At the Montreal Neurofeedback Center, we offer an extensive array of assessments and therapies including neurofeedback , biofeedback and traditional psychotherapy.
This is the first contact with our professionals for all patients. During this 1 hour and a half session, our clinical neuropsychologists will determine if you are a viable candidate for neurofeedback therapy. They can also suggest other possible treatments or even a combination of several treatments. If neurofeedback is not the best suited approach for you, a report describing your clinical profile as well as personalized recommendations will be provided to you. If we believe that neurofeedback should be considered, no report will be given at this stage. The professional will discuss with you the details of the therapy that you will undergo, and will hand you a consent form that will state those details as well as all other administrative information (i.e. fees, number of sessions, patient's rights) related to the whole therapy process. In addition, an appointment for a complete evaluation will be scheduled. Keep in mind that during this session, you will also have the opportunity to ask the neuropsychologist any additional questions you may have concerning your disorder or the suggested therapies.
When neurofeedback is considered appropriate for you, a complete evaluation will be scheduled. It will last approximately 2 hours and it will include neuropsychological testing as well as brainmapping using quantitative electroencephalogram (QEEG). It must take place in the morning, and is preferably done without any stimulants. Accordingly, any substance with stimulating effect (such as caffeine or energy drinks) is better discontinued 5 days prior to testing. If you or your child are taking psychostimulants (such as Ritalin, Concerta, Dexadrine, or Adderal), testing can be done in the morning before the first dose intake. Also, in order to get a better electrode adherence, we strongly recommend washing and drying the hair less than 12 hours before the evaluation (please refer to our downloadable documents for more information). After this session, another one-hour session will be scheduled, during which a detailed written report will be provided to you. All results, as well as a personalized therapy plan, will be discussed at this stage.
Neuropsychological assessment involves the investigation of various aspects of function including intellectual, emotional, perceptual, sensory, strength, and coordination with consideration towards integrity of brain function. Detailed interview, review of medical and educational records, and the use of published standardized psychological tests are the most commonly used methods used in this type of assessment.
Neuropsychological assessment is used for diagnostic purposes (learning disabilities, concussions and more severe brain injury, developmental disabilities, loss of mental efficiency with aging, dementia, posttraumatic stress disorder, and emotional problems), to characterize change following compromise of brain function and to determine return to play in sports as well as mental efficiency in relation to careers.
The Biofeedback assessment is used worldwide to quantify the working relationship between the body and the brain at rest, under stress and during recovery. Reacting to events in a stressful manner or failing to return to baseline after the event is associated with medical and psychological disorders as well as decreased performance in personal and professional activities. When stressed, the body is pre-programmed to fight, flee, or freeze. The heart races, blood is sent to important areas of the body to help mobilize energy for movement and the brain becomes busy. Stresses can be positive (win an award, enjoy another person, etc.) or it can be negative. These responses are adaptive, unless it is a severe shock, or cumulative small stressors across time (e.g. often irritability with work, arguments with others, anxiety over upcoming events, etc.) and they then become maladaptive and potentially harmful.By looking at the physiological activity at rest, in response to stressors and in recovery, in addition to clients' comments about their past and current functioning, this type of assessment allows us to:• Compare clients to a database of profiles of individuals in good psychophysiological health;• Find atypical patterns that may cause problems;• Compare client's perceptions of themselves with their actual physiological and mental activity to see how well they know themselves;• Identify strengths and weaknesses and develop a training program to optimize health.
The aim of this evaluation is to confirm the diagnosis of ADHD, and to specify as well as quantify the different sub-types of this disorder. It can also be used as a baseline before therapy is started. To do so, a combination of questionnaires and standardized tools are used to gather the required information, including:
A QEEG is an assessment tool to evaluate a person's brainwaves and determine to what extent the brainwave patterns differ from normal.
Recent research shows that certain dysfunctions, such as ADHD, schizophrenia, OCD, depression, specific learning disabilities, and others are associated with specific patterns in spontaneous and evoked electrical potentials, recorded from the head by multiple surface electrodes, and that these spontaneous potentials and especially the evoked electric potentials provide reliable brain markers of the brain function and dysfunction.
Measured data of spontaneous and evoked electrical potentials can be compared with data from a normative database, thus helping the clinicians confirm the diagnosis and establish a personalized treatment plan.
To perform a QEEG mapping procedure, electrodes, also known as sensors, are typically positioned on the client’s scalp at 32 standardized locations designated by the International 10-20 System (see below). This is usually accomplished by placing a special tight lycra cap, much like a bathing cap, on the client’s head. This cap has all the electrodes already attached in their proper position and is then connected to a differential amplifier and computer with a special cable. The electrodes in the cap make contact with the skin of the scalp by means of a special gel that reduces the resistance between the electrode and the skin. The electrodes pickup the very faint electrical signals of the brain that pass through the skull and scalp and pass these on to a differential amplifier that may amplify the signal a million times or more and convert the analog signal to a digital signal before passing it on to the computer.
Understanding the numbers and graphics
The numbers generated are Z scores which is a metric which represents how normal or abnormal a score is in comparison to the Neuroguide Database. A Z score of +1 represents a score exceeding 84% of individuals that age; +1.25 exceeds 89%; +1.5 exceeds 93%; +2.0 exceeds 98%.A combination of tables and graphics of Z scores appear below for either the traditional eeg bands (e.g. Delta 1-4 Hz.; Theta 4-7 Hz.; Alpha 8-12 Hz., Beta 12-25 Hz, etc.) or for specific single Hz. bins to enable increased precision. The heads use colors to represent the Z scores at the 19 sites, with the nose on the top. Grey represents scores that are normal (+/- 1 Z score). The dots on the head are electrode sites (e.g. the top two being prefrontal sites)Here is an example of three seconds of EEG recorded at 19 sites which shows the brain making normal brainwaves to start but then shifts into a dysregulated state where it makes the larger, slower brainwaves (theta). This dysregulated state is likely occurring when this ADHD child is inattentive.ADHD Child’s EEG (8yrs old)When this child’s recorded brainwaves are averaged and compared to a database we find that he is making more theta activity in the frontal and prefrontal sites is greater than 97% of children his age. This information can be represented in graphs as seen below.Same ADHD child’s EEG represented graphicallyWe can see his excessive theta activity in the graph below:
Adult with Generalized Anxiety Disorder and acquired brain injuryAn overanxious woman who banged the back of her head has a different looking brainmap, showing the excessive delta and theta in the back of her head, in addition to the excessive alpha everywhere.Adult with Obsessive Compulsive DisorderAn adult suffering with severe Obsessive Compulsive Disorder has a QEEG which shows very excessive fast wave activity, a common pattern in OCD:Adolescent with Seizure DisorderAn adolescent with a severe seizure disorder (5x/week) had this QEEG before and after treatment:
After a course of neurofeedback, you can see he had a much improved QEEG (and only one seizure in 3 months). Notice the significant reduction of Delta and Theta activity.
Connectivity: A measure of how the various parts of the brain communicate with each otherBrainmaps provide a great deal of additional information in a variety of tables and graphs. In addition to measures of the power of the EEG at various speeds, the Connectivity measures give information about but about how well one part of the brain is communicating with another part of the brain.
This adolescent with ADHD and Obsessive Compulsive Disorder has difficulties with effective communication between various prefrontal and frontal lobe sites.
The QEEG human brain mapping procedure is very relevant because it provides more information than the typical electroencephalogram (EEG). By having a QEEG done, the brain activity can be compared to a wide database of other "normal brains," helping to determine which, if any, of the brain functions is actually abnormal. QEEG can be helpful in determining whether a person's symptoms are associated with specific brain dysfunctions .This valuable information can guide treatment planning . Repeated QEEG assessments can also be used to monitor treatment progress by showing changes in brain functioning as treatment progresses and symptoms change.
EEG recording is non noninvasive and a safe procedure.
The Mini quantitative EEG assessment is a short alternative for the full qEEG. Though it provides less information, it is conducted in 2 - 6 minute sessions set in 1-minute epochs. The Mini qEEG assessment shows the clinician exactly if the client's brain is over or underactive on certain points which causes symptoms like attention deficit, depression, anxiety, concentration problems etc.
The concept of Z score biofeedback [also known as Z-Score neurofeedback] in order to identify brain regions that are de-regulated and depart from expected values in real-time..READ more —> http://www.bmedreport.com/archives/6938
EEG neurofeedback is a form of biofeedback that uses real-time digital technology to measure electrical activity of the brain (EEG) and present this information in a form that enables the individual to perceive changes in the state of the brain and learn to modify abnormal EEG patterns . To rewire the brain, we make use of neurofeedback-therapy. This treatment stimulates metabolism and blood flow, strengthens dendritic connections as well as the functioning of neurotransmitters, which accounts for improvement in the patient’s ability to carry out cognitive tasks successfully.
Treatment with EEG neurofeedback is based on the theory that once individuals understand their brain activity and learn to manipulate their own brain waves, they will be able to continue to do so, long after the therapy has ended. Some studies have followed patients for as long as 10 years after being treated with EEG neurofeedback and have shown no significant loss of treatment gains.
We apply electrodes to the scalp to listen in on brainwave activity. We process the signal by computer, and we extract information about certain key brainwave frequencies. (All brainwave frequencies are equal, but some are more equal than others….) We show the ebb and flow of this activity back to the person, who attempts to change the activity level. Some frequencies we wish to promote. Others we wish to diminish. We present this information to the person in the form of a video game. The person is effectively playing the video game with his or her brain. Eventually the brainwave activity is "shaped" toward more desirable, more regulated performance. The frequencies we target, and the specific locations on the scalp where we listen in on the brain, are specific to the conditions we are trying to address, and specific to the individual.
Biofeedback is a type of non-invasive treatment that provides real-time information on brain or body functions. It uses computer technology to record physiological activity that is normally outside conscious awareness (e.g. heart rate, breathing rate, and muscle tension) and to display this activity to the person being recorded. The goal of biofeedback is to teach people to build awareness of patterns of physiological stress and to voluntarily control their physiological activity.
Heart Rate Variability training (for stress, emotional reactivity and cognitive enhancement)
Research has shown that the degree of 'speed-up' and 'slow-down' of the heart - known as Heart Rate Variability (HRV) has profound implications for health and well being. It has been shown that HRV can be modified through Biofeedback training. A number of medical and psychological conditions are now being treated by HRV training, including anxiety, excessive anger, cardiac condition, asthma, irritable bowel syndrome, chronic pain, chronic fatigue syndrome, and , chronic obstructive pulmonary disorder (COPD).
Graphiques modalities HRV
Heart Rate Variability Biofeedback is a new technique for training people to change the variability and dominant rhythms in their heart activity. The heart is a bio-electrical pump beating at an ever changing rate, and this change or variability, is adaptive and is necessary in order to maintain a healthy heart. If you suffer mental or emotional stress, or become depressed, this variability decreases and the heart does not function so well. On the other hand, high HRV is associated with better health and survival from illness.Recent research has now shown it is possible to increase your own HRV using biofeedback. So, if you are frequently stressed and perhaps suffer from one or more of the stress-related illnesses, you can learn to increase your HRV and be on your way to a healthier mind and body. Initial case reports have shown success with HRV biofeedback in reducing anger and anxiety disorders, asthma, cardiovascular disorders, chronic fatigue, chronic pain, essential hypertension and irritable bowel syndrome -228600319405(Lehrer et al, 2004; Lehrer et al, 2006; Hassett et al, 2007).
Thermal Biofeedback training (for stress management, headache prevention, insomnia and attention regulation)Feedback Thermometer - Skin Temperature:
Chronic stress is associated with hypertension (high blood pressure), migraines, tension headaches, digestive problems, anxiety, and mood disorders. Under stress, blood vessels in hands and feet constrict and core muscles constrict to keep organs tight and deactivated in preparation for a response to a stressor. As a result, there is less peripheral blood flow, which is typically associated with lower skin temperature. So, skin temperature is an index of stress-related arousal. A feedback thermometer, usually attached to a finger, detects skin temperature in degrees Celsius or Fahrenheit. Awareness of this arousal can help reduce stress and facilitate relaxation practice.
Galvanic Stress Response training (for emotional reactivity and stress management; GSR)Electrodermograph (EDG) – Skin Conductance:EDG provides one of the fastest and most sensitive measures of stress. The activity of sweat glands in the palms of the hands precisely reflects a person's level of emotional arousal. Mental agitation is expressed almost immedately (within .5 to 3 seconds) in the amount of sweat on the surface of the skin. This can be detected by measuring the conductance of electrcity across the hands hands or fingers (the electric current cannot be felt by the user). Skin Conductance Level (SCL) also known as Galvanic Skin Response (GSR) is measured in kΩ (thousands of ohms). This technology has been used for decades as the basis for the classic "lie detector" test. SCL is also widely used to increase people's awareness of their emotions and for the reduction of stress, anxiety, high blood pressure, and insomnia.Surface Electromyography (sEMG) Biofeedback
Muscle tension is at the root of several stress-related problems including headaches, back and neck pain, temporomandibular joint disorder (TMD). It is also an important symptom of anxiety, worry, stress, and mood problems. With EMG, electrodes on the skin pick up activity from underlying muscles (measured in microvolts) and provide feedback about the state of the muscles. You can uses this information to increase awareness and reduce tension in those muscles.
What is rTMS?rTMS is a procedure in which cerebral electrical activity is influenced by a pulsed magnetic field. The magnetic field is generated by passing brief current pulses through a figure 8 coil. This coil is encased in plastic and is held close to the scalp so that the magnetic field can be focused onto specific areas of the cortex, or surface, of the brain.
• rTMS therapy was approved by Health Canada for clinical delivery in Canada.
The magnetic field that is generated in rTMS can penetrate the scalp and skull safely and painlessly to induce a current in specific regions of the brain. It is termed repetitive TMS, or rTMS, because the magnetic stimulation is delivered at regular intervals.
Many aspects of rTMS, referred to as stimulation parameters, can be changed. The ability to change parameters while directly targeting specific brain areas suggests that rTMS has valuable therapeutic potential.
This means that the delivery of rTMS therapy may be customized for each patient. It also suggests that rTMS may be used to elicit certain desired effects in the brain (i.e. excitatory or inhibitory effects) that have shown promise for treating various conditions or illnesses such as depression. rTMS may be used to elicit certain desired effects in the brain (i.e. excitatory or inhibitory effects) that have shown promise for treating various conditions or illnesses such as:
DepressionIn treating depression, rTMS therapy targets the area in the left cerebral hemisphere just a few inches above the temple and beneath the skull. This area is called the left dorsolateral prefrontal cortex (L-DLPFC, see photo). The L-DLPFC is readily accessible to the magnetic field and is highly interconnected with limbic structures, which play a dominant role in mood modulation and major depression.
rTMS is used to treat depression by inducing a current in the L-DLPFC with stimulation by a magnetic field. The stimulations are short but intense, lasting less than a millisecond. The penetration itself holds little energy. Several studies have suggested that rTMS regulates beta adreno-receptors and increases dopamine and serotonin levels.
Some remote brain structures are also believed to be linked to depression. rTMS may alter activity in these structures not directly accessible to the rTMS coil by focal cortical stimulation. The indirect stimulation occurs via trans-synaptic effects. This means that the accessible areas of the brain, such as the L-DLPFC described above, are first directly stimulated by the magnetic field. This direct stimulation may in turn cause the inaccessible areas of the brain to be stimulated.
The human brain is a natural electrical organ that functions by transmitting electrical signals from one nerve cell to another. Brain imaging techniques demonstrate that individuals suffering from depression often display insufficient levels of glucose metabolism, lower blood flow in the L-DLPFC and increased activity in the limbic system.
rTMS acts on this process by regulating the flow of interactions between neurons that will appropriately increase or decrease the desired regions to relieve the depression.
Acute treatment for depression consists of 20-30 rTMS sessions, over 4-6 consecutive weeks (excluding weekends).
The CBT leans on the theories of the learning, the behavior and the conditioning. These therapies, called "cognitive", are interested in the progressive modification of the mental plans of interpretation of the reality, to eliminate the disorders, annoyance and the unsuitable behavior.
Executives, Students, AthletesPeak performance training using EEG biofeedback can be likened to training in a gym. With repeated excercise, just as muscles respond and gain strength, the brain similarly learns to self-regulate more and more optimally through Neurofeedback.Neurofeedback has been used for optimizing performance by athletes in world class football, basketball and hockey teams. It has been researched for golf performance enhancement and by racquet ball playersCanadian governing body for tennis and McGill University in Montreal have committed to a five years study to put 80 of the regions top athletes through Neurofeedback training.Studies at Imperial College London have shown that Neurofeedback enhances the performance of musicians and dancers.Opera singers, musicians and students have benefitted from Neurofeedback training to improve their performance, creativity and memory. Research has shown it to improve microsugical skills and reducing time on tasks by 26%.Alpha-theta training is a specialised form of Neurofeedback training which is offered without the visual stimulus. Instead the clients relax on a recliner or in the chair with headphones that sends auditory stimuli to the brain. These auditory signals alter in response to the brain states.Awake state, as well as alpha theta training is used according particular performance need of the individual looking for Neurofeedback training for peak performance.The Reaction Time Suite —> (http://www.thoughttechnology.com/reactiontime.htm) includes both continuous performance testing (CPT) and real sports reaction time training
Improvements in training can be seen within 10-20 training sessions. Training can improve both physical and mental skills. Physical skill enhancement can come from improving muscle training (relaxation and correct muscle coordination), sweat response (emotional control), heart rate variability (calmness and efficiency) and temperature (recovery from training). Mental training includes Neurofeedback for improving focus, lessening stress, enhancing imagery effectiveness, eliminating or lessening negative self talk, and recovery from fatigue. In short, it allows athletes to be more consistently 'in the zone'. The BF/NF programs are also designed to match the nature of each sport; the type of skill needed, the time period, and the changes necessary within the actual sport performance. Being calm in one part of a skill may be important but being highly energized in another part may lead to better performance. The brain and body should be trained to be flexible to match the sequence of mental and physical states neededNeurofeedback and sports in the newshttp://www.thoughttechnology.com/thewall1.htmPerformance EnhancementMany Business executives, managers, sales associates, nurses, doctors, lawyers and other professionals have used Neurofeedback services to give them a competitive edge. Musicians, writers, singers, computer programmers and other performing artists have used Neurofeedback & to enhance their creativity and skills to refined their skills and performance, while being able to access and stay in "The Zone"Neurofeedback or EEG Biofeedback helps the brain regulate itself and self regulation is key to optimal brain functioning. It is best considered as mental fitness training that over time teaches the individual's brain improved skills of managing attention, arousal (level of excitability), and affective or emotional stateHere are some examples of optimal frequencies for different tasks;
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The Montreal Neurofeedback Centre3400 Jean-Talon West Suite 100Montreal, QC H3R 2R8Tel: (514) 481-7867Fax: (514) 933-6318Toll Free: 1 866.331-3431
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