What is a Qeeg?

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     A Qeeg is an analysis of a collected sample of EEG from the standard 19 eeg sites on the scalp.  It is a longer collection of eeg than a standard hospital eeg.  For a Qeeg, the eeg is collected in at least two conditions, eyes open (10 minutes or more) and eyes closed (10 minutes or more).  

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This collection is then sent, along with the clinician’s description of the presenting history and symptoms, to a specially trained Qeeg analyst.  Like a hospital eeg, the analysis can include a formal reading by a neurologist.  However, unlike the hospital eeg, a Qeeg is analyzed in a different way by a Qeeg diplomat, specialized in two skills:  visual inspection of the eeg collection, and comparison of the data to a computerized database.

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•  The visual inspection of the raw eeg data:  The diplomat ascertains and removes artifact from the eeg recording.  Then he/she visually inspects the eeg for normal and abnormal activity, such as sub-epileptic threshold paroxysmal activity, spiking of the eeg, and other electrical activity in the brain that might signal need for a neurologist’s attention.  Attention is also given to characteristics of that eeg pattern that might help explain the symptoms and possibly establish a target for neurofeedback training.  This is a methodical and in-depth look at the raw eeg, that goes beyond a typical hospital or neurological office reading.  (It has a different interest and purpose.) Concerns identified may be read as “within normal limits” by a neurologist who does not use it for neurofeedback planning.

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• The data of the eeg is put through a computer program that averages the data in a variety of ways then compares the data with a database of normal eeg’s.  This process helps identify differences from normal eeg’s in different regions of the brain.  For example, it can show if the slow waves are high in the left front region or fast waves are too high in the right temporal area, compared to the database etc.   This inspection can also implicate regions of the brain that may need attention in the neurofeedback protocol, as well as which frequencies (speed) of brain wave to treat.  This analysis can identify not only that eeg output in particular frequencies or locations is more or less than normal, but also HOW MUCH away from average the readings are.  Standard deviation (a measure of how far from normal a measure is) is a term often used in discussing Qeeg.  While we might not pursue a difference only two standard deviations away -- as we might see that as within a reasonable degree of variation -- a difference that is four standard deviations away is more likely to be seen as problematic enough to be considered significant, depending on the symptoms of concern.

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• Discussion and Protocol suggestions:  The Qeeg analyst considers the visual inspection and the comparison to the database -- along with the history provided by the practitioner -- and offers consideration on which aspects of the analysis might explain the symptoms.  Then, suggestions are offered to consider for protocol selection for the neurofeedback training.  Sometimes the report is followed by a one-to-one collegial discussion between the neurofeedback provider and the analyst.  The neurofeedback provider takes all this into consideration along with other data, in making a decision about the eeg neurofeedback protocol selection.

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