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Course Outline: 3 Day QEEG

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Course Outline: 3 Day QEEG 

I. Orientation to Quantitative QEEG

A. Definition of Quantitative QEEG

1. Pioneers and seminal studies in QEEG (e.g. John, Duffy, Thatcher, Sterman, Lubar, others)   

B. Assumptions underlying QEEG II. Basic Neurophysiology & Neuroanatomy    

C. Neurophysiology        

1. Bioelectric origin and functional correlates of EEG, event related potentials (ERPs), and slow cortical potentials (SCPs).          
2. Relationship of post-synaptic potentials and action potentials to QEEG.          
3. EEG signs of activation via classical and reticular routes, (e.g., alpha blocking as a cortical activation). 

D. Neuroanatomy

1. Basic neuroanatomy of dual ascending sensory pathways to cortex via classical and reticular routes.
2. Related dual control of motor neurons via pyramidal and extrapyramidal routes.
3. Thalamic and cortical generators of QEEG.
4. General cortical anatomy and general subcortical anatomy. 

III. Instrumentation & Electronics    

E. Essential Terms & Concepts Basic metrics and terminology in electronics and instrumentation such as Ohm’s Law, impedance, differential amplifier principles, analog and digital filters, QEEG technical terms, digital signal processing terms and principles. 

F. Signal Acquisition1. 10-20 International Standard measurement and nomenclature for 19 recording sites, both classical and modified

1. Use of limited number of electrodes (fewer than 19).
2. Dense electrode arrays (35 to 250) and volume conduction
3. Common Mode Rejection (differential amplifier) as it relates to different montage characteristics and interpretation
4. Artifact (signals of noncerebral origin) recognize and correct, such as but not limited to:    
a. Electromyographic very common, higher frequency invasion    
b. Electro-ocular very common, low frequency invasion    
c. Cardiac (pulse)    
d. Sweat (skin impedance)    
e. Cable sway    
f. 60 Hz (grounding)    
g. Electrode “pop”
5. Acceptable impedance, effect of different impedance at different electrodes, gain, effects of scan rate: Nyquist considerations and upper frequency limits.
6. Evaluation of subject variables during acquisition
a. alertness-drowsiness
b. medication/drug/alcohol effects
c. physical relaxation
d. eyes closed/eyes open/anxiety
e. subject age (child-adolescent-adult development of QEEG)
f. time of day 

G. Signal Processing

1. Analog (“raw” EEG, Time Domain) Metrics and Characteristics Frequency (nomenclature for “classic” frequency bands: delta, theta, alpha, beta, gamma, Mu, SMR) ; clinically significant patterns
2. QEEG and frequency domain metrics and characteristics
3. Normative Databases
a. Matousek and Petersen
b. John and Prichep
c. Thatcher d. Sterman
e. Hudspeth
f. LORETA
g. Brain Resource Company
h. HBI
4. Multivariate functions such as discriminant and cluster functions. 

IV. Research Interpretation of the methodological and statistical criteria and procedures for determining levels of efficacy and effectiveness of QEEG, as outlined in the

V. Psychopharmalogical Considerations

A. Potential effects of prescribed and nonprescribed drugs on clinical presentation.

B. Potential effects of prescribed and nonprescribed drugs on QEEG measures.

C. Potential effects of different drugs on learning tasks. 

E. Treatment Protocol development using QEEG

1. Development of neurofeedback protocols based on results of QEEG analysis
2. Treatment of specific clinical conditions
a. Attention Deficit Disorder and Learning Disabilities
b. Mild Closed Head Injuries
c. Chemical Dependency Problems/Addictions
d. Epilepsy
e. Anxiety and Affective Disorders
3. Other conditions that you agree to treat
4. Adverse reactions and their management
5. Pre and post-treatment assessments such as neuropsychological tests, continuous performance tests, EEG/QEEG, appropriate to your practice and licensure.
a. The limitations in applying pre and post treatment assessments in your practice.
b. Test characteristics appropriate to your practice and licensure; know reliability and validity. 

VII. Professional Conduct

A. Responsibility and competence

1. Responsibilities and liability in provision of services
2. Demonstrated competence in all aspects of service provided
3. Limiting scope of practice to areas of professional training and qualifications
4. Experimental vs. commonly accepted QEEG treatment
5. Contraindications to treatment 6. Familiarity with the ethical principles of BCIA and one’s primary profession
7. Advertising, marketing of services, and public statements
8. Continuing education and training 

B. Client rights

1. Privacy, confidentiality, and privileged communication
2. Informed consent to assessment and treatment
3. Accepting clients, abandonment, and appropriate referral
4. Universal precautions in QEEG
5. Equal access to health care 

C. Supervision

1. Appropriate consultation and supervision in QEEG
2. Purposes of supervision and consultation
3. The process of supervision
4. Guidelines for seeking supervision 

D. Professional relationship

1. Dual relationships
2. Conflicts of interest and exploitation of clients
3. Consultation, referral, and relationships with other professionals
4. Medical and medication monitoring
5. Procedures for dealing with unethical behavior of colleagues 

E. Record keeping

1. Technical and legal records
2. Legally required records and retention
3. Documentation of medical history
4. Security of records to ensure confidentiality