Проблемы когерентности при синдроме Аспергера и аутизме

Обсуждение на форуме Brain-Trainer, 2007 год

Sharrie
Is there anything distinctive on an asmnt that would show aspergers?
In the past to me it just looks like an ADHD type look.

Pete
Sharrie, So what exactly IS Aspergers? Is it autism without the major language issues? Is it ADHD with a kind of schizoid overlay? The symptoms combine coordination problems, rigidity/obsessiveness, internal focus, sensory sensitivity and lack of social connectedness. Excessive right-sided fast activity (right-sided problems such as prosody and reading facial reactions as well as strengths such as musical skills are common), perhaps high fast coherences, possible midline/cingulate involvement and sensorimotor cortex findings could all be present.

Your question is an excellent one as it points up the old issues of difficulty in distinguishing among various diagnoses that have a lot of symptoms in common and the lack of benefit in doing so, since the diagnosis doesn't really tell us anything about what we will want to train in the EEG.

If I may be permitted one brief repetition: identify the behaviors you want to change – forget about giving a name to the problem – find the unusual activation patterns that could relate to the these behaviors—change those.

Celine
I have been working with a young man who had this difficulties and find that targeting amplitude issues takes care of many symptoms related to attention or anxiety etc. but "normalizing" coherence (in this case improving hypocoherence) between right and left frontal sites (F3F4, F7F8) and between left frontal and right parietal / temporal (such as F3T4, F7T6) has helped develop an external focus and improve social connectedness. It's not an aha! experience in the way that amplitude work sometimes is, the person doesn't feel different but after one to two months (two 45 min sessions a week) you see improvements.

Pete
Celine,
Very interesting. How did you identify these issues, and how did you identify frequencies and appropriate "normalized" levels? Was this a client-specific pattern or is it suggested as something related more generically to problems of social connectedness?

Рассказывает об оценке когерентности FL / RB:

Celine
The issues were client specific but common to Asperger, such as narrow interests, a general desire to have friends but great difficulty relating because of narrow interests and a general black and white, unidimensional view of others. I read Jonathan Walker and Rob Cohen's preliminary work on coherence and how, in their experience, coherence issues were crucial to improving symptoms of dyslexia and of autism. I also knew that the Thompson's had been working on coherence and they too found it helped these conditions.

Jonathan Walker and Rob Cohen, to my understanding, treat coherence problems using a bipolar approach, inhibiting the difference between two specific sites to improve coherence or rewarding the difference between two sites to reduce coherence. In June, Thought Technology released Michael Thompson's suite which includes coherence training screens. This suite has two types of screens that I have used, band specific (theta, SMR, etc) or multiband, that allows you to see what is happening across a spectrum of bands. My understanding is that desired coherence should be between 40 and 70. So I looked to see what the coherence was at various sites symmetrical as well as front left and right back as suggested by Rob Cohen and Jonathan Walker, and found that front left - right back coherence was extremely poor (2-5) across all bands. I started with symmetrical F7F8 coherence because it wasn't that bad (15-20) and it seemed a bit easier to train, this produced some results fairly quickly (about 8 sessions) and I then went on to train F7T6. This proved a bit too hard (it wasn't going anywhere) so I tried F3P4 (easier because they're closer?) instead and this is working quite well, although slow going (16 session to go from 2-5 to 5-25). It seems to me this is slow going because the brain was just not wired this way in the first place but even small improvements in coherence seems to bring subtle changes in behavior such as initiating interactions with others. You have to understand that I'm doing this based on what I know from what I've read plus some intuition and trial and error. I think coherence work makes the brain more flexible. It also seems, from my limited experience, that when coherence is low across all bands, it's easier to start training the lowest band (delta) first than trying a higher activation band. Delta or theta work will also improve coherence in the next band up, it seems, so even if you train one band, you also improve coherence in other bands.

Along those lines, I have been using the 18 site assessment consistently since september and I really like all the information it provides. It takes me 60 to 75 minutes to do it all (including site prep since I don't use active electrodes). Would it be possible, I wonder, to have the TLC assessment report tell what the coherence is between non symmetrical sites either on one side of the head (such as frontal temporal parietal connections in case of learning issues) or between left front and right posterior (such as left frontal and right parietal or temporal (T6) for autism spectrum issues).

I hope this helps and is not too long, thank you again Pete for this forum and for all your great teachings and wisdom.

Liz
Celine,
Could you recommend some readings on coherence?
You talk about:
"inhibiting the difference between two specific sites to improve coherence or rewarding the difference between two sites to reduce coherence" using a normative approach where you say "desired coherence should be between 40 and 70" --
Is that a range no matter where you are recording from? in my very limited understanding of Pete's approach, I think he says that you want less coherence where beta is involved (to prevent "locking" and therefore fewer resources)?

Karen
According to the TLC assessment/Pete's teachings: Lobeta Beta and Hibeta coherences everywhere should be below 40 %, except lobeta/SMR in the Central site which should be between 40-70 % Delta theta, Alpha coherences should be between 40-70 everywhere. Hope this helps,

Celine
Liz,
I'm just trying to sort this out myself. The inhibiting or rewarding of the difference I mentionned refers to Rob Cohen and Jonathan Walker's approaches as I understand it which is bipolar 1 channel training, something I don't feel equipped to do now but will certainly look into. I don't know to what extent bipolar training in this manner is the same as using the coherence screens of the Thompsons. The coherence training I do using the Thompson's screens is a 2 channel monopolar approach.

---

Ещё одно обсуждение, 2009 год:

Connie
I took a workshop with Mike Thompson and Coben and Coben showed FMRI (I think that was what it was) to illustrate the connectivity issues with Autism and they were really dramatic. He showed the lack of front to back connectivity and how the brains adapt.

Also, they said that 80 percent of their Autism clients have front to back connectivity issues and Coben even went as far as saying all of them do. The thrust of this new research was that amplitude as well as connectivity were both imperative in treating these kids. This research is coming out this month. Also, they are in the process of organizing a sham study on Autism which could really advance the treatment of Autism with neurofeedback and they have funding.

After looking at these pictures, it is hard for me to not look at these connectivity issues.

That being said, I also know it would be hard to even do an assessment on some of these kids and many technicians I talked to at the conference agreed.

I was just getting ideas from the group. As it stands right now, if I get an autism client (and I hope I do since this is one of my main marketing targets) I would do a Q . After I do a few, I would be able to see if and how the TLC can be enhanced to handle the connectivity issues. My first thought is that if we can do a few additional coherence measures and know what is abnormal, we may be able to not use a Q in many cases. But again, that is just my first thought as it stands right now. I can still see Rob pointing to an area on the right side of the brain and saying that every child he sees with Autism has hypoconnectivity in this area.