Copyright Dr JFL Mureriwa 2020 www drmureriwaeeg co

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 1 EEG NEUROIMAGING AND NEUROPSYCHOLOGY LABORATORY Dr. Joachim F. L Mureriwa www. drmureriwaeeg. co. za 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2 - EEG NEUROIMAGINGA BRIEF OVERVIEW • For the General Public (South Africa) • Of General Interest to Health Practitioners • Acknowledgment: Some of the power-point images were created by Koki Malahlela 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 3 EQUIPMENT AND SOFRWARE USE TO GENERATE EEG IMAGES FOR THE PRESENTATION • Brainmaster 20 Channel EEG: www. brainmaster. com. • Neuroguide Software: www. appliedneuroscience. com • Thought Technology Equipment/ Software: www. thoghttechnology. com • DECLARATION OF INTEREST • None 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 4 TOPICS COVERED • Basic concepts in EEG: • EEG recordings • Brain Locations: Brodmann Areas • Brain networks • EEG biofeedback • Applications of QEEG 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 5 BASIC CONCEPTS IN EEG 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 6 EEG • Means: Electroencephalography. • The brain produces electrical activity. • This electrical activity can be detected by sensors (electrodes) placed on the head. • The brain’s electrical activity accounts for whatever the brain can do. • IMPORTANT: All psychological activities depend on the electrical activities of the brain. • Examples: paying attention, concentration, memory, abstract thinking, planning, emotions. • Emotional & behavioural problems all reflect problems with electrical activity.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 7 SAMPLE: EPOCH OF AN EEG RECORDING 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 8 SINGLE BRAINWAVE FROM ONE HEAD LOCATION: POSITION FPI 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 9 SINGLE BRAINWAVE SPLIT INTO COMPONENT WAVES- LIKE COLOURS OF THE RAINBOW

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 10 AMPLITUDES AND FREQUENCIES OF BRAIN WAVES • EEG amplitudes are measured in microvolts (m. V). • Frequency is the number of wave cycles per second. • Cycles per second are also referred to as hertz (hz) • Brain waves differ with respect to amplitudes and frequencies. • Conventionally, brainwave are classified into 4 broad types: • Delta, theta, alpha, and beta 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 11 ILLUSTRATION OF EEG AMPLITUDE DIFFERENCES 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 12 ILLUSTRATION OF EEG FREQUENCY DIFFERENCES 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 13 DELTA WAVES • The slowest brain waves with high amplitudes. • Associated with deep sleep, or coma. • Therapists never train patients to increase the delta waves. They inhibit it. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 14 THETA WAVES • Slow high amplitude waves. • Associated with sleepiness, lack of focus, poor concentration. Sometimes associated with anxiety and depression. Theta is important in memory function and relaxation.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 15 ALPHA WAVES • Moderately fast moderate amplitude wave. • It is produced when a person is awake but not actively processing information. • Associated with calmness and relaxation.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 16 BETA WAVES 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 17 BETA 1: (SENSORI-MOTOR RHYTHM) (SMR) 12 -15 HZ • Beta 1 is a fast, low amplitude wave most abundant around the sensory-motor strip. • Associated with the organization of brain processes. • Associated with an alert, focused, but calm state. Keeping still whilst ready for action. • Important in the EEG biofeedback treatment of epilepsy. • Important in the biofeedback treatment of ADD/ADHD.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 18 BETA 2 (15 -18 HZ) • Fast, low amplitude wave associated with arousal. • Optimal concentration, focus, and problem solving. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 19 BETA 3 (18 -25 HZ) • Faster than beta 2. High arousal and activation. • May be associated with anxiety. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 20 HIGH BETA (25 -30 HZ) • Very fast low amplitude waves. • Excessive arousal and vigilance. • May be associated with rumination, anxiety, and paranoia. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 21 QUANTITATIVE EEG (QEEG) • The EEG is collected in the same way as is the case for Routine Clinical EEG. • The EEG is then subjected to statistical analyses, to identify numerous variables. • Hence the word “Quantitative” or “Q” • The results are converted to z-scores and other parameters. • The individual’s EEG is then compared to a international normative databases. • In setting up databases, the EEG is co-registered with the f. MRI. • At this practice we use the Neuroguide database: www. appliedneuroscience. co,

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 22 SAMPLE QEEG NEURO-IMAGES 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 23 RECORDING THE EEG ELECTRODE PLACEMENTS. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 24 Watch Video of “A Sample EEG recording” on this website Or watch now https: //drive. google. com/file/d/17 cxx. MNHb. F 5 XITu. AVl_JBWRMw. A 1 z 3 d 4 -7/view

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 25 Find this document under “Knowledge Resources” on this website “ROUTINE CLINICAL EEG AND QUANTITATIVE EEG” 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 26 THE BRODMANN AREAS OF THE BRAIN SOURCE: MURERIWA, JFL (2017 A) 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 27 See Document on this website “Brodmann Areas of the Brain” 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 28 BRAIN NETWORKS • Psychological Functions are not localized to only one brain structure or location. • Multiple brain locations are involved in any psychological process. • Example: Anxiety Network includes: • - Amygdala • - Prefrontal cortex • - Cingulate • - Insula • - and several other structures. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 29 WHERE TO FIND INFO ON BRAIN NETWORKS FOR DIFFERENT PSYCHOLOGICAL DISORDERS • NATIONAL LIBRARY OF MEDICINE • https: //pubmed. ncbi. nlm. nih. gov/26809184/ • Google Search terms: Pubmed Brain Networks in…(Name of disorder, e. g. anxiety). • Other Google search strategies will also work.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 30 BRAIN CONNECTIVITY MEASURES • Coherence: A measure of the extent to which brain areas share information/ activities. • Phase Lag: A measure of the speed of communication between brain areas.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 31 USING QEEG TO ASSESS AND TREAT NEUROLOGICAL, MEDICAL, AND BEHAVIOURAL DISORDERS EEG BIOFEEDBACK [Neurofeedback] 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 32 EEG BIOFEEDBACK IS A SPECIAL APPLICATION OF THE WELL-ESTABLISHED PSYCHOLOGICAL TREATMENT MODALITY CALLED “BEHAVIOUR THERAPY” 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 33 THE TWO MAIN FORMS OF CLASSICAL BEHAVIOUR THERAPY ARE - Classical Conditioning (I. Pavlov). Operant Conditioning (BF Skinner). EEG Biofeedback is based on Operant Conditioning 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 34 In operant conditioning (BF Skinner), behaviour which is rewarded in the presence of particular stimuli will tend to be repeated in future when the same or similar stimuli are present. In other words, behaviour is controlled by its consequences. (Mureriwa, 2017 a), p. 67. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 35 FEATURES OF EEG BIOFEEDBACK • Initial interview to document patient’s symptoms. • Hypothesis: Linking symptoms to brain structures & brain networks. • Initial EEG assessment to determine which brain locations or EEG parameters deviate from normal. • Planned comparisons of symptoms to QEEG. • Symptom-EEG match: Based on current knowledge of brain-behaviour relationships (peer reviewed), do the symptoms match the expected EEG abnormalities. • If there is a symptom-EEG match, training is commenced.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 36 THE EEG BIOFEEDBACK TRAINING SESSIONS (OPERANT CONDITIONING). • Patient is attached to EEG machine, facing a computer screen. • Patient sees the display of their own EEG in real-time. • The EEG is presented graphically as features of a computer game. • Change own brain by changing aspects of the display on the computer screen. • Example: Persons with intractable epilepsy or ADHD: Increase SMR (13 -15 hz), and decrease theta (4 -8 hz). • By small incremental steps, the patient is rewarded for changing the brainwaves in the desired direction.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 37 THE EEG BIOFEEDBACK TRAINING SESSION (OPERANT CONDITIONING). • The computer displays the result of the patient’s success. • This is the “feedback”, about a “bio” logical event: biofeedback. • The reward comes in many forms: e. g. % correct, pleasant sounds, pleasant visual displays, patient’s own favourite music, photos, etc. • For small children, the reward may include actual take-home items, such as toys, depending on the level of success. • Retraining the brain takes many, many sessions.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 38 SYNAPTIC ACTIVITY ASSOCIATED WITH OPERANT CONDITIONING • Anticipation of the reward is associated with a surge of dopamine (reward). • The learning process leads to increased size and number of synapses. • This is a Nobel-Prize winning discovery. • Google Eric Kandel • Psychotherapy and the single synapse • http: //www. columbia. edu/itc/hs/medical/clerkships/psych/misc/articles/kandel. pdf

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 39 APPLICATIONS: ASSESSMENT/ TREATMENT • ADD/ADHD. • Insomnia. • Alcohol/drug abuse. • Intractable Epilepsy QEEG. • Antisocial behaviour. • Intractable psychological disorders. • Anxiety. • Learning/ developmental disorders. • Autism/ Asperger’s. • Post-traumatic Stress Disorder (PTSD). • Brain injury. • Pre/ Post neurosurgery QEEG. • Cognitive problems (e. g. dementia). • Pre/post medical treatment QEEG. • Depression. • Stroke assessment (QEEG).

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 40 ASSESSMENT OF PSYCHOPHYSIOLOGICAL FUNCTIONS OF OTHER BODY SYSTEMS • There are eleven systems of the human body. • The nervous system and its organs represent only one system. • The brain impacts all eleven systems, and it is impacted by all of them. • Brain assessment using EEG/QEEG needs to take into account that the nervous system is embedded in other systems. • A psychophysiologist needs to assess events in other body systems.

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 41 PERIPHERAL PHYSIOLOGY ASSESSMENT • See another video on this website. 2022 -02 -13

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 42 SOME PARAMETERS AMENABLE TO PSYCHOPHYSIOLOGICAL ASSESSMENT • Heart rate, blood volume: Use plethysmograph. • Finger temperature: (vasoconstriction/ dilation detectable by finger thermometer/ stress card). • Breathing rate and breathing patterns: Use respiratory strain gauges. • Skin conductance (Stress-related sweating): Skin conductance sensors. GSR. • Muscle tension/ relaxation: Electromyography (EMG). • All changes due to brain impact: Autonomic Nervous system- adrenaline

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 43 DEMONSTRATION OF PSYCHOPHYSIOLOGICAL ASSESSMENT • This was prepared for a lecture at University of Pretoria in 2018. • Note: At room temperature of 21 -23 o. C, normal temperature is around 33 o. C. • The lower the temperature the more the stress/ lack of relaxation or calmness. • See information sheet on stress thermometer/ card under “Knowledge Resources” • Link to demo: • https: //drive. google. com/file/d/1 Sl 4 Nki. Yjzjbkjw. Z 1 p. TLJ 9 k 5 e. TMD 5 h. IRD/view

Copyright © Dr. JFL Mureriwa 2020; www. drmureriwaeeg. co. za 2022 -02 -13 44 END Thank you!