., 2004; De Gennaro et al., 2005; Pivik &amp; Harman, 1995) and corresponds to vigilance stage A2 and A3 (Bente, 1964; Loomis et al., 1937).</p><p><strong>B1)</strong>&nbsp;Low voltage EEG is increasingly observed during lower vigilance stages. The alpha rhythm disappears (alpha drop-out) and beta power increases (De Gennaro et al., 2001; Tanaka, Hayashi &amp; Hori, 1996; Tanaka, Hayashi &amp; Hori, 1997). This EEG pattern corresponds to vigilance stage B1 (Roth, 1961). The EEG in this state is similar to the EEG during intense mental activity and eyes open condition.</p><p><strong>B2-3)</strong>&nbsp;Increased delta and theta activity is observed in parallel with increasing subjective drowsiness (Strijkstra, Beersma, Drayer, Halbesma &amp; Daan, 2003; Tanaka et al., 1996; Tanaka et al., 1997), corresponding to vigilance stages B2 and B3 (Roth, 1961).</p><p><strong>C)</strong>&nbsp;The occurrence of K-complexes and sleep spindles mark the beginning of definite sleep &nbsp;(Cash et al., 2009; De Gennaro &amp; Ferrara, 2003; Tanaka et al., 1997).</p><p>Based on these EEG features a computer-based algorithm has been created for separating different EEG-vigilance stages (also see figure 4) for consecutive EEG segments. The first version of the algorithm “VIGALL” (Vigilance Algorithm Leipzig) was based upon the Fast Fourier-derived power of the four main EEG frequency bands alpha, beta, delta and theta during two-second segments of continuous EEG data at different sites. An improved second version of the algorithm now takes into account the intracortical source power (derived by Low Resolution Tomography-LORETA) of different regions of interest (ROIs).</p><img src=\"@@PLUGINFILE@@/vigilance%202.jpg\" alt=\"Vigilance model\" width=\"667\" height=\"490\" class=\"img-responsive atto_image_button_left\"><br>\r\n\r\n</div></div><br></p>\r\n<p><br></p>\r\n<br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br>\r\n<hr>\r\n<br><br><h3></h3><br>',1),(16,3,15,10,20,0,1,1,1564604729,1592830567,'Ten Types of Artifacts — Type 5: Sweat Artifact','<br>\r\n<p>Sweat artifact arises when the sodium and water in sweat interacts with the salt-impregnated past of the EEG cap. What you see are high amplitude slow waves, that look like giant delta waves, sometimes slower than 1Hz.</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/Sweaty.mp4\">@@PLUGINFILE@@/Sweaty.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<p>Some analysis programs filter out frequencies less than 1Hz or less than 2Hz, causing the sweat artifact to disappear in the filtered image. It is important to catch sweat artifact when it is happening and try to cool down your client and the room to avoid a poor recording.</p>\r\n<p>In the following video, we can see how checking the filters can prevent slow artifacts, such as sweat, from being noticed by the electroencephalographer. We are removing the low pass filter to see how the data looks with and without automatic filtering.</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\"><source src=\"@@PLUGINFILE@@/check%20the%20filtering.mp4\">@@PLUGINFILE@@/check%20the%20filtering.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<hr>\r\n<br>',1),(17,3,13,0,20,0,1,1,1564604875,1592831170,'Ten Types of Artifacts — Type 10: Medication \"Artifact\"','<br>\r\n<h5><b>Gabaergic Drugs (i.e. Benzodiazepines)</b></h5>\r\n<p>This video and imagery is of benzodiazepine toxicity. In this case, the individual is taking Xanax on an “as needed” basis for pain, which is enough to alter the EEG. When taking a benzodiazepine we see an increase in the amount of GABA, an inhibitory neurotransmitter, which creates a global beta spindling, as we see in this video. This is an EEG finding that we see with GABAergic drugs.</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/Benzos.mp4\">@@PLUGINFILE@@/Benzos.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<p>Benzodiazepine toxicity will lead to a quantitative EEG that has a copious amount of high amplitude beta. Since this is a medication side-effect, neurofeedback and neuromodulation will not help to reduce the amount of high amplitude beta we see in the record.</p>\r\n<br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears-8.png?time=1564142985979\" alt=\"\" width=\"700\" height=\"938\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<p style=\"text-align: center; \"><i>Image 1w: The EEG of someone taking a benzodiazepine will often show a high amplitude beta marker focused centrally. Image generated from Neuroguide version 3.0.6.</i></p>',1),(18,3,19,15,20,0,1,1,1564605133,1592830368,'Ten Types of Artifacts — Type 3: Eye Movement Artifact','<br>\r\n<h5><b>Eyes Closed Eye Artifacts</b></h5>\r\n<p>Sometimes people have a hard time keeping their closed eyes closed. It seems they have to will their eyes shut. You will sometimes see this in small children or adults—they will have an eye flutter. In these cases, you will want to ask the client to place\r\n    their middle finger and index finger lightly atop their eyelids to prevent this type of artifact.</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/eye%20movements.mp4\">@@PLUGINFILE@@/eye%20movements.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<h5><b>Lateral Eye Movement artifacts</b></h5>\r\n<p>Lateral eye artifacts can be seen in channels F7 and F8, typically, and are large swings that look like they’re in a delta frequency. This is because the eyeballs themselves are dipoles with a positive and a negative polarity. Each time we look left and\r\n    right, it causes a large swing in the electrodes.</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/lateral%20eye%20movement.mp4\">@@PLUGINFILE@@/lateral%20eye%20movement.mp4</video>&nbsp;&nbsp;<br></p>\r\nIf lateral eye movements are included in the EEG data, this is what it looks like in a map: high amplitude delta (of course, its not real!)<br><br>\r\n<div style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/linkears-3.png?time=1564142186232\" alt=\"Figure 1o: Lateral eye artifact can appear as high amplitude delta, since the waves are generally under 4Hz. Image generated from Neuroguide version 3.0.6.\" width=\"600\" height=\"798\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"></div>\r\n<br>\r\n<p style=\"text-align: center; \"><i>Figure 1p: Lateral eye artifact can appear as high amplitude delta, since the waves are generally under 4Hz. Image generated from Neuroguide version 3.0.6.</i></p>',1),(19,3,6,18,20,0,1,1,1564605136,1597381497,'Ten Types of Artifacts — Type 2: Eye Blink Artifact','<br>\r\n<p>Eye movement artifact are some of the easiest to spot with the naked eye. Eye blinks are commonly found at Fp1, Fp2, Fz, F7, and F8 locations, respectively. The reason we see artifacts with eye blinks is because eyeballs are dipoles, with a positive polarity up front and a negative polarity in the back.</p><p style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/Eyes%20are%20dipoles.jpg\" alt=\"Eyes as dipoles\" width=\"700\" height=\"423\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center; \"><i>Image 1o: The eyes are dipoles, with a positive polarity at the cornea and a negative polarity at the retina.</i></p><p style=\"text-align: center; \"><i><br></i></p><p>Here is a video of eye blinks, watch the channel locations that are affected so you can later\r\n    spot eye blinks yourself.</p>\r\n<br>\r\n<p style=\"text-align: center; \">&nbsp;&nbsp;<video width=\"600\" height=\"400\" controls=\"true\" class=\"\"><source src=\"@@PLUGINFILE@@/eye%20blinks.mp4\">@@PLUGINFILE@@/eye%20blinks.mp4</video>&nbsp;&nbsp;<br></p>\r\n<br>\r\n<p>Sometimes a client will blink quite a lot, so much that there isn’t a moment in the record where their data is not affected by eye movements. When recording the data from these types of clients, ask that they try to NOT blink for 5 seconds after each\r\n    blink. When artifacting data that is contaminated by eye blinks, you want to make sure that you are not collecting data that has the delta-like swing that follows each blink. We call this the “whiplash.” The following video shows how to avoid the\r\n    whiplash in your editing process.</p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">&nbsp;</span><span style=\"font-size: 1rem;\">&nbsp;&nbsp;&nbsp;<video controls=\"true\"><source src=\"@@PLUGINFILE@@/whiplash%20%282%29.mp4\">@@PLUGINFILE@@/whiplash%20%282%29.mp4</video>&nbsp;</span></p>\r\n<p><br></p>',1),(20,4,0,21,20,0,1,1,1564762933,1656006022,'Concepts of Drug Effects','<ul>\r\n    <li>Individuals may present unique individual effects in the EEG from drugs</li>\r\n    <li>Baseline brain function can either hide or reveal the effects of drugs on the EEG</li>\r\n    <li>Predicting Drug effects is difficult (some drugs produce effects that are inconsistent and variable), although there are response stereotypes to drugs</li>\r\n    <li>Recognizing drug effects is difficult</li>\r\n    <li>Patients taking more than one drug complicates the ease of seeing drug effects in the EEG. Mixtures of drugs become too complex to evaluate any one medication’s contribution, not to mention the synergistic combined effect of many meds</li>\r\n</ul>\r\n<div style=\"padding:56.25% 0 0 0;position:relative;\"><iframe src=\"https://player.vimeo.com/video/438243445?h=4960790efa&amp;badge=0&amp;autopause=0&amp;player_id=0&amp;app_id=58479\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen=\"\" style=\"position:absolute;top:0;left:0;width:100%;height:100%;\" title=\"JAY Gunkelman on MEDICATION\"></iframe></div><script src=\"https://player.vimeo.com/api/player.js\"></script>\r\n<p><a href=\"https://vimeo.com/438243445\"><br></a></p>\r\n<p><br></p>',1),(21,4,20,0,20,0,1,1,1564763450,1591211642,'Generalities','Drugs (prescription and otherwise) can have a significant effect on the EEG. Not all brains respond to drugs similarly, however. Arousal level changes the EEG, but this is patient dependent. For example, a stimulation medication will increase alpha levels in an under aroused subject, but will decrease alpha in an over aroused (anxious) subject.<br><br>There is a reciprocal relationship between alpha and beta. If a drug stimulates the brain stem and alpha generators lose their synchronicity, beta appears in the EEG.\r\n\r\n\r\nThere are five classes of drugs that have effects on EEG:\r\n\r\n<br><br><ul><ul><li>Street Drugs</li><li>Anti-epileptic drugs/anti-convulsant drugs</li><li>Analgesics (includes opioids)</li><li>Anesthetics</li><li>Psychotropics</li></ul>\r\n\r\n\r\n\r\n\r\n</ul>\r\n\r\nGABAergic drugs create the greatest changes (benzodiazepines and barbiturates).&nbsp;<br>This will be discussed in the lesson you\'re embarking upon.<br>',1),(22,5,0,0,20,0,0,0,1564764546,1593955183,'Street Drugs','<p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/WEED2.jpg\" alt=\"WEED\" width=\"280\" height=\"180\" class=\"atto_image_button_text-bottom\"><img src=\"@@PLUGINFILE@@/WEED3.jpg\" alt=\"WEED\" width=\"270\" height=\"180\" class=\"img-responsive atto_image_button_text-bottom\"><img src=\"@@PLUGINFILE@@/WEED.jpg\" alt=\"WEED\" width=\"270\" height=\"180\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\"><br></p>\r\n    <p></p>\r\n    <h3><b>Marijuana/Hashish/THC</b></h3>\r\n    <h5>Marijuana and its sister drugs will Increase frontal alpha amplitude, with increased frontal coherence across the hemispheres, as well as phase synchrony.&nbsp; These findings are reported in chronic exposures.</h5>\r\n    <p>Effects on dampening reaction times in evoked potentials have been noted as well.</p>\r\n    <h4>Anteriorized Alpha in Raw EEG and in the QEEG</h4>\r\n    <p style=\"text-align: center; \"><img src=\"@@PLUGINFILE@@/anteriorized%20alpha.jpg\" alt=\"Anteriorized alpha\" width=\"500\" height=\"711\" class=\"img-responsive atto_image_button_middle\"></p>\r\n    <p style=\"text-align: center; \">&nbsp;</p>\r\n    <p><br><b style=\"color: rgb(55, 71, 79); font-family: &quot;Open Sans&quot;; font-size: 1.715rem;\">LSD (Lysergic Acid Diethylamide)</b><br></p>\r\n    <h3><span style=\"font-size: 1rem;\"><span><span><span><b><p><b><img src=\"@@PLUGINFILE@@/LSD%20%281%29.jpg\" alt=\"LSD Effects\" width=\"455\" height=\"300\" class=\"img-responsive atto_image_button_left\"></b></p></b></span></span>\r\n        </span>\r\n        </span>\r\n    </h3><span style=\"font-size: 1rem;\">The effect of LSD on the EEG is dependent upon the baseline. If the EEG is normal, there is often a decrease in alpha and an increased in beta frequencies.</span><br><br><span style=\"font-size: 1rem;\">With slower EEG backgrounds, there is an\r\n     increase in alpha and beta activity.</span><br><br><span style=\"font-size: 1rem;\">The low voltage fast EEG phenotype shows little change in\r\n     spectral profile with exposure.<br><span style=\"font-size: 1rem;\"><br>An\r\n     increase in </span><i style=\"font-size: 1rem;\">conditioned inhibition is&nbsp;</i><span style=\"font-size: 1rem;\">seen with lower doses, as well as decreased paroxysmal activity.\r\n     The stimulant effects of this powerful drug may cause convulsions at higher doses, such as in the early government studies. In these studies, </span><i style=\"font-size: 1rem;\">milligram</i><span style=\"font-size: 1rem;\"> doses were supplanted for the </span>\r\n    <i style=\"font-size: 1rem;\">microgram</i><span style=\"font-size: 1rem;\"> recommendations from Switzerland, where the LSD was produced (Sandoz).<br></span></span><h3><b><br></b></h3><p><b><br></b></p><h3><b>PCP, Phencyclidine, or Angel Dust</b>&nbsp;</h3><span style=\"font-size: 1rem;\"><br>PCP causes a marked increase in slow activity, with paroxysmal activity and extreme voltages noted with increased dosage. Convulsions have been reported.</span>\r\n        <p></p>\r\n        <p><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/pcp.jpg\" alt=\"pcp\" width=\"250\" height=\"195\" style=\"text-align: center; \" class=\"atto_image_button_text-bottom\"><img src=\"@@PLUGINFILE@@/pcp2.jpg\" alt=\"pcp\" width=\"455\" height=\"324\" style=\"text-align: center; \" class=\"img-responsive atto_image_button_right\"><br></span></p>\r\n        <p><br></p>\r\n        <h3><b><br></b></h3><h3><b><br></b></h3><h3><br></h3><h3><b>Morphine/Opiates/Heroin</b></h3><span style=\"font-size: 1rem;\">Shortly following administration, there is increased alpha, with slowing of alpha during the euphoric high.&nbsp; With increased dose, there is increased slowing, and like barbiturates, the EEG may go iso-electric. There is an increase in REM sleep noted with opiates.</span>\r\n        <p></p>\r\n        <p style=\"text-align: center; \"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/heroin.jpg\" alt=\"Heroin\" width=\"500\" height=\"250\" class=\"img-responsive atto_image_button_middle\"><img src=\"@@PLUGINFILE@@/morphine.jpg\" alt=\"morphine\" width=\"250\" height=\"190\" class=\"img-responsive atto_image_button_middle\" style=\"font-size: 1rem; text-align: center;\"><br></span></p>\r\n        <p><br></p>\r\n        <h3><b style=\"font-size: 1.715rem;\">Isoelectric EEG</b><span style=\"font-size: 1.715rem;\">&nbsp;</span></h3>\r\n        <p><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/isoelectric%20EEG.jpg\" alt=\"Isoelectric EEG\" width=\"500\" height=\"301\" class=\"img-responsive atto_image_button_left\">An isoelectric EEG is defined as complete loss of cortical electrical activity with maximal amplification, if sustained for an hour or more under appropriate clinical circumstances, is highly suggestive of cerebral death.<br></span></p>\r\n        <p><span style=\"font-size: 1rem;\"><br></span></p>\r\n        <p><span style=\"font-size: 1rem;\"><br></span></p>\r\n        <p><span style=\"font-size: 1rem;\"><br></span></p>\r\n        <p><span style=\"font-size: 1rem;\"><br></span></p>\r\n        <p><span style=\"font-size: 1rem;\"><br></span></p>\r\n        <p><span style=\"font-size: 1rem;\"><br></span></p>\r\n        <p><br></p>\r\n        <p><span style=\"font-size: 1rem;\"></span></p>\r\n        <h2>Alcohol</h2>\r\n\r\n        <p><i><img src=\"@@PLUGINFILE@@/alcohol.png\" alt=\"Alcohol\" width=\"299\" height=\"200\" class=\"img-responsive atto_image_button_left\">Ethanol</i>&nbsp;at higher levels causes slowing to occur, with the depressant effect seen behaviorally.&nbsp; In the low voltage fast type EEG (seen in anxious, nervous and in many chronic alcoholics and their family members), the initial\r\n            alcohol exposure causes the sudden occurrence of alpha. With severe chronic alcoholism, there can be an abnormal pattern&nbsp;<i>of periodic lateralized epileptiform\r\ndischarges (PLEDS)</i>&nbsp;seen with altered consciousness. This is not true underlying epilepsy, but rather disappears with the treatment of the alcoholism.\r\n        </p>\r\n        <p><br></p>\r\n        <h4><br></h4><h4><br></h4><h4>Quantitative EEG of a Low Voltage Fast Profile, suggestive of excess GABA-A receptor sites</h4>\r\n        <p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">&nbsp;</span></p>\r\n            <p style=\"text-align: center;\"><br></p>\r\n            <p></p>\r\n            <p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">&nbsp;</span><img src=\"@@PLUGINFILE@@/low%20voltage%20EEG.png\" alt=\"low voltage\" width=\"499\" height=\"427\" class=\"atto_image_button_middle\" style=\"font-size: 1rem; text-align: center;\"></p>\r\n            <p style=\"text-align: center; \"><span style=\"font-size: 1rem;\"><br></span></p>\r\n            <p style=\"text-align: left;\"><span style=\"font-size: 1rem;\">The low voltage fast EEG phenotype is driven by over-arousal. This profile shows a genetic alteration of gene number 4, the gene that controls GABA A receptors, and if you make more receptors than you can saturate, you become over-aroused. This is a prominent variant of people who have alcoholism. Behaviorally, this would show as someone who is over-aroused, perhaps nervous, anxious, or tense. This is someone who will not do well in a highly stressful work environment. But, overall, this it is a normal variant that is present in about 10% of the population. Typically, their alpha is fast and desynchronized.</span></p>\r\n            <h2 style=\"text-align: left;\">Cocaine&nbsp;</h2>\r\n                <p><img src=\"@@PLUGINFILE@@/coke.jpg\" alt=\"coke\" width=\"400\" height=\"300\" class=\"img-responsive atto_image_button_left\" style=\"text-align: center; \"></p>\r\n                <ul type=\"disc\">\r\n                    <li style=\"text-align: left;\">Cocaine decreases <i>synaptic\r\n     reuptake</i>, and amphetamines increase the release of the neurotransmitters in the <i>dopamine/norepinephrine</i> systems in the brain.</li>\r\n                    <li style=\"text-align: left;\"><br></li>\r\n                    <li style=\"text-align: left;\">With lower to moderate doses, there is increased alpha and beta amplitudes. </li>\r\n                    <li style=\"text-align: left;\"><br></li>\r\n                    <li style=\"text-align: left;\">With increased doses, there is a <i>desynchronization</i> of the EEG and faster activity predominates. There is an alpha increase frontally, seen during the euphoric phase of the subjective report. </li>\r\n                    <li style=\"text-align: left;\"><br></li>\r\n                    <li style=\"text-align: left;\">Cocaine is a well-known <i>epileptic potentiator</i>. </li>\r\n                    <li style=\"text-align: left;\"><br></li>\r\n                    <li style=\"text-align: left;\">Chronic abuse causes a “burned out” dopamine system, with delta decreases and slower alpha noted with little improvement even one year later in Prichep’s Phoenix House study.</li>\r\n                </ul>\r\n                <p></p>\r\n                <p style=\"text-align: left;\"><br></p>\r\n                <p></p>\r\n                <p style=\"text-align: center;\"><br></p>\r\n                <p></p>',1),(42,10,0,43,20,0,1,1,1564057663,1567346786,'Collecting EEG Data','<br>\r\n<p>There are several software programs that will allow you to collect 19+ channel EEG data. A few of them include: EEGStudio, Neuroguide, NeuroField, and xxxxx. This section will cover two platforms for recording EEG: NeuroField and Neuroguide.</p>\r\n<br>\r\n<h5><b>The 10–20 System and Electrode Placement</b></h5>\r\n<ol>\r\n    <li>The 10-20 System and Electrode Placement To begin, we first cap up. At present (2019), caps with electrodes placed using the international 10-20 system are popular in clinical neurotherapy. The 10-20 system is an internationally recognized way of\r\n        placing electrodes on a head that is replicable and verified scientifically. The electrodes pick up the EEG from the cerebral cortex underneath the electrode location.</li>\r\n    <li>The “10” and “20” refer to the distances between electrodes, which are either 10% or 20% of the total diameter or radius (transverse and sagittal) of the skull (Figure 1a). The landmarks that are used sagittal are the nasion (the depressed area between\r\n        the eyes on the ride of the nose) and the inion (the bump at the back of the skull, which can be felt with mild palpitation); landmarks that are used transversely (aka coronally) are the ears (often the tragus of the ear) (Figure 1b).</li>\r\n    <br>\r\n	<div class=\"mrow\">\r\n		<div class=\"mcol-sm-6 text-center\">\r\n			<div><img src=\"@@PLUGINFILE@@/electrode-placement.png\" alt=\"Figure 1b: The locations of the nasion, inion, and tragus points for measurement purposes.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height\"></div>\r\n    <p><i>Figure 1a. The International 10-20 system of electrode placements.</i></p>\r\n	\r\n		</div>\r\n		<div class=\"mcol-sm-6 text-center\">\r\n			<div><img src=\"@@PLUGINFILE@@/tragus-points.png\" alt=\"Figure 1b: The locations of the nasion, inion, and tragus points for measurement purposes.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height\"></div>\r\n    <p><i>Figure 1b: The locations of the nasion, inion, and tragus points for measurement purposes.</i></p>\r\n		</div>\r\n	</div>\r\n     \r\n    <br>\r\n    <h5><b>Electrode Labels</b></h5>\r\n    <p>Each electrode is labeled by a letter or pair of letters.</p>\r\n    <ul>\r\n        <li>Fp = Pre-frontal</li>\r\n        <li>F = Frontal</li>\r\n        <li>T = Temporal</li>\r\n        <li>O = Occipital</li>\r\n        <li>P = Parietal</li>\r\n        <li>C = Central</li>\r\n        <li>z = Zenith or Zero (reflecting the midline sagittal plane of the scalp, such as Fpz, Fz, Cz, Oz).</li>\r\n    </ul>\r\n    <br>\r\n    <p>In a 19-channel placement, there are 19 electrodes, the ground, and the reference electrodes (Figure 1c). In a 32, 64, or 128 channel system, there are more electrode names. The additional electrodes are initially placed between the 20% marks and\r\n        are of the “Modified Combinatorial Nomenclature” (MCN) system (Figure 1d). The MCN system adds the following acronyms to designate areas (FC, FT, AF, TP, CP). The MCN system also renames four electrodes in the 10-20 system:</p>\r\n    <ul>\r\n        <li>T3 becomes T7</li>\r\n        <li>T4 becomes T8</li>\r\n        <li>T5 becomes P7</li>\r\n        <li>T6 becomes P8</li>\r\n    </ul>\r\n    <br>\r\n    <p>Even numbered electrodes (2, 4, 6, 8) are on the right hemisphere of the head and odd numbered electrodes (1, 3, 5, 7) are on the left hemisphere of the head.</p>\r\n    <p>A1 and A2 refer to the ear references and M1 and M2 refer to mastoid references.</p>\r\n    <br>\r\n	<div class=\"mrow\">\r\n		<div class=\"mcol-sm-6 text-center\">\r\n    <div><img src=\"@@PLUGINFILE@@/inion.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom m-max-height\"></div>\r\n    <p><i>Figure 1c: 19 active electrodes and reference electrodes (A1 and A2).</i></p>\r\n		</div>\r\n		<div class=\"mcol-sm-6 text-center\">\r\n    <div><img src=\"@@PLUGINFILE@@/mnc-system.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom m-max-height\"></div>\r\n    <p><i>Figure 1d: The electrodes active in the MCN system.</i></p>\r\n	</div>\r\n	</div>\r\n</ol>',1),(43,10,42,44,20,0,1,1,1564077340,1567348951,'Prep and Hygiene','<br>\r\n<p>Before your client comes in for their EEG, you will want to remind them of a few hygiene and self-care tips to ensure you get the best recording possible:</p>\r\n<div><img src=\"@@PLUGINFILE@@/prep-hygiene.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"624\" height=\"290\"></div>\r\n<br>\r\n<ul>\r\n    <li>Don\'t drink alcohol the night before.</li>\r\n    <li>Limit caffeine intake to zero or at most, one cup of coffee.</li>\r\n    <li>Don\'t come in hungry.</li>\r\n    <li>Don\'t come in drowsy.</li>\r\n    <li>Limit hair products.</li>\r\n    <li>Get a good night\'s sleep.<br></li>\r\n</ul>\r\n<br>\r\n<p>The products you will need to prepare your client for EEG acquisition include Nuprep, an alcohol pad or cotton ball + 70% alcohol rubbing alcohol, a blunt tip syringe, and Electrogel. You will need an electrocap, dropped ears, and sponge discs for acquisition.</p>\r\n<p>You can find the links directing you to the prices and descriptions to all these products here:</p>\r\n\r\n<br>\r\n<div class=\"mrow\">\r\n    <div class=\"mcol-sm-3 text-center\">\r\n        <a href=\"https://bio-medical.com/nuprep-eegecg-skin-prep-gel-3-pack-of-4oz-tubes.html\" target=\"new\"><img src=\"@@PLUGINFILE@@/nu-prep.jpg\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height-100\"><br>NuPrep</a>\r\n    </div>\r\n    <div class=\"mcol-sm-3 text-center\">\r\n        <a href=\"https://electro-cap.com/index.cfm/supplies/\" target=\"new\"><img src=\"@@PLUGINFILE@@/blunt.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height-100\"><br>Blunt-tipped needles and syringes</a>\r\n    </div>\r\n    <div class=\"mcol-sm-3 text-center\">\r\n        <a href=\"https://electro-cap.com/index.cfm/supplies/\" target=\"new\"><img src=\"@@PLUGINFILE@@/electro-gel.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height-100\"><br>Electrogel </a>\r\n    </div>\r\n</div>\r\n<br>\r\n<div class=\"mrow\">\r\n    <div class=\"mcol-sm-6 text-center\">\r\n        <a href=\"https://electro-cap.com/index.cfm/supplies/\" target=\"new\"><img src=\"@@PLUGINFILE@@/sponge-disks.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height\"><br>Sponge Disks </a>\r\n    </div>\r\n    <div class=\"mcol-sm-6 text-center\">\r\n        <a href=\"https://electro-cap.com/index.cfm/caps/\" target=\"new\"><img src=\"@@PLUGINFILE@@/electrocaps.png?time=1564078364483\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom m-max-height\"><br>Electrocaps E1-LEX with drop references </a>\r\n    </div>\r\n</div>\r\n<br>\r\n<div class=\"mrow\">\r\n    <div class=\"mcol-sm-6 text-center\">\r\n        <a href=\"https://bio-medical.com/ear-drop-clips.html\" target=\"new\"><img src=\"@@PLUGINFILE@@/electrocaps-2.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height\"><br>Electro-Cap 3 1/2\" DIN Ear Clips </a>\r\n    </div>\r\n    <div class=\"mcol-sm-6 text-center\">\r\n        <a href=\"https://www.amazon.com/gp/product/B001IKKHFO/ref=ppx_yo_dt_b_asin_title_o09_s00?ie=UTF8&amp;psc=1\" target=\"new\"><img src=\"@@PLUGINFILE@@/db-alcohol-swabs.png\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom  m-max-height\"><br>BD Alcohol Swabs 100 Each (Pack of 12) </a>\r\n    </div>\r\n</div>\r\n\r\n<br>\r\n<p>To prep a client, place a pea-sized amount of nuprep on an alcohol pad, and scrub the forehead and the ear lobes.</p>\r\n<p><a href=\"#\">This short instructional video</a> will show how to properly prep a patient’s head and ears for EEG acquisition.</p>\r\n<p>Each hardware/software system differs in the steps you need to take to record. However, whichever system you use, you will need to ensure low impedance. This can be done with a QCheck with the NeuroField System, a Checktrode system, or any built-in impedance\r\n    system, such as EEGStudio’s impedance meter.</p>\r\n<p>To learn how to record in the NeuroField system, <a href=\"#\">watch this short video</a>.</p>\r\n<br>\r\n<table width=\"100%\">\r\n    <tbody>\r\n        <tr>\r\n            <td align=\"center\"><a href=\"https://bio-medical.com/catalogsearch/result/?q=checktrode\" target=\"new\"><img src=\"@@PLUGINFILE@@/ufi.jpg\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"1713\" height=\"1200\"></a></td>\r\n            <td>1089NP Checktrode EEG &amp; qEEG Impedance Meter\r\n                <br> Use the 1089NP to rapidly check applied electrode contact impedance of multiple EEG electrode configurations. Ideal for electrode configurations found in Cranial EEG caps. This EEG impedance meter has a 25 pin connector for Electro-Cap\r\n                19 channel cap connection. <a href=\"https://bio-medical.com/catalogsearch/result/?q=checktrode\" target=\"new\">Learn More.</a></td>\r\n        </tr>\r\n        <tr>\r\n            <td align=\"center\"><a href=\"http://www.neurofield.org/qcheck/\" target=\"new\"><img src=\"@@PLUGINFILE@@/nu-prep.jpg\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"700\" height=\"468\"></a></td>\r\n            <td>QCheck (Electrode Impedance Meter)\r\n                <br> The QCheck is a fully software integrated electrode impedance meter, metering 20 channels on your lexicor pinout EEG cap in real time. With a new interface in NeuroField64, the QCheck makes impedance checking simple and quick.\r\n                <a href=\"http://www.neurofield.org/qcheck/\" target=\"new\">Learn More</a>\r\n            </td>\r\n        </tr>\r\n    </tbody>\r\n</table>',1),(44,10,43,0,20,0,1,1,1564079632,1566388961,'Script to Read to Patients','<br>\r\n<p>Now you are ready to record. You want to minimize the amount of movement in your client’s EEG record, which requires these spoken instructions:</p>\r\n<ul>\r\n        <li>Relax your forehead.</li>\r\n        <li>Soften then muscles around your eyes.</li>\r\n        <li>Relax your jaw.</li>\r\n        <li>Let your tongue fall away from the roof of your mouth.</li>\r\n        <li>Let your teeth slightly part.</li>\r\n				<li><i>Hint—if the client shows frontal eye field when closing their eyes, ask that they lightly place their peace fingers over their eyelids. (Some clinicians opt to use an eye mask when people flutter their eyes.)</i></li>\r\n</ul>\r\n<br>\r\n<p>It is a standard in the USA that 10 minutes of eyes open and 10 minutes of eyes closed data are collected, this is the minimum length an EEG record must be in order to be held as credible in a court of law.</p>',1),(45,11,0,46,20,0,1,1,1564131050,1564605255,'What Are Artifacts?','An artifact is an alteration of EEG data that is from an extra-cerebral source. The artifacts this section will cover includes: <br><br><ol><li>Electromyographic (EMG) Artifact, AKA Muscle Artifact</li><li>Eye Blink Artifact&nbsp;</li><li>Eye Movement Artifact&nbsp;</li><li>Drowsiness Artifact&nbsp;</li><li>Sweat Artifact&nbsp;</li><li>Pulse and Cardio Ballistic Artifact&nbsp;</li><li>Salt Bridge&nbsp;</li><li>Electrode and Equipment Artifacts</li><li>Environmental Noise Artifact</li><li>Medication “Artifact”</li></ol>',1),(46,11,45,47,20,0,1,1,1564131057,1571926857,'Determining Real EEG vs. Not Real EEG','Real EEG data will have what we call “field” and “phase.” What that means is that any activity we see in the raw EEG data—if it is real brainwave activity—will have a surround. What you see emanating from T3 will have a surrounding similar wave pattern\r\nat T5, C3, and F7. Muscle contamination will not share the same phase and field between two or more electrodes. <br><br>\r\n<div>Often it is necessary to validate data at O1 and O2, as the occipitalis muscle is sometimes the culprit of high amplitude beta activity and sometimes O1 and O2 beta activity is real brainwave activity. The video we see here shows two different ways to\r\n    ascertain data’s reality. By first removing the low pass filter, we see the data become “hashy,” but when examining it for field and phase (in WINEEG), we see that O1 and O2 share the same waveform patterns. <br></div>\r\n<div><br></div>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/358114442\" width=\"640\" height=\"373\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe>\r\n  <br></p><br>Another way to check for field and phase in your data is to switch to a montage that places channels in a sequential order, so that the channels are next to their proximal neighbors. In neuroguide, for example,\r\nthe deymen montage places channels next to their neighboring electrode sites:<br><br>\r\n<div style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/electrode-pair.png?time=1564134176374\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"760\" height=\"703\"><br></div><br>\r\n<div style=\"text-align: center;\"><i>Figure 1e: A deymed montage in Neuroguide software will place electrodes sequentially, which will allow the reader to check for field and phase in the EEG between neighboring electrode pairs.</i> <br></div>',1),(47,11,46,48,20,0,1,1,1564135308,1569349372,'Ten Types of Artifacts — Type 1: Electromyographic (EMG) Artifact, AKA Muscle Artifact','<br>\r\n<ul>\r\n    <li>The higher the amplitude, with increasing frequency, the greater the chances that its muscle imitating beta.</li>\r\n    <li>Usually one or two channels </li>\r\n    <li>Frontalis artifact arrives at Fp2 &amp; Fp2</li>\r\n    <li>Temporalis and massater artifact arrives at T3/T4, F7 and F8</li>\r\n    <li>Occipitalis artifact arrives at O1 and O2</li>\r\n</ul>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/emg.png?time=1564591360275\" alt=\"Figure 1f: A stray line of high amplitude in the beta frequencies in a spectrum denotes deviant amplitude and is often an indicator that one electrode is picking up EMG.\" class=\"img-responsive atto_image_button_text-bottom\" width=\"453\" height=\"411\"></div>\r\n<p><i>Figure 1f: A stray line of high amplitude in the beta frequencies in a spectrum denotes deviant amplitude and is often an indicator that one electrode is picking up EMG.</i></p>\r\n<br>\r\n<h5><b>Massater Muscle (Chewing) Artifact (50–60 Hz)<br></b></h5>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/massater.png?time=1564140872778\" alt=\"Figure 1g: The massater muscle is responsible for mastication of food and can create high amplitude beta artifact in EEG data.\" class=\"img-responsive atto_image_button_text-bottom\" width=\"381\" height=\"377\"></div>\r\n<p><i>Figure 1g: The massater muscle is responsible for mastication of food and can create high amplitude beta artifact in EEG data.</i></p>\r\n<br>\r\n<p>See a video of massater muscle artifact here.</p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/358114382\" width=\"640\" height=\"380\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<h5><b>Occipital Muscle Artifact (Posterior EMG) (20–300 Hz)</b></h5>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/artifact-muscle.gif\" alt=\"Figure 1h: The occipitalis muscles are two rectangular-shaped muscles on the back of the skull, which can give pronounced EMG artifact at the O1 and O2 electrode sites.\" class=\"img-responsive atto_image_button_text-bottom\" width=\"240\" height=\"240\"></div>\r\n<p><i>Figure 1h: The occipitalis muscles are two rectangular-shaped muscles on the back of the skull, which can give pronounced EMG artifact at the O1 and O2 electrode sites.</i></p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/emg-artifact.png?time=1564141541047\" alt=\"Figure 1i: Summary page of a Quantitative EEG showing occipitalis EMG artifact. Image generated from Neuroguide version 3.0.6.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"716\" height=\"951\"></div>\r\n<p><i>Figure 1i: Summary page of a Quantitative EEG showing occipitalis EMG artifact. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<br>\r\n<p>See a video of occipitalis muscle artifact here.&nbsp;</p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/358114425\" width=\"640\" height=\"382\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe><br></p>\r\n<br>\r\n\r\n<div class=\"mrow\">\r\n    <div class=\"mcol-sm-6 text-center\">\r\n        <h5><b>Temporalis Muscle Artifact (40–80Hz)</b></h5>\r\n        <p>The temporalis muscle elevates, retracts, and moves the jaw from side to side.</p>\r\n        <div><img src=\"@@PLUGINFILE@@/temporalis.png?time=1564141213287\" alt=\"Figure 1j: The temporalis muscle is a large fan-shaped muscle that covers the sides of the skull.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom m-max-height\"></div>\r\n        <p><i>Figure 1j: The temporalis muscle is a large fan-shaped muscle that covers the sides of the skull.</i></p>\r\n    </div>\r\n    <div class=\"mcol-sm-6 text-center\">\r\n        <h5><b>Frontalis (wrinkling forehead) 30–40Hz</b></h5>\r\n        <br><br>\r\n        <div><img src=\"@@PLUGINFILE@@/frontalis.png?time=1564141288057\" alt=\"Figure 1k: The frontalis muscle is responsible for much of our expression, wrinkling the forehead and furrowing the brow. Muscle artifact from the frontalis muscle will affect Fp1, Fp2, and Fz electrodes, but may also affect F7, F8 and Fz electrodes.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom m-max-height\"></div>\r\n        <p><i>Figure 1k: The frontalis muscle is responsible for much of our expression, wrinkling the forehead and furrowing the brow. Muscle artifact from the frontalis muscle will affect Fp1, Fp2, and Fz electrodes, but may also affect F7, F8 and Fz electrodes.</i></p>\r\n    </div>\r\n</div>\r\n<br>\r\n<p>See a video of frontalis muscle artifact here.&nbsp;</p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/358114494\" width=\"640\" height=\"383\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears.png?time=1564141620674\" alt=\"Figure 1l: Summary page of a Quantitative EEG showing frontalis EMG artifact. Image generated from Neuroguide version 3.0.6.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"712\" height=\"956\"></div>\r\n<p><i>Figure 1l: Summary page of a Quantitative EEG showing frontalis EMG artifact. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears-2.png?time=1564141695313\" alt=\"Figure 1m: The temporalis muscle can generate artifact in the temporal electrodes (T3, T4, T5, or T6, as well as the left or right frontal electrodes, as we see here, with a high amplitude beta artifact arising from F8. Image generated from Neuroguide version 3.0.6.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"715\" height=\"949\"></div>\r\n<p><i>Figure 1m: The temporalis muscle can generate artifact in the temporal electrodes (T3, T4, T5, or T6, as well as the left or right frontal electrodes, as we see here, with a high amplitude beta artifact arising from F8. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<br>\r\n<p>See a video of temporalis muscle artifact here.&nbsp;</p>\r\n\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/358114571\" width=\"640\" height=\"383\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe><br></p>\r\n<p style=\"text-align: center;\"><br></p>',1),(48,11,47,56,20,0,1,1,1564605136,1569349489,'Ten Types of Artifacts — Type 2: Eye Blink Artifact','<br>\r\n<p>Eye movement artifact are some of the easiest to spot with the naked eye. Eye blinks are commonly found at Fp1, Fp2, Fz, F7, and F8 locations. Respectively. Here is a video of eye blinks, watch the channel locations that are affected so you can later\r\n    spot eye blinks yourself.</p>\r\n<br>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/358114682\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p><br>\r\n<p>Sometimes a client will blink quite a lot, so much that there isn’t a moment in the record where their data is not affected by eye movements. When recording the data from these types of clients, ask that they try to NOT blink for 5 seconds after each\r\n    blink. When artifacting data that is contaminated by eye blinks, you want to make sure that you are not collecting data that has the delta-like swing that follows each blink. We call this the “whiplash.” The following video shows how to avoid the\r\n    whiplash in your editing process.</p>\r\n<br>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/358114766\" width=\"640\" height=\"380\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(49,11,54,50,20,0,1,1,1564596020,1566389275,'Ten Types of Artifacts — Type 7: Salt Bridge Artifact','<br>\r\n<p>A salt bridge is caused when there is too much electrogel in a cap, causing two electrodes to conjoin and destroying the signal. Salt bridge artifact will show up in low amplitude channel (often Fz). Typically Fz and the ground create a salt bridge, since\r\n    they are so close together. Very often the artifact will show up in maps as asymmetry stemming at Fz or a 28Hz artifact (sometimes 16Hz) at Fz, which are subharmonics of an electrical artifact.</p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears-4.png?time=1564142753887\" alt=\"Image 1p: In this summary map, the salt bridge disrupted the Fz electrode, causing a focal high amplitude artifact, as well as questionable asymmetry and hypocoherence. Image generated from Neuroguide version 3.0.6.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"716\" height=\"921\"></div>\r\n<p><i>Image 1p: In this summary map, the salt bridge disrupted the Fz electrode, causing a focal high amplitude artifact, as well as questionable asymmetry and hypocoherence. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/fz-electrode.png?time=1564142814872\" alt=\"Image 1q: In this raw recording, the salt bridge disrupted the Fz electrode, causing a low amplitude signal to arrive at the Fz channel, the active electrode in the pain of bridged electrocdes.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"1917\" height=\"1100\"></div>\r\n<p><i>Image 1q: In this raw recording, the salt bridge disrupted the Fz electrode, causing a low amplitude signal to arrive at the Fz channel, the active electrode in the pain of bridged electrocdes.</i></p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears-5.png?time=1564142905223\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"713\" height=\"449\"></div>\r\n<p><i>Image 1r: Often with a salt bridge, a high amplitude spot at the site of the bridge (commonly Fz) will show up at 28Hz. Image generated from Neuroguide version 3.0.6.</i></p>',1),(50,11,49,52,20,0,1,1,1564599968,1569350293,'Ten Types of Artifacts — Type 8: Electrode and Equipment Artifact','<br>\r\n<p>Electrode artifacts are brief transients typically at one channel at a time.</p>\r\n<br>\r\n<h5><b>Electrode Pop</b></h5>\r\n<p>A spontaneous discharge of electric potential (because the skin or electrode can act a capacitors and hold electrical charge across the paste).</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/358115088\" width=\"640\" height=\"400\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<h5><b>Loose Electrode</b></h5>\r\n<p>Poor contact with varying and disorganized morphology (sharp and slow, high amplitude, etc.).</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/358115053\" width=\"640\" height=\"400\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<h5><b>Bad Ear Lead</b></h5>\r\n<p>A bad ear lead will typically distort all of the data—it will appear that all of the data is moving together in synchrony—everything going electro negative and electro positive together. What this will typically produce is a map that shows hypercoherence\r\n    across all channels. Generally a record with a bad ear electrode is immediately suspicious to the eye, even if novice.</p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears-6.png?time=1564143146857\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"715\" height=\"954\"></div>\r\n<p><i>Image 1s: Coherences such as these, with every frequency showing hypercoherence in every channel, should be questioned as it is always a product of a defective ear electrode. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/361349037\" width=\"640\" height=\"362\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>',1),(51,11,52,0,20,0,1,1,1564604875,1569350391,'Ten Types of Artifacts — Type 10: Medication \"Artifact\"','<br>\r\n<h5><b>Benzodiazepines</b></h5>\r\n<p>The final video and imagery in the artifact lesson is benzodiazepine toxicity. In this case, the individual is taking Xanax on an “as needed” basis for pain, which is enough to alter the EEG. When taking a benzodiazepine we see an increase in the amount\r\n    of GABA, an inhibitory neurotransmitter, which creates a global beta spindling, as we see in this video.</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/360592381\" width=\"640\" height=\"369\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<p>Benzodiazepine toxicity will lead to a quantitative EEG that has a copious amount of high amplitude beta. Since this is a medicaqtion side-effect, neurofeedback and neuromodulation will not help to reduce the amount of high amplitude beta we see in the</p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears-8.png?time=1564142985979\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"711\" height=\"953\"></div>\r\n<p><i>Image 1u: The EEG of someone taking a benzodiazepine will often show a high amplitude beta marker focused centrally. Image generated from Neuroguide version 3.0.6.</i></p>',1),(52,11,50,51,20,0,1,1,1564596675,1569350343,'Ten Types of Artifacts — Type 9: Environmental Noise Artifact','<br>\r\n<p>Environmental noise should always strike the electroencephalograher as strange, due to its fast, rhythmic appearance. When an electrical system is not grounded, when there is poor connectivity between devices, when there is “electro-smog” in the environment,\r\n    as we sometimes see in large cities, these are all situations where environmental noise such as this appears. Its best to check a building for environmental noise before moving in, as sometimes the solution is difficult to arrive at.</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/358114992\" width=\"640\" height=\"387\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(53,11,55,54,20,0,1,1,1564604729,1569350001,'Ten Types of Artifacts — Type 5: Sweat Artifact','<br>\r\n<p>Sweat artifact arises when the sodium and water in sweat interacts with the salt-impregnated past of the EEG cap. What you see are high amplitude slow waves, that look like giant delta waves, sometimes slower than 1Hz.</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/360592193\" width=\"640\" height=\"373\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<p>Some analysis programs filter out frequencies less than 1Hz or less than 2Hz, causing the sweat artifact to disappear in the filtered image. It is important to catch sweat artifact when it is happening and try to cool down your client and the room to\r\n    avoid a poor recording.</p>\r\n<p>In the following video, we can see how checking the filters can prevent slow artifacts, such as sweat, from being noticed by the electroencephalographer. We are removing the low pass filter to see how the data looks with and without automatic filtering.</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/360592232\" width=\"640\" height=\"377\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe>\r\n</p>\r\n<br>\r\n<hr>',1),(54,11,53,49,20,0,1,1,1564594925,1569350134,'Ten Types of Artifacts — Type 6: Pulse and Cardio Balistic Artifact (EKG)','<br>\r\n<div><img src=\"@@PLUGINFILE@@/cardiac-artifact.png\" alt=\"Figure 1n: A pulse artifact coming from an ear electrode, which contaminates the ear electrode reference and places the cardiac artifact in every channel.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"1784\" height=\"1076\"></div>\r\n<p><i>Figure 1n: A pulse artifact coming from an ear electrode, which contaminates the ear electrode reference and places the cardiac artifact in every channel.</i></p>\r\n<br>\r\n<p>Watch the video here </p>\r\n <p style=\"text-align:center\"> <iframe src=\"https://player.vimeo.com/video/358114641\" width=\"640\" height=\"386\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<p>for the case example with the cardiac artifact stemming from an ear electrode.</p>\r\n<br>\r\n<p>Often when a global pulse artifact (like this) contaminates the data, the anatomy of the individual is part to play. Often, folks who are stocky, with short large necks, produce artifacts such as this. One possible way to mitigate this artifact is to\r\n    place cottonballs behind the ears. That said, this preventative measure doesn’t work a majority of the time.</p>\r\n<p>Here is another video of a cardiac artifact, only this time it is showing up in only one electrode location.</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/358114663\" width=\"640\" height=\"388\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<p><b><i>How do I know that its cardiac artifact and not something else?</i></b></p>\r\n<p>A regular heartbeat occurs at 72 beats per minute. So, a bump in the raw data that arrives once per second, approximately, will give away that the source of the artifact is the rhythmic beating of the heart.</p>',1),(55,11,56,53,20,0,1,1,1564600493,1569350458,'Ten Types of Artifacts — Type 4: Drowsiness Artifact','<br>\r\n<p>Drowsiness is difficult to see for the untrained eye and would not classify as artifact, however it is data that must be thrown out, unless the quality of someone’s sleep or how quickly they fall asleep are being monitored. In this video, within one minute\r\n    of closing his eyes, this patient falls asleep, generating beta spindles, high amplitude alpha, K-complexes down the vertex, and low amplitude beta.</p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears-7.png?time=1564143083126\" alt=\"\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"713\" height=\"954\"></div>\r\n<p><i>Image 1t: The drowsy EEG was showing vertex slow waves and frontal spindling beta (aka sleep spindles), which show up in a fast fourier transform as high amplitude central theta and high amplitude frontal beta. Image generated from Neuroguide version 3.0.6.</i></p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/358115118\" width=\"640\" height=\"390\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>',1),(56,11,48,55,20,0,1,1,1564605133,1569349604,'Ten Types of Artifacts — Type 3: Eye Movement Artifact','<br>\r\n<h5><b>Eyes Closed Eye Artifacts</b></h5>\r\n<p>Sometimes people have a hard time keeping their closed eyes closed. It seems they have to will their eyes shut. You will sometimes see this in small children or adults—they will have an eye flutter. In these cases, you will want to ask the client to place\r\n    their middle finger and index finger lightly atop their eyelids to prevent this type of artifact.</p>\r\n<br>\r\n<p>INSERT VIDEO OF EYE FLUTTER</p>\r\n<br>\r\n<h5><b>Lateral Eye Movement artifacts</b></h5>\r\n<p>Lateral eye artifacts can be seen in channels F7 and F8, typically, and are large swings that look like they’re in a delta frequency. This is because the eyeballs themselves are dipoles with a positive and a negative polarity. Each time we look left and\r\n    right, it causes a large swing in the electrodes.</p>\r\n<br>\r\n<p style=\"text-align:center\"><iframe src=\"https://player.vimeo.com/video/358114945\" width=\"640\" height=\"388\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<br>\r\n<div><img src=\"@@PLUGINFILE@@/linkears-3.png?time=1564142186232\" alt=\"Figure 1o: Lateral eye artifact can appear as high amplitude delta, since the waves are generally under 4Hz. Image generated from Neuroguide version 3.0.6.\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" width=\"715\" height=\"951\"></div>\r\n<br>\r\n<p><i>Figure 1o: Lateral eye artifact can appear as high amplitude delta, since the waves are generally under 4Hz. Image generated from Neuroguide version 3.0.6.</i></p>',1),(57,13,0,58,20,0,1,1,1564772673,0,'Concepts of Drug Effects','<p><ul><li>Individuals may present unique individual effects in the EEG from drugs</li><li>Baseline brain function can either hide or reveal the effects of drugs on the EEG</li><li>Predicting Drug effects is difficult (some drugs produce effects that are inconsistent and variable), although there are response stereotypes to drugs</li><li>Recognizing drug effects is difficult</li><li>Patients taking more than one drug complicates the ease of seeing drug effects in the EEG. Mixtures of drugs become too complex to evaluate any one medication’s contribution, not to mention the synergistic combined effect of many meds</li></ul><br></p>',1),(58,13,57,0,20,0,1,1,1564772678,1566389458,'Generalities','Arousal level changes the EEG, but this is patient dependent (I.e. a stimulation medication will increase alpha levels in an under aroused subject, but will decrease alpha in an over aroused (anxious) subject .<br><br>There is a reciprocal relationship\r\nbetween alpha and beta. If a drug stimulates the brain stem and alpha generators lose their synchronicity, beta appears in the EEG. There are five classes of drugs that have effects on EEG:\r\n\r\n<br><br>\r\n<ul>\r\n    <ul>\r\n        <li>Street Drugs</li>\r\n        <li>Anti-epileptic drugs/anti-convulsant drugs</li>\r\n        <li>Analgesics (includes opioids)</li>\r\n        <li>Anesthetics</li>\r\n        <li>Psychotropics</li>\r\n    </ul>\r\n\r\n\r\n\r\n\r\n</ul>\r\n\r\nGABAergic drugs create the greatest changes (benzodiazepines and barbiturates)',1),(59,14,0,60,20,0,1,1,1564772833,1565028307,'Info','<p><br></p><p><img src=\"http://via.placeholder.com/600x250\" alt=\"\" width=\"600\" height=\"250\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p><b>Marijuana/Hashish/THC</b>: increased frontal alpha amplitude, with increased frontal coherence across the hemispheres, as well as phase synchrony.&nbsp; These findings are reported in chronic exposures.</p>\r\n<p>Effects on dampening reaction times in evoked potentials have been noted as well.</p>\r\n<h5><span><span style=\"\"><span style=\"\"><span><b>LSD (Lysergic acid diethylamide)</b></span></span>\r\n    </span>\r\n    </span>for normal EEGs, decreased alpha and increased beta. For slow EEGs, an increase in alpha amplitude and increase in fast activity.&nbsp;</h5>\r\n<p><b>PCP, Phencyclidine, or angel dust</b>&nbsp;<br><span style=\"font-size: 1rem;\">A marked increase in slow activity, with paroxysmal activity and extreme voltages noted with increased dosage. Convulsions have been reported.</span></p>\r\n<p><b>Morphine/Opiates/Heroin<br></b><span style=\"font-size: 1rem;\">Shortly following administration, there is increased alpha, with slowing of alpha during the euphoric high, with increased dose there is increased slowing, and like barbiturates the EEG may go iso-electric. There is an increase in REM sleep noted with opioids.</span></p>',1),(60,14,59,0,20,0,1,1,1564772852,1566389515,'Cocaine','<p>The effects of cocaine differ from the amphetamines in that cocaine decreases synaptic reuptake, and amphetamines increase the release of the neurotransmitters in the dopamine/norepinephrine systems in the brain. With lower to moderate doses, there is increased alpha and beta. With increased doses there is a desynchronization of the EEG and faster activity predominates.</p><p>The alpha increase frontally is seen during the euphoric phase of the subjective report. Cocaine is a well-known epileptic potentiator. Chronic abuse causes a “burned out” dopamine system, with delta decreases and slower alpha noted with little improvement even one year late</p>',1),(61,15,0,62,20,0,1,1,1564774051,1564774591,'Page 1','Anti-epileptic drugs and anti-convulsant drugs are most prescribed by neurologists for the treatment of seizures and epileptiform discharges.\r\n<br><b><br>Generic names with&nbsp;brand names<br><br></b>\r\n     <ul>\r\n        <ul><li><span>Acetazolamide&nbsp;</span></li><li><span>Brivaracetam&nbsp;available as&nbsp;Briviact</span></li><li><span>Carbamazepine&nbsp;also available as&nbsp;Carbagen,&nbsp;Tegretol,&nbsp;Tegretol Prolonged Release</span></li></ul>\r\n        \r\n        \r\n    </ul>\r\n \r\n\r\n<p>A favorite partial seizure medicine in the developed world. Carbamazepine affects sodium channels, and inhibits rapid firing of brain cells. Long-acting forms such as Carbatrol or Tegretol-XR can be given once a day. Potential side effects include GI\r\n    upset, weight gain, blurred vision, low blood counts, low blood sodium (hyponatremia). Carbamazepine causes a rash rate of a few percent, sometimes even the dangerous rash called Stevens-Johnson syndrome. People of Asian descent with HLA-B*1502 antigen\r\n    are more at risk. Typical adult dose is 400 mg tid.</p> \r\n    <ul>\r\n        <ul><li>Clobazam&nbsp;also available as&nbsp;Frisium,&nbsp;Perizam,&nbsp;Tapclob,&nbsp;Zacco</li><li>Clonazepam&nbsp;</li></ul>\r\n        \r\n    </ul>\r\n \r\n<p>Clonazepam is a member of the drug class known as benzodiazepines, to which diazepam (Valium), lorazepam (Ativan), clorazepate (Tranxene), alprazolam (Xanax) also belong. Benzodiazepines are used as anti-seizure drugs, sedatives, tranquilizers and muscle\r\n    relaxants. Benzodiazepines increase the effectiveness of GABA, the brain’s main inhibitory neurotransmitter. Clonazepam is more long-acting against seizures than are diazepam or lorazepam. Side effects of clonazepam include sedation, thinking/memory\r\n    impairment, mood changes, addiction. More so than most, its effects wear off over time. A typical adult dose is 0.5-1.0 mg three times a day.</p>&nbsp;&nbsp;\r\n    <ul>\r\n        <ul><li>Eslicarbazepine acetate&nbsp;available as&nbsp;Zebinix</li><li>Ethosuximide&nbsp;</li><li>Everolimus&nbsp;also available as&nbsp;Votubia</li></ul>\r\n        \r\n        \r\n    </ul>',1),(62,15,61,65,20,0,1,1,1564774058,1566389631,'Page 2','<ul><li><b>Gabapentin&nbsp;also available as&nbsp;Neurontin</b><br>\r\nGabapentin has the reputation of being a safe but not particularly powerful AED. The effectiveness criticism probably is because it is often prescribed at too low a dose. The drug probably works by influencing transport of GABA and effects on calcium channels. It has no drug interactions, is not metabolized in the liver and it does not bind to blood proteins. Side effects are unsteadiness, weight gain, fatigue, dizziness. Typical adult dose is 300-600 mg three times a, but doses can be up to 1200 mg three times a day.<br><br></li>\r\n<li><b>Lacosamide&nbsp;available as&nbsp;Vimpat</b><br>\r\n Lacosamide is a new (2009) antiepileptic drug , for partial and secondarily generalized seizures. It is chemically related to the amino acid, serine. Vimpat blocks sodium channels (but in a different way from other seizure medicines), and this block reduces brain excitability. Side effects include dizziness, headache, nausea or vomiting, double vision, fatigue, memory or mood problems. Vimpat may affect the internal organs, blood counts or heart rhythm, but these potentially serious side effects are infrequent. The recommended starting dose is 50 mg twice daily, increased each week by an extra 100 mg, to the recommended maintenance dosage of 100-200 mg twice a day.&nbsp;<br><br></li>\r\n<li><b>Lamotrigine&nbsp;also available as&nbsp;Lamitcal</b><br>\r\nA broad-spectrum alternative to VPA, with a better side effect profile. However, LTG may not be as effective for myoclonic seizures. Lamotrigine works by several mechanisms including blocking release of glutamate, the brain’s main excitatory neurotransmitter. It has the usual side effects of dizziness and fatigue, usually mild cognitive (thinking) impairment. Severe medical side effects are unusual. The practical side effect issue is rash, occurring in several percent of people who take it, especially if the dose is increased too fast. Therefore, it takes a couple of months to get up to the typical adult dose of 200 mg twice a day.&nbsp;<br><br></li>\r\n<li><b>Levetiracetam&nbsp;also available as&nbsp;Desitrend,&nbsp;Keppra</b><br>\r\nLevetiracetam is one of the more used medicines in seizure clinics because it probably is effective for a broad-spectrum of seizures types, has a relatively low incidence of causing thinking/memory problems, and can be started at 500 mg twice a day, which is an effective dose. It has no drug interactions, is not metabolized in the liver and it does not bind to blood proteins. The most common side effects are dizziness, fatigue, insomnia, but the more troublesome problem can be irritability and mood changes. This may occur to some degree in up to a third of those taking the medicine. A typical adult dose is 500 - 1500 mg twice a day.</li></ul>',1),(63,15,66,64,20,0,1,1,1564774717,1566389718,'Page 5','<ul><li><b>Valproic acid&nbsp;available as&nbsp;Depakote, Convulex,&nbsp;Epilim Chrono,&nbsp;Epilim Chronosphere\r\n</b><br>This is the standard broad-spectrum AED (treats all types of seizures) and no other AED is more effective for generalized seizure types. VPA has effects on GABA (at least in very high doses), and a neurotransmitter called NPY to block seizures, and maybe also on calcium channels. VPA has significant side effects: weight gain, tremor, hair loss, GI upset, blood count decreases, hepatic or pancreatic injury, bone weakness over time (osteoporosis), birth defects in up to 10% (folic acid can help to prevent them). Typical adult dose is 250 mg - 500 mg three times a day, but dose can be higher.&nbsp;<br><br></li>\r\n<li><b>Vigabatrin&nbsp;available as&nbsp;Sabril</b>\r\n<br>At time of this writing, vigabatrin is approved in the US, but official package insert information has not become available. Vigabatrin is a “designer drug,” made to block metabolism of GABA, the brain’s main inhibitory neurotransmitter. Sabril has been used for over a decade in many countries, and it is effective for partial seizures, with or without secondary generalization. It also may be very effective for infantile spasms, a serious type of seizures in young children. Release in the US was delayed because the drug is toxic to the retina of the eye in up to 30% of people who take it long-term. This toxicity can result in permanent loss of peripheral vision. Regular vision testing is recommended for all people on this drug. A typical regimen begins with 500 mg twice a day, and can increase over a month or two to 1500 mg twice a day.&nbsp;<br><br></li>\r\n<li><b>Zonisamide&nbsp;also available as&nbsp;Zonegran</b>\r\n<br>Zonisamide is rather similar in its coverage and side effects to topiramate, except glaucoma is not usually listed. Some find less cognitive impairment than with topiramate but this is individual and dose-dependent. Typical adult dose is 100-300 mg twice a day.</li></ul>',1),(64,15,63,67,20,0,1,1,1564775709,1566389785,'Page 6','<b>Negative/Bad Effects of AED Drugs on EEG\r\n</b><ul><ul><li>Diffuse Slowing</li><li>Electro-cerebral Inactivity</li><li>Epileptiform Discharges (this is rare)</li></ul>\r\n\r\n</ul><b>\r\nDrugs that cause this:\r\n</b><ul><ul><li>Phenobarbital</li><li>Benzodiazepines</li><li>Carbamazepine</li><li>Phenytoin</li><li>Ethosuximide</li></ul>\r\n\r\n\r\n\r\n</ul><b>\r\nPositive/Good Effects of Drugs on EEG\r\n</b><ul><ul><li>In epilepsy, reduction in generalized Spike and Wave (classic epileptiform EEG)</li><li>In epilepsy, decreased reactivity to photoparoxysms with photic stimulation</li></ul>\r\n\r\n</ul><b>\r\nOther Effects of AEDs:\r\n</b><ul><ul><li>May reduce alpha frequency and voltage</li><li>Diffuse slowing and depressed levels of consciousness</li><li>Toxicity produces higher amplitude beta spindles</li><li>This includes anything that induces sleep, anything ending in “azepam” or “albetol”</li><li>Some types of anti-epileptic drugs for focal epileptiform discharges can cause seizures, agents that are gabaergic can induce absence or myoclonic epilepsy.</li></ul>\r\n\r\n\r\n\r\n</ul>',1),(65,15,62,66,20,0,1,1,1564775810,1567351888,'Page 3','<ul><li><b>Piracetam&nbsp;available as&nbsp;Nootropil<br><br></b></li>\r\n<li><b>Pregabalin&nbsp;also available as&nbsp;Alzain,&nbsp;Axalid,&nbsp;Lecaent,&nbsp;Lyrica,&nbsp;Rewisca</b>\r\n<br>A relative of gabapentin, it may be better, and can be given twice a day. Some believe that it is more effective against seizures than is gabapentin. Pregabalin has no drug interactions, no liver metabolism, no protein binding, and similar side effects to gabapentin. Typical adult dose is 150 - 600 mg bid.&nbsp;<br><br></li>\r\n<li><b>Primidone&nbsp;<br><br></b></li>\r\n<li><b>Rufinamide&nbsp;available as&nbsp;Inovelon, Banzel<br></b>Banzel is approved for add-on treatment of children age 4 and older and adults with&nbsp;Lennox Gastaut Syndrome. This syndrome can include seizure types such as atonic (drop) seizures, tonic (stiffening) seizures, myoclonic (brief jerking) seizures, or staring (absence) seizures, as well as partial seizures. Banzel works on sodium channels in brain cells, in a way to make them less excitable. Common side effects include headache, dizziness, fatigue and sleepiness, double vision and tremor (trembling). People who have the “short QT syndrome,” a rare heart rhythm irregularity, should not take Banzel. The drug comes as 200 and 400 mg tablets.<br><br></li>\r\n<li><b>Sodium valproate&nbsp;als available as&nbsp;Epilim,&nbsp;Epilim Chrono,&nbsp;Epilim Chronosphere,&nbsp;Episenta,&nbsp;Epival<br><br></b></li>\r\n<li><b>Stiripentol&nbsp;also available as&nbsp;Diacomit<br><br></b></li>\r\n<li><b>Tiagabine&nbsp;available as&nbsp;Gabitril<br><br></b></li>\r\n<li><b>Topiramate&nbsp;also available as&nbsp;Topamax<br></b>\r\nA good broad-spectrum AED (i.e., treats all types of seizures). Topiramate has several mechanisms, including blocking the enzyme carbonic anhydrase, which affects the acidity of brain tissue. More acidity (to a point) suppresses seizures. Side effects include thinking and memory problems in about 1/3rd, renal stones in 1-2%, rare cases of glaucoma (increased eye pressure) and weight loss. Typical adult dose is 150-200 mg twice a day.&nbsp;\r\n\r\n\r\n\r\n</li></ul>',1),(66,15,65,63,20,0,1,1,1564775816,1566389685,'Page 4','<ul><li><b>Valproic acid&nbsp;available as&nbsp;Depakote, Convulex,&nbsp;Epilim Chrono,&nbsp;Epilim Chronosphere</b>\r\n<br>This is the standard broad-spectrum AED (treats all types of seizures) and no other AED is more effective for generalized seizure types. VPA has effects on GABA (at least in very high doses), and a neurotransmitter called NPY to block seizures, and maybe also on calcium channels. VPA has significant side effects: weight gain, tremor, hair loss, GI upset, blood count decreases, hepatic or pancreatic injury, bone weakness over time (osteoporosis), birth defects in up to 10% (folic acid can help to prevent them). Typical adult dose is 250 mg - 500 mg three times a day, but dose can be higher.&nbsp;<br><br></li>\r\n<li><b>Vigabatrin&nbsp;available as&nbsp;Sabril</b>\r\n<br>At time of this writing, vigabatrin is approved in the US, but official package insert information has not become available. Vigabatrin is a “designer drug,” made to block metabolism of GABA, the brain’s main inhibitory neurotransmitter. Sabril has been used for over a decade in many countries, and it is effective for partial seizures, with or without secondary generalization. It also may be very effective for infantile spasms, a serious type of seizures in young children. Release in the US was delayed because the drug is toxic to the retina of the eye in up to 30% of people who take it long-term. This toxicity can result in permanent loss of peripheral vision. Regular vision testing is recommended for all people on this drug. A typical regimen begins with 500 mg twice a day, and can increase over a month or two to 1500 mg twice a day.&nbsp;<br><br></li>\r\n<li><b>Zonisamide&nbsp;also available as&nbsp;Zonegran</b>\r\n<br>Zonisamide is rather similar in its coverage and side effects to topiramate, except glaucoma is not usually listed. Some find less cognitive impairment than with topiramate but this is individual and dose-dependent. Typical adult dose is 100-300 mg twice a day.</li></ul>',1),(67,15,64,68,20,0,1,1,1564776233,1566389823,'Page 7','<b>AEDs used for multiple pathologies</b>\r\n<br>Barbiturates (ending in “barbitol”) are a class of drugs that were used extensively in the 1960s and 1970s as a treatment for&nbsp;anxiety,&nbsp;insomnia, and seizure disorders. Apart from a few specific indications, they are not commonly prescribed these days, having been largely superseded by benzodiazepines.\r\n<br><br><i><b>Effects</b></i>\r\n<br>In barbituates, high amplitude rhythmic 18 to 26 Hz activity is noted, initially frontally, spreading with time to the entire cortex. With increased dose there is an increase in slowing, with further increases the faster activity is decreased and the slowing predominates, progressing to a decreased voltage and even a recoverable iso-electric pattern, in <u>barbiturate coma</u>.\r\n<br><br><ul><ul><li>Low voltage recording</li><li>Electro cerebal inactivity</li><li>Higher amplitude beta 1 and 2 bandwidth</li><li>Diffuse slowing</li></ul>\r\n\r\n\r\n</ul><b>\r\nBenzodiazepines</b>\r\n<br>Benzos cause mild to severe depression of the nerves within the brain (central nervous system) and sedation (drowsiness). Benzodiazepines are a class of agents that work in the central nervous system and are used for a variety of medical conditions. They act on specific receptors in the brain, called gamma-aminobutyric acid-A (GABA-A) receptors. Benzodiazepines attach to these receptors and make the nerves in the brain less sensitive to stimulation, which has a calming effect.\r\n<br><br><ul><ul><li>Diazepam</li><li>Alprazolam “Xanax”</li><li>Librium</li><li>Clonazepam “klonopin”</li><li>Valium</li></ul>\r\n\r\n\r\n\r\n</ul>\r\nBenzodiazepines produce a spindling 18-25Hz pattern\r\n<br><br>Sometimes more pronounced in the front of the head, but the pattern can be seen globally\r\n<br><br>Dosing and systemic vascularity of the being will alter the expression of how the drug will appear\r\n<br><br>INSERT BENZO VIDEO HERE',1),(68,15,67,69,20,0,1,1,1564776679,1566389850,'Page 8','<img src=\"@@PLUGINFILE@@/benzodiazepine.jpg\" alt=\"\" width=\"925\" height=\"979\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br><br>Figure 2: Image of benzodiazepine toxicity in EEG. Image generated from Neuroguide version 3.0.6.<br>',1),(69,15,68,70,20,0,1,1,1564776851,1566389882,'Page 9','<img src=\"@@PLUGINFILE@@/z-scored-fft.jpg\" alt=\"\" width=\"713\" height=\"614\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br><br>Figure 3: Image of Benzodiazepine Toxicity in a Laplacian Montage. Image generated from Neuroguide version 3.0.6.<br>',1),(70,15,69,71,20,0,1,1,1564776969,1566389904,'Page 10','<img src=\"@@PLUGINFILE@@/linked-ears.jpg\" alt=\"\" width=\"714\" height=\"943\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br><br><h5>Figure 4: Image of Benzodiazepine Toxicity in a\r\nLinked Ears Montage. Image generated from Neuroguide version 3.0.6.</h5><br>',1),(71,15,70,0,20,0,1,1,1564777088,1566389933,'Page 11','<img src=\"@@PLUGINFILE@@/hertz-bins.jpg\" alt=\"\" width=\"718\" height=\"360\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br><br><img src=\"@@PLUGINFILE@@/hertz-bins-2.jpg\" alt=\"\" width=\"714\" height=\"361\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br><br><h5></h5>Figure 5: Image of Benzodiazepine Toxicity in individual Hertz bins (linked ears montage). Image generated from Neuroguide version 3.0.6.<br>',1),(72,16,0,73,20,0,1,1,1564848865,1564849073,'Page 1','<p><img src=\"http://via.placeholder.com/600x260\" alt=\"\" width=\"600\" height=\"260\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p><br></p><p>An analgesic or painkiller is any member of the group of drugs used to achieve analgesia, relief from pain. Analgesic drugs act in various ways on the peripheral and central nervous systems. They are distinct from anesthetics, which temporarily affect, and in some instances completely eliminate, sensation.&nbsp;</p><p>Analgesics include acetaminophen, the nonsteroidal anti-inflammatory drugs (NSAIDs) such as the salicylates, and opioid drugs such as morphine and oxycodone.</p><p></p><ul><ul><li><span style=\"font-size: 1rem;\">Tramadol is an opiate analgesic – one of the weaker opiate analgesics, it is used to treat moderate to moderate-severe pain.</span></li></ul></ul><p></p><p><b>Opiates&nbsp;</b></p><p>Opiates include tramadol, oxycodone, morphine,&nbsp; codeine, hydrocodone, dihydromorphine, pethidine</p><p>Effects include:</p><p><ul><ul><li>Slowing in the delta range</li><li><span style=\"font-size: 1rem;\">Greater alpha synchrony</span></li><li><span style=\"font-size: 1rem;\">Burst suppression pattern in neonates&nbsp;</span></li><li>Enhancement of epileptiform activity</li></ul></ul></p><p>The below data is a patient with addiction to pain killers, namely tramadol, oxycontin, and hydrocodone. These medications are known for their addictive properties. Tramadol is an opiate that acts as an SNRI, which occupies a serotonin transporter in the thalamus. This drug can produce a spike wave discharge (giving rise to seizure), however the more common findings are less remarkable: greater alpha synchrony and somewhat heightened beta amplitudes.&nbsp;</p>',1),(73,16,72,74,20,0,1,1,1564849216,1566390069,'Page 2','<p><img src=\"@@PLUGINFILE@@/prominent.jpg\" alt=\"\" width=\"744\" height=\"1089\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p>Figure 6: The 5 – 6Hz rhythm we see prominent at O2 and T6 is a paroxysmal transient that occurs when the patient has closed eyes, opiate addict.<br></p>',1),(74,16,73,75,20,0,1,1,1564849222,1566390100,'Page 3','<p><img src=\"@@PLUGINFILE@@/spindling.jpg\" alt=\"\" width=\"691\" height=\"1102\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p>Figure 7: The spindling beta is a sign of an easily kindled cortex, which gives rise to epileptiform content. Opiate addict.<br></p>',1),(75,16,74,0,20,0,1,1,1564849311,1566390132,'Page 4','<p><img src=\"@@PLUGINFILE@@/amplitude-spindling.jpg\" alt=\"\" width=\"718\" height=\"451\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p>Figure 8: Image of high amplitude spindling beta in an opiate addict.<br></p><p>Figures 7 and 8 (above) shows a fast spindling beta frequency. This is a kindling frequency, which means that it is this fast spindling frequency that ultimately leads to the slow transient discharge that is ultimately the problem. In this case, the spindling beta represents an irritable cortex—one that is easily “kindled,” meaning that it easily sets off an event.&nbsp;<br></p><p><br><img src=\"@@PLUGINFILE@@/opiate-addict.jpg\" alt=\"\" width=\"714\" height=\"456\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p>Figure 9: The slow content that gives rise to seizure activity in an opiate addict.<br></p>',1),(76,17,0,77,20,0,1,1,1564849808,1564850234,'Page 1','Types of Psychotropic Drugs\r\n<ul>\r\n<ul><li>Antidepressants</li><li>Antipsychotics</li><li>Anxiolytics</li><li>Hypnotics</li><li>Mood stabilizers</li><li>Stimulants</li></ul>\r\n\r\n\r\n\r\n\r\n\r\n</ul><b>\r\n\r\nMost Frequently Prescribed Psychotropic Drugs\r\n\r\n</b><ul><ul><li>Xanax (alprazolam), 48.5 million.</li><li>Zoloft (sertraline), 41.4 million.</li><li>Celexa (citalopram), 39.4 million.</li><li>Prozac (fluoxetine), 28.3 million.</li><li>Ativan (lorazepam), 27.9 million.</li><li>Desyrel (trazodone HCL), 26.2 million.</li><li>Lexapro (escitalopram), 24.9 million.</li></ul>\r\n\r\n\r\n\r\n\r\n\r\n\r\n</ul>',1),(77,17,76,78,20,0,1,1,1564850164,1566390181,'Page 2','<b>Anti-depressants</b>\r\n<br>Antidepressants are grouped into classes based on how they affect the chemistry of the brain. While the antidepressants in a class will tend to have similar side effects and mechanisms of action, there are differences in their molecular structures which can influence how well the drug is absorbed, disseminated, or tolerated in different people.\r\nThere are three basic molecules, known chemically as monoamines, that are believed to be involved in mood regulation. These primarily work as neurotransmitters, which literally transmit nerve signals to their corresponding receptors in the brain. Antidepressants work by influencing these neurotransmitters, which include:\r\n\r\n<br><br><ul>\r\n<li><b>Serotonin</b>, the neurotransmitter whose role it is to regulate mood, appetite, sleep, memory, social behavior, and sexual desire<br><br><p style=\"text-align: center;\"><img src=\"http://via.placeholder.com/600x260\" alt=\"\" width=\"600\" height=\"260\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p></li></ul>\r\n<ul>\r\n<li><b>Norepinephrine</b>, which influences alertness and motor function and helps regulate blood pressure and heart rate in response to stress<br><br><p style=\"text-align: center;\"><img src=\"http://via.placeholder.com/600x260\" alt=\"\" width=\"600\" height=\"260\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p></li></ul>\r\n<ul>\r\n<li><b>Dopamine</b>, which plays a central role in decision-making, motivation, arousal, and the signaling of pleasure and reward<br><br><p style=\"text-align: center;\"><img src=\"http://via.placeholder.com/600x260\" alt=\"\" width=\"600\" height=\"260\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p></li></ul>',1),(78,17,77,79,20,0,1,1,1564850251,1567352143,'Page 3','<span>Five classes of anti-depressants - <br><br><ul><li><span>SSRIs<br></span></li><li><span>SNRIs<br></span></li><li><span>MAOs<br></span></li><li><span>TCAs<br></span></li><li><span>Atypical antidepressants</span>\r\n</li></ul></span><br>Selective Serotonin Reuptake Inhibitors (SSRIs)\r\n<br><br>There are a number of antidepressants that work by preventing the reabsorption (reuptake) of neurotransmitters into the body. Collectively known as reuptake inhibitors, they prevent the reuptake of one or more neurotransmitters so that more are available and active in the brain.\r\n<br><br>Selective serotonin reuptake inhibitors (SSRIs) work by specifically inhibiting the reuptake of serotonin. SSRIs are a newer class of antidepressants first developed during the 1970s.\r\n<br><br>Examples include:\r\n<br><br><ul>\r\n<ul><li>Prozac (fluoxetine)</li><li>Paxil (paroxetine)</li><li>Zoloft (sertraline)</li><li>Celexa (citalopram)</li><li>Luvox (fluvoxamine)</li><li>Lexapro (escitalopram)</li><li>Viibryd (vilazodone)\r\n</li></ul>\r\n\r\n\r\n\r\n\r\n\r\n\r\n</ul>\r\nSSRIs tend to have fewer side effects than older antidepressants but are still known to nausea, insomnia, nervousness, tremors, and sexual dysfunction.\r\n<br><br>In addition to treating depressions, SSRIs are also sometimes used to treat obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), eating disorders, and premature ejaculations. They have also proved helpful during stroke recovery.\r\n<br><br><b>Effects</b>\r\n<br>These more modern antidepressants have fewer changes in the slow activity (associated with less viscero/autonomic side-effect), with a mild fronto-central beta increase in the range of 18-25 Hz and a decrease in alpha anteriorly.',1),(79,17,78,80,20,0,1,1,1564850612,1566390244,'Page 4','Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)\r\n<br><br>Serotonin and norepinephrine reuptake inhibitors (SNRIs) work in a similar way to SSRIs except that they inhibit the reuptake of both norepinephrine and serotonin. The first SNRI was FDA-approved in December 1993.\r\n<br><br>Increasing norepinephrine levels in tandem to serotonin levels can be particularly useful or people with psychomotor retardation (the slowing of physical movement and thought).\r\n<br><br>Examples of SNRIs include:\r\n<ul>\r\n<ul><li>Effexor (venlafaxine)</li><li>Cymbalta (duloxetine)</li><li>Pristiq (desvenlafaxine)</li><li>Savella (milnacipran)</li><li>Fetzima (levomilnacipran)\r\n</li></ul>\r\n\r\n\r\n\r\n\r\n</ul>\r\nCommon side effects of SNRIs include nausea, drowsiness, fatigue, constipation, and dry mouth.\r\n<br><br>Some SNRIs, like Cymbalta, can also be used to treat chronic pain, a condition closely linked to the development of depression. They have also proven useful in treating generalized anxiety, post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), panic disorder, and nerve pain associated with fibromyalgia.\r\n<br><br>If the frontal lobe has regular frequency alpha seen in excess, especially with eyes-closed frontal alpha hypercoherence, then in our experience, an SSRI or an SNRI may be used to increase frontal function.',1),(80,17,79,81,20,0,1,1,1564850848,1566390283,'Page 5','Tricyclic Antidepressants (TCAs)\r\n<br><br>Tricyclic antidepressants (TCAs) are an older class of drug first discovered in the 1950s. They were named after their chemical structure, which is composed of three interconnected rings of atoms.\r\n<br><br>TCAs work similarly to reuptake inhibitors in that they block the absorption of serotonin and norepinephrine into nerve cells, as well as another neurotransmitter known as acetylcholine (which helps regulate the movement of skeletal muscles).\r\n<br><br>Examples of TCAs include:\r\n<ul>\r\n    <ul>\r\n        <li>Elavil (amitriptyline)**</li>\r\n        <li>Norpramin (desipramine)</li>\r\n        <li>Asendin (amoxapine)</li>\r\n        <li>Anafranil (clomipramine)</li>\r\n        <li>Pamelor (nortriptyline)</li>\r\n        <li>Tofranil (imipramine)*</li>\r\n        <li>Vivactil (protriptyline)</li>\r\n        <li>Surmontil (trimipramine)</li>\r\n        <li>Sinequan (doxepin)</li>\r\n    </ul>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n</ul><b>\r\nEffects</b>\r\n<br><br>\r\n<ul><ul>\r\n    <li><b>*Imipramine:</b> This drug produces an increase in slow activity, a decrease in alpha and high alpha, with an increase in the faster beta frequencies in the mid to upper 20 Hz range and up.&nbsp;<br><br></li>\r\n    <li><b>&nbsp;**Amitriptyline:</b> This drug produces more slowing than imipramine, though the other effects are similar. This corresponds to an increased initial sedative effect and its use as a sleeping medication for sleep onset as well as the usual\r\n        wakefulness effects of antidepressants. In epileptics, there are increases in paroxysmal discharges, which can be controlled normally with adjustments to the anti-epileptic medications.&nbsp;</li>\r\n</ul></ul>\r\n\r\nIn addition to their use in depression, tricyclic antidepressants can help treat chronic pain. They were also once commonly used in children with attention deficit hyperactivity (ADHD) but have since been replaced with more effective drug agents with fewer side effects.',1),(81,17,80,82,20,0,1,1,1564851295,1566390319,'Page 6','<b>Monoamine Oxidase Inhibitors (MAOIs)</b>\r\n<br><br>One of the first classes of antidepressants developed were monoamine oxidase inhibitors (MAOIs). This antidepressant class, first discovered in the 1950s, inhibits the action of an enzyme called monoamine oxidase, whose role it is to break down monoamines. By blocking this effect, more neurotransmitters are available for use in mood regulation.\r\n<br><br>Examples of MAOIs include:\r\n<ul>\r\n<li>Nardil (phenelzine)</li>\r\n<li>Parnate (tranylcypromine)</li>\r\n<li>Marplan (isocarboxazid)</li>\r\n<li>Emsam (selegiline)\r\n</li>\r\n</ul>\r\nMAOIs have proven useful in treating agoraphobia, social phobia, bulimia, PTSD, borderline personality disorder, and bipolar depression. Even so, its use is usually reserved for when other antidepressant options have failed.\r\n<br><br><b>Effects</b>\r\n<br>These medications have a wider variation of response than the other antidepressants. Isocarboxazide increases 30-20 Hz and decreases slower and higher frequencies, similar to a stimulant profile. Nialamide and Tranylcypromine produce a more typical profile, though with more variability.',1),(82,17,81,0,20,0,1,1,1564851440,1566390375,'Page 7','Atypical Antidepressants\r\n<br>There are also other fairly new antidepressants that do not fit into any of the above-listed categories. Broadly described as atypical antidepressants, they affect serotonin, norepinephrine, and dopamine levels in unique ways. <br><br>Examples of\r\ninclude:\r\n<ul>\r\n    <ul>\r\n        <li>Wellbutrin (bupropion), classified as a <b>dopamine reuptake inhibitor</b>, is used to treat depression and seasonal affective disorder as well as a smoking cessation aid.</li>\r\n        <li>Remeron (mirtazapine) is a <b>noradrenergic antagonist</b> used for major depression, that blocks receptors of the stress hormone epinephrine (adrenaline) on the brain.</li>\r\n        <li>Oleptro (trazodone) and Brintellix (vortioxetine) are <b>serotonin antagonist and reuptake inhibitors</b> (SARIs) used for major depression the both inhibit serotonin reuptake and block adrenergic receptors.</li>\r\n        <li>Symbax combines the SSRI fluoxetine with the antipsychotic drug fluoxetine to treat bipolar depression or treatment-resistant depression.&nbsp;</li>\r\n    </ul>\r\n\r\n</ul><span>\r\nSide effects can vary by drug type but may include dizziness, dry mouth, insomnia, nausea, vomiting, constipation, blurry vision, weight gain, and sexual dysfunction.</span><b>\r\n<br><br>Effects on EEG:\r\n</b><br>Slowing of background activity (alpha slows)\r\n<br><br>Increase in slow frequencies and voltage (theta and delta)\r\n<br>Examples Tricyclinc antidepressants: monamine oxidase inhibitors (MAOs), lithium, phenothiazines and butyrophenones',1),(83,18,0,84,20,0,1,1,1564852917,1567352188,'Page 1','<span><b style=\"\">EEG Frequencies related to anesthetic agents\r\n<br></b></span><br><span>Alpha</span>: maximum in awake patients with eyes closed, appears in the occiput\r\n<br><br>Alpha is created by thalamic pacemaker cells\r\n<br><br>Alpha synchronizes cells in the thalamocortical pathways\r\n<br><br>An <b>anesthetic </b>(American English) or <b>anaesthetic </b>(British English; see spelling differences) is a drug used to induce anesthesia - in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad classes: general anesthetics, which result in a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness.\r\n<br><br>A wide variety of drugs are used in modern anesthetic practice. Many are rarely used outside anesthesiology, but others are used commonly in various fields of healthcare. Combinations of anesthetics are sometimes used for their synergistic and additive therapeutic effects. Adverse effects, however, may also be increased.<sup>[1]</sup> Anesthetics are distinct from analgesics, which block only sensation of painful stimuli.',1),(84,18,83,85,20,0,1,1,1564852928,1566390436,'Page 2','<b>Effects (most volatile)\r\n</b><ul>\r\n<ul><li>Marked drop in gamma band activity (25 – 50Hz)</li><li>Increase in theta/delta frequencies  (Theta comes from inhibition of normal thalamic pacemaker cells, Delta results from extreme depression of the thalamus)</li><li>Increase in the power of the frontal electrodes (Beta: is the result of sensory stimuli influencing the reticular activating system with desynchronization of thalamic pacemakers, maximal in the prefrontal regions)</li><li>Marked increase in hypercoherence/synchrony</li></ul>\r\n\r\n\r\n</ul><i>\r\nNote: Each anesthetic agent will have a different effect on the EEG. Their profile will change the closer they get to isoelectric. Increasing the dose of anesthetics will produce slowing, then burst suppression, then electro-cerebral silence (isoelectric EEG) <br><br>These maps are a patient who was in a car accident and was taking a combination of pain management medications. The blending of sedatives and hypnotics tends to produce an excessive slowing in the EEG.<br><br><img src=\"@@PLUGINFILE@@/hypnotics-sedatives.jpg\" alt=\"\" width=\"724\" height=\"958\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br><br>Figure 10: Excessive slowing in the theta band as a result of combining hypnotics and sedatives.. Image generated from Neuroguide version 3.0.6.<br></i>',1),(85,18,84,86,20,0,1,1,1564853186,1566390485,'Page 3','<i><br><img src=\"@@PLUGINFILE@@/hypnotics-sedatives-2.jpg\" alt=\"\" width=\"716\" height=\"641\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br><br>Figure 11: Excessive slowing into the theta band as a result of combining hypnotics and sedatives.. Image generated from Neuroguide version 3.0.6.<br></i>',1),(86,18,85,0,20,0,1,1,1564853302,1566390523,'Page 4','<b>Stimulants</b> <br><br><img src=\"http://via.placeholder.com/600x260\" alt=\"\" width=\"600\" height=\"260\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\">&nbsp;<br><br><ul><ul><li>\r\nUsed for ADHD disorders mainly</li>\r\n<li>ADHD profiles:\r\n<ul><li>High theta/beta ratio or theta/alpha ratio&nbsp;</li><li>Higher relative theta&nbsp;</li><li>Frontal spindling beta&nbsp;</li><li>Mu rhythm&nbsp;</li><li>Temporal lobe alpha</li>\r\n</ul></li>\r\n</ul>\r\n</ul><b>\r\n\r\nEffects\r\n</b><ul><ul><li>Normalization of EEG</li><li>No change from baseline</li><li>Decrease in theta, theta/alpha, and theta/beta ratios</li><li>Increase in beta amplitudes</li></ul>\r\n\r\n\r\n</ul>\r\nStimulants increase the activity in the RAS, with the Raphe nucleus releasing norepinephrine, decreasing the polarization in the reticular nucleus of the thalamus and thus increasing the “clocking” or peak frequency of the rhythmic alpha activity and increasing faster activity.\r\n<br><br><b>Amphetamines:</b> Both dextro and methamphetamines like Dextrostat or Adderal are similar in effect, with decreased slower activity and increased beta from 12-26 Hz. There is a paradoxical increase in alpha noted in the CEEG work of Itil (Itil et al., 1980). This is likely from the increased activation effect mentioned in the opening section.\r\n<br><br><b>Methylphenidate:</b> Ritalin produces a decrease in delta and theta, with a more pronounced posterior alpha increase and an increase in low beta, with effects delayed up to 6 hours, compared to the rapid effects of the amphetamines.',1),(87,19,0,116,20,0,1,1,1571854475,1586874974,'Basic Info','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/365307579\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(88,20,0,0,20,0,1,1,1571984533,1586607547,'Basic Info','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/368574276\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(89,22,0,0,20,0,1,1,1571985054,1572974389,'Basic Info','<p> Click to Play video</p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/368573977\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(90,23,0,0,20,0,1,1,1572320074,1572974292,'Basic Introduction','<p> Click to Play video</p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/368898820\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\" width=\"640\" height=\"399\" frameborder=\"0\"></iframe></p>',1),(91,24,0,92,20,0,1,1,1586540428,1591032459,'Generators of EEG rhythmicity','<p>Theories of how EEG arises and propagates itself are still evolving. The EEG at the surface of the cortex reflects the summated activity of ensembles of cells in the form of extracellular current flow. This summated activity is due apparently to synchronously\r\n    activated postsynaptic potentials from vertically oriented pyramidal cells. Thus, the production of Local Field Potentials (LFPs) is what is picked up by the electroencephalograh (i.e. amplifier), and LFPs are observed only as radially-oriented (i.e.\r\n    right-angle) dendrites excitatory action potentials summate in the cortical gyri and sulci.&nbsp;</p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/axon-potential.png\" alt=\"Figure xx: Action potential occurring along an axon\" width=\"625\" height=\"406\" class=\"img-responsive atto_image_button_middle\"><br></p>\r\n<p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Figure 1: Action potential occurring along an axon</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><p style=\"text-align: left;\"><br></p><p style=\"text-align: left;\">Figuree 2: Purkinje Cell</p><p style=\"text-align: left;\"><img src=\"@@PLUGINFILE@@/Purkinje%20Cell.jpg\" alt=\"Purkinje Cell\" width=\"459\" height=\"428\" class=\"img-responsive atto_image_button_left\">The cerebellum is uniquely difficult to get EEG source from due to the complexity of its folds and the orientation of the neurons:&nbsp;&nbsp;the human cerebellum is more tightly folded than the neocortex with individual folia being 1–2 mm wide (Braitenberg &amp; Atwood,&nbsp;<a href=\"https://onlinelibrary.wiley.com/doi/full/10.1002/hbm.24951#hbm24951-bib-0005\" id=\"hbm24951-bib-0005R\" data-tab=\"pane-pcw-references\">1958</a>)&nbsp; creating difficulty due to convolution.&nbsp; Furthermore, a good portion of the cerebellum is made of Purkinje cells, which&nbsp;are GABAergic inhibitory projection neurons. Their large somata are located in the&nbsp;<b>Purkinje cell layer</b>&nbsp;(PCL) in the adult cerebellum, and aligned like dominos stacked one in front of the other.&nbsp;</p><p style=\"text-align: left;\"><br></p></span></p>\r\n<p>What we see in the EEG is limited to measuring what is occurring at the cortical excitatory pyramidal neurons, which make up about 80% of the human cortex (or 80 billion of the 100 billion). The high density clustering these excitatory pyramidal neurons’\r\n    synapses create high density network nodes, or hubs in the brain, which serve as metaphorical substations for the relay of energy across functional networks in the brain (Hagmann et al., 2008; He et al., 2008). The actions of inhibitory neurons is\r\n    not visible in the EEG, however, inhibitory neurons serve to hyperpolarize action potentials of pyramidal neurons into in-phase and anti-phase dynamics. And balancing of opposing forces, such as excitation and inhibition, often gives rise to rhythmic\r\n    behavior. The mean time difference between&nbsp; the discharges of any two pairs of cells is zero; that is, interneurons discharge synchronously at approximately the same time. And neurons in the inhibitory network will be inhibited at the same time\r\n    and fire simultaneously after inhibition wears off. Discharge and silence will alternate in all parts of the network synchronously (Buszaki, p. 75). On average, all neurons will fire at zero lag time and will be silenced at the same time (p. 76).\r\n    Oscillator networks made from homogenous inhibitory neurons can have a large deteriorating effect on subsequent synchronous discharge of the neurons. This may explain why gamma-frequency oscillations are typically short-lasting, transient events (Buszaki,\r\n    p. 76)</p>\r\n<p><span style=\"\"></span></p>\r\n<p>GABAergic inhibitory neurons can aid to synchronize neurons in a coordinated manner (into cross-frequency phase shift and phase lock) by shifting the membrane potentials of pyramidal neurons.</p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/pyramidal-neurons.png\" alt=\"Figure xx: Pyramidal Neurons\" width=\"625\" height=\"350\" class=\"img-responsive atto_image_button_middle\"><br></p>\r\n<p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Figure 3: Pyramidal Neurons</span></p>\r\n<p>According to Duffy (1989), excitatory neurotransmitters evoke an electrical change in the excitatory postsynaptic membrane potentials (EPSP), depolarizing the post synaptic membrane and leading eventually to an action potential, while inhibitory neurotransmitters\r\n    result in increased negative charge inside the cell membrane known as the inhibitory postsynaptic potential (IPSP) that hyperpolarizes the cell membrane and inhibits depolarization. Excitatory post synaptic potentials move positive ions (sodium, calcium\r\n    and potassium) down axons and inhibitory post synaptic potentials move negative ions (chlorine) down axons. When recording an EEG, 50% of the data arriving at the site of the electrode is from neurons directly underneath it, and 95% of the data comes\r\n    from within 6 centimeters distance (that’s a circle with a diameter of 2 1/3 inches—big).&nbsp;</p>\r\n<p><span style=\"\"></span></p>\r\n<p>There are two types of connections between synapses: electrical and chemical synapses. Electrical synapses produce very short and high-speed communication (200 nsec to a few msec), which are too short to be measured at the scalp surface, due to filtering\r\n    properties of the skull. However, chemical synapses, which are responsible for the swap of neurotransmitters (small molecules) and neuromodulators (large molecules), produce short duration electrical potentials of 100msec to seconds, which are readable\r\n    via EEG (1 to 300Hz with intra-cerebral electrodes and 1 – 50Hz with scalp electrodes) (Buzsaki, 2006).&nbsp;&nbsp;<span style=\"font-size: 1rem;\">There are “fast synapses” and “slow synapses”. Fast synapses encompass 90% of excitatory synapses, which are modulated with the neurotransmitter glutamate, and 90% of inhibitory synapses, which are modulated by the neurotransmitter GABA. Slow synapses encompass the other 20% are long duration synaptic potentials that last for 100 msec to 1 sec and are modulated by dopamine, acetycholine, serotonin, norepinephrine and histamine (these molecules are within a sub-class of neurotransmitters, called neuromodulators, due to the lack of re-uptake mechanism) (Thatcher, 2012). Fast synapses&nbsp; oscillate at 0 – 80msec and slow synapses oscillate at 100 msec – 1 second), thus the frequencies of 0-80 msec (12.5+ Hz) are ruled by the gaba/glutamate allostasis and the frequencies of 10Hz (100 msec to 1 sec) and under are ruled by the slow synaptic neuromodulators. The frequencies of 10 – 12.5Hz are a blend of fast and slow synapses. If you brain is not producing noephinephrine, your alpha is likely too slow and if you have too much GABA, your alpha is likely too fast.&nbsp;</span></p>',1),(92,24,91,93,20,0,1,1,1586540554,1586541255,'Slow Cortical Potentials','<p>Slow cortical potentials are negative or positive polarizations of the (EEG) (or magnetic field changes in the magnetoencephalogram (MEG)) that last from 300 ms to several seconds.&nbsp; Functionally, they constitute a threshold regulation mechanism for\r\n    local excitatory mobilization (negative slow potentials) or inhibition (positive slow potentials) of cortical networks. SCPs reflect the depolarization of large cortical cell assemblies, reducing their excitation threshold. Slow cortical potentials\r\n    bind networks (this is the binding frequency of consciousness, not gamma—gamma is the by-product of being bound).</p>\r\n<p>Glia generate direct current and slow cortical potentials. Glia are thought to be responsible for the hemodynamics in the brain and this is where bold sugar (glucose) is metabolized. Glucose comes from the Greek word for \"sweet.\" When you metabolize blood\r\n    sugar (glucose), you create the by-product of bi-carbonate ions (a form of carbon dioxide, also known as HCO3) in the blood, which generates an electro-negative charge. Your blood brings bicarbonate to your lungs, and then it is exhaled as carbon\r\n    dioxide. Your kidneys also help regulate bicarbonate. Bicarbonate is excreted and reabsorbed by your kidneys. This regulates your body\'s pH, or acid balance. Bicarbonate also works with sodium, potassium, and chloride, also called electrolytes. These\r\n    are usually measured at the same time as bicarbonate.</p>\r\n<p><span style=\"font-size: 1rem;\">DC fields in the EEG correspond to intention and attention (i.e. what is deemed salient). The DC field potentials in the brain area to wiggle your fingers would cause those areas of the brain to light up. You have between 10-100 glia for every neuron. Glia have many roles, as will be covered in Chapter 4: Basic Neurophysiology and Neuroanatomy. But, suffice it to say, glia are foremost know in acting like scaffolding for each neuron.&nbsp;</span><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/neuron-scaffolding.png\" alt=\"Times\" width=\"307\" height=\"258\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(93,24,92,94,20,0,1,1,1586540657,0,'Delta','Delta is generated in dipoles within sheets of cortical tissues. Delta arises from unmyelinated white matter in early life, as well as in deep dreamless sleep, when pacemakers in thalamic and septo-hippocampal, hypothalamic, and brainstem locations create the slow pulsing carrier wave rhythms of the EEG by activating large groups of synchronous neurons at the same time.. Early in life delta is created by the fundamental neuronal structures of the reptilian system and delta appears during the initial migration of neurons across the lobe of the brain, as they form the basic networks of the brain that make up the fundamental architecture from which everything else springs forth.',1),(94,24,93,95,20,0,1,1,1586540928,0,'Theta','Since all thalamo-cortical activity is considered alpha, much theta activity is truly slowed alpha activity (which is recognizable by its sinusoidal shape). The thalamus can gate as slow as 2Hz and as fast as 14 hz. However, theta is limbically generated in the septo-hippocampal circuit, as well as generated by the nucleus accumbens in the forebrain. Limbically generated theta is thought of as frontal midline theta, since the limbic projections are spatially limied, corticall, at the frontoal and central midline. However, if it is longer than one second it is not frontal midline theta, but more the theta that is attention deficit disorder theta. <br><br>The nucleus accumbens is a part of the reward network (it is considered a monopole because all of the dipoles in it add to zero—it is tightly hooked to the rostral anterior cingulate). The nucleus accumbens provides acetochyline to the temporal lobes via the diagonal band of broca, which creates a feedback loop involving the amygdala and the hippocampus complex. The parahippocampal cortex reflects the temporal lobe\'s monopoles of the hippocampus and amygdala. This feedback loop creates the theta rhythm ,which is occurring in the septo-hippocampal circuit.  Acetylcholine&nbsp;causes muscles to contract, activates pain responses and regulates endocrine and REM sleep functions. <br><br><b>Interesting fact:</b> <i>The venom of a black widow spider acts by causing the release of acetylcholine. When a person is bitten by a black widow, their acetylcholine levels rise dramatically, leading to severe muscle contractions, spasms, paralysis, and even death.</i><br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/dopamine-deficient.png\" alt=\"In ADD/ADHD is dopamine deficient\" width=\"419\" height=\"399\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">In ADD/ADHD is dopamine deficient</span></p>',1),(95,24,94,96,20,0,1,1,1586541345,0,'Alpha','<p>Alpha is a freuqency generated by the gating of the thalamus (it is received at the cortex and is thus, “thalamo-cortical”). When the EEG goes electro-positive, the thalamus closes.&nbsp; As the idling rhythm of the brain, alpha orchestrates (regulates) cortical function. Alpha often acts as a carrier wave that allows the content of gamma to be processed. The wave morphology of alpha is usually typified by a sinusoidal wave, although it may be more sharp than rounded in a few people, especially children and young adults.&nbsp; Current belief (Niedermeyer, 1999a; Steriade, Gloor, Llinas, Lopes da Silva, &amp; Musulam, 1990) is that there are cortico-cortico and thalamo-cortical generators of alpha which interact with one another, although there is no validation of a synchronizing mechanism at a cortical level.<br></p>',1),(96,24,95,97,20,0,1,1,1586541398,0,'Beta','<p>Beta is a cortico-cortical frequency, generated by the six layers of pyramidal neurons that create the cortex of the brain. Beta is responsible for local communication within groups of neurons. Beta arrives in many states and conditions, from the point of birth onward, w=however its predominant function is executive functioning and processing of information for decision making. It is thought to be the brain wave that is responsible for higher level thinking.<br></p>',1),(97,24,96,0,20,0,1,1,1586541486,0,'Gamma','Gamma, which is 40+ Hz, is an emergent property in the EEG and does not have a generator, like the other frequencies. Gamma can be generated everywhere in the brain. Gamma is a resonant property of networks being bound, it arrives like a rainbow arrives via the combination of sun and water vapor. Gamma shows after receiving a stimulus and is thought to be the “aha!” of EEG.',1),(98,25,0,99,20,0,1,1,1586541667,1591032748,'The ABCs','<p style=\"text-align: center;\"><a href=\"@@PLUGINFILE@@/CAMFT-Article-Thompson-Understanding-the-patients-brain.pdf\" target=\"new\"><img src=\"@@PLUGINFILE@@/the-abcs.png\" alt=\"CAMFT Article Thompson Understanding the patients brain.pdf\" width=\"346\" height=\"417\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></a>\r\n</p><p style=\"text-align: center;\">\r\n  <a href=\"@@PLUGINFILE@@/CAMFT-Article-Thompson-Understanding-the-patients-brain.pdf\" target=\"new\">CAMFT Article Thompson Understanding the patients brain.pdf</a></p>\r\n<p></p><p style=\"text-align: center;\"><br></p>The\r\nfirst official classification of brainwave bandwidths was introduced by the International Federation of Societies for Electroencephalography and Clinical Neurophysiology in 1974. It is as follows: delta (0.5 – 4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta\r\n(12-30 Hz), and gamma (&gt;30Hz). Hertz (Hz) is the measure of the speed of brainwaves, noting numerically the frequency in cycles per second. It has been hypothesized that the subconscious and sleep states (dominated by theta and delta) are linked to\r\nthe conscious states (13+ Hz) through the bridge of alpha brain waves (Wise, 2002, p. 53).\r\n<br><br>Brainwaves are characterized by their speed (frequency), size (amplitude) and shape (morphology). More information can be inferred from their phase dynamics. Frequency is the power or speed of the electrical emissions, measured in hertz (Hz). Amplitude is the power of the electricity, measured in microvolts.\r\nPure microvolts is called magnitude and microvolts squared is called amplitude. Here are some other and important definitions. In EEG analysis and brain region analysis, it is helpful to think of the frequency as the adjective (i.e. theta = foggy, groggy,\r\nfuzzy, trance-like, day-dreamy, “not all here,”) and the region that is affected as the noun.',1),(99,25,98,100,20,0,1,1,1586541891,1586857850,'Important Definitions','<p><b>Action Potentials:</b> The exchange of potassium (K+), Chloride (Cl-), Calcium (Ca2+) and Sodium (Na+) along the dendrite of a neuron, which produces a small battery that maintains a voltage of -60 millivolts.</p><p><b>Amplitude:</b> The height of the brainwave, measured in microvolts squared.</p><p><b>Asymmetry:</b> The absence or violation of balance between two hemispheres or quadrants.</p><p><b>Connectome:</b> The complete description of the structural connectivity (the physical wiring) of an organism’s nervous system.</p><p><b>Coherence:</b> The stability of phase relationship between any two areas of the brain. Two areas are said to be coherent if they have constant respective relative phase. Coherence in excess is hypercoherence; coherence in deficiency is hypocoherence.&nbsp;</p><p><span style=\"font-size: 1rem;\"><b>Frequency:</b> Cycles per second. The standard unit of frequency is “Hertz,” which is abbreviated as Hz. 4 Hz is equal to four cycles per second.&nbsp;&nbsp;</span><br></p><p><b>Frequency Band:</b> A range of wave frequencies, typically grouped as follows: delta (0-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), low beta (12-15 Hz), mid beta (15-25Hz), high beta (25-40Hz), gamma (40+ Hz).</p><p><b>Lateralized:</b> Occurring only over one hemisphere</p><p><b>Bilateral:</b> Occurring on both sides of the EEG; occurring over both hemispheres</p><p><b>Diffuse:</b> Widespread, occurring over a large area of one or both hemispheres</p><p><b>Dominant Frequency (Aka Background Rhythm): </b>The frequency of EEG activity that occupies the greater part of the recording</p><p><b>Focal:</b> In a clearly delineated area of the brain as in a focal temporal spike or focal slowing</p><p><b>Harmonic:</b> A wave or frequency that is an integral multiple of a given frequency.</p><p><b>Homologous:</b> Two areas at the same region of the brain, mirrored, sharing common function (i.e. C# is the homologue to C4)&nbsp;</p><p><b>Multifocal:</b> Having several independent foci as in multifocal paroxysmal spike discharges</p><p><b>Sub-harmonic:</b> A frequency that is below the fundamental frequency, which divides evenly into the fundamental frequency.</p><p><b>Synchrony:</b> A balance that occurs if waves of similar frequency occur simultaneously in different areas of the head. Waves that occur in different channels</p><p>&nbsp;without a constant time relationship to each other are called asynchronous.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/gamma-beta-alpha-theta.png\" alt=\"Gamma\" width=\"621\" height=\"412\" class=\"img-responsive atto_image_button_middle\"><br></p>',1),(100,25,99,101,20,0,1,1,1586542751,1586858135,'Slow Cortical Potentials','Slow cortical potentials create networks and thus allow the brain to turn on and off any network. SCP causes the binding of networks, which is caused when glia generate a negative wave. This generation is caused by the ATP<sup>2</sup> cycle , which is\r\nthe generation of an electrically negative charge by burning blood sugar and creating energy (Co<sub>2</sub> + water). A positive wave generated by glia is a calcium channel wave. Glia “primes” an area, which is essentially the act of intention.\r\n\r\n\r\n<br><sup><br>2&nbsp;</sup><i>Adenosine triphosphate (ATP) is a complex organic chemical that provides energy to drive many processes in living cells, e.g. muscle contraction, nerve impulse propagation, and chemical synthesis. Found in all forms of life,\r\nATP is often referred to as the \"molecular unit of currency\" of Adenosine triphosphate (ATP) is a complex organic chemical that provides energy to drive many processes in living cells, e.g. muscle contraction, nerve impulse propagation, and chemical synthesis. Found in all forms of life, ATP is often referred to as the \"molecular unit of currency\" of intracellular energy transfer.[2] When consumed in metabolic processes, it converts either to adenosine diphosphate (ADP) or to adenosine monophosphate (AMP)</i>',1),(101,25,100,102,20,0,1,1,1586543146,1586858173,'Delta','<b>Healthy Delta</b><br><p><span><span style=\"\"><b style=\"\"><u style=\"\">Delta rhythm</u></b></span></span> is a brainwave that is most commonly seen in deep dreamless sleep (NREM 4) in healthy adults and children. It is also a dominant brainwave in infants, since the earliest stages of life are times of, one, a lot of sleep, and two, neurogenesis and angiogenesis. Young brains form, develop and grow with the production of delta. Although usually thought of as being associated with sleep and parts of the brain being “off line,” taking up nourishment, delta activity is always present in normal EEG’s of any age.&nbsp; It is generated cortically and inhibited by afferent stimulation of the cortex.&nbsp;</p><p>There is a substantial QEEG literature relating delta power to higher order mental functions in normal awake humans.&nbsp; Increased delta activity has been observed in normal subjects performing calculations, taking reaction time tests, and thinking abstract thoughts.&nbsp; Delta is thought to have a functional role in allocating attention to internal mental representations, by suppressing extraneous cortical inputs and facilitating internal concentration. Anterior lead voltage in awake subjects is 20%-30% delta.&nbsp; &nbsp;</p><p><br></p><p><img src=\"@@PLUGINFILE@@/healthy-delta.png\" alt=\"Healthy Delta\" width=\"513\" height=\"381\" class=\"img-responsive atto_image_button_middle\"><br></p>',1),(102,25,101,103,20,0,1,1,1586543417,1586858304,'Pathological High Amplitude Delta','When delta is pathological, it represents cognitive impairment or of brain damage. Delta excesses often correlated with damage to the white matter (the white matter axons are exclusively excitatory). Focal&nbsp;delta activity should always be considered abnormal, possibly indicating a lesion, and should result in referral of the patient to a neurologist for further evaluation.&nbsp; Generalized background slowing indicates diffuse cerebral dysfunction, which, similar to focal slowing, is also not specific as to cause. Delta can indicate the effects of sedative centrally acting medications, neurodegenerative disorders, a widespread neurodevelopmental disorder, hydrocephalus, metabolic or toxic encephalopathy, CNS infectious disorders such as meningoencephalitis, traumatic brain injury, hypoxia, or anoxia. The delta band may be composed of delta rhythm activity (usually over 75 µV and rather rhythmic), slow cortical potentials (DC shifts) at .5 Hz and below, and also artifact (e.g., eye movement, glossokinetic artifact, electrodermal or sweat artifact).<br><br><img src=\"@@PLUGINFILE@@/focal-delta.png\" alt=\"Focal Delta in a 12-year-old girl with complications from an anoxic head injury\" width=\"635\" height=\"547\" class=\"img-responsive atto_image_button_middle\"><br><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Figure : Focal Delta in a 12-year-old girl with complications from an anoxic head injury</span></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/focal-delta-z-scored.png\" alt=\"Focal Delta in a 12 year old girl with complications from an anoxic head injury\" width=\"623\" height=\"389\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : Focal Delta in a 12 year old girl with complications from an anoxic head injury<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">An excess of delta activity may be seen in the records of individuals with learning disabilities, Alzheimer’s disease, demyelination, toxic or metabolic disturbances, edema, and with aging there is frequently an increase of delta waves, especially in the left hemisphere.&nbsp; Pathological delta patterns, known as FIRDA (Frontal Intermittent Rhythmic Delta Activity) and OIRDA (Occipital Intermittent Rhythmic Delta Activity) are abnormal and pathological delta patterns. FIRDA is a transient, rhythmic slow wave pattern over the anterio EEG leads, that indicates cerebral lesions, circulation infarcts, stroke victims, and various metabolic disturbances.<br></p><p style=\"text-align: left;\"><br></p><p style=\"text-align: left;\"><img src=\"@@PLUGINFILE@@/firda-pattern.png\" alt=\"FIRDA Pattern in an elderly woman with metabolic encephalopathy\" width=\"627\" height=\"461\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : FIRDA Pattern in an elderly woman with metabolic encephalopathy<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/unhealthly-delta.png\" alt=\"Unhealthy Delta\" width=\"626\" height=\"314\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/global-delta.png\" alt=\"Global Delta in Head Injury, Deprivation of Oxygen for Prolonged Period of Time\" width=\"627\" height=\"357\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Global Delta in Head Injury, Deprivation of Oxygen for Prolonged Period of Time</p>',1),(103,25,102,104,20,0,1,1,1586544848,1586858416,'Pathological Low Amplitude Delta','Decreased delta power in quantitative EEGs has been found to be associated sometimes with complicated depression, chronic migraine, closed posterior head/neck injury, alcoholism, and a subgroup of patients who display lack of control over repetitive thoughts and behaviors and minor motor symptoms (Gerez-Malo &amp; Tell-Valdes, 1996).&nbsp;Low voltage delta can also indicate an old injury or a series of injuries (such is the case with professional athletes (soccer, rugby, and football players) who take many blows to the head.<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/football-player-z-scored.png\" alt=\"Figure : A football player who sustained many concussions and blows to the head. He experiences short term memory impairment\" width=\"723\" height=\"942\" class=\"img-responsive atto_image_button_middle\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Figure : A football player who sustained many concussions and blows to the head. He experiences short term memory impairment</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p>',1),(104,25,103,105,20,0,1,1,1586545476,0,'Pathological Delta: Concussion and Mild Traumatic Brain Injury','<p>Often in a concussion, the initial impact will lead the brain to release the excitatory neurotransmitter glutamate at the areas of damage, which causes a rapid depolarization of the local neurons. After this, the axonal sodium/potassium pump goes into overdrive to rebalance ion/voltage imbalance, more ATP (energy) is required, there is a jump in glucose metabolism, and extracellular swelling starts, reducing blood flow. Then the increase in metabolism with reduced blood flow causes an energy crisis in the cell. Cell is unable to carry out regular activity due to lack of energy and often entire cell groups will go dormant to preserve themselves. This is one cause of a low voltage EEG. </p>\r\n<p>It is very likely that, after a career of having hard knocks to the skull, a client’s brain will form scar tissue at the sites of the accident (after initially experiencing a state of inflammation). If the inflammation is not able to properly heal the brain—which is its’ function—then the brain will ultimately learn to handle the inflammation by altering cellular structures to form tougher tissues, which would consequentially prevent blood perfusion at the sites of the injury and prevent the slower brainwaves of delta and theta from being read from the surface. Among the symptoms that are commonly reported in patients with TBI and mild TBI include impairment in attention, memory, psychomotor speed, and executive functions.</p>\r\n\r\n<p>Some of the symptoms the client may experience as a result of his head injury include: </p>\r\n<ul><li>Difficulty figuring out how to do new things</li>\r\n<li>Disorganization</li>\r\n<li>Difficulty completing activities in a reasonable amount of time</li>\r\n<li>Slower learning than is normal</li>\r\n<li>Becoming easily angered or frustrated</li>\r\n<li>Difficulty with word finding</li>\r\n<li>Extreme sensitivity to light and/or sounds</li>\r\n<li>Difficulty with concentration or focus</li>\r\n<li>Easily distracted</li>\r\n<li>Spacing out</li>\r\n<li>Headaches</li>\r\n<li>Forgetfulness</li>\r\n<li>Impulsivity, impatience, risk taking, rudeness, social impropriety</li>\r\n<li>Fatigue</li>\r\n<li>Difficulty with balance, dizziness, clumsiness and even incontinence</li>\r\n<li>Problems reading</li>\r\n<li>Confusion with puzzles, directions, and telling left from right</li>\r\n<li>Difficulty understanding others</li>\r\n<li>Difficulty switching from one task to another, especially when unexpected.</li>\r\n<li>Getting lost easily</li>\r\n<li>Feeling fidgety</li>\r\n<li>Emotional difficulties (depression, fear, nightmares)</li>\r\n</ul>\r\n<p>\r\nGroups with a delta deficit include cocaine addicts, ADD, subtypes of OCD, and schizophrenia—all of whom have problems with frontal cortical regulation of attention or impulsive behavior, as well as the processing of extraneous stimuli.&nbsp; There is evidence suggesting a significant functional relationship of the delta rhythm to the mesotelencephalic dopamine (DA) projection.&nbsp; \r\n</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/mesotelencephalic.png\" alt=\"Mesotelencephalic Dopamine\" width=\"520\" height=\"478\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : The Mesotelencaphalic Dopamine System<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><p lang=\"en-US\" align=\"LEFT\">\r\n<span lang=\"en-US\">The\r\nestimated location of the major site for delta generation in midline\r\nand the anterior frontal cortex corresponds with the location of the\r\nmain cortical terminal field of the mesotelencephalic DA projection.</span>&nbsp;\r\n\r\n</p><br></p>',1),(105,25,104,106,20,0,1,1,1586545547,1586858560,'Psychodynamic Delta','<p>The basis of my conceptualization of EEG, which has formed from the works of many seminal authors and scholars, is as follows: Delta (1-4Hz) is the collective unconscious, a low frequency, high amplitude brainwave that is connected with psi-phenomena, pre-cognitive abilities, connection with nature, and deep emotional intelligence (Wise, 1995, 2002). Delta is the rhythm of the heart.</p><p>Delta arises out of the cosmic unconscious; Wise (1995, 2002) believed that delta was pronounced in healers, seers, or traumatized individuals. That is, the traumatized child may rely more heavily on premonition or gut instinct, to prevent being abused. Those with higher amplitude delta, according to Wise, may be hypervigilant or even have extra-sensory perception. Delta is the deep primal intuition, instinctual action, empathy and radar, allowing us to glean information that might not be available via consciousness (Wise, 1995, 2002).</p>',1),(106,25,105,107,20,0,1,1,1586545727,1586858724,'Theta','Theta is a frequency of 4-8Hz that emanates from the thalamus to the cortex and back again, it is a thalamo-cortical frequency and arrives in states of trance, deep meditation, drowsiness, under hypnosis and at the top of sleep cycle for healthy adults (REM sleep) during dream state. Theta also arrives in non rapid eye movement sleep (NREM 2 and NREM 3) at the midline and is part of what is called a “K-complex.”<br><br>Otherwise, healthy theta is seen in children under 9 years of age and is linked up to the visual gestalt in infants. Theta is similar to delta in that it is indicative of neurogenesis in the infant and child. From an empirical perspective, theta is one of the main rhythms of the hippocampus, where it is linked to memory encoding, spatial memory, and cognitive processes (Gorochowski, 2009; Stam, 2006). This has been found in many studies using rats. However, from intracranially implanted electrodes in seizure patients, Cantero et al. (2003) found that oscillations in the 4–7 Hz frequency range could be recorded from both the hippocampus and neocortex in humans, whereas previously it was not known if humans created hippocampal theta, as rats do. The hippocampal oscillations were associated with REM sleep and the transition from sleep to waking, and came in brief bursts, usually less than a second long. Cortical theta oscillations, arising from the thalamus and other subcortical structures, were observed during the transition from sleep and during quiet wakefulness; however, the authors were unable to find any correlation between hippocampal and cortical theta waves, and concluded that the two processes are probably controlled by independent mechanisms, however they are likely related. Cortical theta is generated from the thalamus and the nucleus accumbens in the forebrain. Frontal midline theta, as seen in brief bursts on memory retrieval tasks as the nucleus accumbens provides acetylcholine to the temporal lobe\'s limbic structures via the diagonal band of Broca, which is connected to the amygdala/hippocampus complex, allowing rhythmicity (Gunkelman, 2014).&nbsp; Memory uses theta as a carrier wave, upon which other, faster frequencies can ride; the nesting of faster, gamma waves upon theta waves promotes short term memory (DeRidder, 2014; Klimesh, Sauseng, &amp; Hanslmeyer, 2007). According to Gorochowski (2009), theta modulates gamma, which allows for the construction (and reconstruction) of a low-frequency-modulating-phase.<br><br><br>',1),(107,25,106,108,20,0,1,1,1586546092,1586858764,'Healthy Theta','<p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/healthy-theta.png\" alt=\"Healthy Theta\" width=\"610\" height=\"407\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p><span style=\"font-size: 1rem;\">Theta rhythm is a normal finding during drowsiness in the adult EEG. Theta, may be seen at the onset of sleep as the alpha rhythm slows with drowsiness. Theta is also the brainwave state of dreams. As earlier mentioned, the slow waves that occur here correspond to rapid eye movement (REM), which is thought to be healing, developing, and rejuvenating (Crick &amp; Michison, 1983; Evans, 1983; Ornstein, 1986; Oswald, 1980; Shaffery, Oksenberg, Marks, Speciale, Mihailoff, &amp; Roffwarg, 1998; Siegel, 2010). In 1953, the hypnogogic brainwave state was discovered, consisting of a period of several minutes where the mind is overtaken with image fragments or short dramas. At that time, this hypnogogic state was dubbed “theta” and was seen in asynchronous oscillations of 5-8 hertz (i.e., 5 to 8 waveforms over the course of 1 second) occurring over the cortex of the brain. Rhythmic or “synchronous” theta was found to be present in the awake raw EEG, increasing as subjects got drowsy or started daydreaming (Ulrich, 2013, pp. 38-39).&nbsp;</span><br></p><p>From an empirical brainwave perspective, the brain wave patterns of the dreamer have been identified as asynchronous theta and REM sleep state, which is activated endogenously in the dreaming state. Their function, according to Winson (2002) is to further process the memory contents of the past while the individual is asleep. The hippocampus is foundational for its generation in sleep, which allows for the mapping of the sensorimotor, temporal, and environmental space (Bland &amp; Oddie, 2001). This mapping may be linked to the storage of procedural memory, since the right parietal cortical areas (housing the right hippocampus and the medial temporal lobe diencephalon) are activated in spatial and mental imagery exercises (Schore, 2003; Solms &amp; Turnbull, 2002). This is the same area as that which becomes activated both in dreaming and in the infant’s breast-feeding (Winson, 2002).</p><p>Theta generation has been linked to the replenishing of important neuronal proteins, for cell and synaptic growth, as well as the production of growth hormones, neurochemicals, neurotransmitters, and neuromodulators (Shaffery et al., 1998). Furthermore, REM sleep has been linked to the development of the hippocampi—the seat of learning and memory (Lewin &amp; Glaubman, 1975; Shaffery et al., 1998). Theta is a rejuvenating brainwave, responsible for neurogenesis and healing. It is these slow waves that the infant and child spend much of their time in, as these are essential to the building of networks, as well as feelings of safe, calm, and protectedness.</p>',1),(108,25,107,109,20,0,1,1,1586548339,1591033700,'Pathological Theta','<p style=\"text-align: center;\"><br><img src=\"@@PLUGINFILE@@/unhealthly-theta.png\" alt=\"Unhealthy Theta\" width=\"1008\" height=\"540\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\"><br></p><p>Unhealthy theta can mean many different things in EEG. From a clinical perspective, theta can indicate concussion or head trauma, as well as attention deficit disorder, distractibility, foggy thinking, inability to sequence tasks, forgetfulness, or daydreamy-ness. One with excess theta might be accused of being a “space-cadet.”&nbsp; Having too much theta with eyes open would cause one to feel unable to focus on the task at hand for a long period of time. Any \"theta band\" activity may be slowed thalamo-cortical alpha or limbically generated rhythmic slow activity (theta), as stated in Steriade\'s 1990 IFCN position paper.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/soccer-athlete-theta.png\" alt=\"Post Concussive Syndrome in a 17-year old Soccer Athlete, excessive occipital theta (Z-score summary map)\" width=\"720\" height=\"955\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Post Concussive Syndrome in a 17-year old Soccer Athlete, excessive occipital theta (Z-score summary map)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/excessive-theta.png\" alt=\"Figure : Excessive Theta at the right posterior temporal lobe (Eyes Closed)  (Raw Data)\" width=\"717\" height=\"1108\" class=\"img-responsive atto_image_button_text-bottom\"><br>Figure : Excessive Theta at the right posterior temporal lobe (Eyes Closed) (Raw Data)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">When there is a lack of blood flow and oxygen to the area, there is often a consequential slowing of alpha at the area, sometimes into the theta range. As an area degrades, sometimes the alpha slows considerably below the normal alpha band (i.e. less than 8hz). A slowed alpha can represent a compromise of blood flow, and consequentially oxygen, to an area, which will lead to ischemia. The dip in alpha frequency will indicate how severe the ischemia is (Classen and Foreman, 2012). Theta will arise with grey matter damage, which can be resultant of a trauma (such as a blow to the head), a vascular anomaly, an aneurism or structural anomaly (like the jarring of the cerebro-cervical juncture in a car accident).<br><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/theta-and-vascular.png\" alt=\"Theta and Vascular Dementia\" width=\"835\" height=\"661\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><h3 style=\"text-align: left;\">DEMENTIAS</h3><p style=\"text-align: left;\">Parahippocampal slowing and slow alpha will\r\nindicate an <b>Alzheimer’s</b> type dementia. If there is a frontal slowing of alpha\r\nfronto-temporally, with a steady pace of alpha parietally and occipitally, that\r\nindicates <b>Vascular Dementia</b>, indicating microbleeds working away at the frontal lobes memory content.\r\nIf there is a generalized slow EEG, there are tropic changes, which can\r\nindicate <b>Korsakov’s syndrome</b> (which we see in sever alcoholics).\r\nThalamo-cortical dysrhythmias and subcortical abnormal activity indicate\r\n<b>Parkinson’s disease </b>(which is seen in the substantia nigra) and<b> Lewy body\r\ndisease</b> is seen in cortical and subcortical abnormalities. However, Parkinson’s\r\ndementia can have a Lewy body mix in it.<br></p><p style=\"text-align: left;\">&nbsp;Lewy Body dementia can effect the anterior temporal pole\r\nand insulae, which deteriorate disproportionately,&nbsp; leading to\r\nhallucinations, loss of sense of smell (which is the mesial temporal surface,\r\nthe uncus, degrading). Lewy body is difficult because the individual will drift\r\nin and out from hallucinatory states to normal states, making the\r\nhallucinations seem all that more real. This is the same disorder that Robin\r\nWilliams had when he died.<br></p>',1),(109,25,108,110,20,0,1,1,1586548791,1586858868,'Psychodynamic Theta','From Wise’s perspective (1995, 2002), theta is the subconscious, akin to Jung’s personal unconscious. It is the individual’s repressed materials, the abuses, the traumas, the trials, the tribulations, and the terrors. Theta is also the reverie, the deep longings and wishes, all those things that we push down, to be forgotten in our subconscious. Theta gives these deeply repressed memories life at the top of the sleep cycle in the form of dreams. Wise (1995, 2002) notes that theta can also be a repository for suppressed creativity and inspiration; she felt that theta was particularly strong during peak experiences, spiritual insights, and high-functioning brain states (such as deep meditation). She thought that theta brainwave states—which occur predominantly when we dream—were affiliated with the subconscious (a match for Jung’s personal unconscious): underlying interpretations and meanings that we are not privy to, but which we create—those that reside under the threshold of our awareness.  The personal unconscious is the place where we bury our shadows and from which our behaviors unconsciously emerge.',1),(110,25,109,111,20,0,1,1,1586549106,1586858923,'Lambda','<p>Lambda is a triangular shaped wave at the occipital leads that represents visual tracking. It’s a visual, event related potential that has to do with visual searching—it is like an “aha” when you see something. Lambda is called lambdoid or lambdotal if your eyes are closed.&nbsp; You can see repeated sharp transients in the back of the head in an adult that is reading or watching a movie. If a person is put on a task reading and you see theta or higher frequency delta in the back of the head, do not interpret it as a problem, because it might be a lambda wave form showing up. Lambda waves are found mostly in patients 6 months to 10 years.&nbsp;&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/lambda-movie.png\" alt=\"Figure : Lambda in a client watching a movie\" width=\"764\" height=\"515\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Figure : Lambda in a client watching a movie</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/lambda-qeeg.png\" alt=\"Lambda in a qEEG\" width=\"705\" height=\"480\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span style=\"\">Figure : Lambda in a qEEG<br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p><p></p>',1),(111,25,110,112,20,0,1,1,1586549163,1586859053,'Alpha','<p>Alpha is a frequency of 8-12 Hz, responsible as the idling state of the brain. The generation of alpha is cortico-cortical processes (Stam, 2006, p. 49), as well as a cortico-thalamic process (DeRidder, 2014; Gunkelman, 2014). That means that alpha is generated from the cortex, as well as the thalamus. Although you are relaxed when in a predominantly alpha state, you are in the process of taking packets of data with each alpha wavelet (DeRidder, 2014).&nbsp;&nbsp;<br></p>',1),(112,25,111,113,20,0,1,1,1586549324,1586859088,'Healthy Alpha','<p>Alpha is a relaxed and focused space, responsible for the state of flow, being in the zone, and creating. Alpha is the most obvious waveform in the raw EEG, typically showing itself as large amplitude, synchronous waveforms, usually emanating from the occipital regions of the head, regions known as O1, Oz, and O2. Alpha reflects perceptual anticipation of forthcoming stimuli (DeRidder, 2014). High amplitude alpha indicates an internally oriented state (i.e., more difficult to perceive an external trigger), and low amplitude alpha indicates an externally oriented state (i.e., easy to perceive external stimulus) (DeRidder, 2014). Typically, when an individual closes their eyes, the body is signaled to relax and alpha appears in the EEG; when one opens one’s eyes, alpha attenuates. If alpha remains in the EEG for a while after the eyes open, there is a likelihood the individual suffers from brain fog, inability to stay focused, difficulty sequencing thoughts, and difficulty planning; if alpha is imperceptible with closed eyes, the individual typically suffers from a trauma, such as PTSD (Swingle, 2010).&nbsp;</p><p>Alpha has been noted as the brainwave that is responsible for daydreaming, fantasizing, visualization (relaxed, detached awareness), seen heavily in pot smokers, dreamers, poets, and individuals who work in flow states (such as energy healers).Alpha peak frequency is synonymous with posterior dominant rhythm (PDR) and is the subject’s “idling rate”; everyone has their own dominant alpha frequency, which typically falls between 9 Hz and 11 Hz. Average alpha peak frequency is 10 to 10.5 Hz. An 11Hz alpha peak frequency indicates a mind that is capable of processing data quickly, or quicker than most. Put simply, the brain has the capability to crunch 11 packets of data per second (the thalamus is gating at 11hz),an apt analogy is that of a camera with a fast shutter speed. The speed indicates the capability of the photographer to get a clear, high quality shot. A fast alpha peak frequency is a sign of a facile mind that has the capability to process data quickly. In the case of ruminations or obsessions, this asset can work towards unwanted focus or preoccupation, although it is not the cause of the symptoms, but rather a facilitator of fast processing.</p>',1),(113,25,112,114,20,0,1,1,1586549689,1586859136,'Dual Alpha Peak','<p>When someone has two separate alpha peak frequencies you see fusiform alpha. Fusiform alpha is a beat frequency that is the blending of two separate frequencies. This mixing of frequencies will give you an interesting morphology that looks monomorphic, or one shape. Two alpha peaks has been pbserved within my own clinic as a marker of depression or tendencies of low mood and affective disorders.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/spectra-dual-alpha-peaks.png\" alt=\"Spectra of Dual Alpha Peaks\" width=\"629\" height=\"548\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : Spectra of Dual Alpha Peaks<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/raw-eeg-fusiform.png\" alt=\"Raw EEG of Fusiform Alpha (Eyes Closed)\" width=\"415\" height=\"835\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Raw EEG of Fusiform Alpha (Eyes Closed)<br></p><p style=\"text-align: center;\"><br></p><p>Alpha rhythm often comes on when someone closes their eyes; the clinicians should be able to get a reliable alpha reading in 20-30 seconds. Fast alpha (above 11 hz) correlates with good semantic and declarative memory performance). It is not linearlly related to IQ, but is a component of it.&nbsp;</p><p>The quickening of someone’s alpha has been thought of as brain brightening. This enhances memory and semantics. Alpha is your sampling rate. If we see 10 peaks per second, you have 10 hz alpha. You have a higher resolution if you have faster alpha. You have crisper, sharper peceptions if you have fast alpha. The alpha rhythm is considered to be made up of two separate functional components.&nbsp; Low alpha band (8-10 Hz): associated with general or global attention, and high alpha band (10-13 Hz): reflecting directed or task specific attention.&nbsp;&nbsp;</p><p>Both Sterman et al. (1996) and Klimesch et al. (1993) found that individuals with good (versus poor) memories have stronger desynchronization in the lower alpha band during the encoding and retrieval of memory.&nbsp; Crawford et al. (1995) found more lower band alpha power in subjects whose attention was more distractible.&nbsp; When sleep deprivation occurs, it has been found to mostly affect low alpha (and theta), negatively influencing general attention (Sterman, 1999) so that excitation is blunted and the frequent return to an inattentive idling state (Hammond, 2018).&nbsp;</p>',1),(114,25,113,115,20,0,1,1,1586550065,1586859183,'Alpha Slowing','<p>When there is a lack of blood flow and oxygen to the area, there is often a consequential slowing of alpha at the area. As the area degrades, sometimes the alpha slows considerably below the band. But this depends on how severe the ischemia is (Classen and Foreman, 2012). If the slowing is in the theta range, if can be due to a trauma, a vascular anomaly, an aneurism or structural anomaly.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/slow-alpha.png\" alt=\"Slow Alpha\" width=\"1279\" height=\"718\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Slow Alpha<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/anoxic-brain-damage.png\" alt=\"Figure : Background Rhythm of 6 Hz in a 3 year old girl with anoxic brain damage\" width=\"655\" height=\"1105\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Background Rhythm of 6 Hz in a 3 year old girl with anoxic brain damage<br></p>',1),(115,25,114,134,20,0,1,1,1586550432,1586860890,'Frequency','<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/frequency-alpha-rhythm.png\" alt=\"Chart of the common speed of alpha rhythm (“AR”) in pediatrics and the elderly (alpha rhythm matures around age 10)\" width=\"394\" height=\"503\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : Chart of the common speed of alpha rhythm (“AR”) in pediatrics and the elderly (alpha rhythm matures around age 10)<br></p><p style=\"text-align: center;\"><br></p><p>The mean adult frequency was found to be 10.5Hz, and is slightly higher in females than in males (Brazier and Finesinger, 1944; Petersen &amp; Eeg-Olofsson, 1971).&nbsp; Alpha stabilizes at its final peak by the ages of 10 (Niedermeyer, 1999b), although earlier studies have tracked its stability as high as the age 15 (Peterson &amp; Eeg-Olofsson, 1971).&nbsp; Mean alpha below 9 Hz is significantly low, and a mean frequency below 8 Hz “is always abnormal, usually suggestive of a diffuse encephalopathy” (Markand, 1990, p. 181) (e.g., with systemic metabolic disorders like renal or hepatic disorders, hypothyroidism, hypoglycemia, or with cerebral insults).&nbsp; A general rule (Hughes, 1994) is that anyone from age 8 through centenarians should have an alpha background rhythm of at least 8 Hz. Wu and Liu (1995) only found 1% of healthy adults to have a dominant rhythm of 8 Hz. Occasionally a sub-harmonic to alpha is found at ½ the individual’s alpha frequency, and occasionally a fast alpha variant will walk into your clinic, at 13+ Hz. You will know it is alpha, because this 14-15 Hz rhythm will block to eye opening, and it is only found in about 3.6% of the population (Brazier &amp; Finesinger, 1944). Above average mean alpha levels may suggest hypervigilance, high intelligence (Gasser, Von Lucadou-Muller Verleger, &amp; Bacher, 1983) good memory (Klimesch, Doppelmayr, Schimke, &amp; Pachinger, 1996), and a fast processing rate.&nbsp; Worst case, these are the individuals who can spin into delusional thinking and flights of fancy, where their grip on reality is loose.&nbsp;</p><p>The alpha rhythm may also increase with increased body temperature (Gundel, 1984) or hyperthyroidism.&nbsp; The 10-14 Hz range seemed to be important during intellectual activity.&nbsp; Alpha frequency is positively correlated to cognitive performance, speed of information processing, and is significantly higher in individuals with good memory performance (Klimesch, 1999).</p>',1),(116,19,87,117,20,0,1,1,1586597031,1586597485,'Technical Aspects and Use of NeuroField Neuromodulation','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/364338320\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<p><br></p>',1),(117,19,116,0,20,0,1,1,1586597158,1586597514,'NeuroField 64 and the Application of NeuroField Stimulation Only Procedures','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/365307579\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(119,27,0,0,20,0,1,1,1586599035,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405197664\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(120,28,0,0,20,0,1,1,1586600906,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405201677\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(121,29,0,0,20,0,1,1,1586601083,1586878552,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405202044\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(125,30,0,0,20,0,1,1,1586602166,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405203668\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(126,31,0,0,20,0,1,1,1586602371,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405204273\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(127,32,0,0,20,0,1,1,1586602608,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405205119\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(128,33,0,0,20,0,1,1,1586603045,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405205844\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(129,34,0,0,20,0,1,1,1586603269,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405206409\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(130,35,0,0,20,0,1,1,1586603465,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405207096\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(131,36,0,0,20,0,1,1,1586603762,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405207510\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(132,37,0,0,20,0,1,1,1586604197,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405209050\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(133,25,134,135,20,0,1,1,1586861100,1586861208,'Frequency - Alpha Asymmetry','<p>When alpha frequency is slower by 1 Hz or more (and localized in one hemisphere), it may indicate a focal abnormality (Markand, 1990) warranting a neurological consult; a difference of 1.5 Hz or more is particularly worrisome (Duffy, et al., 1989).&nbsp; &nbsp;Any hemispheric amplitude difference in alpha between the two sides of more than 50% is considered significant (Hughes, 1994), Furthermore, because alpha rhythm is usually of higher amplitude on the right side (for right-handed people), a decrease of even 35% on the right may be significant (Duffy et al., 1989).&nbsp; Lastly, Frontal asymmetries in alpha have been found to be significant markers in depression.<br></p>',1),(134,25,115,133,20,0,1,1,1586861100,0,'Frequency - Alpha Amplitude','<p>The highest amplitude of alpha is found in the occipital area and is generally below 50 microvolts (µV).&nbsp; Amplitudes of 20-60 µV have been found in 66% of people, while amplitudes below 20 µV are found in 28%, and above 60 µV in 6% (Simonova et al., 1967).&nbsp; Children have higher amplitudes than adults (50-60 µV) and 9% of children (ages 1-15) have amplitudes of 100 µV or higher (Petersen &amp; Eeg-Olofsson, 1971).&nbsp;&nbsp;</p><p>An inverse relationship exists between the frequency of alpha and alpha amplitude (Brazier &amp; Finesinger, 1944).&nbsp; About 7%-9% of adults have a “low-voltage record,” consisting of amplitudes under 20 µV (Markand, 1990), which may or may not display alpha activity.</p><p>Klimesch (1999) has found that upper band alpha power (10-12Hz) decreases during semantic processing (i.e. talking)&nbsp; and theta power increases during episodic memory retrieval. Klimesch (1999) also found that a low theta/alpha ratio during resting state predicts good cognitive and memory performance, while , while under task, a large increase in theta power (synchronization) and a significant decrease in alpha power (desynchronization) is associated with good cognitive/memory performance.&nbsp; In relation to theta activity, it should be noted that Klimesch finds that theta synchronization occurs in a narrow frequency band in the range of the peak theta frequency, whereas there is a second, inefficient form of theta synchronization associated with large, but irregular activity.&nbsp; Klimesch (1999) concluded:</p><div class=\"editor-indent\" style=\"margin-left: 30px;\"><p><i>Large scale alpha synchronization blocks information processing because very large populations of neurons oscillate with the same phase and frequency.&nbsp; In contrast, alpha desynchronization reflects actual cognitive processes because different neuronal networks start to oscillate at different frequencies and with different phases (p. 190).</i></p></div><p>Synchronous, persistent alpha is expected with eyes closed—this is effectively the brain “twiddling its thumbs.“ However, when eyes are open, alpha ought to diminish. If it does not, especially if it is predominantly seen on one side, the individual ought to consult a neurologist.</p>',1),(135,25,133,136,20,0,1,1,1586861220,1586861303,'Frequency - Alpha Peak Frequency','<p>Alpha is considered the predominant idling rhythm in adults, however theta is the predominant rhythm in children until ages 10 - 13, when alpha becomes the more predominant rhythm. Slow brainwave activity (&lt;8hz) continues to decline in the EEG until the late twenties. Alpha peak frequency speeds up as be age: 6 Hz at one year of age, 8 Hz range by age 3, reaching 10 Hz by about age 10 (Niedermeyer, 1999b).</p><p>Beginning in the later 50\'s, there is a gradual decrease in alpha frequency, most likely due to pathology such as diminished vascular flow to the brain.&nbsp; However, alpha rhythm will remain above 9 Hz in healthy elderly subjects who do not have systemic or neurologic problems (Markand, 1990).&nbsp; Katz and Horowitz (1982) reported an average alpha frequency of 9.8 Hz in individuals in their 70\'s, while Hubbard et al. (1976) found a mean alpha frequency of 8.6 in 10 individuals between the ages of 100 and 105 years of age.&nbsp; Alpha frequency is lowered in dementia patients.</p><p>Alpha peak frequency is the subject’s “idling rate”; every adult has their own dominant alpha frequency, which typically falls between 9 Hz and 11 Hz. Average alpha peak frequency is about 9 to 9.5 Hz. A 10Hz alpha peak frequency indicates a mind that is capable of processing 10 packets of data per second—an apt analogy is that of a camera with a fast shutter speed. The speed indicates the capability of the photographer to get a clear, high quality shot. A fast alpha peak frequency is a sign of a facile mind that has the capability to process data quickly. In the case of ruminations or obsessions, this asset can work towards unwanted focus or preoccupation, although it is not the cause of the symptoms, but rather a facilitator of fast processing.</p>',1),(136,25,135,137,20,0,1,1,1586861316,1586861378,'Frequency -  Alpha Blocking','<p>Alpha is thought to be the brainwave that enacts feelings of being in the “flow,” of being in the “zone,” or of being present. During the production of alpha, we generally are fixed on one task, meditation, or sight. We are typically not dealing with thoughts that would otherwise busy the mind (i.e. monkey mind type of thoughts). When someone closes their eyes and does not produce alpha it is considered alpha blocking, which can indicate an inability to relax and calm down. I will often explain the inability or resistance to producing alpha a “white knuckling” with eyes closed—or a vigilance that remains on, in fear of letting down. In cases like these, the ability to calm, to self sooth, the quiet otherwise troublesome thoughts, might not come as easily as it would to one’s peers.&nbsp;<br></p>',1),(137,25,136,138,20,0,1,1,1586861338,1586861432,'Frequency - Temporal Lobe Alpha','<p>The appearance of alpha at the temporal leads is most easily seen in a Laplacian montage. “Excess Temporal Lobe Alpha” (TLA) classification is used when evidence exists that the temporal lobe generates abnormal amounts of alpha. TLA suggests frontal lobe disengagement which results in temporal lobe idling and suggests an affective perceptual problem, prosodic comprehension difficulty, and even a deficit in spatial reasoning.&nbsp;</p><p>It is important to accurately determine the source of the alpha and to rule out alpha contamination from posterior regions. Alpha contamination occurs when occipital and parietal alpha spreads into EEG sensors placed in the temporal lobe region, creating the illusion of temporal lobe and frontal lobe alpha (due to ear reference contamination) (Hammond &amp; Gunkelman, 2001).&nbsp;</p>',1),(138,25,137,139,20,0,1,1,1586861447,1586861924,'Frequency - Trauma Marker Alpha','<p>With eyes open, when we see the appearance of alpha gating at T6, which has been found to be a common finding in soldiers who have even been in active combat. TLA suggests frontal lobe disengagement which results in temporal lobe idling. At the location of T6 this excessive gating is often seen in individuals dealing with trauma or anxiety.&nbsp;&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/temporal-lobe-alpha.png?time=1586861965988\" alt=\"Temporal Lobe Alpha in Raw EEG data\" width=\"643\" height=\"643\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Temporal Lobe Alpha in Raw EEG data<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/temporal-lobe-alpha-z-scored.png\" alt=\"Figure : Temporal Lobe Alpha in qEEG data\" width=\"633\" height=\"405\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Temporal Lobe Alpha in qEEG data</p>',1),(139,25,138,140,20,0,1,1,1586861937,1586861988,'Frequency - Anteriorized Alpha','<p>Anteriorized alpha can mean there is a heightened degree of vigilance, as well as an affect-regulatory issue. This would be reflected in her depressive and motivational issues. However, frontal alpha in the EEG may reflect drowsiness, as well.&nbsp;<br></p>',1),(140,25,139,141,20,0,1,1,1586861997,1586862217,'Frequency - Hypercoherent Alpha','<p>Eyes open hypercoherent alpha\r\n    waveform often reflects affect regulation issues: such as depression or anxiety. It can also point to attention issues and issues involving the salience network.&nbsp;<br></p><p><br></p>\r\n<p align=\"center\"><img src=\"@@PLUGINFILE@@/hypercoherent-alpha.png\" alt=\"Image of Hypercoherent Alpha from WINEEG\" width=\"314\" height=\"249\" class=\"img-responsive atto_image_button_text-bottom\"></p><p align=\"center\">Figure : Image of Hypercoherent Alpha from WINEEG<br></p><p align=\"center\"><br></p>',1),(141,25,140,142,20,0,1,1,1586862233,1586862737,'Frequency - Mu','<p>Mu rhythm&nbsp; is a monomorphic “wicket rhythm” and is often a tick faster than the individual’s alpha peak frequency (i.e. if one’s alpha peak is at 10Hz, they would present mu at 11+ hz typically). Mu always presents in C3 and C4, over the sensory motor cortex, when the mirror neurons are not engaged. Mu is an indication of frontal lobe disengagement.</p><p>As a baby, mirror neurons enable us to mimic our parents, and “motherese” (a parent’s repeating the “goo -goo” and “gaa-gaa” of babies) enables us to learn speech sounds. We learn all these things by mimicking. Burgoon (1985): 60% of human communication is non-verbal and mu is a sign that non-verbal communication is not being seen or perceived by the brain.</p><p>Mimicking and mirroring speech is controlled by the brain’s frontal central loop and central-temporal loop (The temporals allow for the perceptual comprehension of the mimicry). The right-hand side of the sensory motor strip of the brain (C4) is responsible for mimicking impressions and the emotional tone of speech, as well as integrate empathy, and emotion. Mirror neurons on the left (C3) lay down language. Oxytoxin is for social bonding and oxytocin attenuates mu.&nbsp; Oxytocin is a hormone produced in the hypothalamus and released by the pituitary, which plays a role in social bonding, sexual reproduction, childbirth, and the period after childbirth.&nbsp; When we are creating oxytocin, we cannot create mu.&nbsp;</p><p>If you suspect mu and you ask your patient to wiggle their fingers, the presence of mu will disappear.&nbsp; It is noteworthy that Mu is present in 70% of the autistic population, whereas only 15% of the fully normal population has mu and 50% of the ADHD population have it, as well as 50% of Affective Disorders.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/rhythm-eeg.png\" alt=\"Mu Rhythm in Raw EEG\" width=\"788\" height=\"1105\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : Mu Rhythm in Raw EEG<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/qeeg-mu-rhythm.png\" alt=\"qEEG of Mu Rhythm\" width=\"663\" height=\"553\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : qEEG of Mu Rhythm<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/raw-qeeg-harmonic.png\" alt=\"Raw qEEG representation of mu (red box) and harmonic of mu (green box)\" width=\"571\" height=\"661\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Raw qEEG representation of mu (red box) and harmonic of mu (green box)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/z-scores-mu.png\" alt=\"Mu in 17 year old girl, Z-Scores\" width=\"715\" height=\"650\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Mu in 17 year old girl, Z-Scores<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(142,25,141,143,20,0,1,1,1586862753,1586863207,'Frequency - Beta (1, 2, 3)','<p>Beta occurs from local groups of pyramidal neurons synchronize; beta&nbsp; is a cortico-cortical frequency (which means its origin is the bark of the brain, the cortex). Beta ranges from Beta 1 (12-15Hz) Beta 2 (15-18Hz), Beta 3(18-25Hz), and High Beta (25-30 Hz) (some cap beta as high as 40Hz). Beta predominantly occurs in the frontocentral areas of the brain, usually with an amplitude of 30µV or less and is symmetrical This is the brainwave of our normal waking consciousness and encompasses all executive functioning, such as making plans, acting, and problem-solving. Beta II is at work much of the time that we are processing details, comprehending, and making meaning. Beta III is shown during periods of high focus and engagement. When pathological, beta often appears in high amplitude, often indicating stress, anxiety, fear, and worry. It is beta that allows us to determine what makes us up, who we are, what we believe in (and do not believe in), and all other components of our identity. It might be argued that the other frequencies inform our ego state (and they do), but our primary mode of thought is in beta. Individuals with too much high amplitude beta are often those suffering from neurological conditions. Wise (1995) noted that “excessive amounts of beta can lead to great psychological discomfort” (p. 3).</p><p>Beta is active thought, active thinking. This signature suggests a brain that is having difficulty calming down—there are indications of an hyperaroused or hyperalert state. Of particular interest is the right frontotemporal&nbsp; cortex; it appears this is the origin of the high amplitude fast wave activity.&nbsp; This area contains most of the dopamine sensitive neurons in the human cortex, which are associated with reward, attention, planning, motivation, and short term memory. It is bordered from behind with the pre-central gyrus, containing the primary motor cortex, an area responsible for voluntary body movements.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/anxiety-eeg-amplitude.png\" alt=\"Anxiety as seen in the EEG via high amplitude beta (raw data)\" width=\"1022\" height=\"919\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Anxiety as seen in the EEG via high amplitude beta (raw data)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/qeeg-signifying%20anxiety.png\" alt=\"qEEG for High Amplitude Beta signifying anxiety\" width=\"703\" height=\"932\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : qEEG for High Amplitude Beta signifying anxiety<br></p><p style=\"text-align: center;\"><br></p>',1),(143,25,142,144,20,0,1,1,1586863217,1586863533,'Frequency - Spindling Beta','Spindling beta is associated with:\r\n<br><br>\r\n<ul>\r\n    <ul>\r\n        <ul>\r\n            <li>cortical irritability</li>\r\n            <li>toxic encephalopathy&nbsp;</li>\r\n            <li>epilepsy&nbsp;</li>\r\n            <li>pre-epileptic auras&nbsp;</li>\r\n            <li>benzo toxicity 10% of ADD &amp; ADHD&nbsp;</li>\r\n            <li>Affective disorders</li>\r\n            <li>Bipolar disorders</li>\r\n        </ul>\r\n    </ul>\r\n</ul>\r\nVery often beta of this morphology and frequency acts as a stabilizing rhythm, or as a compensatory frequency for a less stable EEG. Beta Spindles arrive in EEG as sleep spindles, as a stabilizing rhythm, to prevent one from awakening.  Spindling beta represents a nonspecific indicator of cortical dysfunction or encephalopathy when <u>determined <b>not </b>to be a medication effect</u>. Beta spindles often correlate with an overall anxious demeanor characterized by frequent and intense ruminative thinking. Spindling beta is hyper synchronous and is indicative of central nervous system hyperarousal. Spindling beta is also associated with cortical irritability, toxic encephalopathy, epilepsy, pre-epileptic auras, and benzodiazepine toxicity. It also indicates a wakefulness drive, making maintaining sleep more difficult (either difficulty falling asleep or staying asleep). This waveform is kindled easily and is common in bi-polar, anxiety, insomnia, as well as impulsivity.<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/benzodiazepine-spindling-beta.png\" alt=\"qEEG for high amplitude spindling beta (Benzodiazepine use)\" width=\"1036\" height=\"923\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Figure : qEEG for high amplitude spindling beta (Benzodiazepine use)</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p>',1),(144,25,143,0,20,0,1,1,1586863541,1586863615,'Frequency - Gamma','<p>Of all the brainwaves, gamma (40+ Hz) is the least understood. This is largely because of the, until recent, technological limitations of equipment to pick up these very fast, very tiny, 30+ Hz brainwaves. Complicating the process is the fact that gamma is easily confused with muscle artifact from the head and jaw. Gamma is seen in the EEG when the participant is presented with unpredicted stimuli (Arnal et al., 2011).&nbsp; It is the “aha!” or “Eureka!” of the EEG. It arrives in bursts when we recognize something novel.</p><p>Gamma travels in envelopes, which surround the oscillation, making it appear with a spindle shape, and it has the ability to arise in any structure of the brain, because interneurons connected by GABA A receptors are ubiquitous throughout the brain (Buzsaki, 2006, p. 75). Of most interest, gamma has been implicated to be the binding rhythm of consciousness (Buzsaki, 2006, Gold, 1999; Hughes, 2008). It is not generated via a local neurophysiological generator, but is rather an emergent property of networks (Gunkelman, 2015) and is related to subjective awareness (Gunkelman, 2014).&nbsp; Gamma is healthy when it is nested in other frequencies, which is a phenomenon known as phase-amplitude cross frequency coupling, where the phase of one frequency (e.g., theta) changes the amplitude of another frequency (e.g., gamma). As the theta goes electro-negative, gamma is active, but when theta goes positive, gamma attenuates (Gunkelman, 2015). Gamma has also been tied to deep meditative states. Lutz, Greischar, Rawlings, Richard, and Davidson (2004) found that long-term meditators produce self-induced high amplitude gamma when meditating.</p><p style=\"text-align: center;\"></p><p>Gamma-frequency oscillations are typically short-lasting, transient events (Buzsaki, 2006, p. 76). One of the markers of pathological gamma is persistence; healthy gamma ought to occur in bursts or “chirps” (DeRidder, 2014). Low-frequency oscillations (such as those of delta and theta) have been reported to coordinate long-range communication, while gamma oscillations (40-150) coordinate local communication (Buzsaki &amp; Draguhn, 2004; von Stein et al., 2000). Local communication is between very close neuronal pools. At times brainwaves come into harmony (e.g., 45 Hz gamma laid over a background of 9 Hz alpha is a harmonic, since 45 divides into 9), and other patterns that represent certain states of being and of mind.&nbsp;</p>',1),(145,38,0,146,20,0,1,1,1586864738,1586864779,'Pre-natal','<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/developmental-eeg.png\" alt=\"Pre-Natal\" width=\"1187\" height=\"1000\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\"><br></p>\r\n<p>At the point of conception, the strategy of the nervous system is coded in the genes, and the brain follows a pre-defined blueprint. The initial connectome of the brain, which comes into being very early in development, is largely a product of genes and\r\n    randomness.</p>\r\n<p>At 4 weeks, the first brain cells, the neurons, are establishing at 500,000 per minute. These cells will never turn over, unlike the skin. Neurons born in fetal life function all the way into old age. Within the first 13 weeks of life the reptilian structures\r\n    of the brain are fully formed (the brainstem, spinal cord, cerebellum, and pons). The first stage of wiring is when fundamental networks form via an odyssey of the neurons, which grab onto glia, to form long fibrous white mater tracks that build the\r\n    resting state networks in the brain. These are the gross networks of the brain. Low frequency oscillations (i.e., delta and theta) help to coordinate long-range communications that run on these networks, between lobes of the brain (von Stein, Chiang,\r\n    &amp; Konig, 2000). Similar to a musical instrument, the longer the string, the lower the pitch (Kung, 2013). These long connections are architecturally fundamental for the brain’s development.&nbsp;</p>\r\n<p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/fetal-development.png\" alt=\"Fetal Development\" width=\"673\" height=\"707\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Figure : Fetal Development</p>\r\n<p style=\"text-align: center;\"><br></p>\r\n<p style=\"text-align: left; \">By\r\n24 weeks, the vital organs of the fetus are well formed, the lungs\r\nare prepared to fill with air and the brain has billions of neurons,\r\nbuilding 2 million connections every second, until the brain has\r\nbecome a network of trillions of criss-crossing wires with more\r\nconnections than stars in the sky.In this second phase of\r\ndevelopment, connections that will remain as integral are made, as\r\nare less important connections. When a connection is built and\r\nstrengthened, it is reinforced and made to stay, while the less\r\nimportant connections atrophy and are lost—this is called pruning.\r\nDisruption here, within the earliest steps of development, during the\r\ncreation and migration of neurons, is expected to cause abnormalities\r\nthat are easy to see, such as microcephaly and lissencephaly, if the\r\nfetus survives. <br></p><p style=\"text-align: left; \"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/lissencaphaly-gyri-sulci.png\" alt=\"Lissencaphaly, where the brain does not form gyri and sulci, but is smooth, occurs between 12 – 24 weeks of life.\" width=\"461\" height=\"307\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : Lissencaphaly, where the brain does not <br>form gyri and sulci, but is smooth, occurs between 12 – 24 weeks of life.<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/microcephaly-infant-skull.png\" alt=\"Microcephaly versus a Normal Sized Infant Skull\" width=\"819\" height=\"472\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : Microcephaly versus a Normal Sized Infant Skull<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(146,38,145,147,20,0,1,1,1586864752,1586865122,'Pre-natal - Premature Babies','<p>When babies are born before they are fully developed they lack calcification level in the skull and, for that reason, their EEG appears of a larger amplitude than a new born baby.</p><p>While a burst suppression pattern suggests a person is about to die, a premature baby will show a burst suppression pattern, which is a normal pattern for a brain that is not ready to be out of the womb. This pattern consists of long periods of generalized attenuated or “flat” activity interrupted by high amplitude bursts of mixed frequencies and waveforms. The periods of quiescence between bursts can be as short as 6 seconds or as long as 25 to 30 seconds.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/chart-eeg-patterning-early-life.png\" alt=\"A chart of EEG patterning that occurs in early life\" width=\"269\" height=\"696\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : A chart of EEG patterning that occurs in early life<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(147,38,146,148,20,0,1,1,1586865129,1586865197,'Pre-natal - Birth','<p>By the time a baby is born, the creation of neurons is virtually complete. Neurons continue to grow dendritic branches well after birth. At birth, a baby’s brain is less than 1 pound of gelatinous tissue. This is the foundation of the unconscious processes. During this time, as well, delta is prominent because the white matter is not yet myelinated. Consequentially, infants spend a great deal of time in slow-wave sleep, and thus have delta wave activity as their predominant wave form. Analysis of the waking EEG of a newborn infant indicates that delta wave activity is predominant in that age, and still appears in a waking EEG of five-year-olds.[14]</p><p>The neonatal weeks are crucial for the neurophysiological effects of nursing on the somato-sensory projection areas of the mouth and the relevant associative cortical areas. Chugani et al. (1987) have shown in PET recordings that during the first weeks of life there is an increase in blood flow in those brain structures (brain stem, cerebellum, striatum and the sensory areas of the cortex) that participate in nursing responses. At six months, the theta rhythm prevailed in both hemispheres, but had a right hemisphere posterior maximum. Paul et al. (1996) have shown in infants from the age of 2 to 26 weeks that feeding is connected with an amplitude increase and a growing degree of synchronization in the EEG, with an exception of the age of 10 weeks, when no significant EEG changes were recorded. This newly acquired neurophysiological organization between subcortical and cortical structures can give rise to a synchronized activity in wide brain areas (Scher, 1989). The special kind of θ-activity whose activation we were able to recognize during feeding in 6 month-old infants has been termed hedonic θ-activity by Maulsby (1971).</p>',1),(148,38,147,149,20,0,1,1,1586865205,1586865239,'Pre-natal - Vision','<p>New synapses are created at a staggering rate in the infant brain. IN BA 17 alone, over ½ million per second are developed between 2 and 4 months of age. In fetu development also destroys connections (107). Initially the baby sees as though they were looking at a faded photograph through a tube. This prevents excess stimuli.&nbsp;<br></p>',1),(149,38,148,150,20,0,1,1,1586865245,1586865289,'Pre-natal - Breastfeeding','<p>Because the primary source of activity of the EEG is in the cortical neural processes, the change in the EEG pattern in newborn infants during the feeding processes may be indicative of a shaping of a primitive protomental image, i.e. a sensory memory formation at the cortical level, that starts after birth and runs in parallel to the deep automatic brain functions regulating the reflexive and autonomous neural events of the nursing exchanges. This may be important, since the participation of the cortex in the effects of newborn feeding has not been recognized before and its plausible implications for the bodily self experience (the nascent body ego) is so far unknown, in contrast to the relatively well-known role of the brain stem and the diencephalic structures that regulate the sucking reflex, the homeostasis of vital biological func- tions and the basic affective processes (Damasio, 1996, 2000; Lehtonen, 2006; Watt, 2003).</p><p>In another study penetrating the same developmental phenomena, Paul et al. (1996) have shown in infants from the age of 2 to 26 weeks that feeding is connected with an amplitude increase and a growing degree of synchronization in the EEG, with an exception of the age of 10 weeks, when no significant EEG changes were recorded. These observations are quite in line with our findings. Chugani et al. (1987) have shown in PET recordings that during the first weeks of life there is an increase in blood flow in those brain structures (brain stem, cerebellum, striatum and the sensory areas of the cortex) that participate in nursing responses. These references, though short and selected, illu- minate the wide scope of physiological phenomena that are connected with nursing and the multiple changes in the psychophysiological state of the offspring that occur in infant care.</p>',1),(150,38,149,151,20,0,1,1,1586865296,1586865340,'Pre-natal - Auditory Perception','<p>Long before the infant can comprehend language or speak a single word, it has a repertoire of signals to communicate its internal states. Experimental studies suggest the infant is endowed immediately after birth with a readiness to differentiate the mother’s voice from a non-mother voice (Fifer and Moon, 1994). During this fundamental period, the child’s innate neoverbal abilities are hugely influenced by social and emotional factors. Developments occur due to dialogic “face engagements where the emotionally-attuned mother shares in and articulates the child’s emotional state.&nbsp; In these experiences, the infant reads the mother’s face for positive emotions, appraisals of relevant and interesting interactions and events.&nbsp;&nbsp;</p><p>By Approximately one year of age comes the emergence of single word speech. At this stage, the infant increasingly attends to both the visual and auditory stimulation of his caretakers’ faces. The visual information received from faces is utilized in speech perception (Green &amp; Kuhl, 1989).</p>',1),(151,38,150,152,20,0,1,1,1586865354,1586865544,'Pre-natal - Hypnagogic Hypersynchrony','<p>Hypnagogic Hypersynchrony (HH) is the pattern seen in infants and children during the transition from drowsiness to sleep. It consists of high amplitude, paroxysmal, bilateral, rhythmic bursts of 3 to 5 Hz waves. Unlike, POSTS, which live in the occipital leads, HH is a diffuse pattern, tending towards anterior dominance. It may emerge as early as 4 months but is seen in the majority of infants between 6 to 8 months old. HH may be continuous from ages 8 to 12 months but as the child ages a more paroxysmal type of HH is seen. The pattern begins to dissolve by age 2 years and is usually gone by age 12 years. Since this is only a transition pattern, it will disappear once N2 sleep is reached. At three months, the distinctive pattern of hypnagogic hypersynchrony emerges replacing the high amplitude 2 to 3 Hz rhythm seen during drowsiness. This high amplitude bisynchronous rhythmic 3 to 6 Hz activity can be paroxysmal or continuous for several minutes either at the beginning or end of the sleep cycle.</p><p>After 3 months of age, all NREM and REM sleep stages show maturation as well as development of new patterns. REM now only occupies 25% of the total sleep time. During NREM sleep, patterns reach mature formations. Sleep spindles are fully developed, synchronous, and symmetrical by 2 years. The amplitude and incidence of V-waves and K-complexes decrease at 3 to 4 years until the adult waveform is attained.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/hypnogogic-hypersynchrony.png\" alt=\"Hypnogogic Hypersynchrony\" width=\"603\" height=\"386\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : Hypnogogic Hypersynchrony<br></p>',1),(152,38,151,153,20,0,1,1,1586865598,1586865808,'Pediatric EEG (Age 1 to Adolescence)','<p>A child has hundreds of trillions of connections in the brain, twice as many as the adult. Experience determines which of these connections to take away and which of them to leave. This pruning process is what learning is, on a neurodevelopmental level. As the child grows into a adult, the brain becomes more and more complex.</p><p>As the baby grows into an adult, their processing rate also speeds up, from 4Hz at 4 months of age, 6Hz at 12 months of age, and finally 8Hz by 3 years of age. B the time the child reaches 10 (some say even 15) years of age, their alpha peak frequency (also called posterior dominant rhythm) has sped up to 10Hz, roughly, where it will stay until they reach their later 50s.</p>',1),(153,38,152,154,20,0,1,1,1586865814,1586865854,'Pediatric EEG - Language and Auditory Perception','<p>While 13-month-old babies listen and understand with both cerebral hemispheres, but by 20 months the language center of the brain has begun to shift to the left hemisphere, where the majority of adult process primary auditory information (Wernicke’s and Broca’s areas). The brain will begin to specialize in languages that it knows best, and this language will trigger the left hemisphere. Foreign languages will still access the right hemisphere (one of the reasons introducing multiple languages to your child is beneficial to their neurological development).<br></p>',1),(154,38,153,155,20,0,1,1,1586865863,1586866160,'Pediatric EEG - Posterior Slow Waves of Youth (PSWY)','<p>Posterior slow waves of youth are physiologically high-voltage theta or delta waves most commonly seen in children aged 8–14 years, but uncommon in children under 2 years. PSWYs&nbsp; occur in 15% of healthy individuals aged 16–20 years but are rare in\r\n    adults above 21 years of age. These are slow theta and delta waves that are intermixed with alpha waves. They attenuate with eyes opening and they occur as sporadic single waves or as bursts of transient waves interspersed by one or several seconds\r\n    or regular background activity. PSOY are usually bisynchronous but can have shifting symmetry (Stern 2005).<br></p>\r\n<p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/posterior-slow-waves-2n.png\" alt=\"Posterior Slow Waves of Youth in a 2.5 year old male\" width=\"625\" height=\"604\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p>Figure : Posterior Slow Waves of Youth in a 2<sup>1/2</sup> year old male</p>',1),(155,38,154,156,20,0,1,1,1586866181,1586866300,'Pediatric EEG - POSTS','<p>Appearing in children, Positive Occipital Sharp Transients of Sleep (POSTS) are surface positive monophasic or diphasic waves are occipital in origin and synchronized, although they can be asymmetric between posterior electrode arrays. POSTS appear around age 5 years as the occipital delta of sleep begins to decrease (Yamada and Meng 2010). Transient and sharp in nature, they are high amplitude 4 to 5 Hz runs, lasting 1 to 2 seconds, and repeating every 4 to 6 seconds. They are seen during late N1 sleep stage and disappear with deep sleep.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/positive-occipital-sharp.png\" alt=\"Positive Occipital Sharp Transients in a child drifting into NREM2 sleep\" width=\"639\" height=\"513\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Positive Occipital Sharp Transients in a child drifting into NREM2 sleep<br></p>',1),(156,38,155,157,20,0,1,1,1586866314,1586866428,'Pediatric EEG - OIRDA','<p style=\"text-align: left;\">OIRDA stands for occipital intermittent delta activity. OIRDA is a delta pattern that often spreads from the occipital leads to the posterior temporal regions on both the right and the left hemispheres. This pattern is usually seen in children, however the clinical significance of it is not yet agreed upon within the neurological community. While OIRDA has been linked to epileptic disorders, it has also been linked to encephalopathy. There are some cases of OIRDA reported that have not deomnstrated pathological significance.&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/oirda-seen-10-year-girl.png\" alt=\"OIRDA seen in a 10-year old girl\" width=\"1007\" height=\"750\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : OIRDA seen in a 10-year old girl<br></p>',1),(157,38,156,158,20,0,1,1,1586866477,1586866856,'Adolescence','<p>The teenage brain is the final frontier of immense neural development The focus of brain development at this point is the pre-frontal cortex. This region, “the fourth brain,” allows us to make future plans, and is involved in personal responsibility, morality, and self-control. This maturation process shapes personality, behavior and identity.&nbsp; During this time girls are dealing with the flux of estrogen and progesterone, and for boys the production of testosterone increases. This all occurs in the limbic system, generated by the hypothalamus, which can lead to emotional lability and moodiness.&nbsp;</p><p>Adolescents create melatonin on a different schedule than adults, which makes them stay up at night about two hours later. This s one of the reasons teenager sleep until noon on weekends (when they’re not in school). In addition, teenage brains need more sleep than adults (9-10 bours compared to 8).</p><p><br></p>',1),(158,38,157,159,20,0,1,1,1586866884,1586866918,'Adult','<p>Stem cells in a new brain are prolific, but in an adult brain, few neurons are produced and most stem cells remain inactive. It is from age 25 until about 55 (or later 50s) that we are at the seeming apex of our development as humans. Our sleep cycles remain constant, our hormones are also reliable, and we are relatively stable (barring insult). Inless otherwise mentioned herein, when EEG is referenced, in general, it is referenced in view of the normal, healthy adult bran.&nbsp;<br></p>',1),(159,38,158,160,20,0,1,1,1586866925,1586867006,'Senior','<p>One of the fundamental components of how we age has to do with the maintenance of physical exercise. In addition, mental activity and heredity play big roles in our ageing process, but when we exercise, we create more brain-derived neurotrophic factor (BDNF) which fertilizes brain cells and propels the growth of new neurons. Studies have found that rodents who exercise produce two times as much BDNF as their ore sedentary counterparts. The brains of elderly people who exercise are in far better shape, on average, than those who don’t.</p><p>Similar to the body, in a metaphorical sense, the brain is like a muscle. The more that you exercise it with information and novelty, the better it gets. Suddenly, at seventy, you realize the declines of your twilight years have aggregated and that you are not cognitively what you used to be. The more unfamiliar the information, the more trouble you are going to have as an elderly person. A perfect example is the difficulty many baby boomers have with computers, if they did not adopt use of the new hardware (and software) and maintain abreast of the changes as they aged.</p><p>When we learn something new, neurons in the hippocampus send messages across the gaps that connect the terminal buttons, strengthening networks associated with learning. Essential to the strength of the connections are calcium molecules, which go into a neuron and make the connection more reliable. Calcium travels through NMDA receptors, which are inextricably linked to cognitive decline in age. NMDA receptors are glutamate receptor and ion channel proteins found in nerve cells. These receptors are very important for controlling synaptic plasticity and memory function.</p><p>While we may see the diseases and pathologies related to age wreak havoc on the body, they area also wreaking havoc on the brain. As we age, our processing rate slows down from its peak (typically 9 -11 Hz) to a slowed version. We become less able to retain new information and the areas of the brain most recently developed for evolution are the most vulnerable. This is notably the temporal lobes and the pre-frontal cortex (in combination responsible for auditory processing, memory and executive functioning).</p>',1),(160,38,159,161,20,0,1,1,1586867015,1586867257,'EEG of Sleep','<p>In normal adults, a cycle of sleep stages repeats throughout the night, about every 90 minutes. This is referred to as “sleep architecture.”<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/sleep-architecture-evening.png\" alt=\"Figure : Sleep Architecture over the Course of an Evening of Sleep\" width=\"660\" height=\"383\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Sleep Architecture over the Course of an Evening of Sleep<br></p><p style=\"text-align: center;\"><br></p><p><b>NREM1 </b>= Alpha begins to slow and intermittently drop out of the record and we see a suppression of EEG amplitude, overall.&nbsp;</p><p><b>NREM2 </b>= The presence of Vertex Sharp Waves, K-Complexes, and Sleep Spindles</p><p><b>NREM3</b> = The movement towards complete slow waves (Delta and some low frequency theta)</p><p><b>NREM4</b>&nbsp; = Deep dreamless sleep, aka “Slow Wave Sleep (SWS)</p><p><b>REM </b>= Rapid Eye Movement Sleep</p><p>Some schools of thought now combine Stage 3 and Stage 4 of sleep.</p>',1),(161,38,160,162,20,0,1,1,1586867275,1586867456,'EEG of Sleep - Vertex Sharp Waves','<p>Vertex sharp wave transients, appear in Stage NREM2 sleep. These midline sharp waves run down the vertex and are typically theta in frequency and are of high amplitude. A surround may present at the left and right leads.&nbsp; Vertex sharp waves are usually biphasic. They can occur individually or in runs (repeatedly for a brief time). The morphology of V waves varies in sleeping individuals. In some cases, they are sharply contoured, in other cases they can look like epileptiform discharges.&nbsp;&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/vertex-sharp-waves.png\" alt=\"Vertex Sharp Waves\" width=\"402\" height=\"683\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Vertex Sharp Waves<br></p>',1),(162,38,161,163,20,0,1,1,1586867465,1586867589,'EEG of Sleep - Stage NREM 2 Sleep and Sleep Spindles','Sleep spindles, indicate the onset of Stage NREM2 sleep. They serve as a stabilizing mechanism during sleep state, which will prevent the individual from awakening. Sleep spindles are bursts of sinusoidal 12-14 Hz activity, that wax and wane (travel in\r\nan envelope). They are seen over the fronto-central head regions, most often with a maximum over the central midline. They last from half a second to two seconds on average.<br><br>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/sleep-spindles.png\" alt=\"Sleep Spindles\" width=\"492\" height=\"687\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Figure : Sleep Spindles<br></p>',1),(163,38,162,164,20,0,1,1,1586867607,1586867789,'EEG of Sleep - K Complexes ','<p>K complexes usually appear in Stage NREM&nbsp; of 2 sleep, and may also seen in Stages N3 sleep.. K-complexes consist of a broad vertex sharp waves accompanied by a run of sleep spindles.</p>\r\n<p>The slow wave portion of the K complex can exceed 1000 milliseconds in duration. The amplitude may exceed 400 microvolts. K complexes appear spontaneously, or they can be elicited by an auditory stimulus (the “k” in K-complex stands for “Knock”).&nbsp;\r\n    Knocking a counter, clapping, or tapping a pencil on a hard surface are good ways to elicit K complexes during EEG recordings. K complexes should be of equal voltage over both hemispheres.</p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/k-complex-sleeping-eeg.png\" alt=\"Figure : K-Complex in a Sleeping EEG\" width=\"570\" height=\"683\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Figure : K-Complex in a Sleeping EEG<br></p><p style=\"text-align: center;\"><br></p><p>Stage N3 sleep is characterized by an increase in higher voltage slow waves in the theta and delta range. Sleep spindles and K complexes may be present. As Stage N3 sleep progresses, the frequencies seen are slower and the number of sleep spindles decreases.&nbsp;&nbsp;</p><p>In <b>NREM 4</b>, delta increases, sleep spindles are no longer present, and the EEG consists of generalized, high voltage, irregularly shaped slow waves.&nbsp; Deeper sleep stages are seldom seen in routine EEG recordings unless the patient is sleep deprived and the recording period is lengthened.</p>',1),(164,38,163,0,20,0,1,1,1586867797,1586867861,'EEG of Sleep - Rapid Eye Movement (REM) Sleep','<p>REM sleep begins 60-90 minutes after sleep onset. During REM sleep we lose muscle tone, except for eye movements. Respiration and heartbeat may become irregular.&nbsp;</p><p>During REM sleep, small muscle movements (phasic twitches), are seen in the face and extremities. Saccadic eye movements accompany REM sleep, which can be seen under the person\'s closed eyelids. The EEG in REM sleep is of low voltage, with a mixture of rhythms. It may look very much the same as the EEG during wakefulness with eyes open, except for the lack of EMG contamination.</p><p>If REM sleep that begins less than one hour after sleep onset, it is called REM onset sleep. This can be an abnormal finding indicating a sleep disorder called narcolepsy if accompanied by other symptoms and repeatedly demonstrated.</p>',1),(165,39,0,166,20,0,1,1,1586868068,0,'Transient discharges','<p>Paroxysmal transients in EEG can indicate:&nbsp;</p><p><ul><ul><ul><li><span style=\"font-size: 1rem;\">Epileptogenic activity, indicating a seizure disorder</span></li><li>Non-convulsive and non-epileptic activity&nbsp;</li><li>Cerebral vascular issues, tumors, and lesions</li></ul></ul></ul><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/transient-eeg.png\" alt=\"A Transient in the EEG\" width=\"947\" height=\"879\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : A Transient in the EEG<br></p></p>',1),(166,39,165,167,20,0,1,1,1586868094,1586868134,'Focal Slowing','<p>A focal slowing, if seen in the EEG, can indicate trauma, tumor, a lesion, or a healing grey matter injury. If delta is showing it can indicate an injury where the white matter is damaged and myelination is affected, if theta is showing it could indicate a grey matter injury (such as we would see in whiplash or a concussive injury). If the focus is at the posterior temporal lobes, good chance it is a cerebral vascular issue.</p><p><br></p><p></p>',1),(167,39,166,168,20,0,1,1,1586868146,1586868260,'Focal Slowing - Cerebro-vascular disorders','<p>Cerebro-vascular disorders can be indicated by a slowing of alpha at one site. The slow edge of alpha tracks ischemia. An indication of a vascular issue (or impeded flow dynamics) is the presence of headaches or any sort of similar issue.&nbsp; In Nuwer et al (1997) there is a finding in cerebrovascular disease that show ischemia-related cerebral impairment to be seen in focal features (perhaps similar to the finding of slowing in the right posterior temporal lobe).&nbsp;</p><p>When there is a lack of blood flow and oxygen to the area, there is often a consequential slowing of alpha at the area, sometimes into the theta range. As an area degrades, sometimes the alpha slows considerably below the normal alpha band (i.e. less than 8hz). A slowed alpha can represent a compromise of blood flow, and consequentially oxygen, to an area, which will lead to ischemia. The dip in alpha frequency will indicate how severe the ischemia is (Classen and Foreman, 2012). When cerebral blood ﬂow (CBF) becomes compromised, changes occur in both the metabolic and electrical activity of cortical neurons, with associated EEG changes.</p><p></p>',1),(168,39,167,169,20,0,1,1,1586868200,1586868728,'Focal Slowing - Epileptiform Discharge','<p>A common feature of the epileptic disorders is a paroxysmal excitatory activity.</p>\r\n<p>Epileptogenic activity can be seen in the presence of spike waves, sharp waves, and the presence of spike and slow waves. Additionally, fast beta and gamma can indicate a kindling rhythm in the EEG, reflecting an irritable cortex that is pre-disposed\r\n    towards seizure. Very often seizure will manifest in temporal lobes, which are the most vulnerable lobes for this type of pathology.</p>\r\n<p><b>Spike:</b> An epileptogenic transient can be seen in a spike (a transient with a duration of less than 70 msec, but more than 20 msc and commonly negative in polarity. Spike morphology has a step incline.&nbsp;</p>\r\n<p><b>Sharp Wave:</b> A transient that is 80 – 200msec. Morphology is usually pointed and voltage ios usually high.</p>\r\n<p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/widespread-epileptogenic-discharge.png\" alt=\"Epileptiform Discharge as seen in classic Spike and Wave Phenomena\" width=\"531\" height=\"723\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n    <p style=\"text-align: center;\">Figure : Epileptiform Discharge as seen in classic Spike and Wave Phenomena<br></p>\r\n        <p></p>\r\n		\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/epileptiform-discharge.png\" alt=\"Widespread epileptogenic discharge, affecting the EEG due to shared variance via the ear electrodes\" width=\"627\" height=\"841\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Figure : Widespread epileptogenic discharge, affecting the EEG due to shared variance via the ear electrodes<br></p>\r\n    <p style=\"text-align: center;\"><br></p>',1),(169,39,168,170,20,0,1,1,1586868733,1586868987,'Focal Slowing - Phase Reversals','<p>Phase reversals are a focal finding in the EEG where the waveforms go electro-positive and electro-negative, looking as though they are pointing to each other. This is a marker of a physical abnormality and can point to the seizure focus, a lesion, hypoperfusion, localized infarct (a small localized area of dead tissue), or white matter ischemia. This is an “X marks the spot” type of finding. Phase Reversals can be seen using bi-polar montages.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/multi-focal-spikes-eeg.png\" alt=\"Multi-focal spikes in the EEG\" width=\"672\" height=\"1097\" class=\"img-responsive atto_image_button_middle\"><br></p><p style=\"text-align: center;\">Figure : multi-focal spikes in the EEG<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/phase-reversals.png\" alt=\"Phase Reversals\" width=\"542\" height=\"775\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Phase Reversals<br></p><p style=\"text-align: center;\"><br></p>',1),(170,39,169,0,20,0,1,1,1586868998,1586869045,'Focal Slowing - Encephalopathy','<p>Encephalopathy (low voltage slow)—you must also find the etiology, see if it is metabolic, toxic, traumatic, anoxic, electrolytic—no medication will work as long a there is insufficient support for brain function. You will treat this by identifying and rectifying the root of the problem.</p><p>…the qEEG confirms the significance of these.</p>',1),(171,40,0,172,20,0,1,1,1586869216,0,'Low Voltage Fast EEG','<p>The low voltage fast EEG phenotype is driven by over arousal. This profile shows a genetic alteration of gene number 4, the gene that controls GABA A receptors, and if you make more receptors than you can saturate, you are over aroused. This is a prominent variant of people who have alcoholism. Behaviorally, this would show as someone who is over aroused, perhaps nervous, anxious, or tense. This is someone who will not do well in a highly stressful work environment. But, overall, this it is a normal variant that is present in about 10% of the population. Typically, their alpha is fast and desynchronized.&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/low-voltage-fast-eeg.png\" alt=\"Low Voltage Fast EEG\" width=\"723\" height=\"942\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Low Voltage Fast EEG<br></p>',1),(172,40,171,173,20,0,1,1,1586869233,1586869327,'Trauma','<p>According to Porges: there is no way to understand trauma without understanding the biology of trauma: first hyperarousal, crying then screaming, the best clinical term that describes the state of the infant at the level of abuse is panic. In panic there is a dysregulation of the body—the sense of self collapses or explodes in a reenactment of the abandonment.</p><p>Sympathetic excitation is now in the body, as well as in the organs, but its being shut down by a parasympathetic inhibition that tries to regulate this via disassociation—this is considered a moment of psychic death. Dissociation by means of parasympathetic inhibition is the role of the unmyelinated subdiaphrammatic vagus nerve, which is reptilian in its evolutionary origin. It is this dissociative mechanism that creates the feigning of death.</p><p>Dissociation is a right brain survival defense against overwhelming, unbearable, painful emotional experiences. This can manifest, symptomatically, in a number of ways. Dissociation can arrive in the presence of mu rhythm (covered earlier in this chapter), dissociation can occur in the presence of Temporal lobe Alpha.&nbsp;</p><p><br></p>',1),(173,40,172,174,20,0,1,1,1586869333,1586869366,'Temporal Lobe Alpha','<p>With eyes open, in Temporal Lobe alpha, we see the appearance of alpha gating at T6, which has been found to be a common finding in soldiers who have even been in active combat. This appearance suggests an affective perceptual problem, a prosodic comprehension difficulty, and even a deficit in spatial reasoning. “Excess Temporal Lobe Alpha” (TLA) classification is used when evidence exists that the temporal lobe generates abnormal amounts of alpha. TLA suggests frontal lobe disengagement which results in temporal lobe idling. This excessive gating is often seen in individuals dealing with trauma or anxiety.<br></p>',1),(174,40,173,175,20,0,1,1,1586869378,1586869410,'PTSD','<p>Sometimes an individual dealing with post-traumatic stress disorder will create alpha blocking or a rise in the amplitude of beta with eyes closed. For most individuals, when we close our eyes we are able to relax. The brain signals to the body that we are safe and able to rest or fall asleep. The parasympathetic nervous system kicks in, assuring the body (and the brain) that it is safe to rest, digest and recuperate from the activities of the day.&nbsp;</p><p>In the case of PTSD, the opposite happens. When the eyes are closed again, vigilance appears (which can be seen in the rise of amplitude in beta brainwaves).&nbsp; Beta and high beta are the frequencies in which we process cognitive data. These are the brainwaves in which we think. Typically, the waveforms of alpha and ultimately theta and delta rise when we close our eyes. Additionally, we may see a drop in delta and theta when eyes are closed, signifying a further inability to relax.</p><p>What can be expected from an EEG response such as this is difficulty falling asleep and staying asleep, nightmares&nbsp; (due to an overly active brain at rest), and the results from poor or compromised sleep (fatigue, grumpiness, feelings of heaviness, poor attention, inability to stay on task, difficulty sequencing thoughts, et cetera.).</p>',1),(175,40,174,176,20,0,1,1,1586869438,1586869474,'PTSD - OCD and Mood Disorders','<p>Very often obsessive compulsive disorder will live at the anterior cingulate cortex and will have the presence of alpha and other frequencies. This appears as a malfunction in a network node in the error detection and processing network. Usually if you are getting a lot of error codes (“that’s wrong,” “did you forget to lock the door,” “your hands are not yet clean,” etc.) this maker could signify an obsessive compulsive or oppositional defiant marker.&nbsp;</p><p>The anterior midline holds a model of what is going on in the world at the subgenual anterior Cingulate location. When that spot is not working properly, you end up having error codes. In addition, Mood Disorders are often seen stemming from a dysregulation in this area and can manifest as depression, amotivational, and angry behaviors.</p><p><br></p>',1),(176,40,175,0,20,0,1,1,1586869492,1586869598,'Reactive Attachment Disorder and Trauma','<p>There are different attachment styles: (1) secure attachment, (2) insecure attachment with anxious/avoidant and anxious/resistant subtypes, and (3) disorganized attachment (Ainsworth, Blehar, Waters &amp; Wall, 1978; Bowlby, 1988; Main &amp; Solomon, 1986). The child needn’t be abused to be in trouble, he merely needs to experience himself as abandoned by his mother. Reactive Attachment Disorder describes the effects of pathogenic care on the child’s ability to bond appropriately. These children are either hypervigilant, aggressive, and averse to comfort, or in fewer cases, inhibited, ambivalently needy, and withdrawn. They are suspicious of caretakers, a suspiciousness that, sadly, they come by honestly. They are prone to dissociative states and in the fugue of mother loss, they do not readily perceive their primary caretaker (Fisher, 2014, p. 4).</p><p>Often the mother of a baby may be physically present but emotionally absent.&nbsp; Even though mother may change diapers, feed her baby, and pick baby up from the crib, she may have difficulty interacting with the baby—that is, mirroring facial expressions, mimicking baby’s coos, eetc. The depressed mother who cannot, from her own deadened state, enliven her baby.&nbsp;</p><p>This could result in a dissociative EEG presentation, such as <b><u>mu rhythm</u></b>. Attachment research has shown that babies depend on face--, eye-to-eye, voice-to-voice emotional reciprocity (Bowlby, 1988; Ainsworth et al., 1978; Main &amp; Solomon, 1986; Tronick, 2007). Alexithymia means inability to describe or articulate feelings, and for some it means trouble recognizing that they even have feelings. (107), this type of symptomology would be present in a child who was not mirrored.</p><p>Sebern Fisher has seen excess slow wave (as low as 2 Hz) in the temporal lobes of people with developmental trauma. High amplitude, of 50 microvolts, is also seen. This can indicate dissociative processes. If there is excess slow wave—particularly delta to slow theta—at a particular site, it is not communicating adequately with the outside world; it is mainly talking to itself.</p>',1),(177,41,0,178,20,0,1,1,1586869728,0,'Head Injury and Concussion','<p>Often in a concussion, the initial impact will lead the brain to release the excitatory neurotransmitter glutamate at the areas of damage, which causes a rapid depolarization of the local neurons. After this, the axonal sodium/potassium pump goes into overdrive to rebalance ion/voltage imbalance, more ATP (energy) is required, there is a jump in glucose metabolism, and extracellular swelling starts, reducing blood flow. Then the increase in metabolism with reduced blood flow causes an energy crisis in the cell. Cell is unable to carry out regular activity due to lack of energy and often entire cell groups will go dormant to preserve themselves. This causes a low voltage EEG. However, for the record, a low voltage EEG is also a normal phenotype (Johnstone et al, 2005).&nbsp;</p><p>It is very likely that, after a career of having hard knocks to the skull, that clients’ brains will form scar tissue at the sites of the accident (after initially experiencing a state of inflammation). If the inflammation is not able to properly heal the brain—which is its’ function—then the brain will ultimately learn to handle the inflammation by altering cellular structures to form tougher tissues, which would consequentially prevent blood perfusion at the sites of the injury and prevent the slower brainwaves of delta and theta from being read from the surface.</p><p><br></p>',1),(178,41,177,179,20,0,1,1,1586869732,1586869796,'TBI, Stroke and Concussion','<p>When brain trauma occurs, the brain sends slow, healing brainwaves to the areas receiving damage. Typically, a recent wound (whether open or closed) will result in an abundance of delta and theta brain waves—indicating damage to the white matter of the brain. Birnbaumer (2007) has suggested that if the neuronal assemblies adjacent to the injury,&nbsp;</p><p>rather than the homologue in the contra lateral hemisphere, assume the function of&nbsp;</p><p>damaged neurons more recovery is possible. Other signs and symptoms of frontal lobe injury are difficulty with flexibility, problem solving, attention span and memory (Thompson &amp; Thompson, 2015, p. 39).</p><p><br></p>',1),(179,41,178,180,20,0,1,1,1586869812,1586869857,'Anxiety via Low Theta-Beta Ratio','<p>A high theta over beta ratio at Cz has been confirmed by the Food and drug administration as an indicator of ADHD. The theta/ beta ratio is best known as a predictor of Attention Deficit disorders. Typically, when one has too much theta and not enough beta, their abilities to focus and concentrate are compromised. In the case of a low theta/beta ratio, the amount of theta is too low and the amount of beta is too high, suggesting one who veers to the other end of the attention spectrum. This could manifest in many ways, including someone who is rigid or fixed in thought, someone who pays meticulous attention to detail, sometimes to a fault.&nbsp;</p><p>There is the possibility that the “small stuff” is a source of stress, where details can become overwhelming and the component parts of a task, job, or endeavor are scrutinized and overthought to a detrimental degree.&nbsp; There could be signs or symptoms of obsession, rumination, and the desire to take care of things oneself, instead of having others handle tasks, under the belief that “my way is the best way” or “only I know how to do it right.” In its best light, this low ratio may indicate a high level of proficiency and efficiency; someone who produces meticulous, detail oriented, high quality work. The question then is: is this effort pleasurable?</p><p><br></p>',1),(180,41,179,181,20,0,1,1,1586869861,1586870176,'ADD/ADHD via High Theta-Beta Ratio','<p>The theta/beta ratio is a predictor of attention deficit disorder according to the FDA and American Academy of Pediatrics.&nbsp; However, 30% of ADHD kids show excessive alpha frontally.</p><p></p><ul><ul><ul><li>T/B ratio is driven largely by slow alpha</li><li>The theta beta ratio changes over time</li><li>Monastra/Lubar (1999) shows accuracy of 95% of using the T/B/ ratio for the diagnosis of attention spectrum disorders</li></ul></ul></ul><p>20% of ADD/ADHD cases is the varioation of&nbsp; frontal beta spindles. This profile manifests is an inability to regulate attention, its not a deficit of attention. Easily kindled or excitable cortex will show in beta spindle.&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/adhd-spindling-beta-variant.png\" alt=\"ADD/ADHD Spindling Beta Variant in Raw EEG\" width=\"1034\" height=\"929\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p><p style=\"text-align: center;\">Figure : ADD/ADHD Spindling Beta Variant in Raw EEG<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/adhd-spindling-beta-variant-qeeg.png?time=1586870316567\" alt=\"ADHD/ADD Spindling Beta Variant in qEEG\" width=\"709\" height=\"918\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : ADHD/ADD Spindling Beta Variant in qEEG<br></p>',1),(181,41,180,182,20,0,1,1,1586870181,1586870309,'Spectrum Based Disorders','<p>The rate of brain growth is abnormal in autistic children. Researchers speculate in autism that too few connection are created between the frontal cortex and other regions of the brain (Seung, 2009). Along with the phase dynamics of the brain, aberrant\r\n    brain connectivity, especially as it pertains to long-distance underconnectivity, has been recognized as a candidate pathophysiology of autism spectrum disorders.&nbsp; The current meta-analysis of diffusion tensor imaging studies in subjects with\r\n    autism spectrum disorders emphasizes important roles of connections in the superior and inferior longitudinal fasciculi, inferior fronto-occipital fasiculus, uncinate fasciculus, and the anterior portion of the corpus callosum that extends into the\r\n    frontal lobes in the pathophysiology of autism spectrum disorders (Bashat et al, 2010; Joe et al., 2010).&nbsp;&nbsp;<br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/abnormal-phase-dynamics-spectrum.png\" alt=\"Abnormal Phase Dynamics as seen in Spectrum-Based Disorders\" width=\"530\" height=\"540\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p></p>\r\n<p style=\"text-align: center;\">Figure : ADD/ADHD Spindling Beta Variant in Raw EEG<br></p>\r\n<p style=\"text-align: center;\"><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/adhd-spindling-beta-variant-qeeg.png?time=1586870316567\" alt=\"ADHD/ADD Spindling Beta Variant in qEEG\" width=\"709\" height=\"918\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Figure : Abnormal Phase Dynamics as seen in Spectrum-Based Disorders<br></p>',1),(182,41,181,0,20,0,1,1,1586870341,1586870397,'References','<p>Ainsworth, M.D. S., Blehar, M. C., Waters, E. &amp; Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillside, NJ: Erlbaum.</p><p>Barrett, M.D. (1985). Children’s single-word speech. Chichester, England: Wiley.</p><p>Bland BH, Oddie SD (2001). Theta band oscillation and synchrony in the hippocampal formation and associated structures: The case for its role in sensorimotor integration. Behav Brain Res 127:119–36.</p><p>Bloom, L. (1973). One word at a time: The use of single word utterances before syntax. The Hague: Morton.</p><p>Bowlby, J. (1988). A secure base. New York, NY: Basic Books.</p><p>Chugani HT (1998). A critical period of brain development: Studies of cerebral glucose utilization with PET. Prev Med 27:184–8.</p><p>Chugani HT, Phelps ME, Mazziotta JC (1987). Positron emission tomography study of human brain functional development. Ann Neurol 22:487–97.</p><p>Cortina, M. and Marrone, M. (eds) (2003) Attachment Theory and the Psychoanalytic Process, London: Whurr Publishers.</p><p>de Boysson-Bardies, B., Sagart, L., &amp; Durand, C. (1984). Discernible differences in the babbling of infants according to target language. Journal of Child Language, 11. 1-15.</p><p>Damasio AR (1996). Descartes’ error. Emotion, reason, and the human brain. London: Papermac.</p><p>Damasio AR (2000). The feeling of what happens. Body, emotion and the making of consciousness. London: Vintage.</p><p>Fonagy, P. (1999) “Psychoanalysis and attachment theory”, in J. Cassidy and P. Shaver (eds), Handbook of Attachment. Theory, Research and Clinical Applications, New York and London: Guilford Press.</p><p>Freud S (1923). The ego and the id. SE 19, p. 3–66.</p><p>Futagi Y, Ishihara T, Tsuda K, Suzuki Y, Goto M (1998). Theta rhythms associated with sucking, crying, gazing, and handling in infants. Electroencephalogr Clin Neurophysiol 106:392–9. Ginzburg A (2004).</p><p>Green, K.P. &amp; Kuhl, P.K. (1989). The role of visual information in the processing of place and manner features in speech perception. Perception and psychophysics, 45. 34-42.</p><p>Greenfield, P., &amp; Smith, J. (1976). The structure of communication in early language. New York: Academic Press.</p><p>Hagmann, P., CAmmoun, L., Gigandet, X., Meuli, R., Honey, C.J., Wedeen, V.J., Sporns, O. (2008) Mapping the structural core of the human cerebral cortex. PLoS Biol. 6, e159.&nbsp;</p><p>He, B.J. et al (2008) Electrophysiological correlates of the brains intensive large-scale functional architecture. Proc. Nat’l Acad. Sci. USA, 105, 16039 – 16044.</p><p>Kandel, E. (2012). Biology and the future of psychoanalysis: A new intellectual framework for psychiatry revisited. Psychoanalytic Review, 99(4), 607-644.</p><p>Kouvelas, E.D. (2012). Unconscious and plasticity: Bridges between psychoanalysis and neuroscience. International Forum of Psychoanalysis, 21. 214-217.</p><p>Lehtonen J (2006) In search of early mental organization of the infant. Contributions from the neurophysiology of nursing. In: Mancia M, editor. Psychoanalysis and neuroscience, p. 419– 31. Milan: Springer. 392 p.</p><p>Lewin B (1946). Sleep, the mouth, and the dream screen. Psychoanal Q 15:419–34.</p><p>Lewin B (1955). Dream psychology and the analytic situation. Psychoanal Q 24:169–99.</p><p>Main, M., &amp; Solomon, J. B. (1986). Discovery of an insecure-disorganized/disoriented attachment pattern. Westport, CT: Ablex.</p><p>Mandler, J. (1992) “‘How to build a baby’: II. Conceptual primitives”, Psychological Review, 99(4), 587– 604.</p><p>McEwen BS, Sapolsky RM: Stress and cognitive function. Curr Opin Neurobiol 1995; 5:205–216&nbsp;</p><p><br></p><p>McGurk, H. &amp; MacDonald, J. (1976). Hearing lips and seeing voices. Nature (London), 264, 746-748.</p><p>Mehler J, Bertoncini J, Barriére M, Jassik-Gerschenfeld D (1978). Infant recognition of mother’s voice. Perception 7:491–7.</p><p>Sapolsky RM: Why stress is bad for your brain. Science 1996; 273:749–750</p><p>Scher MS (1989). Pediatric electroencephalography and evoked potentials. In: Swaiman KF, editor. Pediatric neurology: Principles and practice, vol. I, p. 67–103. St Louis, MO: Mosby.</p><p>Schore, A. N. (1994). Affect regulations and the origin of the self. The neurobiology of emotional development. New Jersey: L. Erlbaum &amp; Associates.</p><p>Schore, A. (2014). Book Review: The Emotional Life of Your Brain, by Richard J. Davidson and Sharon Begley. Psychoanalytic Psychology, 32(3). 539-547.</p><p>Shalev, I., Moffitt, T. E., Sugden, K., Williams, B., Houts, R.M., Danese, A. et al. (2013) Exposure to violence during childhood is associated with telomere erosion from 5 ro 10 years of age: A longitudinal study. Molecular Psychiatry, 18(5). 576-581.</p><p>Spitz RA: Hospitalism: an inquiry into the genesis of psychiatric conditions in early childhood. Psychoanal Study Child 1945; 1:53–74</p><p>Tronic, E. Z. (2007). The neurobehavioral and social-emotional development of infants and children. New York: Norton.</p><p>Vaslamatzis, G. (2010). Framework for a new psychoanalytic approach between psychoanalysis and neurosciences: Is the combined neuropsychoanalytic approach the missing link? In M. Issidorides-Radovich and G. Vaslamatzis (Ed.), Dialogue of psychoanalysis and neurobiology: Theoretical and therapeutic aspects (pp. 169?78). Athens: BETA Medical Publishers.</p><p>Winson J (2002). The meaning of dreams. Sci Am (Special issue 12):54–61.</p><p>Yamaguchi Y, Aota Y, Sato N, Wagatsuma H, Wu Z (2004). Synchronization of neural oscillations as possible mechanism underlying episodic memory: A study of θ-rhythm in the hippocampus. J Integr Neurosci 3:143–57.</p>',1),(183,42,0,0,20,0,1,1,1586876681,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405195479\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(184,43,0,0,20,0,1,1,1586877816,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405202568\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(185,44,0,0,20,0,1,1,1586878168,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405221983\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(186,45,0,0,20,0,1,1,1586878509,0,'Basic','<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/405203148\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>',1),(187,46,0,188,20,0,1,1,1587043770,0,'Basic','The central nervous system includes the brain (contained within the skull), which weighs 1.3–1.4 kg in humans, and also the spinal cord, which extends into the vertebral canal. The brain is grossly divided into the brainstem, cerebellum, and cerebrum. The cerebrum is further divided into the basal ganglia, limbic system, and neocortex.',1),(188,46,187,0,20,0,1,1,1587043776,1587044221,'Spinal cord','The spinal cord descends from the brainstem down through the shielded tunnel of the vertebrae,  and transmits information from the body to the brain and from the brain to the body. Thus, the central nervous system is composed of nerves the are rooted to both the surface of the brain, as well as to the spinal cord. Most nerves are peripheral nerves, which extend and branch toward the surface of the body.<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/spinal-cord.png\" alt=\"Spinal Cord\" width=\"438\" height=\"275\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">The brain grows like an onion. The triune brain was first described by MacLean in 1990, as consisting of three layers that depict our evolution individually as a species. The first layer is the reptilian brain (its core), responsible for activation, arousal, homeostasis, and reproductive drives. This is the dinosaur brain, the same brain that has been around for 2,000,000 years. The reticular formation at the conjunction of the thalamus and the brainstem oscillates at 2 Hz (delta) (Thatcher, 2015). At birth, this structure is already in place and fully functional.&nbsp;<br></p>',1),(189,47,0,190,20,0,1,1,1587044388,0,'Basic','<p>The reptilian brain controls the body’s most basic, involuntary actions, like heartbeat, breathing, body temperature regulation, and balance. It consists of the brainstem and the cerebellum (which joins the limbic thalamus by the reticular activating system). The cerebellum is the most densely packed area; surprisingly, this is where 80% of the brain’s neurons live (Herculano-Houzel, 2010). Used mostly for gross movements and balance, parts of the cerebellum are involved in the coordination of language, memory, and reasoning (Schmahmann, 1997). Interestingly, new literature suggests that the cerebellum plays a significant role in regulating the cerebrum, both via white matter (sub-cortically) and via grey matter (cortically) (Schmahmann, 1997, 1998, 2000; Teicher, Anderson, &amp; Polcari, 2012). This is the part of the brain that is cradled by the hand of a loving mother, and the part of the brain that also unconsciously senses the absence of her hand, in situations of neglect (Fisher, 2014, p. 23).<br></p>',1),(190,47,189,0,20,0,1,1,1587044395,1587044538,'Brainstem','<p>The brainstem is responsible for carrying all information from the body to the cerebrum and cerebellum (hindbrain) and from the brain to the body. The pathways ascending from the body to the brain are the sensory pathways and communicate to your brain that which is going on with the body (pain, hunger, desires, temperature, sensations, etc). The descending pathways move from the brain to the body. The last job of the brain stem is its regulation of various systems, such as your cardiovascular system, respiratory system, pain sensitivity controls, as well as alertness, and consciousness.</p><p>The brainstem plays a primary role in conduit functions. That is, all information related from the body to the cerebrum and cerebellum and vice versa, must traverse the brain stem. The ascending pathways coming from the body to the brain are the sensory pathways. Descending tracts are upper motor neurons destined to synapses on lower motor neurons. The brain stem also has integrative functions. It is involved in cardiovascular system control, respiratory control, pain sensitivity control, alertness, and consciousness.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/the-triune-brain.png\" alt=\"The Triune Brain\" width=\"602\" height=\"325\" class=\"img-responsive atto_image_button_middle\"><br></p>',1),(191,48,0,192,20,0,1,1,1587044651,1587044683,'Basic','<p>The next layer, the paleomammalian brain, better known as the limbic system, is primed and ready to be further developed by early life experiences. This area is largely responsible for the functions of memory, learning, and emotion. This second layer is responsible for basic autonomic functioning, as well as reflexes, and basic survival (DeRidder, 2014). The proliferation of the limbic system created higher frequencies, such as theta and alpha. The limbic structures include the amygdala, hippocampus, thalamus, hypothalamus, basal ganglia, and cingulate gyrus. These limbic structures are wrapped in the cerebral cortex, which is the outermost and third layer of the brain.&nbsp;&nbsp;</p><p>From an evolutionary perspective, the reptilian brain is fully functional at birth and the second layer—the limbic system—is prepared for the organizational experiences of early life. The neuronal development of the brain’s first and second layers are virtually complete at birth; the branching of dendrites that occurs thereafter is dubbed “wiring,” since the growth of neurons and dendrites resembles wires (Seung, 2012). The wiring and creation of oligodendrocytes (glia cells responsible for myelination) now occurs from the limbic structures into the cortex. The self-reliance of the brain circuits has increased as we have evolved, and have moved to higher levels in the brain, ones that have less and less contact with sensory inputs.</p><p>Most of our significant early emotional and intellectual experiences, those that shape our later perceptions and reactions, occur when the limbic and reptilian structures are in dominance (Cozolino, 2002, p. 9). That is to say, many of our social-emotional reactions and behaviors are literally programmed beneath the surface of our consciousness. Indeed, empirical evidence suggests that processing emotion can occur without conscious awareness (Balconi &amp; Lucchiari, 2008; Bunce, Bernat, Wong, &amp; Shevrin, 1999; LeDoux, 1998a).&nbsp;</p>',1),(192,48,191,0,20,0,1,1,1587044664,1587045805,'Parahippocampal Gyrus','<p>The parahippocampal gyrus is a region which is responsible for many functions, most notably for short-term working memory. The left-hand side is related to more verbal processes than the right, the right hand side has more to do with forming associations. This area of the brain has much to do with the encoding and recognition of scenes; this area of the brain becomes active when taking in topographical scenes (images of cities, landscapes, and rooms—images of places).&nbsp; Furthermore, this area is involved in procedural memory consolidation, recognition, and recall. It is a component part of the networks for autobiographical memory, embarrassment, and regret.&nbsp;</p><p><b>Pituitary:</b> The pituitary is a small pea-size master gland of the endocrine system that sits in a bony depression beneath the hypothalamus. Its job deals with directing chemical changes to regulate the entire organic system.</p><p><b>Reticular formation:</b> The reticular formation is at the core of the brainstem and plays a vital role in sleep, emotion, breathing, blood pressure, and heart rate.&nbsp;</p><p><b>Thalamus:</b> The thalamus is an egg-shaped structure deep within the brain that acts as a relay station, receiving information from all senses (except olfactory) processing the data and passing it up into the cerebral cortex.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/the-limbic-system.png\" alt=\"The Limbic System\" width=\"258\" height=\"179\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p><br></p><p><br></p><p>Proponents of the collective unconscious theory in neuroscience have suggested that neurobiological correlates to the collective unconscious are the subcortical areas of the brain, specifically the thalamus (which oscillates in delta, theta, and alpha rhythms). The thalamus operates like a regulatory gateway, since all of the sensory input that comes into the brain, and all motor output, goes through the thalamus. The thalamus regulates what goes in and what goes out.&nbsp; Because these structures are located centrally, linking the brain with the rest of the nervous system, they are said to control vital processes, such as emotions and long-term memory (Hunt, 2012). Arousal occurs in the face of a threat, triggered by the amygdala, which is an almond shaped structure in the brain responsible for mediating the fear response. The amygdala locks down the hippocampus so as to react by shutting down this structure, the seat of the memory (LeDoux, 1998b). LeDoux speculates, however, that psychoanalysis works by strengthening the cortical control of the amygdala. In fact, the face-to face reciprocity between infant and mother is crucial for the development of the pre-frontal cortex, which serves to mediate the amygdala and regulate affect (Schore, 1994, 2003; Siegel, 1999; Stern, 2013; Tronick, 2007).</p><p>Sigmund Freud, quite rightly, believed that mental activity was rooted in phylogenically-old emotion and motivation systems, which were constructed in early mental development, and instantiated throughout later adult life (LeDoux, 1998a; Panskepp, 1998). Thus, affective reactivity, such as dissociation, can be seen as a return to nonverbal, largely unconscious parts of the brain. These are areas that can influence the higher-ordered neo-mammalian brain (Cozolino, 2002, p. 6). Furthermore, these older regions are innervated by the vagus nerve, which literally means “wandering nerve.” The vagus nerve is also called the \"wandering nerve\" because it\'s the longest nerve in the human body and has countless branches that wind their way from the brainstem all the way down to the lowest part of the intestines, touching most major organs along the way. The vagus nerve is the tenth cranial nerve and is the main afferent pathway connecting the gut to the brain. This nerve modulates the parasympathetic nervous system, which counterbalances the fight, flight, or freeze stress response by eliciting the so-called \"relaxation response.\"</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/the-limbic-system-3.png\" alt=\"THE LIMBIC SYSTEM\" width=\"342\" height=\"1000\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">A study released in June of 2015 noted the discovery of vessels directly connecting the brain and the lymphatic system, a finding which will likely have continual substantial implications for major neurological diseases and also more common psychopathologies (Louveau et al., 2015). This finding changes the way scientists perceive neuro-immune interaction, and may make the link between the body and the brain/mind something beyond esotericism.&nbsp;<br></p>',1),(194,49,0,195,20,0,1,1,1587046113,0,'Basic','<p>The cortex is the neomammalian brain, which is the grey matter. The cortex is the bark of the brain, “cortex” literally translating to bark in Latin. This part of the brain continues to develop and mature into the third decade of life, creating our learned social-emotional behaviors, and emotions. Higher-level primates (including humans) oscillate at faster frequencies here. This layer of the brain is responsible for all conscious thought, learning, and self-awareness (MacLean, 1990). Approximately 40,000 years ago, with the Cro-Magnon man, both hemispheres of the brain underwent a major functional reorganization. It was at this time that the frontal lobes increased in size, bonding processes (sexual and social) became more complex, and the ability to communicate and express ideas began to emerge, notably in drawings, etchings, carvings, and sculpture (Joseph, 1992, p. 25). It is this third layer of the cortex that allows for self-conscious awareness, among other qualities (Professor H. LaFace, personal communication, January 25, 2013).</p><p>In a cortical organization, neurons are arranged in layers and the neurons in each layer are functionally alike and different from those in other layers. The crinkled sheet of nerve cells (grey matter) that is the cortex is 1/5” thick.&nbsp; This is the house of the highest level of neural processing (e.g. language, memory, cognitive functioning). The cerebral cortex can be divided into areas concerned with particular functions. What lies underneath the cortex is considered white matter.</p><p>Cortical interneurons make up 1/5 of the cortical neuronal population (65) and release the inhibitory neurotransmitter GABA (gamma-aminobutyric acid). Although they are outnumbered, interneurons innervate principle neurons at strategic places and with synaptic terminals, which allows for Inhibitory Post Synaptic Potentials (IPSPs)&nbsp; to approximately match the effects of excitatory postsynaptic potentials (EPSPs). It is through this dance that the balance of cortical activity is established.</p><p>Brain systems with “simple” computational demands evolved only a few neuron types. The thalamus, basal ganglia, and cerebellum possess a low degree of variability in their neuron types. In contrast, cortical structures have evolved not only five principle-cell types, but also numerous classes of GABAergic inhibitory neurons (Buszaki, 2006).</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/the-cortex.jpg\" alt=\"\" width=\"663\" height=\"391\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: left;\">MacLean noted the unconscious reptilian and limbic brain regions influence the higher ordered neomammalian brain. The cortex consists of “bumps,” called gyri (“gyrus” is singular) and “grooves” called sulci (“sulcus” is singular). Some anatomists call the deepest sulci “fissures” (Catani &amp; Thiebaut de Schotten, 2012, p. 8).<br></p>',1),(195,49,194,196,20,0,1,1,1587046134,1587046462,'Gyrus','<p><b>One of the elevations in the convolutions of the surface of the brain caused by the infolding of the cortex.</b><br></p><p><b><br></b></p><p style=\"text-align: center;\"><b><img src=\"@@PLUGINFILE@@/the-lateral-surface-human-brain.jpg\" alt=\"The lateral surface of the human brain\" width=\"896\" height=\"625\" class=\"img-responsive atto_image_button_text-bottom\"><br></b></p><p style=\"text-align: center;\"><b><br></b></p><p style=\"text-align: left;\"><span><span><b>Sulcus-</b></span><br></span></p><div class=\"editor-indent\" style=\"margin-left: 30px;\"><p style=\"text-align: left;\"><span><span><span><span><b>Literally a groove, trench or furrow. A general term used to designate such a depression especially those on the surface of the brain.</b></span></span></span></span></p></div><p style=\"text-align: left;\"><span><span><span><span></span></span></span></span></p><p lang=\"en-US\" align=\"LEFT\">The Longitudinal fissure is the long sulcus that divides the left and right hemispheres of the brain.<br></p><p></p>',1),(196,49,195,197,20,0,1,1,1587046499,1587048001,'Right hemisphere and Left Hemisphere','There are differences between the functionality of the right and the left hemispheres of the brain.&nbsp; The right hemisphere of the brain is unique in that it is not temporally associated (unlike the left hemisphere, which uses the precedent of the past to project into the future in anticipation). Whereas the left hemisphere is the side of our brain that speaks, read, writes, calculates, and takes care of numbers and facts (and some more specific responsibilities, such as making metaphors, lexical ability, self-reflection, self-appraisal, and inferences during reading), the right-hand side plays the role of assimilating all of this information. The right-hand side of the brain does not distinguish where I end and you begin, nay, it is an associational hemisphere that is more concerned with making meaning of all the component parts. It is the part of the brain that creates and draw similarity. It is the part of the brain that recognizes the connectivity of things, events, and people. allows for us to connect with others, to understand the connectivity of things, to comprehend situations and data in a sensory way, even in a psi-phenomenological way.&nbsp;<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/fissure-hemispheres.png\" alt=\"Longitudinal Fissure that Divides the Hemispheres\" width=\"448\" height=\"488\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\">Figure : Longitudinal Fissure that Divides the Hemispheres<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">The central sulcus (aka Rolandic Fissure) is the transverse sulci that separates the frontal lobes from the parietal lobes, as well as the sensory motor strip into the motor cortex and the somatosensory cortex.&nbsp;<br></p><p style=\"text-align: left;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/central-sulcus-rolandic.png\" alt=\"Central Sulcus, aka Rolandic Fissure\" width=\"541\" height=\"332\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Central Sulcus, aka Rolandic Fissure<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/sylvian-fissure.png\" alt=\"Sylvian Fissure, aka Lateral Sulcus\" width=\"679\" height=\"493\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Sylvian Fissure, aka Lateral Sulcus<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(197,49,196,199,20,0,1,1,1587047746,1587048589,'The Cortex','<p style=\"text-align: left;\"><b>Cortex</b><br></p><p style=\"text-align: left;\"><span><b>The convoluted layer of grey matter covering the surface of the cerbral hemispheres about half of which is hidden within the folded walls of the sulci.</b><br></span></p><p style=\"text-align: left;\"><span><span><span>The cortex is composed of six layers of neurons, called the pyramidal neurons. The pre-frontal cortex is involved in working memory, the planning of complex behaviors, and coordination of thought in relation to goals and decision-making (Gorochowski, 2009). This area of the brain is responsible for higher-ordered tasks, such as thinking, planning, motor execution, and mood control (Thatcher, 2015). With the evolution of the cerebral cortex, our early ancestors (Cro-Magnon man), once a free-roaming and wild species wholly reliable upon instincts, found themselves with higher cognitive thought, which upturned the previous reliance on unconscious drives and desires. With this outward growth of their brains, they were forced to think, deduce, calculate, and consider cause and effect.&nbsp;“Unhappy people, reduced to their most fallible organ, their consciousness” (Nietzsche, 1985, p. 153).&nbsp;</span><br></span></span></p><p style=\"text-align: center;\"><span><span><span><img src=\"@@PLUGINFILE@@/cerebral-cortex.png\" alt=\"Cerebral Cortex\" width=\"349\" height=\"217\" class=\"img-responsive atto_image_button_middle\"><br></span></span></span></p><p style=\"text-align: center;\"><span><span><span><br></span></span></span></p><p style=\"text-align: left;\"><span><span><span>One interesting component of neurophysiology that has been discovered is that our prefrontal cortex can simulate the future (Byrne &amp; Reiner, 2006). This has been most popularly described in the case of Olympian athletes (Byrne &amp; Reiner, 2006). It has been proven that the same portions of the brain fire when these individuals complete their event in their mind as does when they are actually competing in the event. Taking the internal perspective triggers the somatosensory perspective (Casey &amp; Romanyshyn, 2010). In interviewing gymnasts, many of those who have qualified for the Olympics speak of using internal imagery—that is, they saw themselves inside their minds conducting their gymnastic feats, whereas those who did not qualify for the Olympics commonly used external imagery; they watched video tapes more and relied on observing others (Byrne &amp; Reiner, 2006).&nbsp;<br></span></span></span></p><p style=\"text-align: left;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/prefrontal-cortex.png\" alt=\"Prefrontal Cortex\" width=\"834\" height=\"338\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(199,49,197,0,20,0,1,1,1587048600,1587049399,'Meninges','<p style=\"text-align: left;\">The three membranes of elastic connective tissues that envelop the brain and the spinal cord are called meninges. The three layers are:</p><p style=\"text-align: left;\"></p><ul><ul><ul><li><b>Dura Mater</b> – the outermost and toughest layer of the meninges</li><li><b>Arachnoid Mater</b> – The web-like middle layer of the meninges</li><li><b>Pia Mater</b> – The innermost layer of the meninges</li></ul></ul></ul><p></p><p style=\"text-align: left;\"><span>The purpose of the meninges is to protect the brain and support its structure, including anchoring the brain and the brain stem to the skull. They also contain cerebrospinal fluid (CSF), which acts as a cushion for the brain and provides a solution in which the brain is suspended, allowing it to preserve its shape.</span></p><p style=\"text-align: left;\"><span><br></span></p><p style=\"text-align: left;\"><span><img src=\"@@PLUGINFILE@@/pia-mater.png\" alt=\"\" width=\"820\" height=\"566\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\"><br></span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/pia-mater-2.png\" alt=\"\" width=\"999\" height=\"623\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: left;\"><span>Meningitis is inflammation of the meninges and spinal cord membranes, often caused by an infection.<br></span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/meningitis.png\" alt=\"\" width=\"452\" height=\"255\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p>',1),(200,50,0,201,20,0,1,1,1587049960,0,'Basic','<p>The basic division of each of the hemispheres is into four lobes: frontal, parietal, temporal, and occipital. Two prominent ﬁssures allow this subdivision to be made — the central ﬁssure and the lateral ﬁssure.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/lobes-1.jpg\" alt=\"Cerebral Sulcus\" width=\"557\" height=\"368\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(201,50,200,202,20,0,1,1,1587049967,1587050325,'Pre-Frontal Cortex','<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/lobes-2.jpg\" alt=\"Pre-Frontal Cortex\" width=\"306\" height=\"242\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n\r\n<p>The prefrontal cortex makes up over 10% of the volume of the brain, The PFC contains the Brodmann areas 8, 9, 10, 11, 12, 13, 14, 24, 25, 44, 46 and 47&nbsp; This brain region has been implicated in planning complex cognitive behavior, personality expression,\r\n    decision making, moderating social behavior, and moderating certain aspects of speech and language. The basic activity of this brain region is considered to be orchestration of thoughts and actions in accordance with internal goals. The most typical\r\n    psychological term for functions carried out by the prefrontal cortex area is executive function. Executive function relates to abilities to differentiate among conflicting thoughts, determine good and bad, better and best, same and different, future\r\n    consequences of current activities, working toward a defined goal, prediction of outcomes, expectation based on actions, and social \"control\" (the ability to suppress urges that, if not suppressed, could lead to socially unacceptable outcomes)..</p>\r\n<p>Patients with prefrontal cortex damage can experience blunted emotional responses, which may be another factor that negatively affects their ability to make decisions.</p>\r\n<p><br></p>',1),(202,50,201,203,20,0,1,1,1587050338,1587050501,'Sensory motor Cortex','The sensory motor cortex registers sensation that is connected with specific body parts or body functions. The motor strip is part of the frontal lobe and is anterior to the sensory cortex, which is in the parietal lobe. Collectively, the sensory motor cortex forms the central lobes of the brain. The primary motor cortex is Brodmann area 4, which works with other motor areas of the brain to plan and execute movements. The primary motor cortex receives thalamic inputs from different cell bodies within the thalamus. The nerve fibers that cast somatosensory information all over the body.  The sensory motor cortex is made up of Brodmann areas 1, 2, 3, 4, and 5.<br><br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/central-lobes.jpg\" alt=\"Center Lobs\" width=\"559\" height=\"425\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><br></p>',1),(203,50,202,204,20,0,1,1,1587050516,1587050936,'Homunculus','The homunculus is a neurological map that corresponds to the brain’s territory for different body parts. Homunculus is a Latin term that literally means “little man.”  The anatomically correct homunculus demonstrates the brain area that is overly proportioned for the hands, mouth and tongue, second only to the ears, nose and eyes.<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/homunculus.png\" alt=\"\" width=\"627\" height=\"319\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/temporal-lobes-1.png\" alt=\"\" width=\"325\" height=\"352\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(204,50,203,205,20,0,1,1,1587050971,1587051547,'Temporal Lobes','<p>The temporal lobe is so named because of its proximity to the temples. It is positioned toward the base of the center of the cortex, just behind the temples. The temporal lobe is involved in primary auditory perception, such as hearing, and holds the\r\n    primary auditory cortex. The primary auditory cortex receives sensory information from the ears and secondary areas process the information into meaningful units such as speech and words. Much of the auditory work of the temporal lobes is processed\r\n    through the top of the temporal lobes - the superior temporal gyrus. This region directly receives sound input from the ear. Some of the other important functions of this brain region are:</p>\r\n<p>\r\n    </p><ol>\r\n        <li>The formation of visual memories. In coordination with the amygdala and the hippocampus, this region create long term memories of conscious events.&nbsp;</li>\r\n        <li>The interpretation of visual stimuli (this region recognizes faces and reads body language)</li>\r\n        <li>The controlling of unconscious and automatic relations, such as hunger and thirst</li>\r\n        <li>The production of speech, which involves a conscious choice of what to say (this region is involved in “tip-of the-tongue” phenomena.</li>\r\n        <li>The recognition of language (both verbal and non-verbal).</li>\r\n        <li>Kolb &amp; Wishaw (1990) have identified eight principle symptoms of temporal lobe damage:&nbsp;</li>\r\n        <ol type=\"a\">\r\n            <li><span style=\"font-size: 1rem;\">disturbance of auditory sensation and perception,&nbsp;</span></li>\r\n            <li><span style=\"font-size: 1rem;\">disturbance of selective attention of auditory and visual input,&nbsp;</span></li>\r\n            <li><span style=\"font-size: 1rem;\">disorders of visual perception,&nbsp;</span></li>\r\n            <li><span style=\"font-size: 1rem;\">impaired organization and categorization of verbal material,&nbsp;</span></li>\r\n            <li><span style=\"font-size: 1rem;\">disturbance of language comprehension,&nbsp;</span></li>\r\n            <li><span style=\"font-size: 1rem;\">impaired long-term memory,&nbsp;</span></li>\r\n            <li><span style=\"font-size: 1rem;\">altered personality and affective behavior,</span></li>\r\n            <li><span style=\"font-size: 1rem;\">altered sexual behavior.</span></li>\r\n        </ol>\r\n    </ol><span style=\"font-size: 1rem;\">The temporal lobes includes the hippocampal formation and the inferior horn of the lateral ventricle.</span><br><p></p>\r\n<p>The temporal lobe is made up for Brodmann areas 20 21, 22, 28, 35, 36, 37, 38, 41, 42, and 52.</p><p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/parietal-lobes.png\" alt=\"\" width=\"695\" height=\"519\" role=\"presentation\" style=\"font-size: 1rem;\" class=\"img-responsive atto_image_button_text-bottom\"></p>\r\n<p style=\"text-align: center;\"><br></p>',1),(205,50,204,206,20,0,1,1,1587051554,1587051633,'Parietal Lobes','The parietal lobes are divided into the superior and inferior parietal lobes. This region of the brain is known largely for visuo-spatial attention, navigation, the integration of senses and the major sensory inputs from the skin, which relay through the thalamus to the parietal lobes. The parietal lobe is abutted by the Rolandic Fissure, which runs coronally through the brain, the Sylvian Fissure, which separates the temporal lobe from the parietal and the frontal lobe, and the parieto-occipital sulcus.\r\n<br><br>The posterior parietal cortex is made of the superior parietal lobe (Brodmann areas 5 and 7) and the inferior parietal lobes (Brodmann areas 39 and 40, which are separated by the intraparietal sulcus. This sulcus and the adjacent gyri are essential in limb and eye movement. Each hemisphere rules the sensation of the skin on the opposite side of the body. The parietal lobes are used for the manipulation of objects. The parietal lobe also includes the dorsal stream of vision, which is the “where” in space an object appears. And the “how” stream, which has to do with vision for action..',1),(206,50,205,207,20,0,1,1,1587051692,1587051723,'Inferior Parietal Lobule (BA 39 & 40)','The Inferior parietal lobule has been involved in the perception of emotions in facial stimuli, and interpretation of sensory information. The Inferior parietal lobule is concerned with language, mathematical operations, and body image, particularly the supramarginal gyrus and the angular gyrus.',1),(207,50,206,208,20,0,1,1,1587051744,1587051771,'Superior Parietal Lobe (BA 5 & 7)','<p lang=\"en-US\" align=\"LEFT\">\r\n<span lang=\"en-US\">There\r\nis a great deal of activity at the superior parietal lobe. This area\r\nis responsible for spatial orientation, as well as sensory input from\r\nthe hand.  This region is also responsible for the integration of\r\nsensory information in various modalities, including navigation and\r\norienting oneself in space. It is the main sensory area as related to\r\ntouch and sensory inputs from the skin (touch, temperature and pain\r\nreceptors), which are relayed through the thalamus).  </span>\r\n</p>',1),(208,50,207,209,20,0,1,1,1587051781,1587051883,'Occipital Lobe','<p lang=\"en-US\" align=\"LEFT\">The occipital lobe of the brain is divided into Brodmann areas 17, 18 and 19. This region is known as the visual cortex of the brain. Visual nerves run straight from the eye to the primary visual cortex to the visual association cortex. The lateral occipital sulcus divides the occipital gyrus into a superior and inferior part. The cuneus is a smaller lobe in the occipital lobbe of the brain. This region is bounded anteriorly by the parietao-occipital sulcus, and inferiorly by the calcitrine sulcus.&nbsp;</p><p lang=\"en-US\" align=\"LEFT\">The occipital lobe is responsible for visual processing. This includes the perception of light, intensity, motion, shapes, patterns, and color. Pattern recognition is important for piecing together words, reading sentences, and decoding visual stimuli in general.</p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/occipital-cortex.png\" alt=\"Occipital Cortex\" width=\"541\" height=\"424\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(209,50,208,0,20,0,1,1,1587051918,1587052083,'Cerebellum','<p lang=\"en-US\" align=\"LEFT\">The cerebellum is the hindbrain structure that is connected to the brainstem by fibers that carry information into and out of its interior. The main function of the cerebellum is coordinating movement and planning motor activity (balance, muscle tension, joint position, and coordinated movements). It is folded, like the cortex, which gives it high information processing power.&nbsp;</p><p lang=\"en-US\" align=\"LEFT\">Eighty percent of the brain’s neurons are in the cerebellum (Herculano-Houzel, 2010) and emerging literature (Schmahmann, 1997; 1998, 2000; Teicher, Anderson, &amp; Polcari, 2012; Levin, 2009) suggests that the cerebellum plays a significant role in regulating the cerebrum, both cortically and sub-cortically. This is the part of the brain that remembers how to ride a bike, and remembers being rocked by mother.</p><p lang=\"en-US\" align=\"LEFT\">The cerebellum has strong connections with the brainstem and is situated behind the brainstem (inside the skull) in humans. Because the cerebellum is a simpler form of cortex, it consists of only three layers&nbsp; (as opposed to the more evolved cerebral cortex, which has six layers). Parts of the cerebellum are quite old in the evolutionary sense, and parts are relatively newer. This “little brain” is involved in motor coordination and also in the planning of movements. The cerebellum is involved with motor control and is part of the motor system, inﬂuencing posture, gait, and voluntary movements. Many of the connections to the cerebellum, including pathways and nuclei, are found in the brainstem.</p><p lang=\"en-US\" align=\"LEFT\"><br></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/cerebellum.png\" alt=\"Cerebellum\" width=\"497\" height=\"399\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><br></p><p lang=\"en-US\" align=\"LEFT\">According to Sebern Fisher (2014), Babies and young children learn through their senses and the integration of sensory input. Sensory integration is the province of the parietal cortex and the cerebellum . . . . the development of the infant’s cerebellum depends mostly on the security, consistency, and rhythmicity of his parents’ holding. When there is a history of significant neglect, the mother does not hold her infant with intentionality or feeling. Many in fact report never having been rocked or held, activities which promote the development of the cerebellum (22). Some folks comment that they feel an emptiness at the back of their head, where a loving hand would normally cradle the baby (22).</p>',1),(210,51,0,211,20,0,1,1,1587052553,0,'Basic','<p>The initial approach to understanding what part of the brain controlled what function was the legacy of Sherrington (1857 – 1952) who found that different parts of the brain have different cellular architecture and control different functions and sensations. And in 1909, Korbinian Brodmann discovered that different regions of the brain had different cellular architecture, which he divided into numbered areas (today called “Brodmann areas”).&nbsp; He dissected the brain into 52 distinct regions. The cerebellar cortex is also subdivided into nearly a hundred areas. Currently, we know that each of these divisions is composed of characteristic neuronal circuits that consist of numerous neurons of diverse types interconnected with each other via synapses.&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/brodmann.png\" alt=\"Original Cortical Atlas by Brodmann, Colorized Lateral View of the left hemisphere\" width=\"405\" height=\"284\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Original Cortical Atlas by Brodmann, Colorized&nbsp;<br><span style=\"font-size: 1rem;\">Lateral View of the left hemisphere</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/brodmann-area.png\" alt=\"The 52 Brodmann areas of the brain\" width=\"621\" height=\"277\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span style=\"\">Figure : The 52 Brodmann areas of the brain<br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p>',1),(211,51,210,212,20,0,1,1,1587052560,1587053116,'Bas 3, 1,and 2','<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/bas-3-1-2.png\" alt=\"Bas 3, 1,and 2\" width=\"271\" height=\"254\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: left;\">This region is the primary somatosensotry cortex and is located at the post central gyrus of the brain (behind the Rolandic Fissure). It is divided into Brodmann areas 1, 2, 3a, and 3b. 3b is thought to be the primary somato-sensory cortex, and projects the outputs received from 3a to Brodmann areas 1 and 2. BA 3 mediates boldily sensations, because its wired to pathways bringing touch, pain, and temperature signals from the spinal cord, BA1 gets information on texture and Brodmann area 2 gets information on the size and the shape of an object. COOL!!</p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/broadmann-area-12-3.png\" alt=\"The 52 Brodmann areas of the brain\" width=\"625\" height=\"464\" class=\"img-responsive atto_image_button_middle\"><br></span></p>',1),(212,51,211,213,20,0,1,1,1587053129,1587053269,'BA 4','Brodmann area 4 is the primary motor cortex of the brain and is located at the pre central sulcus.  It is considered the most posterior part of the frontal lobe. BA 4 controls movements of the body and sends many axons to the spinal cord, which in turn is wired to the muscles of the body.\r\nThis region is the region of the motor homunculus, which is mainly involved in controlling voluntary dynamic, kinesthetic movements.<br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-4.png\" alt=\"\" width=\"487\" height=\"747\" role=\"presentation\" class=\"img-responsive atto_image_button_middle\" style=\"font-size: 1rem;\"></p>',1),(213,51,212,214,20,0,1,1,1587053305,1587054122,'BA 5','Brodmann area 5 is part of the parietal cortex, making up the superior parietal lobe as part of the post central gyrus. It is right behind Brodmann areas 1, 2, and 3, the primary somatosensory cortex. This area is involved with spatial orientation, and receives a great deal of visual input as well as sensory input from one\'s hand.<p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-5.png\" alt=\"\" width=\"595\" height=\"949\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(214,51,213,215,20,0,1,1,1587053443,1587054057,'BA 6','<p style=\"text-align: left;\">BA 6 are part of the frontal lobe and lie anterior to the motor cortex (Brodmann area 4). The functions of Brodmann area 6 are the premotor cortex are diverse and project directly to the spinal cord. This region therefore may play a role in the direct control of behavior, with a relative emphasis on the trunk muscles of the body. It may also play a role in planning movement, in the spatial guidance of movement, in the sensory guidance of movement, in understanding the actions of others, and in using abstract rules to perform specific tasks. This area is also responsible for intention.&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-6.png\" alt=\"\" width=\"248\" height=\"394\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(215,51,214,216,20,0,1,1,1587053506,1587053997,'BA 7','<p style=\"text-align: left;\">Brodmann area 7 part of the parietal cortex of the brain and located posterior to the primary somatosensory cortex (Brodmann areas 3, 1 and 2), and superior to the occipital lobe. This region is believed to play a role in visuo-motor coordination (e.g. tool use, reaching to grasp an object, handwriting, and visuospatial attention. (e.g., in reaching to grasp an object). In addition, area 7 along with area 5 has been linked to a wide variety of high-level processing tasks, including activation in association with language use.[2] This function in language has been theorized to stem from how these two regions play a vital role in generating conscious constructs of objects in the world, including self-reflection.<br></p><p style=\"text-align: left;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-7.png\" alt=\"\" width=\"246\" height=\"395\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(216,51,215,217,20,0,1,1,1587053648,1587053917,'BA 8','<p style=\"text-align: left;\">The area is anterior to Brodmann area 6 and is part of the frontal cortex. It includes the frontal eye fields (so that if one has a stroke on injury to the brain in this region, the eyes will drift towards the injury. It is involved in the management of uncertainty, as well as the encoding of hope (a higher-order expectation positively correlated with uncertainty).&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-8.png\" alt=\"\" width=\"249\" height=\"393\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(217,51,216,218,20,0,1,1,1587054141,1587054492,'BA 9 and 10','<p>Brodmann area 9 located in the pre-frontal cortex is responsible for executive memory, abstract thinking, intentionality and motivation, memory (working memory, spatial memory, short term memory, memory encoding and recognition, memory retrieval, forgetting), motor skills, error detection, inductive reasoning, language skills (verbal fluency, metaphor comprehension, semantic categorization, verbal fluency, word-stem completion, generating sentences, etc). This area is underactive in individuals dealing with bipolar depressive disorders.&nbsp;</p><p>Left BA9 is responsible for empathy, processing pleasant and unpleasant emotional scenes, self-criticism, and attention to negative emotions.&nbsp;</p><p>Right BA9 is responsible for attention to positive emotions, recognizing the emotions of others, attributing intention, suppressing sadness, theory of mind, working memory and spatial memory, as well as planning, calculation, and religiosity.</p><p>Between BA</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-9-10.png?time=1587054661870\" alt=\"BA 9 &amp; 10\" width=\"499\" height=\"393\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(218,51,217,221,20,0,1,1,1587054506,1587057934,'BA 10','<p style=\"text-align: left;\">Brodmann area 10 is the anterior-most portion of the pre-frontal cortex. Overall, this area of the brain governs working memory; spatial memory; recognition; recall; intentional forgetting; recognizing emotions; calculation; pain; organization, maintenance,\r\n    and implementation of intentions, source monitoring (who said what information), logical inference, hypometabolism in bipolar disorder (with paralimbic, insula, and cingulate hypermetabolism).<br></p>\r\n<p style=\"text-align: left;\"><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-10.png\" alt=\"\" width=\"258\" height=\"400\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><b>\r\n\r\nBrodmann area 10L\r\n\r\n<br><br></b><p style=\"text-align: left;\">Brodmann area 10L is responsible for self-reflection (about one\'s own abilities, traits and attitudes), Syntax, Metaphor, Lexical processing, Verbs, Self-reflection, Self-appraise, Inferences during reading,&nbsp; Forgiveability judgment (of a crime),\r\n    the integration of disparate relationships, dysfunction during remission in major depression, and the execution of delayed intentions.<br></p><b> \r\n\r\nBrodmann area 10 R\r\n<br><br></b><p style=\"text-align: left;\">Brodmann area 10 is responsible for recalling episodes, nonspeech sounds, familiar odors, reward vs conflict, risk vs benefit, and carrying out delayed intentions.</p>',1),(221,51,218,222,20,0,1,1,1587057042,1587057233,'Dorso-Lateral Pre-Frontal Cortex','<p>Between Brodmann areas 9, 10, 44 and 45 is the Dorso-Lateral Pre-Frontal Cortex (DLPFC). This area is the highest cortical area responsible for motor planning, organization and regulation. It has an important role in the integration of sensory and mnemonic information.</p><p>This area has cortical (surface) and sub cortical (under the surface—white matter) circuits for complex mental activity and executive functions. It plays a large role in executive memory (working memory, spatial memory, and short term memory), memory retrieval and encoding/recognition, as well as prospective memory, abstract thinking, intentionality and motivation.&nbsp;</p><p>In addition, this area is responsible for error processing and detection, processing emotional stimuli, self-reflection in decision making, pleasant and unpleasant emotions, inferential reasoning, decision weighing (conflict and reward), planning, and attribution of intention to others.</p><p>The sensory responsibilities of the dorsolateral pre-frontal cortex have to do with joint attention and autonomic nervous system regulation. The autonomic nervous system (ANS or visceral nervous system or involuntary nervous system) is the part of the peripheral nervous system that acts as a control system that functions largely below the level of consciousness to control visceral functions, including heart rate, digestion, respiratory rate, salivation, perspiration, pupillary dilation, micturition (urination), sexual arousal, breathing and swallowing. Most autonomous functions are involuntary but they can often work in conjunction with the somatic nervous system which provides voluntary control.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-10.png?time=1587057223964\" alt=\"\" width=\"258\" height=\"400\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p>',1),(222,51,221,223,20,0,1,1,1587057245,1587058520,'Brodmann Area 11 ','<p>BA11 is the orbito-frontal cortex, right above the eye sockets. It governs personal and social behavior, emotion, and decision making, the formation and retrieval of temporal context of episodic information·&nbsp; Encoding of new material, olfaction,\r\n    nonspeech sounds, reward vs conflict.</p><b>BA11 L is responsible for\r\n</b><br>\r\n<ul>\r\n    <ul>\r\n        <ul>\r\n            <li>Unexpected outcomes&nbsp;</li>\r\n            <li>Idioms&nbsp;</li>\r\n            <li>&nbsp;Face-name recognition&nbsp;&nbsp;</li>\r\n\r\n        </ul>\r\n    </ul>\r\n</ul><b>\r\n\r\nBA 11R is responsible for\r\n\r\n</b><ul>\r\n    <ul><ul><li>Experience of happiness&nbsp;</li><li>Self-calm&nbsp;</li><li>Conscious perception of odors&nbsp;</li><li>Empathy (Judge others\' emotional states) and forgiveness judgments</li></ul></ul>\r\n</ul><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-11.png?time=1587058703643\" alt=\"\" width=\"253\" height=\"399\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(223,51,222,224,20,0,1,1,1587058087,0,'BA 12','Brodmann did not identify area 12 in humans, but it has been located as part of the orbito-frontal cortex, linked to taste perception, decision making and mental time travel.&nbsp;&nbsp;<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-12.png\" alt=\"\" width=\"261\" height=\"399\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p>',1),(224,51,223,226,20,0,1,1,1587058555,1587058733,'BA 13 and 16: The Insula','The lateral ﬁssure, when “opened,” reveals some buried cortical tissue; this area is called the insula. This area is responsible for receiving taste sensations, relayed from the brainstem, and olfactory sensation.<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/insula.png\" alt=\"Insula\" width=\"429\" height=\"287\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p>The insula is also responsible for the processing of sensation, motor movements and motor planning, verbal memory, motivational reasoning, vocal pitch, humor appreciation, risk taking, the expression of fear and disgust. The right side is responsible for gating affect and impulse, including explosivity, unreasonable responses, and the like.&nbsp;</p><p>The anterior insula has been shown to play a part in the mental conditioning of pain perception—in a sense, the thought pattern associated with pain means that “the worse it gets the worse it gets.” The more the individual catastrophizes, ruminates, worries, and focuses on the pain, the greater the expectation and manifestation of the pain.</p><p>The insular cortex is thought to connect to the sensory inputs from our internal organs. It serves interoception, the perception of information that arises from the center of the body and contributes to the felt sense of being. It also rules proprioception, the sense of how one’s body feels.&nbsp; It also inhibits the firing of the amygdala. Early emotional trauma that interferes with the experience-dependent maturation of the insula and negatively impacts its role in generating an image of one’s physical state (body image), a process that underlies the experiencing of basic emotions (Schore, 2003, p. 202).</p><p>Craig (2004), found that there is expansion of the right anterior insula and adjacent orbitofrontal cortices in therapists and other folks who are empathically attuned.</p><p></p>',1),(225,51,226,227,20,0,1,1,1587058741,1587058901,'BA 17, 18 and 19','These regions are located at the occipital lobe and visual nerves run straight from the visual cortex to the visual association cortex.&nbsp;<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-17-18-19.png\" alt=\"\" width=\"410\" height=\"145\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p><br></p><p></p>',1),(226,51,224,225,20,0,1,1,1587058920,1587058975,'BAs 14 and 15','BAs 14 and 15 do not exist in humans.',1),(227,51,225,228,20,0,1,1,1587058995,1587059071,'BA 17','Brodmann area 17 is important in the perception of light intensity, distinguishing visual patterns, contours, colors and motion. It is involved in spatial orientation and transmits information to the dorsal stream and the ventral stream. The dorsal stream is the “where pathway” which is associated with motion, representation of object locations, and control of the eyes and arms. The ventral stream is the “what pathway” and is associated with form recognition and object representation. It is associated with the storage of long-term memory. This area is involved with the discrimination of shapes, textures, objects and faces.',1),(228,51,227,229,20,0,1,1,1587059077,1587059131,'BA 18','Brodmann area 18 is important for the perception of light intensity, motion, and in the monitoring of color, shape, and visual patterns. Face-name association and word-face encoding are related to this area. If visual agnosia is present, the ability to track visual motion patterns and discriminate finger gestures may be compromised, as may be orientation and selective attention (another possibility is that these things may be heightened).',1),(229,51,228,230,20,0,1,1,1587059155,1587059191,'BA 19','<p>Brodmann area 19 is the associative visual area. It is also used for light intensity and pattern detection. This region comprises parts of the lingual gyrus, the cuneus, the middle occipital gyrus, and the superior occipital gyrus. This area is important in the spatial orientation of the stimulus.&nbsp; This area is also implicated in the focusing of attention and the phonological properties of written words.&nbsp;&nbsp;</p><p>The cuneus is responsible for the evaluation of stimuli. It is also implicated in the recall of episodic memory and has a role in pain perception. It is important in attention comprehension and visual processing. (Choo et al., 2012; Choo et al., 2009). It also plays a key role in the integration and synthesis of almost all sensory input.&nbsp; This area is also implicated in the distinction of self from other (Thompson &amp; Thompson, 2015). There is the possibility that one may feel anterograde amnesia when it is damaged. This area, lastly, is involved in the identification of pain and has connections to the hippocampus, the posterior parietal cortex, the posterior parahippocampal gyrus, and the dorsal striatum (all implicated in memory) (Thompson &amp; Thompson, 2015).</p>',1),(230,51,229,231,20,0,1,1,1587059200,1587059287,'BA 20','<p>Brodmann area 20 is the inferior temporal lobe. This region is implicated in the higher levels of the ventral stream of visual processing and the representation of complex object features. It also contains the fusiform gyrus and is thought to be involved in face perception. The most common symptom of inferior temporal lobe damage is visual agnosia, which involves impairment in the identification of familiar objects.&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-20.png\" alt=\"\" width=\"248\" height=\"398\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(231,51,230,232,20,0,1,1,1587059337,1587059567,'BA 21','<p>Brodmann areas 21 is over the temporal lobe, encompassing most of the lateral temporal cortex. This region is also referred to as the middle temporal cortex. This region is linked to sentence generation and word processing, specifically:</p><p><ul><ul><ul><li>Word generation&nbsp;</li><li>Monitor speech&nbsp;</li><li>Repeating words&nbsp;</li><li>Complex sounds&nbsp;</li><li>Deductive reasoning&nbsp;</li><li>Categorization&nbsp;</li><li>Observe motion&nbsp;</li><li>Complex sounds&nbsp;</li><li>Mirror neuron system&nbsp;</li></ul></ul></ul></p><p>This area of the brain is vital for long term memory, like facts and events. The structures in the medial temporal gyrus include the hippocampus, the amygdala, brainstems and other regions critical for memory formation and storage.</p><p>This area also holds the primary auditory cortex which is involved in high level auditory processing, and the processing of speech and words. This is an area where auditory signals from the cochlea reach the cerebral cortex and are processed by the primary auditory cortex.&nbsp;</p><p>The ventral part of the temporal cortices are involved in high-level visual processing of complex stimuli such as faces and scenes, and the anterior parts are for object perception and recognition.&nbsp;</p><p>Damage in this areas would lead to disturbance of auditory sensation and perception, disturbance of selective attention of auditory and visual input, disorders of visual perception, impaired organization and categorization of verbal material, disturbance of language comprehension, impaired long-term memory, and altered personality and affective behavior (Kolb &amp; Wilshaw, 1990).</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-21.png\" alt=\"\" width=\"258\" height=\"398\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p><br></p>',1),(232,51,231,233,20,0,1,1,1587059579,1587059654,'BA 22','<p>Brodmann area 22 is also known as Wernicke’s area, which is essential for auditory working memory. Responsible for auditory perception and processing, this is responsible for high-level auditory processing. It is possible that damage to this area would show a lack of discrimination for auditory detail, as well as difficulty in sentence generation. The left hemisphere helps with generation and understanding of individual words. On the right side of the brain it helps to discriminate pitch and sound intensity, both of which are necessary to perceive melody and prosody. This part of the brain is active in processing language and is part of Wernicke\'s area. The other main region included in Wernicke\'s area is Brodmann area 40, the supramarginal gyrus.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-22.png\" alt=\"\" width=\"265\" height=\"387\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p><br></p>',1),(233,51,232,234,20,0,1,1,1587059672,1587059759,'BA 23','<p>Brodmann area 23 is part of the posterior cingulate cortex. This area is also known as ventral posterior cingulate area 23. The PCC is a highly connected node in the brain. This is a fundamental area of intersection for all of the networks in the brain to convene and converge into what is called the rich club. The name “rich club” is analogous to social systems, where highly central individuals— being rich in connections—form a highly interconnected club (Zhou &amp; Mondragon, 2004). Rich clubs are very similar to the substation system in power grids. The substations are there to facilitate the transmission of power, disseminating loads at appropriate intervals to conjoining substations, allowing for the ease of transmission and the prevention of system failure.</p><p>The PCC mediates the person’s recognition of the existence in space. The precuneus is here and it may hold a good deal of a person’s autobiographical memory, and in that, her sense of identity. This area is poorly infused with blood in fMRI studies of the DMN in patients with developmental trauma. The DMN networks cycle at .1 hz.&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-23.png\" alt=\"BA 23\" width=\"258\" height=\"394\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(234,51,233,235,20,0,1,1,1587059767,1587059859,'BA 24','<p>This Brodmann area occupies most of the anterior cingulate gyrus in an arc around the genu of the corpus callosum. Its outer border corresponds approximately to the cingulate sulcus.&nbsp;</p><p>Broadmann area 24 is responsible for several types of attention, arousal and inhibition of responses, and memory (like episodic and those related to odor and taste). It is involved in learning the value of actions (performance monitoring with adjustments made by orbital frontal cortex and the dosro lateral pre frontal cortex, and detecting uncertainty. It play a major role in the Intention Network ( (9R, 47R, 20R, 38L, 24LR, 21LR, cerebellum), and verbal initiation. This region deals with mood swings, worry, self-other overlap and novelty seeking personality. Francis Crick listed area 24 as the seat of free will because of its centrality in amotivational syndromes.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-24.png\" alt=\"BA 24\" width=\"294\" height=\"467\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(235,51,234,236,20,0,1,1,1587059882,1587059915,'Anterior Cingulate Cortex','<p>The anterior cingulate cortex is a collar of white matter that surrounds the corpus callosum (the bundle of fibers that connects the hemispheres of the brain. This is a major network hub of the brain, responsible for the integration of network activity of all sorts.&nbsp; The anterior cingulate cortex is responsible for much of our autonomic functioning, including heart rate, decision making, empathy, impulse control and emotion.&nbsp;&nbsp;</p><p>Mood Disorders are often seen stemming from a dysregulation in this area and can manifest as depression, amotivational, and angry behaviors. The ACC can also be disorganized if one was predispositioned towards developmental trauma.</p><p>Studies on meditators of various disciplines (notably transcendental meditation) show the anterior cingulate gyrus as activated by alpha when in deep states.&nbsp; This has been linked to a surge in dopamine, in honing of attention (and expertise in attention), and in the ability to self-regulate easily.&nbsp; The ACC is disorganized in developmental trauma. Hyperreactivity of the anterior cingulate is also the brain signature of OCD (also in substance abuse).</p><p><br></p>',1),(236,51,235,237,20,0,1,1,1587059936,1587060026,'BA 25','<p>This area of the brain, Brodmann area 25, is called the subgenual area because it is “below the knee” of the corpus callosum. This area is very deep in the midline cortex and has an very important link to the affect network. It is this area that is considered to be of key intervention to people who have intractable depression. It is rich in serotonin transporters and is influential in many networks. This area governs personality and social behavior, such as moral reasoning and the evaluation of emotional words. It influences the hypothalamus and the brain stem, which are involved in sleep and appetite, as well as the hippocampus, which is essential for memory formation and self-esteem.&nbsp;</p><p>Irregular independent components at the subgenual anterior cingulate affect the function of the brains’ Error Detection and Correction processes.&nbsp; This system which can be stuck in the “off position” as much as it can get stuck “on.” Usually if you are getting a lot of error codes (“that’s wrong,” “did you forget to lock the door,” etc.) a significant marker here could signify an obsessive compulsive or oppositional defiant disorders. The anterior midline holds a model of what is going on in the world at the Subgenual Anterior Cingulate location. When that spot is not working properly, you end up having error codes.&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-25.png\" alt=\"BA 25\" width=\"260\" height=\"383\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(237,51,236,238,20,0,1,1,1587060037,1587060077,'BA 26','<p style=\"text-align: left;\">Brodmann area 26 is located at the isthmus of the posterior cingulate gyrus. Its role is not well defined.<br></p>',1),(238,51,237,239,20,0,1,1,1587060084,1587060267,'BAs 27 & 28 ','<p style=\"text-align: left;\">Brodmann area 27 is a&nbsp; cortical area that is a rostral part of the parahippocampal gyrus of the guenon. Brodmann areas 27, 28, 36 and 37 exist in the parahippocampal or fusiform gyrus of the ventral temporal lobe in humans. These regions of the brain are responsible for representing space, such as those involving head-direction cells or grid cells, in areas 27 (the parasubicular cortex) and 28 (the ventral entorhinal cortex).</p><p style=\"text-align: left;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-28.png\" alt=\"\" width=\"256\" height=\"381\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(239,51,238,240,20,0,1,1,1587060287,1587060397,'BA 29','Brodmann area 29 is the medial area of the cortex that is part of the paralimbic cortex, involved in semantic associations (not conscious) and novelty. It is one of the less studied areas of the brain.  It lies between the posterior cingulate are the hippocampal areas and may be integral to the synthesization and integration of new information (i.e. memory).<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-29.png\" alt=\"\" width=\"259\" height=\"400\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p>',1),(240,51,239,241,20,0,1,1,1587060408,1587060484,'BA 30','Brodmann area 30 is the retrosplenial region and is part of the cingulate cortex and cuneus. This area is implicated in the affect, memory, and default mode network. It has a role in attending to speech, listening to sentences and understanding the emotional aspects of words. It has connection to limbic areas and is implicated in mood regulation. It is one of the central midline structures, is involved in the default mode network, and has a role in appraisal of one’s self (insight) (Thompson &amp; Thompson, 2015).<br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-30.png\" alt=\"\" width=\"254\" height=\"392\" role=\"presentation\" style=\"font-size: 1rem;\" class=\"img-responsive atto_image_button_text-bottom\"></p>',1),(241,51,240,242,20,0,1,1,1587060491,1587060601,'BA 31','Brodmann area 31, also known as dorsal posterior cingulate area 31, is a subdivision of the cytoarchitecturally defined cingulate region of the cerebral cortex. In the human it occupies portions of the posterior cingulate gyrus and medial aspect of the parietal lobe. The region is typically discussed as having a unitary function because of a common pattern of relative deactivation observed during attentionally demanding tasks. One influential hypothesis is that the posterior cingulate cortex has a central role in supporting internally-directed cognition. It is a key node in the default mode network and shows increased activity when individuals retrieve autobiographical memories or plan for the future, as well as during unconstrained ‘rest’ when activity in the brain is mind wandering.<br>',1),(242,51,241,243,20,0,1,1,1587060609,1587060922,'BA 32','<p>This area is also known in the human brain as the <b>dorsal anterior cingulate area 32</b>, which controls self-monitoring of current emotional or somatic states, such as the anticipation and detection of targets (indicating novelty), the influence of motor responses, and the cognitive control of action selection, such as detecting errors when reward was expected for an action, but did not materialize.&nbsp; Involved in reward-based decision making and activated by active distress.</p><p>The ACC functions to inhibit the firing of the amygdala. It is often referred to as the transitional limbic cortex because it lies at the transition between the cortical and the subcortical regions. Joseph (1996) describes the ACC as “a supra-modal area that is involved in the integration of motor tactile, autonomic, and emotional stimuli, as well as in the production of emotional sounds and the capacity to experience psychological pain and misery (p.243). In some abuse cases, this area has little blood flow; no blood flow means little neuronal activation, which likely correlates directly to the sense of the self as a black hole—as non-existent.</p><p><b>Brodmann area 32L controls</b></p><p><ul><ul><ul><li>Visual uncertainty&nbsp;</li><li>Mood regulation&nbsp;</li><li>Evaluate emotional words&nbsp;</li></ul></ul></ul></p><p><b>Brodmann area 32 Right controls</b></p><p><ul><ul><ul><li>Sustain response set&nbsp;</li><li>Identify pain&nbsp;</li><li>Self-insight&nbsp;</li><li>Reward&nbsp;</li><li>Reappraise negative emotions&nbsp;</li></ul></ul></ul><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-32.png\" alt=\"\" width=\"436\" height=\"681\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p></p>',1),(243,51,242,244,20,0,1,1,1587060937,1587061002,'BA 33 ','<p style=\"text-align: left;\">Brodmann area 33 is part of anterior cingulate cortex is a subdivision of the cytoarchitecturally defined cingulate region of cerebral cortex. It is a narrow band located in the anterior cingulate gyrus adjacent to thesupracallosal gyrus in the depth of the callosal sulcus, near the genu of the corpus callosum.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-33.png\" alt=\"\" width=\"252\" height=\"393\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p>',1),(244,51,243,245,20,0,1,1,1587061048,1587061164,'BA 34','Area 34 of Brodmann refers to a subdivision of the cytoarchitecturally defined hippocampal region of the human cerebral cortex. It is located in the entorhinal area on the medial aspect of the temporal lobe.&nbsp;<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-34.png\" alt=\"\" width=\"258\" height=\"369\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p>',1),(245,51,244,246,20,0,1,1,1587061170,1587061270,'BA 35','<p>Brodmann area 35 is perirhinal area 35. It is a subdivision of the cytoarchitecturally defined hippocampal region of the cerebral cortex. In the human it is located along the rhinal sulcus. Cytoarchitectually it is bounded medially by the entorhinal area 28 and laterally by the ectorhinal area 36.</p><p>The hippocampus is responsible for synthesizing short term into long term memory, episodic memory, autonomic processes, response inhibition, and spatial cognition. Hippocampus damage can lead to anxiety disorders and an inability to suppress responses that have been conditioned. It also encodes emotional responses from the amygdala. Damage to the hippocampus will result in the inability to form new memories. This is also an area that is responsible for conflict detection and approach-avoidance behaviors, linking it to some anxiety conditions.</p><p>There are two hippocampi—one for each hemisphere. Each has a different role in memory. The RH hippocampus records memory in spatial and temporal fields and the LH holds verbal memory. The RH hippocampus is central to implicit, non verbal memory—in a sense, unremembered memory. When RH memory begins to return, it is often in felt experiences and in pictures and in spatial contexts. The LH hippocampus is involved in declarative or explicit memory, also called semantic memory (i.e. related to words), and gives us the ability to used words to communicate emotional states. Sustained stress and high levels of circulating cortisol and other stress hormones (i.e. glucocorticoids) lead to a smaller hippocampus, structurally, and as a result, to impaired memory. “ A likely explanation is that the shrinkage in the hippocampus is due to the effects of heightened cortisol, which is known to be toxic to the hippocampus” (van der Kolk, 2007, p. 233).</p><p>The hippocampus is responsible for synthesizing short term into long term memory, episodic memory, autonomic processes, response inhibition, and spatial cognition. Hippocampus damage can lead to anxiety disorders and an inability to suppress responses that have been conditioned. It also encodes emotional responses from the amygdala. Damage to the hippocampus will result in the inability to form new memories. This is also an area that is responsible for conflict detection and approach-avoidance behaviors, linking it to some anxiety conditions. The flow of information in the hippocampus is mostly unidirectional, or so called feed forward&nbsp; (Buszaki. 70).</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-35.png\" alt=\"\" width=\"248\" height=\"380\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p>',1),(246,51,245,247,20,0,1,1,1587061176,1587061334,'BA 36','<p>Ectorhinal area 36 is a subdivision of the cytoarchitecturally defined temporal region of cerebral cortex. With its medial boundary corresponding approximately to the rhinal sulcus it is located primarily in the fusiform gyrus, which is respsonbiel for the recognition of faces. Cytoarchitecturally it is bounded laterally and caudally by the inferior temporal area 20, medially by the perirhinal area 35 and rostrally by the temporopolar area 38</p><p>Area 36 (the lateral perirhinal cortex) is crucial for various types of associative learning. Earlier human neuroimaging studies have also indicated that faces, bodies and visual word forms are represented in different regions of area 37 in the posterior fusiform gyrus. Recent neuroimaging studies in humans have shown substantial functional differentiation between face-related regions in areas 37 and 36, which is similar to that seen in macaque monkeys, as shown through their face patches. This implies the crucial involvement of both areas in face processing.&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-36.png\" alt=\"\" width=\"253\" height=\"383\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p>',1),(247,51,246,248,20,0,1,1,1587061403,1587061489,'BA 37','<p style=\"text-align: left;\">This area is known as occipitotemporal area 37. It is a subdivision of the cytoarchitecturally defined temporal region of cerebral cortex. Left BA37 is a common node of two distinct networks—visual recognition.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-37.png\" alt=\"\" width=\"254\" height=\"397\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p>',1),(248,51,247,249,20,0,1,1,1587061503,1587061628,'BA 38','<p>BA 38 is part of the temporal cortex. The temporal pole is a paralimbic region involved in high level semantic representation and socio-emotional processing. The uncinate fasciculus provides a direct bidirectional path to the orbitofrontal cortex, allowing mnemonic representations stored in the temporal pole to bias decision making in the frontal lobe. The temporal pole appears to be a convergence zone where semantic memories that are stored in the ventral anterior temporal lobe are imbued with emotional significance and personal meaning.&nbsp; In addition, concepts of individual people, abstracted away from the perceptual representations, are stored in a “face patch” in the temporal pole. This face patch is found in both non-human primates and humans.&nbsp; This relates to early work showing that damage to the temporal pole can cause an amnestic prosopanosia in which knowledge of familiar people is lost.&nbsp;&nbsp;</p><p>Bilateral damage to the temporal poles, though rare, can cause dramatic changes in personality. Kluver-Bucy syndrome involves damage to the greater temporal pole as well as the amygdala. In this disorder, individuals demonstrate fearlessness, hyper sexuality, and hyper orality.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-38.png\" alt=\"\" width=\"254\" height=\"397\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(249,51,248,250,20,0,1,1,1587061663,1587061741,'BA 39','<p>BA39 encompasses the angular gyrus, lying near to the junction of temporal, occipital and parietal lobes. This region is thought to have correlation with the visual representation of words and phonemes, damage to Brodmann area 39 may result in dyslexia or in semantic aphasia. Albert Einstein had more glia in this region than the normal person and it has been hypothesized this is why he had remarkable mathematical genius.</p><p><br></p>',1),(250,51,249,251,20,0,1,1,1587061761,1587061850,'BA 40','<p>Brodmann area 40 is located the inferior parietal lobule. This region of the brain is responsible for: attention to phonemes, categorization, verbal creativity, aversiveness, emotional working memory, conscious recollection, visual grasping, gesture imitation, visuomotor planning, intention/conflict detection, deduction, empathy, and goals.</p><p>Brodmann area 40 is responsible for attendance to calculation, phonemes, categorization, verbal creativity, aversiveness, emotional working memory, conscious recollection, visual grasping, gesture imitation, visuomotor planning, Repetitive passive movements, intention/conflict detection, deduction, empathy , music performance, goals, imitation of novel actions.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-40.png\" alt=\"\" width=\"258\" height=\"387\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(251,51,250,252,20,0,1,1,1587061857,1587062020,'BA 41 and 42','<p>Brodmann areas 41, and 42 are all parts of the auditory cortex. In extreme cases, damage here will show loss in the conscious awareness of sound, 41 and 42 are areas that comprise Herschel’s gyrus, an area that is known for picking up and recognizing the paralinguistics of speech (including prosody, tone, gait, tenor, timbre, tempo, volume, and patterns). This area is responsible for how we decode what the other is saying. Herschl’s gyrus and has a direct corollary to the densely packed cochlear nucleus, which is responsible for the processing of sounds. In this region of the brain words and sounds are decoded through the heteromodal association cortex and are given meaning through the angular gyrus, where they are then related to other words and meanings encountered in the past.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-41.png\" alt=\"BA 41\" width=\"489\" height=\"757\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(252,51,251,253,20,0,1,1,1587062028,1587062181,'BA 43','<p>Brodmann Area 43 responds to pressure on the eardrum and to oral intake (eating and drinking). Because eating and drinking change pressure on the middle ear and eardrum, Brodmann Area 43 may be the primary somatosensory cortex of the eardrum.</p><p>Additionally, Brodmann Area 43 was found to be functionally active in a study differentiating the roles of the left-frontal and right-cerebellar regions during semantic analysis. Brodmann Area 43 showed a major increase in functional activation by fMRI, when study participants were asked to complete tasks which involved the selection of a verbal response from many possible responses, rather than a sustained search for a verbal response from few possible responses.&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-43.png\" alt=\"BA 41\" width=\"256\" height=\"391\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(253,51,252,254,20,0,1,1,1587062188,1587062348,'BA 44 and 45','<p>Brodmann areas 44 and 45 are the pars opercularis and the pars triangularis, respectively. These areas are part of Broca’s area and cover the insula. Broca’s area was discovered in a patient who was unable to produce speech. This area is importance for semantics, phonetics, as well as verbal understanding, speech articulation, grammatical processing, and speech fluency. Boiled down, this is the area that enables us to speak. When compromised, we may see difficulty producing speech, stuttering, and other symptoms of difficulty producing words. This area is also important for internal speech and the internal rehearsal of information.&nbsp;</p><p>The pars traingularis (Brodmann area 45) is important in memory networks, particularly episodic, syntactic, semantic, and declarative memory encoding. When reading aloud, this area allows for the decoding and correct pronunciation of speech&nbsp; (Thompson &amp; Thompson, 2015, p. 51-52).</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-45.png\" alt=\"\" width=\"538\" height=\"700\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(254,51,253,255,20,0,1,1,1587062374,1587062497,'BA 46','<p>Brodmannn area 46 is intimately connected to areas 8 and 9, all the executive regions of the brain.&nbsp; These are the areas of the prefrontal dorsolateral cortex, which are implicated in making judgments, planning, monitoring, revising, sustaining attention, working memory, inhibition of responses, willed actions and verbal and episodic memory retrieval.&nbsp; Mirror neurons are located here. Spatial information is also processed here (Thompson &amp; Thompson, 2015).</p>',1),(255,51,254,0,20,0,1,1,1587062508,1587062613,'BA 47','<p>Brodmann area 47 is part of the frontal cortex that curves from the lateral surface of the brain to into the orbital frontal cortex. This area is implicated in deductive reasoning, language and emotions. It is located in the pre-frontal cortex near Brodmann areas 9 and 10, parallel to Brodmann area 11.&nbsp; This area is part of the executive network and is important in processing syntax and semantics of language (oral and sign language) categorization and aspects of language and speech. It is also important for episodic and working memory. It is one of the key areas for deductive reasoning and is important in making inferences, as well as monitoring actions and incoming information and behavior. Lastly, it is important in the temporal coherence of processing music (Thompson &amp; Thompson, 2015, p. 54).&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ba-47.png\" alt=\"\" width=\"483\" height=\"728\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(256,52,0,257,20,0,1,1,1587062796,0,'Basic','<p>The discovery of neurotransmitters and the firing of the EEG were different discoveries. Hans Berger was not the first electroencephalographer (Caton was), but Berger was the first to dedicate time to studying the firing of the brain. Berger was excessively self-conscious about his initial findings on EEG, so much so that he undertook 5 years of testing and surveying the results of his studies on EEG before he released it to the public in report form. Loewi was the first neuroscientist to prove that neurotransmistters are released in the junction (synapse) between the vagus nerve and the heart muscle. He received a Nobel Prize with Henry Hallett Dale from Cambridge England in 1936 for their discoveries. Loewi wrote: -</p><div class=\"editor-indent\" style=\"margin-left: 30px;\"><p><i>The night before Easter Sunday of that year, I awoke, turned on the light, and jotted down a few notes on a tiny slip of thin paper. Then I fell asleep again. It occurred to me at six o’clock in the morning that I had written down something most important, but I was unable to decipher the scrawl. The next night, at three o’clock, the idea returned. It was the experiment to determine whether or not the hypothesis of chemical transmission that I had though about years ago was correct. I got up immediately, went of&nbsp; the laboratory, and performeds a simple experiment on a frog heart according to the nocturnal design. (Loewi, 1960, 15).</i></p></div>',1),(257,52,256,258,20,0,1,1,1587062803,1587063295,'Neuron','<p>The major cell of the central nervous system is the <b><u>neuron</u></b>. Neurons are pretty much the most basic unit of the brain, as well as the most complicated cell in the human body.</p><p>The brain has about 100 billion neurons with an estimated 200 trillion connections between them (Buszaki, 2006). A neuron has a cell body (also called soma, or perikaryon); dendrites, which are the branched&nbsp; projections of a neuron that act to conduct the electrical stimulation received from other neural cells to the cell body, or soma, of the neuron from which the dendrites project. Dendrites extend a short distance from the soma (each of them having spines that absorb neurotransmitter); and an axon (also called fiber), which connects one neuron with others. The fibrous axons occupy more space in the brain than neurons, dendrites, and spines combined.&nbsp;</p><p>Neuronal membranes are specialized for electro-chemical events, the firing of action potentials and the release/reception of neurostransmitters. This is how neurons communicate to one another. The dendrites and cell bodies of the neurons receive information, and the axons transmit the ﬁring pattern of the cell to the next neuron. Generally, each neuron receives synaptic input from hundreds or perhaps thousands of other neurons, and its axon distributes this information via collaterals (branches) to hundreds of other neurons. The overwhelming majority of neurons are used for the processing of information and are called interneurons. The more dramatic the level of processing, the more the interneurons are involved.</p><p>Neurons prefer to take the shortest paths with their surrounding peers. They receive most of their information from their immediate neighbors and act locally (p. 45). In order to communicate with distant neurons, it requires the use of costly connections metabolic resources and connections to transporting electrical pulses over long distances (Buzsaki, 2006).</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/synapses.png\" alt=\"\" width=\"216\" height=\"165\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">Communication between neurons occurs almost exclusively at specialized junctions called&nbsp; <b>synapses</b>, using biological molecules called <b>neurotransmitters</b>. Neurotransmitters modify ion movements across the neuronal membranes of the synapse and alter neurotransmission (with each action potential neurotransmitters travel across the synaptic gap) — neurotransmitters can be excitatory or inhibitory in their action, or modulate synaptic excitability. The post-synaptic neuron will modify its ﬁring pattern depending on the summative effect of all the synapses acting upon it at any moment in time. The action of neurotransmitters depends also on the speciﬁc receptor type; there is an ever-increasing number of receptor subtypes allowing for even more complexity of information processing within the CNS. Drugs are being designed to act on those receptors for therapeutic purposes.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/axon.png\" alt=\"\" width=\"670\" height=\"374\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p>When measuring EEG—we are measuring “action potentials” along the axon. An action potential is a firing—bam!—that is the swapping of potassium and sodium along the border of the axon. Much of the substance of the brain consists of <b>axons</b>, also called ﬁbers, which connect one part of the brain with other areas. Low frequency oscillations (i.e., delta and theta) coordinate long-range communications, between lobes of the brain (von Stein, Chiang, &amp; Konig, 2000).&nbsp;</p><p>This stage of wiring the brain happens in utero, with the long connections being the most fundamental (Grubin, 2011). It is these long fibrous white matter tracks that theta and delta traverse. Many of the axons are myelinated by oligodendrocites (a type of glial cell), this “insulation,”&nbsp; serve to increase the speed of axonal conduction; the thicker the <b>myelin sheath</b>, the faster the conduction. Axons originating from one area (cortex or nucleus) and destined for another area usually group together and form a tract, also called a pathway (or fasciculus).</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/mitochondrion.png\" alt=\"\" width=\"679\" height=\"419\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: left;\">Moreover, there are even more numerous glial cells and finely branch blood vessels that support and nourish the neurons. The neuronal circuits in each subdivision constitute local networks, which are further integrated to form global neural systems across subdivisions or divisions. Current neuroscience is based on the belief that these networks and systems operate through specific mechanisms and play specific functional roles in the living body.<br></p><p style=\"text-align: left;\"><br></p>',1),(258,52,257,259,20,0,1,1,1587063314,1587063715,'Glia','<p>Other than neurons, the other major cells of the Central nervous system are glia; there are more glia than neurons. There are two types of glial cells:&nbsp;</p><p><ul><ul><ul><li>Astrocytes, which are involved in supportive structural and metabolic events&nbsp;</li><li>Oligodendrocytes, which are responsible for the formation and maintenance of the myelin that ensheaths the axons.</li></ul></ul></ul><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/glia.png\" alt=\"\" width=\"600\" height=\"600\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p>Neural circuits that produce a self-sustaining pattern of behavior are called central pattern generators. The most studied central pattern generator is an intraspinal network of neurons responsible for locomotion (Buszaki, vii). Oscillators coordinate or synchronize various opertions within and across neuronal networks (viii). Compromised oscillators lead to rhythm-based cognitive maladies: epilepsy, parkinson’s, and sleep disorders.</p></p><p>The brain “chunks” or segregates perceived events according to its ability to package information in time, and such packaging, I propose, can be achieved by neuronal oscillations (p. 10)</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/basal-ganglia-and-limbic-system.png\" alt=\"\" width=\"875\" height=\"788\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(259,52,258,260,20,0,1,1,1587063726,1587063773,'Diencephalon','<p><b>Thalamus</b></p><p>I also look at the posterior alpha peak which is the rhythm responding to eye open/close, not just 8-12. The thalamus makes activity from 3 to 20 Hz... so it can be mistaken for \'theta\' easily..&nbsp; The thalamus also becomes rhythmic with ACH, with this provided by the \'reticular nucleus of the thalamus\' (a thin \"skin\" surrounding the rest of the thalamus).</p>',1),(260,52,259,261,20,0,1,1,1587063779,1587063986,'Ventricles','<p><b>Cingulate</b></p><p><span>Developmental trauma seems to impact the cingulate’s function. Circuitry connecting homologous sites in the LH and RH pass through the cingulate. It is divided into anterior and posterior regions, which have separate but complementary functions.</span></p><p>Networks are built of nodes and connections; nodes are highly connected and highly central neocortical regions in the brain that are responsible for the integration of information, globally (across many networks) (Van den Heuvel &amp; Sporns, 2011). Some nodes are more densely connected than others, some less. Rubinov and Sporns (2010) identified different nodes as different kinds of hubs, based upon their level of participation in their respective networks, or communities, as well as their level of connectedness to other modules.&nbsp;&nbsp;</p><p><b>Cuneus and PCC</b></p><p>Observations of the default mode network (DMN) during sleep show, just as during the DMN activity in mind wandering, that portions of the pre-frontal cortex are active during dreaming, as are the medial temporal lobe structures and the posterior cingulate (all of these points are nodes that make up the network of the DMN). Conversely, other studies show that, in REM sleep, executive-processing regions of the pre-frontal cortex are mostly deactivated, beyond levels seen during waking mind wandering, which suggests that dreaming may be an “intensified” version of waking mind wandering (Fox, Nijeboer, Solomonova, Domhoff, &amp; Christoff., 2015). Rizzolatti, Semi, &amp; Fabbri-Destro (2013) contend that the activation of the DMN might correspond to the psychoanalytic unconscious (p. 5).</p><p><b>Ventro-Medial Pre-frontal cortices</b></p><p>The left ventro-lateral pre-frontal cortex (VMFPC), an area responsible for high level executive processing. Excessive high amplitude beta in the occipital and posterior temporal regions is often responsible for feelings of stress, anxiety, and overwhelm, with or without a stressful stimulus. The temporal regions are known for sensorial processing.&nbsp;</p><p>F7, the ventro-medial prefrontal cortex, is important in deductive reasoning. The nature and importance of deductive reasoning in the condition of OCD may be one reason the amplitude of beta is higher at these regions of the brain. This area is also important for the production of words (as it is a part of the brain called Broca’s area) and it may also be important for the imitation of movements and in the copying of social interactions 9as it pertains to predicting the behavior of others).&nbsp;</p><p><b>F7</b></p><p>The F7 site (left hand side) is located above the ventromedial prefrontal cortex, but also affects the dorsolateral prefrontal cortex and the executive system. This includes auditory working memory, selective attention, word retrieval, and functions related to Broca’s area, including word generation. Mood regulation dealing with emotional-contextual information also has to do with this area, as well as verbal fluency, lexical functions, phonemes, grammar and syntax. This area is also involved in episodic, declarative, and working memory. This area covers Brodmann areas 44, 45 and 46. On the right hand side, in adults (F8), this involves spatial and visual working memory, sustained attention, prosody, sensing the gestalt, and the conscious processing of facial recognition and emotions (Thompson &amp; Thompson, 2015, p. 53).&nbsp; These bilateral areas (F7 and F8) have links to the medial prefrontal cortex, the insula, and the anterior cingulate, which are involved in the cortisol secretion related to stress (Levine et al, 1998).&nbsp;</p><p><br></p>',1),(261,52,260,263,20,0,1,1,1587063992,1587064257,'The Limbic System','<p>Any \"theta band\" activity may be slowed thalamo-cortical alpha or limbically generated rhythmic slow activity (theta), as stated in Steriade\'s 1990 IFCN position paper on EEG rhythm generators.&nbsp;&nbsp;</p><p><span style=\"font-size: 1rem;\">The limbic projections are spatially limited cortically at the frontal/central midline via the cingulate as well as the temporal locations seen from the parahippocampal cortex. The parahippocampal cortex reflects the temporal lobe\'s monopoles of the hippocampus and Amygdala. Monopoles are not seen exteriorly directly, but we often see a reflection in adjacent areas even without the direct measurement.... this s the case with the cingulate theta which reflects nucleus accumbens activity seen in \"FMT\" frontal midline theta seen in brief bursts on memory retrieval tasks as the NA provides ACH to the temporal lobe\'s limbic structures via the diagonal band of Brocca connected to the amygdala/hippocampus complex allowing rhythmicity.</span><br></p><p><b>Precuneus</b></p><p>The precuneus&nbsp; is suggested to be the \'core node\' or \'hub\' of the default mode network, a web of connections that are activated during \"resting consciousness\" in which people do not engage intentionally in sensory or motor activity. This involvement in the default network is suggested to underlie its role in self consciousness.&nbsp; It is one of the areas of the brain most deactivated during slow-wave sleep and rapid eye movement sleep and&nbsp; is involved in memory tasks, including episodic memory, source memory, and contextual associations. Lastly, it is also, together with the dorsal premotor cortex, involved in visuospatial mental operations.&nbsp; While the premotor area engages in the mental operation, the precuneus aids monitoring the success of that operation in terms of internally represented visual images.</p><p><b>Amygdala</b></p><p>The small almond shaped amygdala lies deep in the temporal lobe and is involved primarily in rage, shame, and fear reactions, but also more generally in establishing the emotional valance of incoming stimuli. The RH amygdala is devoted to survival and reacts to threats, both real and perceived (63). This area of the brain is prone to kindling, which is essentially repetitive Neuronal firing that gives rise to high amplitudes, until the pattern collapses. Each kindling lowers the threshold of the future ones, making them more likely.</p><p><b>Cuneus &amp; PCC</b></p><p>The areas, subcortically, which appear to be the origin of the excessive delta and theta are the cuneus and the posterior cingulate cortex. Both of these areas are implicated in the use of the default mode network, one of the basic resting state networks of the brain.&nbsp; Observations of the default mode network (DMN) during sleep show, just as during the DMN activity in mind wandering, that portions of the pre-frontal cortex are active during dreaming, as are the medial temporal lobe structures and the posterior cingulate (all of these points are nodes that make up the network of the DMN). Conversely, other studies show that, in REM sleep, executive-processing regions of the pre-frontal cortex are mostly deactivated, beyond levels seen during waking mind wandering, which suggests that dreaming may be an “intensified” version of waking mind wandering (Fox, Nijeboer, Solomonova, Domhoff, &amp; Christoff., 2015). Rizzolatti, Semi, &amp; Fabbri-Destro (2013) contend that the activation of the DMN might correspond to the psychoanalytic unconscious (p. 5).</p><p>This area is responsible for the evaluation of stimuli. It is also implicated in the recall of episodic memory and has a role in pain perception. It is important in attention comprehension and visual processing. (Choo et al., 2012; Choo et al., 2009). It also plays a key role in the integration and synthesis of almost all sensory input.&nbsp; This area is also implicated in the distinction of self from other (Thompson &amp; Thompson, 2015). There is the possibility that one may feel anterograde amnesia when it is damaged. This area, lastly, is involved in the identification of pain and has connections to the hippocampus, the posterior parietal cortex, the posterior parahippocampal gyrus, and the dorsal striatum (all implicated in memory) (Thompson &amp; Thompson, 2015).</p><p><b>VMPFC</b></p><p>The F7 site (left hand side) is located above the ventromedial prefrontal cortex, but also affects the dorsolateral prefrontal cortex and the executive system. This includes auditory working memory, selective attention, word retrieval, and functions related to Broca’s area, including word generation. Mood regulation dealing with emotional-contextual information also has to do with this area, as well as verbal fluency, lexical functions, phonemes, grammar and syntax. This area is also involved in episodic, declarative, and working memory. This area covers Brodmann areas 44, 45 and 46. On the right hand side, in adults (F8), this involves spatial and visual working memory, sustained attention, prosody, sensing the gestalt, and the conscious processing of facial recognition and emotions (Thompson &amp; Thompson, 2015, p. 53).&nbsp; These bilateral areas (F7 and F8) have links to the medial prefrontal cortex, the insula, and the anterior cingulate, which are involved in the cortisol secretion related to stress (Levine et al, 1998).</p>',1),(263,52,261,264,20,0,1,1,1587064416,1587064592,'PCC','<p><b>Blood Supply</b></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/blood-supply.png\" alt=\"\" width=\"380\" height=\"350\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p><br></p><p><b>Functional Systems</b></p><p>One of the most basic laws of the universe is the law of periodicity. This law governs all manifestations of living and non-living. In its broadest definition, periodicity refers to the quality, state, or fact of being regularly recurrent: a repeating pattern or structure in time or space. What goes up must come down. The sun rises and sets, and the days wax and wane. Without periodicity there is no time, without time, there is no past, present or future. In living systems, the periodicity of individual lives gives rise to the continuity of life on Earth. Our existence has meaning only when experienced in time. ” (Buszaki, p. 5).</p><p>Resting state networks</p><p><b>Sensory Systems&nbsp;</b><br></p><p style=\"text-align: center;\"><b><img src=\"@@PLUGINFILE@@/sensory-systems.png\" alt=\"\" width=\"492\" height=\"324\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></b></p><p><p lang=\"en-US\" align=\"LEFT\">\r\nSensory\r\nhomunculus has genitals in side.</p><p lang=\"en-US\" align=\"LEFT\"><br></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/frontal-lobe.png\" alt=\"\" width=\"500\" height=\"425\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: left;\">Frontal lobes have the abilty to regulate eye movement this is visual accommodation and convergence, the ability of the eyes to go left and right and focus and read.&nbsp; There is a physiological problem with ADD/ADHD kids—they have more doffoculty keepingtheir eyes still.<br></p><br></p>',1),(264,52,263,265,20,0,1,1,1587064626,1587064779,'Motor Systems','<p><b>Networks</b></p><p>Neural&nbsp; networks self-organize t in such a way that principle cells will not be trapped in a perpetually excitatory state, nor will they become completely suppressed. The network will maintain itself in this metastable state until perturbed. This maintained phase transition is called “self-organized criticality” in physics. (64)</p><p><b>RESTING STATE NETWORKS</b></p><p>These corresponded to: default mode network (DMN), dorsal atten- tion network (DAN), ventral attention network (VAN), right frontoparietal network (rFPN), left frontoparietal net- work (lFPN), language network (LN), cingulo-opercular network (CON), auditory network (AN), ventral somato- motor network (VSN), dorsal somatomotor network (DSN), visual foveal network (VFN), visual peripheral net- work (VPN), medial prefrontal network (MPN), and lateral prefrontal network (LPN),&nbsp;</p><p>Neuronal oscillations supporting functional interactions between distant brain regions are thought to be mainly in the alpha and beta bands. To test this directly on our data, we examined the performance in RSN reconstruction for different frequency bands. Notably, the DMN could be fully reconstructed using alpha-band power envelopes, and only partially using power envelopes for delta, theta, beta, and gamma bands (Fig. 3). When we extended this analysis to other networks (see Methods), we noticed that some of these could be better reconstructed with power envelopes of other frequency bands than the alpha one. Thus, there was no frequency band that was optimal for all networks (Supporting Information Fig. S7).</p><p>The default mode network is an area o the brain that is active when the brain is in wakeful rest. Generally speaking, w hen we are not doing anything in particular, but are instead simply “being.” When we see hypo phase lag, as we do here, there is a possibility that the DMN is off balance, and that the process of resting in a present state is off balance.</p><p><br></p><p><img src=\"@@PLUGINFILE@@/eeg-rsn-maps-obtained.png\" alt=\"\" width=\"1171\" height=\"861\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>',1),(265,52,264,266,20,0,1,1,1587064788,1587065980,'Reticular Formation','<p><b>Fasiculi</b></p><p><span><b>Short Fasiculi:</b> Also known as U-Fibers, shaped like a bow, which interconnect cortical regions.</span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/short-fasiculi.png\" alt=\"\" width=\"291\" height=\"181\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span><br></span></p><p style=\"text-align: left;\"><span><b>Superior Longitudinal Fasiculus: </b>Connects the frontal, temporal, parietal and occipital lobes<br></span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/short-fasiculi-long.png\" alt=\"\" width=\"262\" height=\"179\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span><br></span></p><p style=\"text-align: left;\"><span><p lang=\"en-US\" align=\"LEFT\"><b>\r\nArcuate\r\nFasiculus:</b> Subset of the Superior Longitudinal Fasiculus, connects\r\nBroca’s to Wernicke’s&nbsp;<span style=\"font-size: 1rem;\">Areas</span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/arcuate-fasiculus.png\" alt=\"\" width=\"271\" height=\"184\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: left;\"><span style=\"\"><b>Inferior Longitudinal Fasiculus: </b>Connects Occipital and Temporal Lobes<br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"\"><img src=\"@@PLUGINFILE@@/inferior-longitudinal-fasiculus.png\" alt=\"\" width=\"271\" height=\"184\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"\"><br></span></p><b>Uncinate Fasiculus: </b>Connects Anterior Temporal and Inferior frontal Lobes<br></span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/uncinate-fasiculus.png\" alt=\"\" width=\"257\" height=\"165\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span><br></span></p><p style=\"text-align: left;\"><span><b>Cingulum (C-shaped) fasiculus: </b>Connects the hemispheres and runs parallel with the cingulate and the parahippocampal gyrus<br></span></p><p style=\"text-align: left;\"><span><br></span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/cingulum.png\" alt=\"\" width=\"285\" height=\"175\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span><br></span></p><p style=\"text-align: left;\"><span><b>Perpendicular Fasiculus: </b>Runs up and down, intralobular in the occipital lobe<br></span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/perpendicular-fasiculus.png\" alt=\"\" width=\"265\" height=\"186\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span><br></span></p><p style=\"text-align: left;\"><span><p lang=\"en-US\" align=\"LEFT\"><span style=\"font-size: 1rem;\"><b>Corpus\r\nCallosum: </b>Bundle of fibers that connects the hemipsheres of the brain</span><br></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/corpus-callosum.png\" alt=\"\" width=\"435\" height=\"335\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: left;\"><span style=\"\"><b>Anterior Commisure:</b> connects the anterior temporal lobes and the olfactory bulbs<br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"\"><img src=\"@@PLUGINFILE@@/anterior-commisure.png\" alt=\"\" width=\"541\" height=\"375\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: left;\"><span style=\"\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: left;\"><span style=\"\"><b>Corona Radiata: </b>Connects the cortex to the subcortical structures, such as the thalamus, the brainstem, etc.<br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"\"><img src=\"@@PLUGINFILE@@/corona-radlata.png\" alt=\"\" width=\"243\" height=\"195\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"\"><br></span></p><p lang=\"en-US\" align=\"LEFT\" style=\"text-align: center;\"><span style=\"\"><br></span></p><br></span></p><p style=\"text-align: center;\"><span><br></span></p>',1),(266,52,265,0,20,0,1,1,1587065989,1587066200,'Internal Capsule','<p><span>The internal capsule is a thick sheet of white matter consisting of projection fibres passing to and from the cerebral cortex. It makes a sharp ‘knee-bend’ or genu around the apex of the lentiform nucleus (Latin: genu, knee). This gives it a V-shape when viewed in axial (horizontal) section (Fig. 3.22). There is therefore an anterior limb (between the lentiform nucleus and the head of the caudate nucleus) and a posterior limb (between the lentiform nucleus and the thalamus).</span></p><p><br></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/anterior-limb.png\" alt=\"\" width=\"406\" height=\"346\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span><br></span></p><p style=\"text-align: left;\"><span><b>Fornix: </b>The fornix (meaning \"arch\" in Latin) is a C-shaped bundle of nerve fibers in the brain that acts as the major output tract of the hippocampus. The fornix also carries some afferent fibres to the hippocampus from structures in the diencephalon and basal forebrain. The fornix is part of the limbic system.<br></span></p><p style=\"text-align: center;\"><span><img src=\"@@PLUGINFILE@@/fornix.png\" alt=\"\" width=\"544\" height=\"351\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span><br></span></p><p style=\"text-align: left;\"><span></span></p><p style=\"text-align: center;\"><span><br></span></p>',1),(267,53,0,268,20,0,1,1,1587141900,0,'Basic','<p>The definition of quantitative EEG is very broad and encompasses all quantified EEG in term of phase, coherence, power and/or other brain-computer interfaces. However, for the sake of simplicity, we will refer to the quantitative EEG as a test comparing the electroencephalography of the individual (EEG) to a normative database, which is a database of “normal” people within the clients age range who are physiologically and psychologically healthy. The individual is assessed from the perspective of how many standard deviations from the norm their EEG data occurs within.&nbsp; This creates what we know as a “brain map.” Maps are taken using standard deviations from the norm by way of or power output (measured in microvolts squared or microvolts—amplitude and magnitude, respectively).&nbsp; &nbsp; &nbsp;</p><p>When recording, traditionally in the field of neurotherapy, the international 10-20 system for electrode placement is used (a 19-channel cap) and electrode impedance of less than five kilo ohms is used. Activity at the functional regions of the brain, including Brodmann areas, can be incorporated into the findings with the use of Low Resolution Brain Electromagnetic Tomography (LORETA) software.</p><p>Typically, an EEG is recorded in two conditions: eyes open and eyes closed. A clinician can use as many or as few databases as they wish, each database has its own high points and short comings.&nbsp; Depending on the database, data can be understood from a variety of different montages.&nbsp;</p><p>The images created by quantitative EEGs will show an overall view of the client’s brain waves (EEG) relative to a normative database of other people their own age. Colors are often used to indicate how many standard deviations they are from the normal population. Also (often) shown are connectivity issues in coherence (the stability of the phase relationship between different sites in the brain) and phase lag (a measure of how waveforms come into and out of synchronization).&nbsp;</p><p>Quantitative databases usually give an overall view of the individual’s data from a Fast Fourier Transform (FFT) perspective.&nbsp; Absolute Power is the total voltage, or energy, that the brain is emitting, measured in microvolts squared in disparate frequencies. Relative Power is a measure of clients’ EEGs, viewed in relation to their absolute power profile, used to determine what may be deviant, in relative terms. Magnitude is measured in pure microvolts.</p><p>A measure of clients’ EEGs, viewed in relation to their absolute power profile, used to determine what may be deviant, in relative terms.&nbsp; Coherence is the stability of phase relationship between any two areas of the brain. Two areas are said to be coherent if they have constant respective relative phase. Coherence in excess is hypercoherence; coherence in deficiency is hypocoherence. Phase is any one point or portion in a recurring series of changes, as in the changes of motion of one of the particles constituting a wave or vibration; the metrics of phase are very similar to coherence.</p><p>When reading a Z-score map, 1.64 standard deviations is considered the threshold of clinical significance.&nbsp;</p>',1),(268,53,267,269,20,0,1,1,1587141908,1587142350,'Interpreting the Data','<p>The summary pages of many QEEEG reports give an overall view of the goings on from a neurophysiological perspective. Each column contains the activity for one bandwidth (delta, theta and so on). Each row contains a separate metric. The colors indicate how many standard deviations, or Z-scores, the client is from the normal population. The thickness of the lines also depicts deviance in Z-score measures. Absolute Power is the total voltage, or energy, that the brain is emitting, measured in disparate frequencies and typically portrayed after processed via a “normative database.” Relative Power is a measure of clients’ EEGs, viewed in relation to their absolute power profile, used to determine what may be deviant, in relative terms.&nbsp;</p><p>Coherence is the stability of phase relationship between any two areas of the brain. Two areas are said to be coherent if they have constant respective relative phase. Coherence in excess is hypercoherence; coherence in deficiency is hypocoherence. Phase is any one point or portion in a recurring series of changes, as in the changes of motion of one of the particles constituting a wave or vibration; the metrics of phase are very similar to coherence and will be discussed further in the document.</p><p>As mentioned previously, the instantaneous Z scores are much smaller than the FFT Z scores in&nbsp; NeuroGuide TM which uses the same subjects for the normative database.&nbsp;&nbsp;</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/quantitative-database.png\" alt=\"A summary Page from a Quantitative Database (NeuroGuide)\" width=\"716\" height=\"955\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : A summary Page from a Quantitative Database (NeuroGuide)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/quantitative-database-skil.png\" alt=\"Figure : A summary Page from a Quantitative Database (NeuroGuide)\" width=\"729\" height=\"453\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : A summary page from a Quantitative Database (SKIL)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/individual-bins-skil.png\" alt=\"\" width=\"638\" height=\"332\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : A Summary Page of Individual Hz bins in SKIL<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(269,53,268,270,20,0,1,1,1587142378,1587142442,'How to get a valid qEEG Brain Map','When gathering data, the clinician must begin with visual analysis of the data and proceed to edit the EEG information, removing all artifacts and, if they are persistent or unremovable,  denoting how they will affect the qEEG, so as to not misinterpret the artifactual findings as real.',1),(270,53,269,271,20,0,1,1,1587142465,1587142519,'Impedance','Typically, when gathering QEEG data, the clinician starts by ensuring the electrodes have a low impedance. They might use a checktrode impedance metere or another built-in impedance checking system.&nbsp;',1),(271,53,270,0,20,0,1,1,1587142530,1587142773,'QEEG databases ','Many quantitative EEG Databases use Z-scores to measure how deviant the individual is from the normal population, in terms of amplitude/magnitude (often referred to as “power”), coherence, phase measures, and symmetry.&nbsp;<br><br><p><b>Z scores</b></p><p><ul><ul><ul><li>Z = subject value – mean value of the same/ SD of the sample</li><li>Z= probability that the subject value lies within the normal range. 1.96 Z scores is 2 SDs.</li></ul></ul></ul><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/chap7-z-score.png\" alt=\"\" width=\"273\" height=\"184\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\"><b>LORETA</b><br></p><p style=\"text-align: left;\">LORETA stands for Low Resolution Electromagnetic Tomographical Analysis and was developed and published on by Roberto Pascual-Marquis et al. in 1994. LORETA was a way to locate electric activity in the brain based upon multi-channel EEG recordings. LORETA assumed the that, among the infinite set of possibilities of source localization for EEG, the neighboring neurons were simultaneously synchronized with the source defined. The computational task that LORETA undertakes is finding the smoothest of all possible 3D tomographical distributions (a common procedure in generalized signal processing). Tomography is the term used, as it is accurate in the sense that it is used in PET, MRI, and CT scans.<br></p></p>',1),(272,54,0,273,20,0,1,1,1587142881,0,'Basic','<p>Neurofeedback is based on the success of operant conditioning, the underlying thesis of which is the Law of Effect, which states, when you reward something, you reinforce that behavior. In the case of neurofedback, the patient is rewarded for making the appropriate (programmed) brain wave frequency or connectivity metrics, via either visual or auditory reinforcement.</p><p>Many neurofeedback modalities are preceded by an assessment of the brainwave activity, typically through a Quantitative EEG brainmap; there are schools of neurofeedback that do not do this, including the Othmer method and Valdeen Brown’s Neuroptimal.&nbsp;</p><p>There are many different modalities and ways to do neurofeedback. Some are single channel (one active electrode) some are two channels, some are four channels, and some use a 19-channel cap. Since neurofeedback is EEG biofeedback, using the brainwaves as the mechanism that is measured is brainwave activity.&nbsp;</p><p>During neurofeedback training, individual EEG electrodes or a full 19-channel cap are placed on the scalp and the EEG activity of the patient is monitored and fed back to them in real time. Based on the feedback and the practitioner’s guidance, changes in brainwave patterns occur and are associated with positive changes in physical, emotional, and psychological states of being.&nbsp;</p><p>Often a patient will ask: “how do I make this work?” or “what do I do?” and the answer is they “will” the screen (or tone) to respond positively to them. The answer that I always use is: “get out of your own way and let your brain do its thing, do not get too attached to doing better or doing worse, it will continue to ebb and flow.”&nbsp;</p><p>Neurofeedback is based on the principle that the brain responds to ‘information’ on a conscious and nonconscious manner, and typically without any assistance. We have the ability for complex processing. We find most tasks like breathing, eating and digestion are ultimately performed without our focused attention.</p>',1),(273,54,272,274,20,0,1,1,1587142890,1587143074,'LENS and HPN','<p>The LENS, or Low Energy Neurofeedback System, purports to reset the neural-connectivity of the brain. The Low Energy Neurofeedback System (LENS) was developed in the early 1990s by Len Ochs, PhD, a northern California psychologist. LENS was created as an alternative to medication for brain-based problems and is often used along with psychotherapy. LENS is a computer-based software program that is connected to an EEG box, which measures brainwaves. LENS directly stimulates biochemical changes that are thought to help the brain regulate itself.</p><p>With the LENS, the client doesn’t “do” anything, and there is nothing to learn.&nbsp; The typical session with the LENS lasts 3-4 minutes.&nbsp; This means that the LENS works well for people who either cannot or will not pay attention to a computer screen for longer time periods.&nbsp;</p><p>The LENS works much faster than traditional neurofeedback with the number of</p><p>sessions ranging from as few as 1 to an overall average number of sessions of 20. Sessions are often as short as a few seconds and as long as five minutes.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/a-lens-feedback.png\" alt=\"\" width=\"919\" height=\"234\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : A LENS Neurofeedback System</p><p style=\"text-align: center;\"><br></p><p>The LENS works well with problems of the Central Nervous System, which can be numerous.These include symptoms of anxiety-depression spectrum, attention deficits, behavior disorders, various sleep disorders, headaches and migraines, PMS and emotional disturbances. It is also useful for org anic brain conditions such as seizures, the autism spectrum, and cerebral palsy.&nbsp; These are all signs of Central Nervous System dysfunction which result in the body’s difficulty&nbsp;<span style=\"font-size: 1rem;\">regulating itself.&nbsp;</span></p><p>High Performance Neurofeedback, aka HPN Ultra Low Power Neurofeedback, was invented by Cory Snook and is thought to be another version of the LENS. HPN is a type of brainwave based biofeedback&nbsp; that has shown promise of clinical efficacy in addressing the symptoms associated with Traumatic Brain Injury (TBI), Post-Concussive Syndrome, Post-Traumatic Stress Disorder (PTSD), Anxiety, Depression,&nbsp; “brain-fog,”&nbsp; and attention deficit disorders.</p><p>HPN measures and tracks the electrical activity of the brain (brainwaves) and then sends directly back to the brain a very weak, imperceptible signal containing information based on the just preceding brainwave activity.&nbsp; The power in the signal is estimated to be about 3 p W (picowatts).&nbsp; Although the power in this signal is amazingly small, the brain appears to be able to adjust its own functioning based on this feedback.</p>',1),(274,54,273,275,20,0,1,1,1587143111,1587143141,'Slow Cortical Potential Neurofeedback and Infra Slow Fluctuation  Neurofeedback','<p>Slow Cortical Potential Neurofeedback and Infra-Slow Neurofeedback are two different names for the same type of feedback.&nbsp; This type of feedback involves dialing in the right slow cortical potential frequency for the client. In a colloquial sense, these neurofeedback modalities are said to coordinate electrical activity in the brain, controlling activation and deactivation of those behavioral networks.&nbsp;<br></p>',1),(275,54,274,276,20,0,1,1,1587143146,1587143230,'What Are Slow Cortical Potentials? ','<p>Slow Cortical Potentials are slow shifts in the EGE that last from 0.3 seconds to several seconds. These are shifts in the EEG that reflect the depolarization of large groups of pyramidal cells in the cortex. These slow shifts are caused by the burning of blood glucose, that makes up the hemodynamics of the glial cells. These cells create large electro-negative swings when they depolarize. Sheets of cortical neurons are depolarized in the creation of SCPs. IT has been hypothezised that in autism spectrum cases, the threshold of depolarization is too high and in ADHD cases, the threshold of depolarization is too low. Additionally, in patients with seizure conditions, large negative potential shifts have been observed moments before a seizure. (ADHD children are taught to increase the negativity of the SCP, while autistic and seizure cases are taught to decrease the negativity of the SCP).</p><p>In Europe this method is taught by Ute Strehl, who uses a visual to reflects higher arousal (in electro-negative potentials, that is, going up) and lower arousal (in electro-positive potentials, going down). In clinical thresholding, it is important to verbally encourage and reward the patient, especially if they are children.</p><p>Ute Strehl has published extensively on her work, for which she has used a slow-wave filter and a 500-millisecodn interval moving window. This methodology is available using thought technology equipment and screens (www.thoughttechnology.com)</p><p>In America, this method is being taught by the Othmers and by Mark Smith. Smith has reported clinical results including increased relaxation, better sleep, profound changes in physiology, and a renewed sense of well-being in daily life. ISF neurofeedback was put to the test by using Biofeedback equipment that measured a subject’s physiological response to the training. What was found during that training was blood pressure normalized, heart rate slowed, hands became warm and dry, breathing became deeper and slower and the big muscles in the shoulders (Trapezius) relaxed. All direct indications of the relaxation response.</p>',1),(276,54,275,277,20,0,1,1,1587143241,1587143574,'Alpha-Theta','<p>Alpha/theta training, in which the goal is to achieve an altered, hypnogogic state of&nbsp;</p><p>consciousness, useful for therapeutic purposes.&nbsp; During alpha theta training, the participant is typically reclined or laying supine, in a comfortable room in a comfortable position, with their eyes shut, They are listening to auditory feedback (one popular set of sounds is the sounds of ocean waves and the sound of waves upon the shore). The individual in alpha theta training is trained to increased the amplitude of their theta frequencies so that they surpass their alpha frequencies, inducing what is considered a deep state. This increase of theta and decrease of alpha is called a cross-over and is the clinical goal of alpha-theta neurofeedback.</p><p>Some clinicians use Alpha-Theta neurofeedback only as polish at the end of many neurofeedback sessions, as the accessing of theta while conscious can create abreactions in individuals who are not ready to access the deeper realms where suppressions and repressions reside. On the flip side, this can be a hugely healing protocol for individuals who need to integrate and incorporate the activation behind stress responses.&nbsp;</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/theta-crossover.png\" alt=\"A diagram showing the concept of an alpha theta crossover, the y-axis related to amplitude\" width=\"434\" height=\"238\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : A diagram showing the concept of <br>an alpha theta crossover, the y-axis related to amplitude<br></p><p style=\"text-align: center;\"><br></p><p>Many of the great minds of our times—artists, musicians, scientists, and geniuses of all sorts—have described arriving at their discoveries and innovations often when in a deep dream-like reverie. The alpha-theta brain wave state that reflects this level of trance teeters on the borderline between consciousness and unconsciousness and is the threshold between alpha and theta—a soft, awake brain wave state. This altered state of consciousness has been called different things by different researchers. Maury (1848) called it “hypnogogia,” Green, Green, &amp; Walters (1970) called it “the reverie state,” and Budzynski (1977) dubbed it “the twilight state.”</p><p>Individuals will often enter this state when daydreaming, resting, meditating, engaging in “mindless” activity (i.e. running, driving long distances), or entering sleep. This state is a calm, relaxed, and unattached presence wherein people report receiving imagery, sounds/music, or thoughts of novelty. Einstein reported coming to the notion of this theory of relativity while daydreaming, observing sunbeams and imagining what it would be like to ride on them (Boyd, 1995). Thomas Edison used to intentionally induce this state to answer his pressing questions by falling asleep in a chair while holding a ball bearing, with a pie tin placed on the ground underneath his hand. Upon entering light sleep, he would drop the ball bearing onto the pie tin, waking him—at which point he would scribble the ideas that arrived in his mind (Robbins, 2000, p. 191).&nbsp;</p><p>In a letter published in 1912, Mozart wrote a colleague about his experience around creativity, music, and this light stage of reverie:</p><div class=\"editor-indent\" style=\"margin-left: 30px;\"><p>When I am . . . completely myself, entirely alone, and of good cheer—say, traveling in a carriage or walking after a good meal, or during the night when I cannot sleep, it is on such occasions that my ideas flow best and most abundantly. Whence and how they come I know not, I cannot force them. . . . All this fires my soul, and provided I am not disturbed, my subject enlarges itself, becoming methodized and defined, and the whole, though it be long, stands almost complete and finished in my mind, so I can survey it, like a fine picture or a beautiful statue, at a glance. Nor do I hear in my imagination the parts successively, but I hear them, as it were, all at once. What a delight this is, I cannot tell! All this inventing, this producing, takes place in a lively dream. (34)</p></div><p>This brain wave state Einstein, Mozart, Edison, and others created their masterpieces in is was likely composed of two frequencies: alpha, which is recorded on an electroencephalogram (EEG) as 9-12 oscillations per second (Hz), and theta, 5-8 oscillations per second (Hz).&nbsp; Alpha theta is used for many clientele populations, including&nbsp; peak performance neurofeedback training. This training is a means of inducing in the performer heightened amplitudes and presence of alpha and theta brain wave states, theorized to bring about “flow” states, or experiences of “being in the zone.” The goal of this type of neurotherapy is to increase the ratio of theta to alpha, encouraging a crossover, whereby the amplitude of theta brainwaves supersedes the amplitude of alpha being produced. In personal neurofeedback practice as clinician, I often incorporate alpha-theta training into neurotherapy sessions once an individual has worked through their major psychological or emotional problems via psychotherapy or other forms of neurofeedback, demonstrating self-regulation. Otherwise there is risk in accessing the unconscious memories residing in theta state and bringing them into conscious awareness while the individual is psychologically unprepared. Alpha-theta training is like a polish, used once a subject displays evidenced psychological readiness to fine-tune their higher-level functioning skills.</p><p>In Egner and Gruzelier’s 2003 study on the enhancement of musicianship in music conservatoires with the aid of neurofeedback, it was discovered that individuals training alpha-theta brainwave states had a positive trend in three criteria of instrumental competence (notably, “perceived instrumental competence, especially rhythmic accuracy”), musicality (notably “stylistic accuracy, interpretive imagination, and expressive range”), and communication (notably “emotional commitment and conviction, ability to cope with the stress of the situation and with deportment”), whereas the study’s control group (without any neurofeedback) evidenced no improvements (p. 3). In the conservatoires’ real-life quantification, the neurofeedback recipients also saw an average a jump of two class grades.&nbsp;</p><p>Another study testing novice singers’ singing abilities as a result of alpha-theta training found similar results in performance communication (specifically “scales of commitment, confidence, enjoyment, attention holding, and deportment”) as well as in the technical areas of “breathing, diction, and pitch.” Lastly, the individuals subject to alpha-theta neurofeedback experienced “increased expressiveness, confidence, and stage presence,” all of which positively corresponded with their respective alpha-theta learning indices (Leach et al., 2008). While these studies are exciting and noteworthy, they are the first of few and there remains to be a lack of science linking alpha-theta brainwave states and musical abilities.</p>',1),(277,54,276,278,20,0,1,1,1587143582,1587143642,'Amplitude','<p>Amplitude training was the first neurofeedback “protocol” to be developed, and is uptraining or downtraining the size (or amplitude) of an EEG frequency or range of frequencies. Peak to peak (P – P) and root mean squared (RMS) are measures of a frequency’s amplitude from peak to valley. Single channel EEG feedback is usually simple amplitude training, where the individual is suppressing or enhancing frequency bands of delta, theta, alpha, beta, or hight beeta. The Neurofield amplitude training is currently the only modality that allows for the uptraining of gamma frequencies. In the use of single channel training, a clinician can use ear electrodes as references, or they can use bi-polar training, where one area of the head is trained relative to another area of the head. Amplitude training can also be undertaken using a full 19-channel EEG cap.&nbsp;<br></p>',1),(278,54,277,279,20,0,1,1,1587143659,1587143710,'Single Channel  v 19-channel','<p>At one time in the history of the field, there was a debate as to whether single channel was better than full 19-channel, and vice versa. The difference is the difference in training one to four channel locations, as opposed to training with 19 active electrodes. One is not better than the other, and the question to ask is: is it preferable to train the entire brain (based on the client’s presentation and EEG brainmap) or is it preferable to train single channels? There are many single channel amplifiers&nbsp; on the market.<br></p>',1),(279,54,278,280,20,0,1,1,1587143720,1587454963,'Z-score','<p>Z-score neurofeedeback is used to train the individual towards the “Z of zero.” This means that the individual’s EEG is bring driven towards the normal range. Z-score neurofeedback can be used for measures of coherence, phase, and power differentials in the brain.&nbsp; Providers that offer Z-score training softwares are Brainmaster, Neurofield, and Neuroguide.&nbsp;</p><p>Live Z-scores can be used either for live assessment or for feedback training, depending on how the system is configured and used.&nbsp; When used for assessment, live Z-scores can be viewed during data acquisition, and can also be recorded and reviewed. Z-score neurofeedback relies upon a database of neurotypical EEGs as a basis of relatively.&nbsp; The Z-scores are integrated into the feedback design and they are used to control displays, sounds, and other information for the purpose of opreant conditioning and other learning paradigms.&nbsp;</p><p>In Neuroguide, for instance, the live Z-scores are monitored using a dynamic JTFA mode (joint time frequency analysis), as opposed to a fast fourier transform (FFT), which is more commonly used for QEEG results (an average of data over time). A Joint time frequency analysis allows for instant z-score feedback, providing real-time information about the state of the brain.&nbsp;</p><p>The rapid analysis and feedback of Z-scores is essential for timely feedback. Z-score training can be accomplished with 2 or 4 channels of EEG, or with 19 channels. However, the live feedback is not the same as those observed using the postprocessed QEEG results.&nbsp;</p><p>When inspecting individual live Z-scores in Neuroguide, it is observed that their typical values are not the same as those observed when using postprocessed QEEG results. This is not a problem or defect in the system, it is a natural consequence of watching a live statistic, versus a static statistic. Live Z-scores can be used to train a combination of variables including absolute and relative power, power ratios, coherence, phase, and asymmetry.&nbsp; When used in this manner, the EEG Biofeedback Training Using Live Z-Scores and a Normative Database system is no longer targeting just a single variable or attribute.&nbsp; Rather, the possibility arises of training the brain in a complex multidimensional manner, so that it learns a comprehensive brain state.</p><p>With Z-score training we can also choose to uptrain or downtrain any components we like, including combinations of components, or relationships between components.&nbsp; So we can train to a Z-score of 2 or 3, or +2 or +3 or even +6 if we choose.</p><p>Real time Z-score neurofeedback uses instantaneous measures of the EEG data compared to a Gaussian distribution to averaged “instantaneous” time domain spectral measures from groups of normal subjects and then cross validates the means and standard deviations for each subject for each instant of time.</p>',1),(280,54,279,281,20,0,1,1,1587143880,1587145932,'Wide Band Inhibit (aka “squash”) & Neuroptimal','<p>Little is known about the mechanism of action in Valdeen Brown’s Neuroptimal. This program is a simple set up, where the active electrodes are placed at C3 and C4 and the references are place on the upper ear cartilage and the ground electrode is placed\r\n    on the ear lobe. The activity of the EEG is measured and displayed (using&nbsp; feedback visual called a “mind mirror”) . The slowest activity measured is 0.1Hz and the fastest is 64 HZ. The frequencies are squashed, overeall, and this is thought\r\n    of as a squash protocol to many in the field. As stated on the Neuroptimal website: “The differences in electrical signal are measured in terms of Duration, Intensity, Frequency and Shift and is unique to Neuroptimal. This information is offered back\r\n    to the brain in real time via auditory and visual interruptions of the media.” . The Neuroptimal approach involves training both sides of the brain at the same time, over the motor strip, using multiple frequencies and reinforcement tones. There are\r\n    three basic stages of training, and the system alters training frequencies at each stage. The neuroptimal system is dedicated to reducing abnormal variability in the EEG to enhance system integration and functioning.<br></p>\r\n<p>The system is described on the website as “a unique and highly expanded Neurofeedback process that is more sophisticated than the antiquated linear approaches that only include the 2-D model of frequency and amplitude as initially founded in the field\r\n    of [NF. As a result, Neuroptimal is able to recognize the incredible natural potential of the brain and give information (or communication) that mirrors what the CNS just did. This information takes the form of mathematical interruptions in the auditory\r\n    and visual fields that offers the individual a “mirror” into their own electrical activity. Thereby reminding the individual to move away from discomfort.”&nbsp;</p>\r\n<p>The Neuroptimal system is marketed to non-clinical users, noting that brain maps and other means of clinical assessment are not necessary, since the device has not been termed a medical device by the FDA, but instead as a personal wellness device. They\r\n    are explicit that the system does not diagnose, treat, mitigate, prevenet, or cure any disease, disorder, or abnormal physical state.</p>\r\n<p>More information about the Neuroptimal system can be found <a href=\"@@PLUGINFILE@@/PF_ENG_Welcome_Ebook_Aug.20_FINAL.pdf\" target=\"new\" alt=\"Click Here to View PRF\" title=\"Click Here to View PRF\">here</a>:</p>\r\n<p style=\"text-align: center;\"><a href=\"@@PLUGINFILE@@/PF_ENG_Welcome_Ebook_Aug.20_FINAL.pdf\" target=\"new\" alt=\"Click Here to View PRF\" title=\"Click Here to View PRF\"><img src=\"@@PLUGINFILE@@/neuro-optimal.png\" alt=\"Neuroptimal system \" width=\"741\" height=\"428\" class=\"img-responsive atto_image_button_text-bottom\"></a><br></p>\r\n<p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/amplitude-frequencies.png\" alt=\"Figure : Mind Mirror Neurofeedback, Displaying the Amplitude on the Y-axis and the frequencies on the X-axis\" width=\"428\" height=\"249\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Figure : Mind Mirror Neurofeedback, Displaying the <br>Amplitude on the Y-axis and the frequencies on the X-axis<br></p><p style=\"text-align: center;\"><br></p>',1),(281,54,280,282,20,0,1,1,1587145941,1587146010,'Multi-Variate Training','<p>Four channel multi-variate training is a type of neurofeedback that Rob Coben invented, which measures and trains coherence between four electrodes. The protocol works when inputs from sensors are transformed into multivariate coherence values across all possible combinations of the four locations or sensors. This information makes up the reward band. Additionally, there are three user-defined inhibit hands that encourage a decrease in EEG frequencies, as a form of amplitude training.&nbsp;&nbsp;</p><p>The multivariate nature of how coherence is calculated comes close to the brain’s noise, itself, and Coben theorizes this makes it easier for the client to train, as opposed to the typical coherence model, where cross correlations between pairs of electrodes is used (bivariate coherence). The compromise to using pairwise coherence measures include inter-electrode distance, volume conduction of the brain, and the inability to capture three-dimensional brain activity (Nnez, 1994; Nunes and Srivinasan, 2006).</p><p>This method has been demonstrated on the EEGer Training system (developed by Ed Hamlin). Coben and Myers (2010) have shown that four channel multi-variate training has had greater efficacy than single or dual channel coherence training; they believe that one advantage to four-channel multi variate training is the number of electrodes used, as well as the statistical sophistication of what is actually fed back to the client.</p><p>Coben intends to continue to refine his model of four channel multi-variate coherence training, foreshadowing future enhancements involving functional connectivity.&nbsp;</p>',1),(282,54,281,283,20,0,1,1,1587146018,1587146075,'HEG','<p>Hemoencephalography (HEG) is a method of measuring brain function by measuring the brain blood flow. Hershel Toomim first coined the term hemoencephalography in 1997. Toomim discovered that the manipulation of brain blood flow is voluntary and can be trained using neurofeedback techniques. With the sensor giving feedback of increased blood flow, we can voluntarily increase brain blood flow at the location of the sensor. HEG trains the subject to increase blood ﬂ ow to a targeted area of the brain. Neurofeedback, as we have known it so far, measures the electrical activity of the brain, EEG, as a feedback signal to be controlled by the patient. Here EEG is substituted with blood oxygenation for the same purpose.</p><p>There are two kinds of HEG, pIR and nIR (near infrared), the former is up training temperature and the latter is uptraining oxygen via interaction with an infrared light. Near-infrared HEG (nirHEG): uses a spectrophotometer to measure the oxygenated blood flow inside the skull. The bone is translucent and lets light in. The Instrument measures the amount of blood that\'s carrying oxygen. This is similar to the \"pulse-oximeter\" that is used as a finger clip in the hospital, and that shines a red light through your skin to measure the blood oxygen level.&nbsp;</p><p>The advantage to using the nirHEG is that the elastic band on the head is easily moved to any location on the scalp to train the corresponding area of the brain. HEG is used on the frontal lobes and other areas where skin is showing. it will not work when placed on the hair, however.</p><p>Unlike traditional neurofeedback, HEG is not affected by eye blinks or facial movement which cause distortion when using EEG.</p><p>Neurofeedback using this new technique provides a means to exercise selected brain areas. Exercise increases blood ﬂ ow to the chosen brain module.&nbsp; Capillaries and dendrites grow with brain exercise (Kaiser 1997, Thompson et al. 1998, Joyce and Seiver 1997, Rossiter 1996, 1996, Kaiser 1997). An audible tone was devised that increased in pitch to signify increased blood oxygenation. To increase oxygenation one would merely attend to the highest note in each trill and will the next higher note to sound. Application of the headband and monitoring patient progress is simple. The treatment process is divided into ten-minute segments. Usually three to four such segments constitute a treatment session.</p>',1),(283,54,282,284,20,0,1,1,1587146084,1587146244,'HEG-Why is brain blood flow important?','<p>Active areas of the brain are marked by high oxygen density and higher than normal temperature. The blood carries the fuel for the brain: oxygen and glucose. When an area of the brain is more active, it has increased blood supply. The brain dilates the capillaries of the area in use to bring more blood supply. With continued use, more capillaries and more synaptic connections between neurons are built in that area. When we increase blood flow, that area of the brain is able to do it\'s job better and more efficiently.</p><p>Sequential processing, including using language and executing tasks in proper order, takes place in the frontal lobes. Increased blood supply helps the brain accomplish these tasks.&nbsp;</p><p>The frontal cortex is in charge of inhibiting impulses, when appropriate. If the frontal cortex is not functioning well, a person will show a lot of impulsive behaviors. Also involved in this inhibition is control of migraines. Jeffrey Carmen has shown that when the frontal cortex has increased blood supply, migraine headaches are well controlled. The frontal lobes are important in the function of working memory. Working memory is important for reading comprehension and carrying out tasks.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/single-photon-emission-computerized.png\" alt=\"\" width=\"679\" height=\"364\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Single Photon Emission Computerized <br>Tomography (SPECT Scan) demonstrating blood flow pre-and post-treatment<br></p>',1),(284,54,283,285,20,0,1,1,1587146267,1587146305,'Othmer Method','<p>The Othmer method (can be found at eeginfo.com) is recommended for intractable brain based disorders of childhood, such as seizures, conduct disorder, bipolar disorder, spectrum based disorders, pervasive developmental delays, cerebral palsy, birth trauma, and acquired birth injuries.&nbsp; Their device is an amplifier, and they rely exclusively on bipolar montages.&nbsp;</p><p>Building primarily on the work of Sterman, they developed a basic and reliable approach to neurofeedback that does not utilize brain mapping. Much of their early techniques involve balancing left and right hemispheres with respect to levels of arousal (1999).</p><p>The Othmers now largely proffer&nbsp; a new paradigm called Infra-low Frequency Training that involves training sub-delta frequencies that are actually slow shifts in dc brain potentials. This method involves training in frequency ranges of .0003 Hz or lower. Despite considerable controversy over whether present day amplifiers are actually capable of accurately providing data on such low frequencies, the Othmers claim that they have modified their amplifiers to achieve this feat. These slow frequencies are thought to be base frequencies of the EEG, also considered frequencies of hemodynamics—or the burning of blood glucose. A large number of clinicians have adopted this approach. It has gained recognition among clinicians for being very effective, especially in developmentally challenged children. Mark Smith has adopted a more conservative approach with this paradigm by building on more accepted frequency ranges of .001-.003 Hz or higher that can be easily measured with modern amplifiers.&nbsp;</p>',1),(285,54,284,286,20,0,1,1,1587146314,1587146352,'How does It Work?','<p>Slow cortical potentials are slow event-related direct-current shifts of the electroencephalogram. Slow cortical potential shifts in the electrical negative direction reflect the depolarization of large cortical cell assemblies, reducing their excitation threshold. They change periodically from being electrically positive to electrically negative. They are described as a phasic tuning mechanism related to activities in the brain stem reticular process, the thalamus and the basal ganglia. These dc shifts are reflected in the superficial cortical layers and represent synaptic activities in the apical dendrites in those layers. Negative shifts represent increased probability of firing while positive shifts represent decreased probability or inhibition. Negative shifts are described as related to the utilization of resources for attention, memory, and other related cognitive mechanisms.<br></p>',1),(286,54,285,287,20,0,1,1,1587146359,1587146402,'At Home Trainers','<p>There are at home trainers on the market currently, some offered through New Mind Academy (Richard Soutar’s work), others offered through a program called Myndlift, which uses a muse device to train the pre-frontal cortex of the brain. Through this program, people are directed through at home use with the assistance of a local clinician.&nbsp;<br></p>',1),(287,54,286,0,20,0,1,1,1587146412,1587146660,'LORETA (Low Resolution Electromagnetic Tomographical Analysis)','<p>When recording an EEG, 50% of the data arriving at the site of the electrode is from neurons directly underneath it, and 95% of the data comes from within 6 centimeters distance (that’s a circle with a diameter of 2 1/3 inches—big) (Nunez, 1982; 1995, Cooper et al., 1965). This is one of the reasons that EEG is limited in terms of what it can determine spatially (i.e. where something lives in the brain). LORETA neurofeedback training is Z-score training that uses three dimensional source localization so that the location within the interior of the brain can be pinpointed with accuracies of 1cm. LORETA neurofeedback is thought to target subcortical structures that are showing deviance in the amount of frequency generated.&nbsp;</p><p><b>LORETA Z-score&nbsp;</b></p><p>LORETA Z-Score neurofeedback is thought to regulate the deep structures of the brain and improve connectivity between the brain networks through targeting the central voxel within certain regions of the brain. In each session, a cap with 19 sensors is applied to your head. During training, your brainwaves learn to become balanced and normalized as they are rewarded.</p><p>The goal of LORETA is to reinforce stability of information processing in dysregulated networks and connections based on the client’s symptoms. It targets the specific areas of the brain and connections between nodes that are linked to the symptoms. In doing so it specifically targets deep brain structures that are out of balance. Similar to traditional Neurofeedback (single channel Neurofeedback) training it provides operant conditioning (rewards) based on your brainwaves compared to the brainwaves of a healthy population.</p><p>It is possible to train coherence, phase, and power from 88 Brodmann areas in LORETA Z-score neurofeedback.&nbsp;</p><p>There are a few ways to choose what regions of the brain to train using LORETA Z-score Neurofeedback. One means is using a symptom checklist, which is created from the patient’s EEG. Another method is using Neurodesigner.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/loreta-neurofeedback.png\" alt=\"\" width=\"762\" height=\"1565\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Image from NeuroGuide Z-Score LORETA Neurofeedback<br></p><p><br></p><p><br></p>',1),(288,55,0,289,20,0,1,1,1587146762,1587146886,'Basic','<p>Neuromodulation is also known as neurostimulation is different than neurofeedback, but fits under the umbrella of neurotherapy. Neurofield’s neurotherapy system is known for the blending of neurostimulation into neurofeedback training. Neuromodulation, at the clinical level, is comprised of transcranial alternating current stimulation (tACS), transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS), transcranial pink noise stimulation (tANS) and pulsed electro-magnetic field stimulation (PEMF).<br></p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/neuromodulation-modalities.png\" alt=\"\" width=\"452\" height=\"456\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Three Stimulation Modalities used in Neuromodulation<br></p>',1),(289,55,288,290,20,0,1,1,1587146769,1587147042,'tACS','<p>tACS is a form of electrical stimulation that uses two electrodes (a positive electrode called an anode and a negative electrode, the cathode) to pass current back and forth through either the brain or the body. It is called alternating current because the side which is giving and receiving electrons (anode and cathode) continuously switches. Any frequency, or blend of frequencies, can be given with these devices. So, if a patient is in need of more delta, the clinician can stimulate them in the delta frequencies. This technology is engineered, developed, and sold through Neurofield, Inc, (founded by Nicholas Dogris and Brad Wiitala). Clinicians use stimulation devices to help their patients heal, recover, and change the behavior of the brain and their bodies. As opposed to neurofeedback, neurostimulation shows the brain how to behave and the brain, like a copy cat, mimics the stimulation frequency.&nbsp;</p><p>In transcranial alternating current stimulation, one applies current and encourages neural synchronization. As electrons pass through the brain (from anode to cathode) the populations of neurons they go through become more likely to fire. This increased likelihood of firing is generalized to the entire area where current is applied. This can cause neurons which were formerly out of phase with each other to align. This happens not just during treatment, but is hypothesized to cause lasting changes to the brain. This is called Spike Timing Dependent Plasticity.&nbsp;&nbsp;</p><p><br></p><p><img src=\"@@PLUGINFILE@@/tacs-current.png\" alt=\"\" width=\"777\" height=\"415\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : The Mechanism of transcranial Alternating Current Stimulation<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(290,55,289,291,20,0,1,1,1587147049,1587147159,'tDCS','<p>tDCS is transcranial direct current stimulation. It is a form of electrical stimulation that is used to treat many conditions and pathologies, both in the brain and in the body. The technology uses a positive and a negative electrode (called the anode and the cathode, respectively). Direct current passes a one-way current through the brain or the body. In the brain, a surge in calcium ions and in sodium ions creates a condition of neuroplasticity, which makes the brain more susceptible to neurofeedback and pEMF conditioning. tDCS&nbsp; It increases the potential of the brain to change, learn and grow.</p><p>tDCS 1) increases blood flow at the targeted areas and, thus, leads to vaso-profusion (which helps to heal wounds on the brain and the body and also encourages angiogenesis and neurogenesis), 2) causes large scale network organization, 3) stimulates/excites the positive electrode site (anode) which increases glutamate and decreases GABA, and inhibits the negative electrode site (cathode) creating more GABA at the site of stimulation, and causes calcium and sodium surges in the glial cells, which leads to flexibility in polarity shifting. TDCS does not force the brain to fire. Some of the symptoms and pathologies addressed by tDCS include migraines, age-related cognitive decline, and other disorders where the tissues of the brain agree damaged or compromised (such as cerebro-vascular issues, stroke, and some epileptogenic profiles). tDCS protocols cause the underlying blood vessels to dilate, which allows oxygenation of the affected areas. A recent meta-analysis showed no serios adverse effets on over 1,000 people across 33,200 sessions (Bikson et al., 2016).<br><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/transcranial-direct-current.png\" alt=\"\" width=\"350\" height=\"337\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : The application of transcranial direct current<br></p><p style=\"text-align: center;\"><br></p>',1),(291,55,290,292,20,0,1,1,1587147187,1587147297,'Transcranial Random Noise Stimulation','<p style=\"text-align: left;\">tRNS is a form of electrical stimulation that is used to pass noise (like the white noise of a television screen) through the brain and/or the body. One way to consider tRNS is as a “Wall of noise”. tRNS is different from tDCS because instead of giving steady current from anode to cathode, it is giving current at randomized frequencies and milliamperes between the two sites. This means that the region of the brain between the electrodes are stimulated, increasing neuroplasticity and reducing stuck patterns.&nbsp; This is one modality used to unlearn problematic fixed patterns. tRNS has also shown benefit for learning in people with developmental abnormalities. When tRNS stimulation is given during math lessons, it helps more than sham stimulation or behavioral therapy.&nbsp; &nbsp;Issues of hyper or hypo coherence and hyper or hypo phase lag are addressed by white noise, in addition, white noise is often used at the first layer of multi-layer protocols.&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/white-noise-stimulation.png\" alt=\"\" width=\"956\" height=\"346\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Different Forms of White Noise Stimulation<br></p>',1),(292,55,291,293,20,0,1,1,1587147305,1587147453,'Pink Noise Stimulation','Pink Noise is filtered white noise. This form of stimulation affects the restng membrane potneitl and has the same types of de-coupling properties as white noise. It also creates increased blood perfusion. Pink noise appears to have an effect on microstates, which are associated with the “on-off” switching of a neuon. In using pink noise, you can saturate a neuron with a failtered set of frequencies, that influence the switching of the neurons, effectively changing the ways that they fire. tRNS is one modality that can be used to address stuck patterns, such as thalamo-cortical dysrhythmias (which are found in many hearing disorders, form of mood and affect regulation disorders, some attention deficit disorders, and some movement disorders). Thalamo-cortical dysrhythmias are disorders where there is a persistent gamma waveform attached to&nbsp; a slower carrier wave (typically 8hz or less). Pink noise is typically one step in a multi-step protocol.<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/pink-noise.png\" alt=\"\" width=\"343\" height=\"213\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : The bell curve of pink noise.&nbsp;<br></p>',1),(293,55,292,294,20,0,1,1,1587147392,1587147597,'pEMF','<p>Pulsed Electromagnetic Field (pEMF) stimulation is imperceptible, yet the effects are real. pEMF creates an electromagnetic field, which allows cells and tissues in its wake to oscillate at the same frequency. The frequency and duration of the pEMF are important components of the effectiveness of the treatment. This modality is gentle compared to other stimulation technologies. You can\'t feel it because an electromagnetic field is generated through a wire coil that flows through the air and passes through your body effortlessly. One of the happy benefits of pEMF is the increase in blood flow at the site of the stimulation, which can increase angiogenesis by way of allowing more oxygen rich blood to make its way to the site.&nbsp; At low intensity pEMF is safe and has numerous clinical benefits, including affecting the resting membrane potential (without the forced depolarization of the membrane), inflammation reduction, nerve healing, the healing of bones, the remediation of depression and other affective disorders, and postoperative pain.&nbsp;</p><p>Due to the low-level voltage output of pEMF, it is safe for infants, the elderly, and animals.&nbsp;</p><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/pEMF-devices.png\" alt=\"\" width=\"976\" height=\"618\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : pEMF devices are known for the ability to help reduce pain<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(294,55,293,295,20,0,1,1,1587147604,1587147646,'CES','<p style=\"text-align: left;\">Cranial electrotherapy stimulation (CES) is a form of neurostimulation that delivers a small, pulsed, alternating current via electrodes on the head. Recently, a systematic review (2018) found insufficient evidence that CES has clinically impactful effects on fibromyalgia, headache, neuromusculoskeletal pain, degenerative joint pain, depression, or insomnia and there is low-strength evidence suggesting modest benefit in patients with anxiety and depression (Shekelle et al, 2018)<br></p>',1),(295,55,294,0,20,0,1,1,1587147662,1587147714,'References','<p><i>Bikson, Marom &amp; Grossman, Pnina &amp; Thomas, Chris &amp; Zannou, Adantchede &amp; Jiang, Jimmy &amp; Adnan, Tatheer &amp; Mourdoukoutas, Antonios &amp; Kronberg, Greg &amp; Truong, Dennis &amp; Boggio, Paulo &amp; Brunoni, Andre &amp; Charvet, Leigh &amp; Fregni, Felipe &amp; Fritsch, Brita &amp; Gillick, Bernadette &amp; Hamilton, Roy &amp; Hampstead, Benjamin &amp; Jankord, Ryan &amp; Kirton, Adam &amp; Woods, Adam. (2016). Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016. Brain Stimulation. 9. 10.1016/j.brs.2016.06.004.</i></p><p><i>Coben, R., and Myers, T. E. (2010). The relative efficacy of connectivity guided and symptom based EEG biofeedback for autistic disorders. Appl. Psychophysiol. Biofeedback 35, 13–23. doi: 10.1007/s10484-009-9102-5&nbsp;</i></p><p><i>Nunez, P. (1994). Neocortical Dynamics and Human EEG Rhythms. New York, NY: Oxford University Press.</i></p><p><i>Nunez, P., and Srivinasan, R. (2006). Electrical Fields of the Brain: The Neurophysics of EEG. New York, NY: Oxford University Press, doi: 10.1093/acprof:oso/9780195050387.001.0001</i></p><p><i>Shekelle PG, Cook IA, Miake-Lye IM, Booth MS, Beroes JM, Mak S (2018). \"Benefits and Harms of Cranial Electrical Stimulation for Chronic Painful Conditions, Depression, Anxiety, and Insomnia: A Systematic Review\". Ann Intern Med. 168 (6): 414–421. doi:10.7326/M17-1970. PMID 29435567.</i></p>',1),(296,56,0,0,20,0,1,1,1587148829,1587148869,'Preamble','<p>This module covers all ethical and professional considerations for neurotherapy clinicians and technicians. The practice of neurotherapy is both an art and a science. It will vary in terms of approach, modality, method of delivery, and services provided. This chapter covers a code of ethics that neurotherapist need adhere to. When working with patients, may situations can arise; if a situation is not covered in this chapter on ethics, it does NOT mean that ethics do not apply. While the specific wording behind these standards is important, it is the spirit and intent of these standards which must be applied to situations. Violation of these standards by any QEEG-D or neurotherapist ought to be brought to the Attention of the QEEG-D Certification Board, at <b>EMAIL ADDRESS</b>, <span><b>PHONE NUMBER</b>,</span> <b>SNAIL MAIL ADDRESS.</b></p><p>Neurotherapy members are encouraged to apply for membership to either the AAPB (Association of Applied Psychophysiology and Biofeedback) or ISNR (international Society for Neurofeedback and Regulation) for belonging to a larger board and for inclusion in a group of colleagues and professionals engaging in the same business. The professional standards adhered to by the professional organizations of neurofeedback professionals all maintain the highest ethics, values of competence, promotion of intellectual freedom, respect, integrity, honesty, fairness, and trustworthiness.</p><p>Because the trade organizations supporting and advocating for neurofeedback professionals are committed to the protection of human rights, thjy strive to maintain respect amongst other professional communities, fostered by professionalism, integrity and dignity.&nbsp; Clinicians mut hold themselves accountable for their clients welfare as it pertains to the their neurotherapy regimens, and they mist limit their services only to those areas in which they have expertise and are competent.</p>',1),(298,57,0,299,20,0,1,1,1587149169,0,'Basic','<p><p>The goal of the neurotherapist is to advance the patient’s well being and maintain their best interests at all times.&nbsp;</p><p><b>Non Discrimination:</b>&nbsp;Neurotherapists will not discriminate or deny services to anyone based upon religion, gender identity,&nbsp; sexual orientation, ethic or national origin, race, socioeconomic status, or disability. Within reason, neurotherapists make accommodations to treat all individuals within their scope of practice. If a neurotherapist believes someone is outside of their scope of practice (e.g. an infant), they will do their best to find a suitable referral for those seeking help.&nbsp;</p><p><b>Dual Relationships:</b>&nbsp;A dual relationship is one that occurs outside of the neurotherapy clinic as a separate and distinct relationship during or after the termination of the neurotherapeutic relationship. Neurotherapists avoid dual relationships with patients that are able to impair professional judgment, as they are aware of their influential position in the patient-therapist dynamic. Not all dual relationships are unethical and some dual relationships cannot be avoided.&nbsp;</p><p><b>Unethical dual relationships</b>&nbsp;are those wherein a therapist borrows money from a patient, hires a patient, engages in business ventures with a patent, or enters a close personal relationship with a patient (this applies to patient’s spouses, partners and family members, as well). Sexual contact, intimacy or intercourse with a patient during the therapeutic relationship or two years following the relationship is unethical and strictly prohibited. If a neurotherapist engages in intimacy with a former patient or their spouse or partner, or immediate family member, within two years of the termination of the patient-therapist relationship, the neurotherapist risks the revocation of their quantitative EEG diplomacy and/or their board certification in neurotherapy. This type of conduct is considered harmful and potentially exploitative to the patient.&nbsp;&nbsp;</p><p><b>Treatment disruption, abandonment or termination:</b>&nbsp;It is a neurotherapists professional and clinical responsibility to maintain practices and procedures that assure undisrupted care. This mat include providing contact information in case an emergency situation arises while the therapist is away. IT is important that a neurotherapist uses clinical judgment when terminating a relationship, as termination must be done in an appropriate manner and based upon sound reason (e.g. the patient is not benefitting from treatment, continuing treatment is no longer beneficial or appropriate, the neurotherapist can no longer provide treatment due to extenuating circumstances, or in order to avoid an ethical conflict or problem. It is unethical to abandon&nbsp; to neglect a patient in treatment; if a therapist is unable to continue providing treatment, they must attempt to provide their patient an alternative health care professional for their accommodation.</p><br></p>',1),(299,57,298,300,20,0,1,1,1587149180,1587149229,'Hygiene','<p></p><p></p>It is imperative that the neurotherapist maintains a clean and hygienic office for the protection of both clients and staff. This includes all equipment, sensors, pastes and gels used, preventing for cross contamination or any human byproduct (i.e. sweat, saliva, blood, etc.).<br><p></p>',1),(300,57,299,301,20,0,1,1,1587149244,1587149305,'Financial Concerns','It is unethical for a therapist to maintain a client relationship solely for financial gain, nor is it ethical to terminate a patient relationship for non-payment of fees, unless the termination is handled in a clinically appropriate manner. All services billed by the practitioner must be for clinical services provided directly by the clinician or by their technician.',1),(301,57,300,302,20,0,1,1,1587149319,1587149364,'At Home Training','<p>Neurotherapists recommending and enacting at home training are responsible for the patient’s (or patient’s care-takers) education and application of all neurofeedback modalities and their use. Since at home systems involve the neurotherapist not being present, the neurotherapist must take extra precautions to meet their responsibility to their patients.&nbsp;</p><p>Before implementing at home system use, a neurotherapist must consider the competence and capability of a patient or patient’s caretaker to administer treatments from an at home setting, and must be present via an online screen share for the initial training sessions to ensure the equipment and the set-up is appropriate. When at home training occurs, a neurotherapist must inform patients of the risk of at home training, consequences, limitations, and appropriate emergency responses, should a situation emerge. It is the neuerotherapist’s responsibility to ensure the patient signs all appropriate paperwork regarding at home training, its risks, consequences, and potential adverse effects before engaging in at home use.</p>',1),(302,57,301,303,20,0,1,1,1587149371,1587149410,'Intake','<p>During the initial intake, a neurotherapist will get written informed consent from their patients and clients when providing clinical services, including a form indicating the patient is aware of the QEEG procedure (if being done) as well as the neurotherapy procedures at hand.<br></p>',1),(303,57,302,304,20,0,1,1,1587149416,1587149446,'Disclosures','<p>A neurotherapist ought to provide clear information about the neurotherapy modalities used in easy to understand language so the patient can make an educated decision about partaking in neurotherapy. It is of paramount importance that the neurotherapist informas their patients of potential risks and benefits of therapy and any common side effects that occur from the treatment modalities they utilize.&nbsp;</p><p>It is strongly recommended that the neurotherapist informs their patient of their background, theoretical and professional orientation, education, training, and modalities of treatment.&nbsp;</p>',1),(304,57,303,305,20,0,1,1,1587149451,1587149485,'Non-Neurotherapist Roles','When a neurotherapist acts in a professional role other than the role of a neurotherapy provider (be it psychologist, psychotherapist, nurse, nutritionist, acupuncturist, chiropractor) they are acting soley within that role and may clarify, when necessary, which role they are acting in in order to prevent confusion.&nbsp;<br>',1),(305,57,304,306,20,0,1,1,1587149490,1587149597,'Supervisor, Supervisee, Educator and Student Responsibilities','Neurotherapists maintain professional roles and boundaries when in the role of student or supervisor/educator. The supervisor/educator takes seriously their impact on their students and supervisees and, thus, do not exploit the trust and dependency of their supervisees. A neurotherapist does not engage in romantic or sexual relationships with supervisees/students (over whom they exercise professional authority). Other unethical acts include: borrowing money from students, engaging in a close personal relationship with a supervisee, engaging in a businesses venture with a supervisee, barter with supervisees, or engaging in any of the aforementioned with the student’s spouse. It is mandatory that a supervisor maintain their professional skills with recurring courses and trainings.<br><br><p><b>Competence of Supervisee</b></p><p>Neurotherapists make sure their supervisees are addressed and taught at the level of their competence and are not providing services before they are clinically capable.&nbsp;</p><p><br></p>',1),(306,57,305,307,20,0,1,1,1587149543,1587149636,'Consultation with Outside Parties and Referrals','It is important that neurotherapists have access to professional communities of other clinicians doing similar work in the cases that they need to consult, collaborate with, and refer patients out to other professionals, physicians, and community resources. In cases where neurotherapy is not leading to desired results, neurotherapists ought to offer treatment alternatives that are appropriate for the patient’s symptoms.&nbsp;<br>',1),(307,57,306,0,20,0,1,1,1587149643,1587149687,'Treatment Decisions and Case Notes','All mental health care practitioners keep notes of their patient sessions, including the patients subjective state, their demeanor and reported changes or challenges since the last neurotherapy session, as well as the protocol given at the time of the appointment in as much detail as is necessary. This latter form of note keeping may be kept in electronic format, but it is paramount that the neurotherapist maintains a backup copy of the treatments undertaken in the case of computer failure.<br>',1),(308,58,0,309,20,0,1,1,1587149943,0,'Basic','<p>A neurotherapist is held to the same levels of confidentiality as other mental health care practitioners: all information exchanged by the patient is confidential with these exceptions:&nbsp;</p>\r\n<ol><li>If the patient seems unstable, it is the professional obligation of the neurotherapist to see that the patient is taken to the hospital, even if by an involuntary hold (a 5150 code). This may involve the police or calling 911 if the patient is resistant.<br><br></li>\r\n    <li>If the patient is abusing or knows of someone abusing an elderly person or a child (in which case it is the neurotherapists duty to reach out to the proper authorities (e.g. child protective services or the police);<br><br></li>\r\n    <li>If the patient is homicidal or threatening acting against another violently, in which case it is the neurotherapists duty to make sure all endangered parties are informed, by contacting the police.</li>\r\n</ol>\r\n<p></p>\r\n<p><br></p>',1),(309,58,308,310,20,0,1,1,1587149950,1587149992,'Limits of Neurotherapist’s Role and Contact','<p>A neurotherapists will act solely within the provision of their role as a neurotherapist and within the role of their professional license, if applicable. A chiropractor is free to do chiropractic work, an acupuncturist is free to do acupuncture, a psychotherapist is free to do psychotherapy, etc., but no neurotherapist is allowed to reach beyond the bounds of the professional license with any neurotherapy client. For example, it would be unethical for someone without a license in mental health care to conduct psychotherapy with a patient while doing neurotherapy. The therapist will also purchase liability insurance that covers the extent of their neurotherapeutic work, including all forms of neurostimulation and neurofeedback.<br></p>',1),(310,58,309,311,20,0,1,1,1587149999,1587150035,'Competence','<p>A neurotherapist is expected to practice within the limits of their professional competence, based upon their experience, their education, and their training.&nbsp; It is also the therapist’s role to inform their patients about particular procedures and possible negative effects. A clinician who received the QEEG-D designation ought to have the competence of an intermediate practitioner and it is advised that they pursue their BCIA (Biofeedback Certification International Alliance) certificate before pursuing the QEEG-D or QEEG-T.&nbsp;</p><p>If a professional is serving in the role of a biofeedback or neurofeedback technician or assistant, they will engage in the practice only under the supervision of a qualified professional.&nbsp; Misrepresentation of one’s credentials, training, experience, degrees, or specialty is a violation of ethics and a violation of law in certain circumstances.&nbsp;</p>',1),(311,58,310,312,20,0,1,1,1587150043,1587150086,' Treatment Alternatives and Referring Out','<p>Sometimes a client will seek neurotherapy who would be much better suited by another form of treatment. Sometimes a patient will seek neurotherapy who has a condition that is more severe than the neurotherapist can address or is foreign to the neurotherapist. In other situations a patient may come to a neurotherapist without knowing what is wrong with them, in dealing with a severe situation. In these situations it is the ethical duty of the neurotherapist to consider the client’s best interests and either refer to an appropriate specialist for a more suitable treatment or appropriate assessment and diagnosis.&nbsp;<br></p>',1),(312,58,311,0,20,0,1,1,1587150092,1587150134,'Complaints','<p>If a neurotherapist receives a filed complaint from a client, the board to which the complaint must first be presented is to the clinician’s professional licensure board, be it the American Psychological association, the American Nurses Association, the American Psychiatric Association, the American Medical Association, etc. The professional boards for the practice of neurotherapy, including the International Quantitative EEG Certification Board, The Biofeedback Certification International Alliance (BCIA) Board of Directors, and the Association of Applied Biofeedback and Psychophysiology (AAPB) will be the secondary board to determine whether or not the member failed to comply with either ethical and/or legal requisites.&nbsp;<br></p>',1),(313,59,0,0,20,0,1,1,1587150286,0,'Basic','<p>These core professional values are borrowed from the AAPB Code of Ethics:</p>\r\n<p>\r\n    </p><ol type=\"a\">\r\n        <li>Enhancing human development and improvement through the life span</li>\r\n        <li>Honoring diversity and embracing a multicultural approach in support of the worth, dignity, and uniqueness of people within their social and cultural context</li>\r\n        <li>Promoting social justice</li>\r\n        <li>Safeguarding the integrity of the provider/client relationship</li>\r\n        <li>Practicing in a competent and ethical manner</li>\r\n    </ol>\r\n<p></p>',1),(314,60,0,315,20,0,1,1,1587150830,0,'Basic','<p><b>Absolute Power:</b> The total voltage, or energy, that the brain is emitting, measured in disparate frequencies and typically portrayed after processed via a “normative database.”</p><p><b>Amplitude:</b> The height of the brainwave, measured in microvolts squared.&nbsp;</p><p><b>Asymmetry:</b> is the absence of, or a violation of, symmetry or the lack of balance.</p><p><b>Coherence:</b> The stability of phase relationship between any two areas of the brain. Two areas are said to be coherent if they have constant respective relative phase. Coherence in excess is hypercoherence; coherence in deficiency is hypocoherence.&nbsp;</p><p><b>Common mode rejection:</b>&nbsp; The input amplifier is more sensitive in relation to the signal components that are different at the electrodes than to those components that are of equal amplitude and polarity. It indicates the ability of the amplifier to accurately cancel voltages that are common to both inputs.</p><p><b>Complex Adaptive System</b></p><p>The statistical properties of the brain’s dynamics reflect the statistics of the environment , this is because our brain is a complex adaptive system (CAS) which arises when two conditions are fulfilled: 1) structure has small world topology and 2) the presence of noise (variability)—the brain is a complex adaptive system.&nbsp;</p><p><b>Fast Fourier transforms:</b> The fast Fourier transform is a mathematical method for transforming a function of time into a function of frequency. Sometimes it is described as transforming from the time domain to the frequency domain. It is very useful for analysis of time-dependent phenomena. FFT’s are of great importance to digital signal processing in EEG applications.</p><p><b>Frequency: </b>How many waves are made per second interval, represented in hertz (Hz), or cycles per second.</p><p><b>Phase:</b> Any one point or portion in a recurring series of changes, as in the changes of motion of one of the particles constituting a wave or vibration.</p><p><b>Relative Power:</b> A measure of clients’ EEGs, viewed in relation to their absolute power profile, used to determine what may be deviant, in relative terms.&nbsp;</p><p><b>Symmetry: </b>Generally conveys two primary meanings. The first is an imprecise sense of harmonious or aesthetically-pleasing proportionality and balance; such that it reflects beauty or perfection. The second meaning is a precise and well-defined concept of balance or \"patterned self-similarity\" that can be demonstrated or proved according to the rules of a formal system: by geometry, through physics or otherwise.</p>',1),(315,60,314,316,20,0,1,1,1587150847,1587150890,'Montages','<p><span>An EEG montage is the placement of electrodes. All EEG signals are measured by subtracting the signal measured at 2 sites: the active electrode and the reference electrode.&nbsp; This is called common mode rejection.&nbsp; The reason for this is that we need to subtract out all the environmental electrical noise (which is much larger than the brainwave signal) in order to see the brain\'s activity.&nbsp; Any scalp electrode site measurement must be referenced to some other measured site.&nbsp; In the past, the most common site for reference was linked ears.&nbsp; But you can use the nose, or any other scalp location or, as explained above, any average of multiple sites.&nbsp; So, there are many montages available and they all have strengths and weaknesses.&nbsp; There is no best montage for all purposes.</span></p>',1),(316,60,315,317,20,0,1,1,1587150914,1587151215,'Referential Montages','<p>Many will refer to the “active” electrode and the “reference“&nbsp; electrode. Commonly used “referential montages” include the ear references (linked ear, ipsilateral or contralateral ear), the Cz location or a “vertex” reference.&nbsp; Local function in the EEG does not shown well with linked ears (that is, if you had a focal slowing, Linked Ears would not be a good montage to view it). Linked ears montages show global firings well.</p><p>The linked ear montage can spread temporal lobe activity into reference electrodes. The activity seen at T5 and T6 are most likely to be seen in the electrodes on the ears but activity at T3 and T4 may influence the ear electrodes, as well as F7 and F8 in rarer cases.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/linked-ears-montage.png\" alt=\"\" width=\"519\" height=\"512\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Linked Ears Montage<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/cz-reference-montage.png\" alt=\"Cz Reference Montage\" width=\"490\" height=\"320\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Cz Reference Montage<br></p>',1),(317,60,316,318,20,0,1,1,1587219857,1587220731,'Sequential Montages','<p>Sequential references (commonly termed “bipolar”) are those that we see in the transverse bi-polar and longitudinal transverse bi-polar montage. Sequential montages (such as transverse or longitudinal transverse, are often used in neurology practices\r\n    to determine the location of any focal findings in the EEG. This is seen with “phase reversals’ in the EEG, where two electrodes seem to “point” to one another (i.e. one line moves eletro-negative and the one next to it moves electro-positive.&nbsp;\r\n    This is a marker of a physical abnormality and can point to the seizure focus, a lesion, hypoperfusion, localized infarct (a small localized area of dead tissue), or white matter ischemia. This is an “X marks the spot” type of finding. You can determine\r\n    the site of the finding based upon the shared electrode between the two pairs. Phase reversals are relevant in slow frequencies (typically 8Hz and under).<br></p>\r\n<p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/banana-montage.png\" alt=\"Phase Reversals located at T5 in a double banana montage\" width=\"418\" height=\"722\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Phase Reversals located at T5 in a double banana montage<br></p>\r\n    <p style=\"text-align: center;\"><br></p>\r\n    <p style=\"text-align: left;\">When there is a lack of blood flow and oxygen to the area, there is often a consequential slowing of alpha at the area. As the area degrades, sometimes the alpha slows considerably below the band. But this depends on how severe the ischemia is (Classen\r\n        and Foreman, 2012). The previous figure shows that we have a left posterior temporal change that may be due to an ischemia. This type of finding can be due to a trauma, a vascular anomaly, an aneurism or structural anomaly.<br></p><p style=\"text-align: left;\"><br></p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/408145737\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<p style=\"text-align: center;\">Video of localization of ischemia via identifying phase reversals in a bipolar montage</p>\r\n\r\n    <p style=\"text-align: center;\"><br></p>\r\n    <p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/bi-polar-montage.png\" alt=\"Transverse Bi-Polar Montage\" width=\"835\" height=\"767\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n    <p style=\"text-align: center;\">Transverse Bi-Polar Montage<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/bi-polar-montage-longitudinal.png\" alt=\"Longitudinal Bi-Polar Montage (aka “double banana montage”)\" width=\"683\" height=\"610\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Longitudinal Bi-Polar Montage (aka “double banana montage”)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/double-banana-montage.png\" alt=\"Double Banana Montage\" width=\"548\" height=\"383\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Double Banana Montage<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),(318,60,317,319,20,0,1,1,1587220761,1587221408,'Average Montages','An average reference that is often used in EEG is based on Laplacian mathematics; it is variously called the Laplacian reference, Hjorth reference, and local average. Other computerized references (meaning no individual reference electrode is required)\r\ninclude the common average or global average and the weighted average reference (Scherg, et al., 2002). A Laplacian montage is useful for understanding what is happening on a focal level (i.e. Laplacian montages are good at seeing focal findings). An\r\naverage reference is a good way to understand what is happening without referencing the ear electrodes, which are often contaminated with real (EEG) or fake (artifactual) findings.<br><br>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/ear-reference-contaminated.png\" alt=\"An EEG with an Ear Reference contaminated by a heartbeat (which is thus seen in every channel)\" width=\"800\" height=\"558\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p>\r\n<p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">An EEG with an Ear Reference contaminated by a heartbeat (which is thus seen in every channel)</span></p>\r\n<p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p>\r\n<p>The Laplacian technique (aka “local average” or “Hjorth” montage) is quite good at showing localized findings. The Laplacian montages are good at eliminating cardioballistic artifacts (as seen in the previous image). However, Laplacian montages are thought\r\n    to have an “unforgiving” nature of display, due to minor distortions at the edge electrodes, commonly a small percentage error (not a real problem for clinical utility).&nbsp;</p>\r\n<p>The Laplacian montage is not good at displaying global or regional EEG findings, due to false localization to the perimeter or edge of the finding (Scherg et al., 2002).&nbsp;</p>\r\n<p>An “average” montage uses the average of all electrodes as the reference. This technique is not good for displaying generalized changes, especially generalized paroxysmal activity. However, this “weighted average” reference is very popular when using\r\n    dense arrays in topographic mapping.</p>\r\n<p><span style=\"\"></span></p>\r\n<p>No montage is the “right one” or the “best” montage, they each have their own strengths and weaknesses. It is important to switch references from a linked ears (or other referential montage) to an average or a Laplacian or Hjorth, to understand the differences\r\n    between montages. One example where linked ears may be deceiving is when strong temporal alpha contaminates the ear lobe. In this case, the ear references will create the appearance that alpha is global, when it is in fact located in the temporal\r\n    and picked up (and thus transmitted) by the reference electrode site—the ear. Thus, the ear references when contaminated create “false alpha.”&nbsp;</p>\r\n<p><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/identify-focal-findings.png\" alt=\"Switching from Linked Ears to an Average Reference to identify focal findings\" width=\"920\" height=\"517\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Switching from Linked Ears to an Average Reference to identify focal findings</p><p style=\"text-align: center;\"><br></p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/408145826\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe><span style=\"font-size: 1rem;\">Appearance of Diffuse Alpha in Lined Ears Reference, due to a contaminated reference electrode, properly localized to T3 when montage is shifted</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p style=\"text-align: left;\"><span style=\"\">The failure to shift montages creates problematic coherences, which are impossible for the human brain to create. When we failed to shift montages, in cases of shared variance, we will often end up with global hypercoherence, which is artifactual and should never be considered real.&nbsp;<br></span></p><p style=\"text-align: left;\"><span style=\"\"><br></span></p><p style=\"text-align: center;\"><span style=\"\"><img src=\"@@PLUGINFILE@@/qeeg-hypercoherence.png\" alt=\"QEEG Map with False Hypercoherence, due to contaminated reference\" width=\"717\" height=\"953\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span style=\"\">QEEG Map with False Hypercoherence, due to contaminated reference<br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p><p>Using a variety of montages is a part of the minimum guidelines for EEG and a commonly adopted guideline developed by the American Society of Electroneurodiagnostic Technologists (ASET). This practice of switching perspectives avoids the reader being fooled by a false localization when a reference is contaminated with voltages as described above. The proper selection of montages will allow the reader to get a good view of the EEG phenomenon and its distribution across the cortex. Understanding of the topographic distribution of brain function is required to understand what the neuropsychological impacts of the EEG changes might be. If you switch to global and you see that it is very different, you must determine which EEG is accurate and which is not.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;</p><p><span></span></p><p>The montage is like a perspective, it is used to present information from a particular point of view. Each montage has strengths as well as weaknesses, including the problem of failed neutrality of the reference. A single ear reference will avoid any problem associated with the other ear’s contamination though it does not cancel the EKG as well as the linked ear reference, as well as creating an apparent asymmetry due to the systematically different inter-electrode distances between the two hemispheres. The Cz reference will give good resolution for the temporal areas but not the central area. The Cz montage is also a poor choice where there is drowsiness, with the associated vertex sharp waves and spindles which are seen maximally along the midline anteriorly and at the vertex which will contaminate the vertex electrode.</p>',1),(319,60,318,320,20,0,1,1,1587221437,1587221558,'Power displays','There are a number of ways power is seen in EEGs. Different power metrics are: 1) raw power measured in amplitude (microvolts squared) or magnitude (microvolts); 2) absolute power (seen in norm-referenced quantitative EEGs); and 3) relative power (seen in norm-referenced EEGs).&nbsp; The different transforms through which EEG can be seen is Fast Fourier Transform and Joint Time Frequency Analysis.&nbsp; &nbsp;<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/isync-brain.png\" alt=\"Depiction of Power Display in IsyncBrain\" width=\"703\" height=\"681\" class=\"img-responsive atto_image_button_text-bottom\" style=\"font-size: 1rem;\"></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Depiction of Power Display in IsyncBrain</span></p>',1),(320,60,319,0,20,0,1,1,1587221564,1587221790,'Absolute Power','Absolute Power is power measured in discreet Hertz bins, by amplitude or magnitude. This can be displayed in a norm-referenced fashion or in raw individual hertz bins.&nbsp;&nbsp; &nbsp;<br><br><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/absolute-power-displayed.png\" alt=\"Absolute Power Displayed in Raw EEG (not norm-referenced)\" width=\"717\" height=\"874\" style=\"font-size: 1rem;\" class=\"img-responsive atto_image_button_text-bottom\"></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">Absolute Power Displayed in Raw EEG (not norm-referenced)</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/absolute-power-displayed-zs.png\" alt=\"Absolute Power Displayed in Z-Score EEG (norm-referenced)\" width=\"716\" height=\"825\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span style=\"\">Absolute Power Displayed in Z-Score EEG (norm-referenced)<br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p>',1),(321,61,0,0,20,0,1,1,1587221924,1587222194,'Basic','<p>The differences in absolute and relative power are differences between the total voltage, or energy, that the brain is emitting, measured in disparate frequencies and typically portrayed after processed via a “normative database” (absolute power) and the measure of clients’ EEGs, viewed in relation to their absolute power profile, used to determine what may be deviant, in relative terms (relative power).&nbsp; Relative maps are subject-specific, in the sense that we are witnessing the deviances (and excesses) in and of the client, taking into account the particulars of the subject’s overall amplitudes.</p><p>Relative power is especially telling when a client is low amplitude overall, or high amplitude overall. In the next figures, we see an individual who has a high amplitude EEGs—meaning that the overall voltage that their brain emits is larger than their same aged peers, in every bandwidth. In this case, we can see in what frequency band they spend the most time.</p><p>Because the absolute power row is high voltage (2+ Z-scores above the norm in every frequency bin) we have to use the relative power rows to determine where this person has the most energy allocated. In the image we can see that the client spends the most time (relatively) in the alpha band and the least amount of time in the delta range.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/aap-eeg.png\" alt=\"High Amplitude Absolute Power EEG\" width=\"560\" height=\"721\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">High Amplitude Absolute Power EEG<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">In the next figure, we see an EEG that is low voltage, overall. We can see that the client is 1-2+ standard deviations low in every bandwidth. When looking at relative power, we learn that the balance of his EEG is quite good—he is spending similar amounts of time in all five bandwidths measured.&nbsp;<br></p><p style=\"text-align: left;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/voltage-eeg.png\" alt=\"Low Voltage EEG\" width=\"560\" height=\"739\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Low Voltage EEG<br></p><p style=\"text-align: center;\"><br></p>',1),(323,62,0,0,20,0,1,1,1587222995,0,'Fast Fourier Transform','<p>Jean Baptiste Fourier demonstrated that any repetitive signal, over the course of time, could be broken down into a series of sine waves by boiling it down into its component parts, in integral numbers. His Fast Fourier Transform is a mathematical calculation that transforms time-related EEG into a frequency domain. So, in Fast Fourier decomposition, the raw EEG is broken down into disparate frequencies, divided into bandwidths: delta (0.5 – 4HZ), theta (4 – 8Hz), alpha (8-12 Hz), Beta 1 (12-15Hz), Beta 2 (15 – 19Hz), Beta 3 (19-25 Hz) and High Beta (25 – 30Hz), as well as individual hertz bins. Many normative databases also break down gamma into individual Hz bins, thought not all give normative data for gamma frequencies.</p><p>Essentially, the Fast Fourier Transform takes a signal and breaks it down into sine waves of different amplitudes and frequencies. Fourier’s theorem states that any waveform within a time domain can be represented by the <b><u>weighted sum of sines and cosines</u></b>.&nbsp;</p><p>In the below image, we are first seeing two sine waves, where one is three times as fast as the other.&nbsp; When you add them, you can see you get a different signal. This is the sum of the two frequencies. A Fast Fourier transform will allow us to see them as separate frequencies.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/summation-two-signal.png\" alt=\"The summation of two signals\" width=\"561\" height=\"450\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">The summation of two signals<br></p><p style=\"text-align: center;\"><br></p><p>In Fisch, it is written: “The FFT function is based on the fact that any signal can be described as a combination of sine and cosine waves of various places, frequencies and amplitudes (Fisch, 1999, p. 125).&nbsp; Although the etiology of EEG does not neatly compartmentalize into individual frequency bins, FFT is one way to better understand the role of various frequencies. When using a decomposition method, such as FFT, you lose the morphology of the raw EEG, which is essential for understanding the fundamentals of the person’s data.</p><p>If we were to take a signal generator and create a perfect 10 Hz wave, but receive electrical contamination at 60Hz, we would see a sharp peak at 10Hz and at 60Hz in a spectrogram. In the below picture, 10HZ is represented by the blur arrow and 60Hz is represented by the red arrow.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/spectrogram-amplitude.png\" alt=\"How a perfect 10Hz (blue) and perfect 60Hz (red) signal would look in a spectrogram with Amplitude on the Y-axis and frequency on the X-axis\" width=\"420\" height=\"321\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\">How a perfect 10Hz (blue) and perfect 60Hz (red) signal </span><span style=\"font-size: 1rem;\">would look&nbsp;<br></span><span style=\"font-size: 1rem;\">in a spectrogram with Amplitude on the </span><span style=\"font-size: 1rem;\">Y-axis and frequency on the X-axis</span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><br></span></p><p style=\"text-align: left;\"><span style=\"font-size: 1rem;\"></span></p><p>One way to tell real EEG from artifact generated by electricity, is the spectrogram will show an abnormal peak, signifying one frequency. Subharmonics of electricity in the United States and western nations are at 16Hz and at 28Hz. The peak seen at 16Hz in the following image is the result of a saltbridge that occurred at the ground electrode, contaminating every other electrode, as a consequence. A real human EEG signal will have “kurtosis,” which means “curved” or “arching” in Greek and is a measure of tailedness within the probability distribution of EEG frequency. We expect to see kurtosis in all dominant frequencies of the EEG.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/spectrogram-electrical.png\" alt=\"Spectrogram showing diffuse electrical contamination at 16Hz\" width=\"603\" height=\"548\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p></p><p style=\"text-align: center;\">Spectrogram showing diffuse electrical contamination at 16Hz<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/kurtosis-eeg.png\" alt=\"A peak showing sides, or kurtosis in real human EEG, indicating that this client not only produces 10Hz, but the also produce the frequencies surrounding 10Hz, as one would in a normal distribution\" width=\"604\" height=\"553\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">A peak showing sides, or kurtosis in real human EEG, indicating that this client not only produces 10Hz, but the also produce the frequencies surrounding 10Hz, as one would in a normal distribution<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/mathematical-eq.png\" alt=\"The mathematical equation for frequency decomposition and the summation of frequencies \" width=\"900\" height=\"507\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">The mathematical equation for frequency decomposition and the summation of frequencies<br></p>',1),(324,63,0,0,20,0,1,1,1587223404,0,'Basic','<p>Joint Time Frequency Analysis is like a shorter Fast Fourier Transform where wavelet packets are analyzed and transformed into quantitative displays. By applying a form of JTFA, you can identify not only the frequency content of a signal, but also how\r\n    that content evolves over time. Thus, JTFA is great at showing changes over time (we get to see “what” is happening “when.”</p>\r\n<p>Joint-Time Frequency-Analysis (JTFA) is used for real-time EEG biofeedback and is used to compute statistical Z scores in real-time. JTFA relies on complex demodulation, which is an analytic technique that multiples a time series by a sine wave and a\r\n    cosine wave and then applies a low pass filter (Granger et al, 1964; Otnes and Enochson, 1977). JTFA computes instantaneous power, instantaneous phase differences, and instantanous coherences. Unlike the Fourier transform,&nbsp; which depends on windowing\r\n    and integration over an interval of time, JTFA complex demodulation computes and creates an instantaneous Z score within subject variance of instantaneous electrical activity as well as the between subject variance for subjects of a given age. The\r\n    summation of instantaneous Z scores is Gaussian distributed and has high crossvalidation (Thatcher et al, 1987; 2007), however, the individual time point by time point Z score is always smaller than the summation due to within subject variance.</p>\r\n<p><br></p>\r\n<p style=\"text-align: center;\"><iframe src=\"https://player.vimeo.com/video/408145806\" width=\"640\" height=\"399\" frameborder=\"0\" allow=\"autoplay; fullscreen\" allowfullscreen=\"\"></iframe></p>\r\n<p style=\"text-align: center;\"><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/spectrogram-eeg.png\" alt=\"A colorful spectrogram showing, over the course of time, what frequencies and what amplitudes are being created in the raw EEG\" width=\"881\" height=\"403\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">A colorful spectrogram showing, over the course of time, what <br>frequencies and what amplitudes are being created in the raw EEG<br></p>\r\n<p style=\"text-align: center;\"><br></p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/jtf-neuroguide.png\" alt=\"Joint Time Frequency Analysis of Head Maps in Neuroguide\" width=\"586\" height=\"592\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Joint Time Frequency Analysis of Head Maps in Neuroguide<br></p>\r\n<p style=\"text-align: center;\"><br></p>',1),(325,64,0,0,20,0,1,1,1587223739,0,'Basic','<p>In the process of Fast Fourier Transform, the analysis assumes it is reading a periodic signal and an integer number of periods (epochs), when the editing process of EEG is rarely this perfect. The edited measured signal is usually not in an integer number\r\n    of periods, which means that—if we were to edit an EEG, only choosing periods where the data looks good (i.e. artifact free), we would have to “smooth” the ends of the snips together. (When the number of periods in the acquisition is not an integer,\r\n    the endpoints are not continuous). If we were to simply patch together the snips of edited EEG data, without smoothing, we would have rather sharp transitions, that would not bode well for FFT transform analysis (the discontinuities would show up\r\n    as high frequency components).</p>\r\n<p>Windowing matches the ends up when you cut the EEG and make epochs. If you splice ends together and there’s discontinuity you get Gibb’s artifact or “spectral leakage.” The spectrum you get by using a FFT, therefore, is not the actual spectrum of the\r\n    original signal, but a smeared version. Thus, the process of windowing gently turns on the epoch at the beginning and turns it off at the end, this is called smearing—this is preferential to Gibb’s artifact. Windowing reduces the amplitude of the\r\n    discontinuities at the boundaries of each finite sequence.</p>\r\n<p>There are a few different kinds of windows: Barlett, Hanning (Hann), Hamming, and Blackman are some of the most used windows. An ideal window starts at 0. Bartlett (triangular window) has a narrow peak at the top. In general, the Hanning (Hann) window\r\n    is satisfactory in 95 percent of cases. It has good frequency resolution and reduced spectral leakage. Both the Hamming and Hanning windows have a sinusoidal shape, which touches zero at both ends eliminating discontinuity. The Blackman-Harris window\r\n    is similar to Hamming and Hann windows. The resulting spectrum has a wide peak, but good side lobe compression.</p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/hamming-hanning.png\" alt=\"Hamming and Hanning Windowing\" width=\"444\" height=\"630\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Hamming and Hanning Windowing<br></p>\r\n<p style=\"text-align: center;\"><br></p>',1),(326,65,0,0,20,0,1,1,1587223896,0,'Asymmetry','<p>Asymmetry is a reflection of a power differential in the brain. Asymmetry can be reflective of pathology.&nbsp; Alpha asymmetry has been studied in diagnosis of pathology. In right-handed individuals, alpha is typically higher in amplitude in the right hemisphere.&nbsp; However, when alpha frequency is slower by 1 Hz or more in one hemisphere, its can indicate a focal abnormality (Markand, 1990) warranting a neurological consult (Duffy, et al., 1989).&nbsp; Likewise, an amplitude difference in alpha between the two sides of more than 50% is considered significant (Hughes, 1994), and because in normal people alpha rhythm is usually of higher amplitude on the right side, a decrease of even 35% on the right may be significant (Duffy et al., 1989).&nbsp; Focal lesions may cause alpha to be disorganized ipsilaterally, to be of lower or higher amplitude, and may cause alpha to fail partially or totally to block following eye opening on the affected side.&nbsp; But, “in the absence of other findings, one should use caution in interpreting isolated amplitude asymmetry of the alpha rhythm, because amplitude asymmetries of the order as high as 2:3 are not uncommon in normal subjects” (Markand, 1990, p. 181, emphasis added).<br></p>',1),(327,66,0,0,20,0,1,1,1587224353,0,'Basic','<p>The measure of coherence is the measure of the stability of the phase relationship between different sites in the brain. That is to say, we are measuring connectivity from the perspective of flexibility.&nbsp; Hypercoherence shows a lack of flexibility\r\n    in the connection relationships; firings are locked into the same rhythm. Imagine soldiers goose-stepping or a crowd clapping in unison. Hypercoherence is an “over-connectivity,” or the stability of the phase relationship between the areas of the\r\n    brain are in a locked pattern.</p>\r\n<p>Hypercoherence is problematic in the sense that it can create “tunnel vision” or the inability to switch tasks readily. On the other hand, it may lead to a sort of frenetic distractibility, where nothing gains the complete attention and the individual\r\n    always feels “scattered,” “distracted,” and busied. When attempting to understand what theta hypercoherence would feel like, in comparison to beta hypercoherence, it is best to consider the frequency, itself, as an adjective describing the “stuckness”\r\n    of coherences.</p>\r\n<p>Hypocoherence is a lack of stability, in terms of the brain waves never remaining consistent in their relative relationship to other areas of the brain. A metaphor for hypocoherence is cacophony in a symphony. When we see hypocoherence it indicates a\r\n    failure to synchronize, a lack of stability in the in frequencies. Very often hypocoherence will result in feeling “off,” and an inability to connect things.&nbsp;</p>\r\n<p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/depiction-hypercoherence.png\" alt=\"Depiction of Hypercoherence in Theta and Beta Frequencies\" width=\"647\" height=\"459\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n<p style=\"text-align: center;\">Depiction of Hypercoherence in Theta and Beta Frequencies<br></p>\r\n    <p style=\"text-align: center;\"><br></p>\r\n    <p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/fft-coherence.png\" alt=\"Depiction of Hypocoherence in Beta Frequencies\" width=\"647\" height=\"459\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n    <p style=\"text-align: center;\">Depiction of Hypocoherence in Beta Frequencies<br></p>\r\n    <p style=\"text-align: center;\"><br></p>\r\n    <p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/brain-normative-database.png\" alt=\"Coherence Measures in Gamma in iSync Brain Normative Database\" width=\"493\" height=\"437\" class=\"img-responsive atto_image_button_text-bottom\"><br></p>\r\n    <p style=\"text-align: center;\">Coherence Measures in Gamma in iSync Brain Normative Database<br></p>',1),(328,67,0,0,20,0,1,1,1587228837,0,'Phase Shift, Phase Lock, and Phase Reset','<p>For 200 – 1,0000 msec clusters of neurons assemble into phase synchrony (aka “phase lock”); conversely, for 200-1,000 msec clusters of neurons disassemble into loss of phase synchrony (aka “phase shift”).&nbsp; The dominant acting force for these synchronizatons and desycnhronizations&nbsp; is that of stochastic resonance (“stochasm” is latin for “purposeful randomness”).</p><p>Phase reset is made of phase shift and phase lock, which is the synchronization and desynchronization of neurons. Phase shift is like a “shout out,” where neurons are recruited to synchronize with the action potential activity at the time.</p><p>Thatcher et al. (2008) identified that longer phase shift dynamic is related to superior I.Q., with an optimized balance between phase shift and phase lock being ideal.&nbsp; Phase shift duration is related to the average local inhibitory post synaptic potential duration on cell bodies and the phase lock duration is positively related to the average excitatory post synaptic potential summation on the dendrites of cortical pyramidal cells.</p><p>When phase shift duration is too short then there are fewer neural resources available to be phase locked into a stable dynamic. Longer phase shift duration increases the probability of identifying larger numbers of neurons capable of being phase locked (this is why there is a direct relationship between shift duration and I.Q.). However, when phase shift duration is too long then there is increased noise and reduced number of neurons available for phase locking. When phase lock duration is too long then there is less flexibility and there are reduced resources available to be allocated by the phase shift mechanism. However, too short of phase locking will result in less information processing and less efficiency of the allocated resources with premature release of the resources by a subsequent phase shift.&nbsp; In short, an optimal balance between phase shift duration and phase lock duration is related to higher levels of intelligence because of an optimal balance results in maximum speed and efficiency of information processing.&nbsp;</p><p>The dynamic balance between synchronization and desynchronization is essential for normal brain function and abnormal balance is often associated with pathological conditions such as epilepsy (Lopes da Silva and Pihn, 1995; LeVan Quyen et al, 2001b; Chevez et al, 2003; Netoff and Schiff, 2002), schizophrenia (Lee et al., 2002) and dementia (Stam et al., 2002a; 2002b).</p><p>Phase dynamics are represented in Bob Thatcher’s qEEG analysis as the metric of “Phase Lag.” Phase lag can be normal (no lines presented), hyper phase lag (red lines) or hypo phase lag (blue lines). Hyper phase lag indicates too much phase lag and not enough phase synchrony (i.e. not enough phase lock). This can result in increased neuronal noise and a reduced amount of neurons available for phase locking.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/z-fft-phase-lag.png\" alt=\"Hyper Phase Lag in Theta in a 60-year-old man complaining of memory difficulties\" width=\"627\" height=\"467\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Hyper Phase Lag in Theta in a 60-year-old man complaining of memory difficulties<br></p><p style=\"text-align: center;\"><br></p><p>Hypo phase lag indicates not enough phase lag (and too long phase lock) indicating that neuronal assemblies are coming into synchrony too frequently and for longer duration than is ideal. The individual in the following image report difficulty keeping attention on any given task.</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/z-fft-phase-lag-2.png\" alt=\"\" width=\"528\" height=\"384\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure : Hypo Phase Lag in all Frequencies in a 12-year-old&nbsp;<br><span style=\"font-size: 1rem;\">girl who has poor organization skills, focus and concentration</span></p><p><br></p>',1),(329,68,0,0,20,0,1,1,1587228934,0,'Detail','<p>Thatcher, R., North, D. M., and Biver, C., J. (2008). INTELLIGENCE AND EEG PHASE RESET: A TWO COMPARTMENTAL MODEL OF PHASE SHIFT AND LOCK. Neuroimage.<br></p>',1),(330,69,0,331,20,0,1,1,1587457112,1591042975,'Intro','<p>Quantitative EEG analysis (qEEG) refers to signal processing and extraction of features from the EEG signal, in some cases there is a normative group that the individual being surveyed is compared to, and sometimes the data is digitized without a comparative reference.&nbsp;</p><p>In the typical neurotherapy practice, 19 channel EEG is digitized, edited or adjusted to remove extra cerebral artifact, and subjected to spectral analysis using the fast Fourier transform (FFT).&nbsp; There are numerous clinical normative databases for many different medical comparisons; normative databases help to evaluate clinical disorders.&nbsp; The National Library of Medicine’s database has a comprehensive list of normative databases, that can be found by search for “normative database: at: <a href=\"http://www.ncbi.nlm.nih.gov/sites/entrez\" target=\"_blank\">http://www.ncbi.nlm.nih.gov/sites/entrez</a>. In using a normative database, we are comparing a single person to a population of “normal” individuals for comparative purposes. A normative database will not only identify frequencies or metrics in which the patient is not normal, but will also identify the degree of their deviance.&nbsp;</p>',1),(331,69,330,332,20,0,1,1,1587457136,1591043651,'Inclusion and Exclusion Criteria for Normative Databases','<p>Normative databases are constructed and validated based upon the scientific standards of gaussianity, cross-validation, amplifier matching and peer reviewed publications. Normative databases must use healthy participants who do not have any psychological or physiological pathologies.&nbsp;A clinically normal database is one where individuals are carefully screened for relevant abnormalities using other clinical tools such as psychometric assessment or MRIs.&nbsp;While it may be too expensive and exhaustive to require that all individuals have full MRI, PET, fMRI, complete neuropsychological evaluation, genetic analysis, blood and urine testing, etc., it would be ideal. A second-best option, then, is to get questionnaire information and objective assessments of general health, and social and intellectual functioning.</p><p>The database should represent the mix of ages, gender, ethnicity, socioeconomic status and other demographic factors present in the overall population. “Representative sampling” means a demographically balanced sample of different genders, different ethnic backgrounds, different socio-economic status and different ages. Using a rigorously screened population, deviations represent the difference from “well-functioning” as compared to “average.” Poor screening procedures result in admitting individuals into a normal group who have significant clinical problems. Careful screening of the subjects that comprise a normative database is critical so that representative samples of healthy and otherwise normally functioning individuals are selected and individuals with a history of neurological problems, psychiatric problems, school failure and other deviant behaviors are excluded. It is especially important to get many children sampled in a normative database, because dramatic developmental changes occur in children and adolescents in relatively short time intervals. Where two years difference will not alter the demographics of an adult, it can signify important differences in, say, a 4-year-old and a 6-year-old.&nbsp;</p><p><span style=\"font-size: 1rem;\">It is important for a database to have a large sample size, although ultimately this criterion is less important than careful calibration, elimination of artifact, rigorous standards during data collection and rigorous standards for data analysis and approximation to a Gaussian distribution. To be considered a clinically valid normative database, there must be peer review (published), tests of reliability, tests of statistical validity, cross-validation tests, full disclosure of the inclusion and exclusion criteria, and adequate sample sizes for different age groups.&nbsp;</span></p><p><span style=\"font-size: 1rem;\">Figure xx: Asymmetry in Quantitative EEG Maps (NeuroGuide)<br></span></p><p style=\"text-align: center;\"><span style=\"font-size: 1rem;\"><img src=\"@@PLUGINFILE@@/asymmetry-z-scored.png\" alt=\"Asymmetry in Quantitative EEG Maps (NeuroGuide)\" width=\"712\" height=\"538\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: left;\"><span style=\"font-size: 1rem;\">Many normative databases available for clinical use contain the mean values of EEG features (absolute power, relative power, coherence measures, etc.); the “normative” quantification of theta data is the standard deviation of the features relative to the normal population (see John, Prichep, &amp; Easton, 1987). Certain databases provide magnitude (the square root of power), while others provide amplitude (which is power measured in microvolts squared).&nbsp; Relative power represents the percentage of power in any bands compared with the total power in the patient’s EEG (e.g., “relative theta” is the percentage of theta of the combined sum of delta, theta, alpha, and beta). One way to describe relative power is “how the client spends their time.” Other derived measures that have been normed include hemispheric asymmetry for power (which often reflects the power differential between different sites in the brain), coherence (the stability of the phase relationship between electrode sites, and phase (the measure of time delay between activities at two sites). It should be recognized that these measures are not statistically independent, and significant deviations on more than one feature may be representing the same neurophysiological process (i.e. hypercoherence in alpha may also be represented in a global alpha amplitude deviation, due to a contaminated reference).&nbsp; While some normative databases rely on a linked ears reference, the savvy clinician will reference a database that has multiple montage possibility (in the case of contaminated reference). A problem with most of the currently available databases is the sole reliance on the linked ear reference. Problems using linked ear references can be resolved by switching to bi-polar or average references.&nbsp;<br></span></p><p style=\"text-align: left;\"><span style=\"\"><br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p><p style=\"text-align: center;\"><span style=\"\"><img src=\"@@PLUGINFILE@@/coherence-WinEEG.png\" alt=\"Coherence in Quantitative EEG Maps (WinEEG and iSyncBrain)\" width=\"291\" height=\"270\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span style=\"\">Figure #A - Coherence in Quantitative EEG Maps (WinEEG and iSyncBrain)<br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p><p style=\"text-align: center;\"><span style=\"\"><img src=\"@@PLUGINFILE@@/coherence-iSyncBrain.png\" alt=\"Coherence in Quantitative EEG Maps (WinEEG and iSyncBrain)\" width=\"427\" height=\"379\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span style=\"\">Figure #B - Coherence in Quantitative EEG Maps (WinEEG and iSyncBrain)<br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p><p style=\"text-align: center;\"><span style=\"\"><img src=\"@@PLUGINFILE@@/quantitative-eeg-maps.png\" alt=\"Phase Measures in Quantitative EEG Maps (Neuroguide)\" width=\"712\" height=\"539\" class=\"img-responsive atto_image_button_text-bottom\"><br></span></p><p style=\"text-align: center;\"><span style=\"\">Figure xx: Phase Measures in Quantitative EEG Maps (Neuroguide)<br></span></p><p style=\"text-align: center;\"><span style=\"\"><br></span></p>',1),(332,69,331,333,20,0,1,1,1587457586,1587457639,'Quantitative “Normative” and Non-Normative Database Validation Steps','<p style=\"text-align: left;\"><span style=\"\">A quantitative database should represent the mix of ages, gender, ethnicity, socioeconomic status and other demographic factors present in the overall population. The method of recruitment of normal individuals also should be considered. Poor screening procedures will result in admitting individuals into a normal group who have signiﬁcant clinical problems. Regardless the method of recruitment, care must be exercised not to entice individuals to participate and falsify information because of the ﬁnancial gain. Normative databases are to be constructed and validated in respect to the basic scientific standards of gaussianity, cross-validation, amplifier matching and peer reviewed publications.<br></span></p>',1),(333,69,332,0,20,0,1,1,1587457646,1591044064,'Statistical Analysis of Normative Databases','<p>Spectral power is an often used measure in qEEG studies. The amount of power for each frequency or frequency band for a given electrode is computed and compared to the database mean value. The results are often represented as z-scores, that is the difference between the mean score of a population and the patient’s individual score divided by the standard deviation of the population. Z-scores detect and characterize potential abnormalities from the tested individual, relative to the normative population within his/her own age range. It is not strictly the number of deviations, rather the pattern of deviations that is most relevant. The use of parametric statistics assumes a normal (Gaussian) distribution of the variable(s) in question.&nbsp;</p><p></p><p>The Gaussian distribution is a fundamental distribution that is used throughout science, for example, the Schrodinger wave equation in Quantum mechanics uses the Gaussian distribution as basis functions (Robinett, 1997).&nbsp; The application of the EEG to the concept of the Gaussian distribution requires the use of standard mathematical transforms by which all statistical distributions can be transformed to a Gaussian distribution (Box and Cox, 1964). Quantitative EEG uses transforms that are applied to the power spectrum of the digital time series in order to approximate a normal distribution.&nbsp;</p><p><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/gaussian-distribution.png\" alt=\"Gaussian distribution\" width=\"763\" height=\"555\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Gaussian distribution<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">The next two figures are representations of raw, un-normed data, and Z-score data, respectively, in spectral graphs. The top image shows the raw absolute power of the EEG in microvolts squared. We see that 10Hz shows up at approximately 16mV2 . The second image shows the data in Z-scores, or how deviant from the norm these frequencies are. In the second image, we can see that the purple line (representing one electrode) is 3+ standard deviations above the norm between 14 – 16 Hz, and 4+ standard deviations above the norm at 28 Hz. Both of these findings are potentially artifactual, but this cannot be determined without an analysis of the raw EEG.<br></p><p style=\"text-align: left;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/microvolts-spectral.png\" alt=\"Spectral Power in Microvolts squared (y-axis) and hertz (x-axis)\" width=\"599\" height=\"553\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Spectral Power in Microvolts squared (y-axis) and hertz (x-axis)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/spectral-power-z-score.png\" alt=\"Spectral Power in Microvolts squared (y-axis) and hertz (x-axis)\" width=\"595\" height=\"541\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Spectral Power in Z-Scores (y-axis) and hertz (x-axis)<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">The next figure we see is showing, one channel per graph, the raw data in the EEG on a spectral display. This imagery is from WinEEG. Each peak represents a rhythm in the data, showing kurtosis, or the expected shape of a peak with sides that indicates it is a frequency range.<br></p><p style=\"text-align: left;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/spectra-raw-eeg.png\" alt=\"Spectra of Raw EEG (not Norm referenced) as seen at each electrode in WinEEG\" width=\"900\" height=\"572\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #1 - Spectra of Raw EEG (not Norm referenced) as seen at each electrode in WinEEG<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">The figure below illustrates a common modern quantitative EEG analysis where EEG traces are viewed and examined at the same time that quantitative analyses are displayed so as to facilitate and extend analytical power.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/raw-EEG-quantitative-EEG.png\" alt=\"Raw EEG and Quantitative EEG\" width=\"1920\" height=\"1160\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Raw EEG and Quantitative EEG<br></p><p style=\"text-align: center;\"><br></p>',1),(334,70,0,335,20,0,1,1,1587458305,0,'Basic','<p>The earliest quantitative EEG (QEEG) reference normative database was developed in the 1950s at UCLA as part of the NASA study and selection of astronauts for purposes of space travel (Adey et al, 1961; 1964a; 1964b). Clinical inclusion and exclusion criteria were not used because there was no intended clinical application of this early QEEG reference normative database. However, the essential quantitative foundations of QEEG normative databases were tested such as the calculation of means and standard deviations and measures of Gaussianity, complex demodulation, fourier spectral analysis and basic statistical parameters necessary for any reference normative database.<br></p>',1),(335,70,334,336,20,0,1,1,1587458318,1587458360,'History of Sample Size per Age Group ','<p>There is no absolute sample size that is best for a QEEG database because statistically sample size is related to the “effect size” and “power” (Hayes, 1973; Winer, 1971). The smaller the effect size then the larger the sample size necessary to detect that effect. The power of a statistical measure varies as a function of sample size and the effect size (Cohen, 1977). Another issue related to sample size is the degree to which a sample approximates a Gaussian distribution. Increased sample size is often necessary in order to achieve closer approximations to Gaussian which in turn is related to the accuracy of cross-validation. Thus, the sample size is one of several inter-related issues in all normative databases and the sample size should not be singled out as being the most important factor in a QEEG normative database.</p><p>In regard to pediatric EEGs, there are rapid changes in EEG measures during early childhood. For this reason, a relatively large sample sizes is required during the period of time when the brain is changing most rapidly, as well as during old age when potential rapid declines in neural function may occur.</p>',1),(336,70,335,337,20,0,1,1,1587458385,1591044755,'History of Gaussian Distribution Approximation and Cross-Validation','<p>The statistics of replication and independent cross-validation of normative QEEG databases was first applied by E. Roy John and collaborators in 1974 to 1977 (John, 1977; John et al, 1977; 1987). The importance of approximation to a Gaussian distribution was emphasized by both Dr. E. Roy John and Dr. Frank Duffy a Harvard Neurologist in the 1970s and 1980s. In 1994 the American EEG Association produced a position paper in which the statistical standards of replication, cross-validation, reliability and Gaussian approximation were iterated as acceptable basic standards to be met by any normative QEEG database (Duffy, 1994). The American EEG Society included the same standards.</p><p>Matousek and Petersen (1973) computed means and standard deviations in one-year age groups and were the first to use Z scores to compare an individual to the&nbsp;</p><p>normative database means and standard deviations.&nbsp; &nbsp;The Z score is an excellent statistic defined as the difference between the value from an individual and the mean of the population divided by the standard deviation of the population or&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/cross-validation.png\" alt=\"\" width=\"102\" height=\"65\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">This translates to Z= [normative value - observed value]/normative standard deviation</p><p style=\"text-align: center;\"><br></p>',1),(337,70,336,338,20,0,1,1,1587458473,1587459141,'Inclusion and exclusion criteria for normative databases','<p>John and colleques expanded on the use of the Z score for clinical evaluation including the use of multivariate measures such as the Mahalanobis distance metric.A direct normalization of the Gaussian distribution using Z scores is useful in comparing&nbsp; individuals to a QEEG normative database. That is, the standard score form of the&nbsp;</p><p>Gaussian is where the mean = 0 and standard deviation = 1 or, by substitution into the&nbsp;</p><p>Gaussian equation for a bell shaped curve, then&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/shaped-curve.png\" alt=\"\" width=\"120\" height=\"79\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p>, where Y = Gaussian distribution and the Z score is a deviation in&nbsp;</p><p>standard deviation units measured along the baseline of the Gaussian curve from a mean of 0 and a standard deviation = 1 and deviations to the right of the mean being&nbsp;</p><p>positive and those to the left negative.&nbsp; By substituting different values of Z then different values of Y can be calculated.&nbsp; &nbsp;For example, when Z = 0, Y = 0.3989 or, in other words, the height of the curve at the mean of the normal distribution in standard score form is given by the number 0.3989.&nbsp; For purposes of assessing deviation from&nbsp;</p><p>normal, the values of Z above and below the mean, which include 95% of the area of the Gaussian is often used as a level of confidence necessary to minimize Type I and&nbsp;<span style=\"font-size: 1rem;\">Type II errors.</span></p><p>The Gaussian distribution is a fundamental distribution that is used throughout science. The application of EEG to Gaussian distribution requires the use of standard mathematical transforms by which all statistical distributions can be transformed into Gaussian distributions. The pyramidal neurons exhibit rhythmic bursts and periods of asynchrony in a non-Gaussian distribution as a function of time. In order to run Z-score analysis or Z-score neurofeedback, it is mandatory to transform EEG digital data to approximate a Gaussian shape (a bell curve).&nbsp;</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/gaussian-distribution-across-metrics.png\" alt=\"Gaussian Distribution across metrics\" width=\"587\" height=\"461\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #2 - Gaussian Distribution across metrics<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">Figure #5 below is a summary and overview of the procedures that are used to eliminate artifact, maximize reliability, approximate Gaussian distributions, cross-validate and compute clinical correlations as a standard set of procedures and sequences to make normative database creation more easy.&nbsp;<br></p><p style=\"text-align: left;\"><img src=\"@@PLUGINFILE@@/statistical-considerations-databases.png\" alt=\"Statistical considerations in databases\" width=\"587\" height=\"628\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #5: Statistical considerations in databases<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: left;\">Figure #6 below is a list of the Gold Standards of a QEEG Normative Database, as developed by Robert Thatcher.<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/QEEG-Normative-Databases.png\" alt=\"Gold Standards of QEEG Normative Databases, from Thatcher\" width=\"528\" height=\"288\" role=\"presentation\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #6: Gold Standards of QEEG Normative Databases, from Thatcher<br></p>',1),(338,70,337,339,20,0,1,1,1587459152,1587459260,'Basic statistical analysis','<p>The selected normal subjects are grouped by age with sufficiently large sample size and&nbsp;<span style=\"font-size: 1rem;\">the means and standard deviations of the EEG time series and/or Frequency domain&nbsp;</span><span style=\"font-size: 1rem;\">analyses are computed for each age group.&nbsp; &nbsp;Transforms are applied to approximate a&nbsp;</span><span style=\"font-size: 1rem;\">Gaussian distribution of the EEG measures that comprise the means.&nbsp; &nbsp;Once&nbsp;</span><span style=\"font-size: 1rem;\">approximation to Gaussian is completed, then Z scores are computed for each subject in the database and leave one out Gaussian Cross Validation is computed in order to arrive at an optimum Gaussian Cross —validation sensitivity.&nbsp; &nbsp;&nbsp;</span></p><p>Finally, the Gaussian validated norms are subjected to content and predictive validation procedures such as correlation with neuropsychological test scores and intelligence, etc. and also discriminant analyses and neural networks and outcome statistics, etc.&nbsp; &nbsp;The content validations are with respect to clinical measures such as intelligence, neuropsychological test scores, school achievement, clinical outcomes, etc.&nbsp; The predictive validations are with respect to the discriminative, statistical or neural network clinical classification accuracy.&nbsp; Both parametric and non parametric statistics are used to determine the content and predictive validity of a normative EEG database.&nbsp;</p>',1),(339,70,338,0,20,0,1,1,1587459274,1587459356,'Major Databases','<p><b>Neuroguide</b></p><p>Robert Thatcher’s Neuroguide database was collected at the University of Maryland in 1990, where initially a sample of 625 normal subjects constituted the normative database. This database included clinical selection criteria, an age range of 2 months to 282 years, cross-validation tests, demographics.</p><p>The NeuroGuide database has been tested and re-tested and the sensitivity of the statistical distributions has been calculated for each montage and condition. Normalcy was determined by response to a neurological history questionnaire which was given to the child’s parents and/or filled out by each subject. IQ and other age appropriate psychometric testing, academic achievement, as well as classroom performance as determined by school grades and teacher reports also were used in determining normalcy. Nine hundred and forty-three (943) variables were computed for each subject including measures of absolute and relative power, coherence, phase, asymmetry, and power ratios. Z-score transforms are available in single Hz bins. Sliding averages were used to compute age-appropriate norms. Results were inspected for Gaussian distribution (for further details see Thatcher, Walker, Biver, North, &amp; Curtin, Sensitivity and cross-validation of a lifespan normative EEG database — at: http://www.applied neuroscience.com/LSNDB.htm.) Recording with task challenges was not performed. The construction and composition of this database are relatively well documented.&nbsp;</p><p>The NeuroGuide software allows the user to import previously recorded EEG data, edit and analyze data, and process the data into maps and necessary statistics. Neuroguide is built from 625 normative comparisons of relative power, absolute power, power ratios, coherence, and phase and amplitude asymmetry.</p><p>Some of the attributes of Neuroguide include automatic artifact rejection, dynamic FFTs with comparisons to FFT lifespan, and Eyes Open and Eyes Closed Norms covering ages from birth to 82 years of age. NeuroGuide includes a Traumatic Brain Injury and Learning Disability discriminant functions, as well as an integrated statistical package. It also includes predictions of neuropsychological test scores using the Brain Performance Index.</p><p>One of the tools is EEG Neuroimaging to evaluate Brodmann Areas and nodes and connections of functional networks in the brain likely linked to symptoms, statically or in real-time.</p><p>NeuroGuide provides a retrospective view of EEG waveforms and offline artifact rejection. NeuroGuide also offers calculations of Spectral Energy, Power and Coherence along with discriminant Functions, Signal Generator, LORETA Norms, and Brain Performance Index (QEEG Information).</p><p>NeuroGuide uses a Fast Fourier Transform (FFT) with .5Hz and 1Hz resolution to provide color headmaps with a bandwidth of 0-40Hz, a Joint-Time-Frequency Analysis component to identify time events greater or less than a threshold value, as well as LORETA analysis. Montage selection and creation are allowed, as well, including bipolar montages, current source density montages and average reference montages in eyes closed and eyes open conditions.</p><p>The mathematical details of complex demodulation used to compute the instantaneous Z scores as contained in the Applied Neuroscience, Inc. “dll” are published in Otnes and Enochson, (1977);Granger and Hatanaka, (1964); Bloomfield, 2000; Thatcher et al, (2007). Complex demodulation is a time domain digital method of spectral analysis&nbsp;<span style=\"font-size: 1rem;\">whereas the fast Fourier transform (FFT) is a frequency domain method.&nbsp; These two&nbsp;</span><span style=\"font-size: 1rem;\">methods are related by the fact they both involve sines and cosines and both operate in the complex domain and in this way represent the same mathematical descriptions of the power spectrum.&nbsp; The advantage of complex demodulation is that it is a time&nbsp;</span><span style=\"font-size: 1rem;\">domain method and less sensitive to artifact and it does not require windowing nor&nbsp;</span><span style=\"font-size: 1rem;\">even integers of the power of 2 as does the FFT.&nbsp; &nbsp;The FFT integrates power in a&nbsp;</span><span style=\"font-size: 1rem;\">frequency band over the entire epoch length and requires windowing functions which can dramatically effect the power values whereas, as mentioned previously, complex demodulation does not require windowing (Otnes and Enochson, 1972).&nbsp; &nbsp;Complex demodulation was&nbsp;</span><span style=\"font-size: 1rem;\">computed for the linked ears and eyes open and eyes closed conditions for all 625 subjects in the normative database.&nbsp;</span></p><p><br></p>',1),(340,71,0,341,20,0,1,1,1587459827,0,'Basic','<p><span style=\"font-size: 1rem;\">Information in this description taken from -&nbsp;</span><i style=\"font-size: 1rem;\">\"Use of Databases in QEEG Evaluation, Jack Johnstone, PhD &amp; Jay Gunkelman, QEEG-D\"</i><br></p><p>The SKIL database currently includes 135 adults ranging from 18 to 55 years old (see Sterman &amp; Kaiser, 2001). No normative information is currently available for children or young adults. SKIL does not consider age as a factor in computing z-score deviations. The reference population is comprised of students and laboratory personnel (50%), volunteers recruited from the community (25%), and U.S. Air Force personnel (25%). Screening was based on questionnaire regarding medical history, drug use, and recent life events.</p><p>The SKIL database incorporates recordings at rest (eyes closed and open) and during task&nbsp; challenges involving audio-visual information processing and visual-spatial tracking. A correction for the time of day of recording is available which is based on combined cross-sectional and longitudinal data rather than the preferred method of tracking within-subject changes over time.&nbsp; The SKIL database covers a restricted range of frequencies, from 2 Hz to 25 Hz. This method deletes signiﬁcant slow and fast frequency data which may be of clinical importance. However, the database does have the advantage of providing norms for each single Hz increment over this frequency range. The SKIL database relies exclusively on the linked ear reference. The SKIL analysis has not received FDA 510(k) clearance and is labeled as “not intended for medical use.”&nbsp;</p><p>The SKIL database does not have a measure of EEG coherence but rather includes a similarity measure termed“comodulation,” which is quite like coherence but does not yield a measure of phase.&nbsp; Comodulation is essentially the correlation of the spectrum for two recording electrodes over time using a sliding one second data window moved in 250 millisecond increments. Although this effectively deals with windowing issues, it also is clear that the degree of correlation between electrode sites is not computed on independent, but rather overlapping, spectral analyses.&nbsp;</p><p>Since the SKIL database relies exclusively on the linked ear reference, the comodulation similarity measure is strongly inﬂuenced by the fact that both sites are connected to a common source. This can lead to shared variance, which can cause erroneous comodulation results. Nevertheless, the comodulation metric is currently being explored for possible clinical utility.&nbsp;</p><p>As discussed previously, there must be a balance between the number of individuals in a database and the number of variables used in assessment to account for multiple statistical tests. The SKIL database has the advantage of a large number of features (e.g., multiple conditions, 1 Hz bins) but has the disadvantage of a relatively small number of individuals represented in the database. This tends to increase the number of false positive ﬁndings. A solution to the problem of false positive results is to replicate ﬁndings on independent samples of data from the individual patient.</p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/brands-of-power-skill.png\" alt=\"Image of Bands of Power in SKIL\" width=\"538\" height=\"439\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #1 Image of Bands of Power in SKIL<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/unity-measure-skil.png\" alt=\"Image of Theta Unity measure in SKIL\" width=\"627\" height=\"586\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #2&nbsp;Image of Theta Unity measure in SKIL</p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/skill-img-spectra.png\" alt=\" Image of spectra at each site from SKIL\" width=\"677\" height=\"352\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #3 -&nbsp;Image of spectra at each site from SKIL</p>',1),(341,71,340,0,20,0,1,1,1587459836,1587459894,'iSync Brain Database (South Korean Database)','<p>iSync uses independent component analysis (ICA), a statistical method to separate independent sources from superimposed signals. It is the most common method that has been used in EEG data decomposition, and can be used to identify and remove the artifacts from raw EEG data.&nbsp;</p><p>The iSync database initially cleans out artifact with the application of high-pass and low-pass filers. This reduces distortions (artifacts) from common physiological sources such as face or eye muscle movements, as well as extrinsic non-physiological sources such as electrical devices, power lines, and poor electrode contact. This is the only database currently on the market (2020) that uses the automatic cleaning process (one can choose not to have this process undertaken).</p><p>Features in the iSyncBrain database include time series, power spectrum density (PSD), component scalp map (Topomap), dipole source location (Source location) extracted from ICA are shown for each component.</p>',1),(342,72,0,343,20,0,1,1,1587459968,1587460302,'Basic','<p>Independent components are spatially and spectrally independent variables in the EEG. Independent component analysis (ICA) is a statistical method to separate independent sources from extracerebellar signals. It is the most common method that has been used in EEG data decomposition, and can be used to identify and remove the artifacts from raw EEG data. Features including time series, power spectrum density (PSD), component scalp map (Topomap), and dipole source location are extracted from ICA are shown for each component. iSyncBrain computes the EEG and breaks it down into its component parts, represented in components that are ranked by their variability.&nbsp;<br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/isyncbrain-quantitative-database.png\" alt=\"Figure #1: Image of an Independent Component from iSyncBrain Quantitative Database\" width=\"743\" height=\"305\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #1: Image of an Independent Component from iSyncBrain Quantitative Database<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/isyncbrain-power-finding.png\" alt=\"Figure #2: Subcortical Power Findings in iSyncBrain\" width=\"718\" height=\"621\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #2: Subcortical Power Findings in iSyncBrain<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/eeg-isync-brain.png\" alt=\"Figure #3: Connectivity Findings in the EEG in iSync Brain\" width=\"739\" height=\"605\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #3: Connectivity Findings in the EEG in iSync Brain<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><img src=\"@@PLUGINFILE@@/isyncbrain-ica.png\" alt=\"Figure #4: ICA Cleaning as seen in iSyncBrain\" width=\"676\" height=\"493\" class=\"img-responsive atto_image_button_text-bottom\"><br></p><p style=\"text-align: center;\">Figure #4: ICA Cleaning as seen in iSyncBrain<br></p><p style=\"text-align: center;\"><br></p><p style=\"text-align: center;\"><br></p>',1),