Transcript 48x36 Poster Template

The Use of Neurofeedback
in Military Post-traumatic Stress Disorder.
OPTIONAL
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Pearson, Heather J, BSc, MD, FRCPC*, McCulloch, Janet, MD, CCFP, FRCPC, Beckett, Linda, MD, CCFP*.
*Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada.
Background
About
this template
Results
Results for all Measures at 0, 4, 8 and 12 Weeks
Military personnel are commonly exposed to
traumatic events which may lead to the
development of Operational Stress Injury (OSI) or
Post-traumatic Stress Disorder (PTSD). This
results in serious symptoms that interfere with life
functioning, and other consequences such as
substance abuse, domestic violence and suicide.
Subjects & Design
13 Veterans from the Canadian Military, ages
ranging from 30-60, attended 36 minute
neurofeedback sessions twice weekly for 8
weeks, and then given the option to attend
once or twice weekly for a further 8 weeks.
These Veterans all had been medically
released because of OSI/PTSD. During the
study, participants continued treatment as
usual with their primary physicians.
Measures collected were State-Trait Anxiety
Inventory, PTSD Checklist-Military and Beck
Depression Inventory at baseline and weeks 4,
8, 12, and 16. Clinician-Administered PTSD
Scale (CAPS) was done at baseline and weeks
8 and16. This study is still in process and
week 16 results are pending.
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120.0
p= 0.001
N =11
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Dan
Aaron
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Pierre
Geoff
Amber
Jeff
Richard
Jonas
Andy
Wayne
Sean
John
Christine
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Average Week
Week
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8 12
p= 0.001
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CAPS
## 87 ##
STAI-State
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p= 0.127
STAI-Trait
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PCL-M
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# BDI-II
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p= 0.003
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p=
0.038
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Week 8
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58.4
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## 51.1
26.7
p= 0.032
p= 0.191
p= 0.047
p= 0.036
Week 12
56.8
Summary of Interim Results
EEG-Biofeedback is a promising approach in the
treatment of Veterans who suffer from PTSD.
Neurofeedback is readily accepted by this group
of patients and tolerance and compliance are
excellent. In this study, the onset of action
appears to be as rapid or more than conventional
treatment modalities and there are few reported
adverse effects. This preliminary work suggests
that further research, such as a randomized
controlled trial, would be beneficial in confirming
results.
References
57.5
54.5
26.4
Neurofeedback Procedure
Neurofeedback is the process whereby a
participant is provided with information on their
own EEG signal, enabling modification of this
signal. Many neurofeedback systems seek to
entrain the brain to create specific frequencies in
specific brain areas, following a clinician
determined protocol.
p= 0.001
p= 0.001
# # # 80.0
# # # - # - # # # # - 0 CAPS
# # # # # # - # - # # # # - 8 CAPS
STAI - Trait
PCL-M
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60.0
# # # # # # # #STAI# - 48#
# 0 STAI-S
State
# # # # # # - # - # # 42# # - STAI-T
40.0
# # # # # # - # - # # 34# # - 4 STAI-S
BDI - II
# # # # # # - # - # # 41# # - STAI-T
# # # 20.0
# # # - # - # # # # - 8 STAI-S
# # # # # # - # - # # # # - STAI-T
# # # 0.0
# # # - # - # # # # - 12 STAI-S
Week 0
Week 4
# # # # # # -- # -- # # # # -- 16 STAI-T
STAI-S
CAPS
100.0
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STAI-T
## ##STAI-State
## ## ## ## -- ## -- ## ## 41#
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0 P-CL
29#
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4 P-CL
63.3
52.8
## ## ## ## ## ## -- ## -- ## ## ## ## -- 12
8 P-CL
P-CL
16 P-CL
STAI-Trait
63.9
61.1
## ## ## ## ## ## -- ## -- ## ## 14#
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0 BDI-II
7
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4
BDI-II
## ##PCL-M
## ## ## ## -- ##63.4-- 9
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56.8- 8 BDI-II
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12
BDI-II
- 35.516
BDI-II
BDI-II
28.1
Group Means (Raw scores)
There is a compelling need to find effective
treatments for OSI/PTSD which is one of the most
treatment resistant mental health conditions of this
century. EEG biofeedback or “neurofeedback”
has anecdotal reports of its successful use in
OSI/PTSD. The goal of this study was to formally
measure effects of one neurofeedback protocol
(Neuroptimal) in a case series, to establish
positive treatment responses and pave the way for
further investigation.
CAPS Subscales
The system used in this study, Neuroptimal, does
not seek to push the brain to create certain
frequencies but is based on the conception of the
brain as a self-organizing and self-regulating organ.
Feedback is provided when it is determined by a
specific software algorithm that the characteristics
of real time brain frequencies are unstable. A nonconscious process inherent in the brain is theorized
to occur, which causes the brain to return to a
stable state. Over time, learning is thought to take
place, whereby the brain is less likely to become
'stuck' in these states and develops improved
resiliency and flexibility. The system is described
as providing brain training, rather than treatment.
Chae, J., Jeong, J., Peterson, B. S., Kim, D., Bahk, W., Jun, T., et al. (2004).
Dimensional complexity of the EEG in patients with posttraumatic stress disorder.
Psychiatry Research: Neuroimaging, 131(1), 79-89.
Falconer, E. M., Felmingham, K. L., Allen, A., Clark, C. R., McFarlane, A. C.,
Williams, L. M., et al. (2008). Developing an integrated brain, behavior and
biological response profile in posttraumatic stress disorder (PTSD). Journal of
Integrative Neuroscience, 7(3), 439-456.
Hickling, E. J., Sison, G. F.,Jr, & Vanderploeg, R. D. (1986). Treatment of
posttraumatic stress disorder with relaxation and biofeedback training.
Biofeedback & Self Regulation, 11(2), 125-134.
Jokic-Begic, N., & Begic, D. (2003). Quantitative electroencephalogram (qEEG) in
combat veterans with post-traumatic stress disorder (PTSD). Nordic Journal of
Psychiatry, 57(5), 351-355.
Kemp, A. H., Griffiths, K., Felmingham, K. L., Shankman, S. A., Drinkenburg, W.,
Arns, M., et al. (2010). Disorder specificity despite comorbidity: Resting EEG
alpha asymmetry in major depressive disorder and post-traumatic stress disorder.
Biological Psychology, 85(2), 350-354.
Lewine, J. D., Canive, J. M., Orrison, W. W.,Jr, Edgar, C. J., Provencal, S. L.,
Davis, J. T., et al. (1997). Electrophysiological abnormalities in PTSD. Annals of
the New York Academy of Sciences, 821, 508-511.
Smith, W. D. (2008). The effect of neurofeedback training on PTSD symptoms of
depression and attention problems among military veterans. Dissertation
Abstracts International: Section B: The Sciences and Engineering, 69(6-B), 3862.
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