Advanced Diagnostics and Imaging Techniques: Advanced diagnostics and imaging techniques allow us to evaluate the brain and its function in ways that must be viewed as truly miraculous.  New methods go beyond just looking for tumors, strokes and other pathologies giving us a window into the brain and its function.   One of the problems with some kinds of advance imaging besides their high cost is their associated health risks.  For example, CT scans, SPECT scans and PET scans while all providing valuable information, often give a double dose of radiation.  One dose comes from the machine and another dose comes from the radioactive dyes used to enhance the image.   Another form of advanced imaging, MRI provides excellent detail for viewing pathologies.  Unfortunately, it also heats up the brain and it too requires radioactive dyes to evaluate function in the brain.   One new collection of methods takes an older technology and gives it a new twist.  The combination of EEG, QEEG, and LORETA provides a safer, much less expensive alternative than other methods and for many conditions it will provide a more accurate picture of the brain and its ability to function too.  While not appropriate for everyone, EEG/QEEG/LORETA examinations are a valuable tool providing information for the diagnosis of many conditions. EGG EEG The first electroencephalogram (EEG) was recorded by Hans Berger and published 1929.  Before the advent of CT and MRI, EEG was often the only method available for evaluating the brain.  Even now, it is still a valuable tool in the evaluation of the brain and cognition. EEG measures the electrical activity coming from the brain.  In order to do this the signal coming from the brain cells must be amplified one million times.  Modern equipment allows this to be stored digitally and thus allows the manipulation of the data contained in the EEG by computer.  When this is done, it is called a quantitative electroencephalograph or QEEG. QEEG Quantitative electroencephalography allows the use of advance mathematical formulas and calculations to graph or present pictures that represent the function of clusters of neurons in the brain.  The following describes just some of the many insights we can gain by the use of this tool. Absolute Power Absolute Power Absolute power is a measure of pressure that drives the electrical charges in the brain.  It is often measured in microvolts squared. Relative Power Relative power tells us where most of the power is at in the brain.  Relative power measures at each frequency level, how much brain power is available. It lets us know if one part of the brain is dominating the others. Ratios Ratios compare one set of frequencies of the brain to another.  They let us know if one frequency of the brain is dominating the others. Z-Scores Z-scores are comparisons against a data base.  The data base represents an average of normal patients.  So z-scores represent a comparison of the patient’s scores against an expected normal. Coherence and Phase Lag Coherence is a measure of which parts of the brain is working together.  It can be measured at each frequency.  Coherence can be just right, too much or too little.  Phase lag indicates the speed of the connections. Coherence and Phase Lag Discriminant Analysis Discriminant analysis is a mathematical computation of the predictability of the patient having a learning disability or a traumatic brain injury based on the electrical findings from the EEG.  These predictions have been found to be highly accurate. Discriminant Analysis Psychophysiological Measures: IQ Another variation of discriminant functions is the ability to estimate the IQ of a patient based on the electrical activity in the brain.  Since the electrical activity of the brain can be changed with treatment, this provides a measure of change and improvement. Discriminant Analysis LORETA LORETA stands for low resolution brain electromagnetic tomography.  It is a way of visualizing a point source of electrical activity in the bran. Here are some ways it’s used: LORETA Source Localization LORETA allows localization and identification of areas of increased or decreased activation.  LORETA is a functional measure and may provide information unavailable via CT or MRI images. LORETA Source Localization LORETA 3-D Localization Another feature of LORETA is the ability to use 3-D graphics to show changes in activation.  LORETA is able to demonstrate this at 1 Hertz steps allowing the full range of evaluation of brain waves. LORETA 3-D Localization LORETA Source Correlation LORETA Source Correlation of regions of interest, often called ROI’s, allow a graphic comparison of connectivity between various parts of the brain and a particular region of the brain that is selected for evaluation.  The scale gives a measure of connectivity by color.  In this case, blues indicate less connectivity and reds indicate a high degree of connectivity. LORETA Source Correlation Conditions appropriate for the use of EEG/QEEG/LORETA:   • AD/HD   • Learning Disorders   • Memory Difficulties   • Head Injuries   • Seizure Disorders   • Developmental Delays   • Brain Mapping   • And many other conditions