Innovative Medicine

Psychiatry - Evolving Science

Psychiatry is a rapidly evolving science. New research constantly leads to new and promising medications, new diagnostic procedures, and better approaches to difficult problems. Our goal is to keep abreast of this research so that we can continue to improve our care. One thing that distinguishes us is our use of innovative technology.

Psychiatric medication treatment has largely been a process of educated guesses unlike other areas of medicine where diagnosis and treatment are based upon physical and laboratory findings. However, new technologies now provide a more objective basis for treatment.

EEG

Electroencephalograms or EEGs measure the electrical activity or the “brainwaves” of the brain. They are a sort of electrical brain scan, somewhat like other imaging technologies, such as fMRI, SPECT, and PET scans, primarily used in research.

rEEG

Referenced-EEG or rEEG, a technology developed by CNS Response, provides the first clinically useful method of guiding medication treatment based upon identified brain abnormalities. The technology is based upon data collected from 7,000 patients over many years, treated with some 17,000 different medications. Because treatment is based upon selecting medications demonstrated to address specific brain abnormalities rather than on a group of symptoms, rEEG appears useful in treating a broad range of psychiatric diagnoses. Studies to date of rEEG have consistently shown effectiveness rates of greater than 65% in treatment unresponsive patients, a much higher rate than prior approaches.

Quantitative EEG

Different brainwave patterns reflect different mental states such as drowsiness, relaxation, and active attention. Abnormal brainwave patterns may reflect underlying psychiatric problems. Quantitative EEG is a method to analyze one’s brainwave patterns and identify abnormalities and localize them to specific areas of the brain.

Quantitative EEG is not used to diagnose in isolation but can assist clinicians in diagnosing patients undergoing proper clinical evaluation. In particular, quantitative EEG appears useful in distinguishing different physical subtypes within diagnoses, which may be responsive to different treatments. In one recent study of 159 children, one particular EEG abnormality correctly identified those children diagnosed with ADHD 87% of the time and correctly identified those without ADHD 94% of the time, which was much better than the rates found in using parent and teacher rating scales. Those diagnosed with ADHD had different brain abnormalities that would not be responsive to the same treatment.

Neurofeedback

Once we identify abnormality in the brain with quantitative EEG the question is what to do about it. Medications are frequently the answer. Another solution employs EEG as a treatment modality. Neurofeedback, also called EEG biofeedback or neurotherapy, attempts to normalize abnormal brainwave patterns using EEGs as a biofeedback tool. In repeated sessions, one receives positive visual and auditory cues as brainwave abnormalities achieve more normal patterns. Basically, neurofeedback is a way of retraining one’s brain.

There are a growing number of research studies indicating the effectiveness of neurofeedback, primarily in ADHD, but also in seizures, traumatic brain injury, anxiety and depression. In a recent issue of Child and Adolescent Psychiatric Clinics of North America the editors concluded: “EEG biofeedback meets the American Academy of Child and Adolescent Psychiatry criteria for clinical guidelines (CG) for treatment of ADHD, seizure disorders, anxiety (OCD, GAD, PTSD, phobias), depression, reading disabilities, and addictive disorders.”

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