REFERENCED EEG METHOD GUIDES PSYCHIATRIC TREATMENT SELECTION

 

Our treatment method

Physiology is the organizing principle of the medical model. This is the reason that illness is defined as a physiological variance from a normal range. Physicians use laboratory tests of organ function to identify if there is any physical disorder and to differentiate the type of abnormality. Physical measurement is necessary to justify medical therapy that is intended to change physiology. Measuring physiology permits individualized therapeutic recommendations that are logical and likely to yield a favorable clinical outcome. 

Contrasting with the physiological organizing principle of the medical model, treatment selection in naturalistic psychiatry is based primarily on symptoms and behaviors. These are sorted and classified by a list of syndromes called DSM-IV (DSM) disorders. Psychiatrists use interviews, rating scales and performance measures to describe a patient’s behavioral syndrome and as the basis for selection of medical treatment. However, clinical experience makes obvious that there is no consistent relation between these symptoms and behaviors and response to neuroactive medications. Particular symptoms and behaviors may suggest a mental disorder, but do not characterize individual neurobiology or likely neuroactive response. 

This explains the diverse medication outcomes that are currently observed in naturalistic psychiatry. Lacking a measure of individual brain function in these disorders, psychiatric medication selection remains educated guessing and medication response a chance occurrence.

 To improve the random nature of psychiatric therapeutics, in 1986 our laboratory began electroencephalographic (EEG) and quantitative EEG (QEEG) medical research. We sought to distinguish differences in individual brain function and improve psychiatric therapeutics in populations who suffer with mental disorders. This work has evolved into a referenced EEG method that characterizes features of brain function underlying a broad range of psychiatric syndromes. In this procedure, a prospective patient’s EEG data is compared with a large, clinical outcome database of heterogeneous EEG/QEEG’s and their diverse medication responses. The prospective patient’s EEG data is then mathematically classified and correlated with neuroactive medication(s) likely to improve their particular brain function. 

 Our laboratory has retrospective, double blind prospective and unblinded prospective medical research, which demonstrates the ability of individual EEG data to improve medication selection and treatment outcomes in certain DSM disorders. Our growing EEG/QEEG database includes children (from six years of age), teenagers and adults (to ninety years of age) with a broad range of DSM diagnoses. Diagnosesinvolving mood (depression), attention, learning, eating (anorexia and bulimia), chemical dependency or substance abuse, anxiety, panic, insomnia, chronic fatigue or fibromyalgia, various tic disorders, obsessions and compulsions are represented. The database also contains patients with chronic headaches, including refractory migraine headache and/or other pain disorders.

 Our therapeutic EEG method has been licensed to Central Nervous System Response, Inc. (CNSR), a medical information technology company. CNSR is conducting a successful pilot program in Atlanta, Georgia with a US healthcare company. In this ongoing program, patients with eating disorders, substance abuse disorders, mood disorders and/or attention deficit disorders, who previously did not respond to two or more medication trials, were eligible to receive EEG testing with referenced EEG medication correlation. Psychiatrists who are using CNSR rEEG medication correlation have achieved favorable treatment outcomes in more than 70% of these previously treatment non-responsive patients. This robust outcome demonstrates that psychiatric physicians using rEEG analysis within the medical model – physical measurement directs selection of medical intervention – can improve therapeutic outcomes of biologically heterogeneous samples of patients within and across diverse DSM disorders.

An introductory literature on the scientific basis and utility of rEEG medication correlation is listed in the Psychiatric EEG Research section.

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