Research on EEG Neurofeedback for Chronic Fatigue Syndrome
Treatment of Chronic Fatigue Syndrome with Neurofeedback and Self-Hypnosis: A Case Report
D. Corydon Hammond, Ph.D. University of Utah, School of Medicine
Research suggests that there may be two clusters of chronic fatigue patients: A group with relatively rapid onset and no psychiatric symptom history, and a group with a gradual onset and a significant history of depression and other psychiatric disturbance. It has been suggested that the former may represent patients most likely affected by a virus.
This paper describes the treatment of a young woman with more rapid onset CFS without a psychiatric history. QEEG results will be presented showing a mild left frontal theta excess. This was treated with three sessions weekly with a Lexicor neurofeedback unit utilizing a protocol to increase 12-15 Hz while inhibiting theta frequencies at F3. Within only a few sessions, symptomatic improvement was occurring. Two efforts to increase 15-18 Hz activity resulted in unpleasant responses.
After 15 sessions and considerable improvement, the patient had a training session with a Roshi unit utilizing photic stimulation, reinforcing 12-15 Hz while inhibiting theta. Her immediate post-session response was: "The other sessions have been good, but this was terrific." A few subsequent sessions with traditional neurofeedback received continued positive responses, but her strong subjective response was that treatment with Roshi was clearly more powerful.
The patient was found to frequently have very cold hands (70's and low 80's). Subsequently she began doing daily self-hypnosis, gradually being able to warm her hands to 94 degrees after self-hypnosis. Regular evaluations were conducted using the Profile of Mood States, which showed excellent improvement in Vigor and decreases in Fatigue and Confusion as treatment progressed.
The patient has used a light/sound device on 14 Hz stimulation for 15 minutes twice daily as a follow-up maintenance procedure, reporting very positive results. It has also been important to counsel her to not "overdo," and to maintain balance in her activity level. Periodic follow-up reinforcements and evaluations have occurred confirming maintenance of progress.
A Trial of 18 Hz AVS on Attention and Concentration in Chronic Fatigue Syndrome
David L. Trudeau, M.D.
Introduction: The effect of AVS on symptoms of decreased attention and concentration was studied in an uncontrolled open clinical trial in members of a CFS support group.
Methods: Volunteer subjects completed written, informed consent and received 60 daily sessions of AVS at a target frequency of 18Hz. Pre and post intervention QEEG's, Beck depression scale, Magill pain questionnaire, T.O.V.A., and the DSM-IV ADHD symptom checklist were done. None of the subjects had Wender Utah criteria for childhood ADHD.
Findings: Out of 15 subjects registered in the study, only 3 were found to have normal QEEG's in terms of amplitude abnormalities. The dominant abnormal pattern is high occipital and parietal beta, (9/15) and the second most dominant pattern is high occipital delta (3/15)- these changes appear to be unrelated to medication. As of this writing, 10 subjects have completed the study.
Following 60 daily sessions of 15 minutes of AVS at 18HZ, there is a significant decrease in Beck depression inventory scores from an average of 17 to 9 (p<.05) and DSM-IV impulsivity-hyperactivity criteria from 3 out of 9 to 0 out of 9 (p<0.01). Consistent with the decrease in self assessed impulsivity is a trend toward decreased measured impulsivity on the T.O.V.A. Anecdotally subjects reported onset of dreaming and improved sleep and higher energy levels, but no instrument was used to assess sleep quality.
Discussion: These results are based on a very small sample and although promising, should be viewed as preliminary. One possible interpretation of the finding of high beta relative amplitude is that people with CFS have QEEG findings similar to those seen in persons on chronic sedative medication. This may be a reflection of toxic events in the brain, or could also be explained by medication effects, since most subjects in this study were on multiple medications.
Focus may be improved following AVS, and depression symptoms may be improved. Clearly more study is required, and further trials should include sleep assessment.
David L. Trudeau, M.D., Editor, Journal of Neurotherapy, Fax 651-298-8144, Voice 651-298-9773, Mail to: #4402, 168 East 6th St., St. Paul, MN 55101, trude003@maroon.tc.umn.edu
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