Üsküdar University Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, attended the “5th Psychiatry Summit 12th Anxiety Congress.” At this year's 5th summit, held with the main theme of Building Bridges from Theory to Practice: A Holistic Approach from Childhood to Old Age, Tarhan presented his talk titled “QEEG as a Prognostic Biomarker.” Tarhan stated that the greatest need for those dealing with psychiatric illnesses is measurability.
“I Learned QEEG Through My Own Efforts”
Prof. Dr. Nevzat Tarhan stated that he learned and developed QEEG treatment through his own efforts; “I learned and developed QEEG with neurologist friends on my own. Because we couldn't learn QEEG in our own training. While finishing my residency, I asked to finish three months late so I could work a little in the qEEG laboratory.” he said.
“We Use It as a Criterion in Patients”
Stating that there is a problem with measurability in psychiatry, Tarhan said; “There are electrophysiological studies related to addressing this, P300 and QEEG studies. There are also neuropsychological criteria. By measuring psychomotor functions and executive functions, we can use these as criteria in patients.”
Tarhan made the following evaluations at the summit:
The greatest need in psychiatry is measurability!
“The predictive, diagnostic, and prognostic value of neurophysiological imaging in psychiatric diseases is increasingly coming to light. It is known that the greatest need for those dealing with psychiatric illnesses is measurability.
Numerous brain imaging techniques have been used to investigate the relationship between mental illnesses and abnormalities in the brain. These methods include: Magnetic resonance imaging (MRI), positron emission tomography (PET), computed single-photon emission tomography (SPECT), and quantitative electroencephalography (QEEG).
In their 1999 QEEG review, Hughes and John state: “Evidence from these brain imaging methods has unequivocally proven that mental illnesses have definite connections with brain dysfunction.” (Dr. Aharon D.Shulimson, Murray, Utah, 801-281-3188)
In recent years, there has been a significant increase in the number of publications on the value of QEEG as a predictive, diagnostic, and prognostic biomarker.
Nomenclature for digital and quantitative EEG, FROM THE AMERICAN ACADEMY OF NEUROLOGY 2014 REPORT
Digital EEG
Quantitative EEG (QEEG)
Signal analysis
Automatic event detection
Monitoring and orientation
Source analysis
Frequency analysis
Topographical maps (“brain mapping”)
Statistical analysis
Comparison with normative values
Diagnostic discriminant analysis
Over 500 studies on EEG and QEEG have shown electrographic correlations of mental illnesses, including Attention Deficit/ADHD, depression, Obsessive-Compulsive Disorder, Anxiety, schizophrenia, bipolar disorder, and substance abuse. Clinical correlations for traumatic brain injury, bipolar disorder, and dementia have also been identified.
The purpose of Quantitative EEG is to compare a patient's brain wave activity with that of an average person of their age and to look for clinical correlations of Attention Deficit/ADHD and other conditions. A report including diagnostic impressions and recommendations for neurofeedback, a form of therapy that treats EEG abnormalities, was developed. Applications for medication management based on QEEG research were also discussed. QEEG has many advantages over MRI, PET, and SPECT. It is non-invasive, less expensive than other brain imaging methods, and provides much more information about brain function.
QEEG provides clinicians with 4 techniques: Absolute power, Relative power, Connectivity, Consistency (Phase, amplitude changes).
As a result of correlating QEEG information with clinical knowledge, we can interpret the patient's brain function.
The first FDA-approved result for this was in ADHD on July 15, 2013.
A Neuropsychiatric EEG-based system called NEBA was used. It was announced that in children and adolescents, the Theta-Beta ratio measured by QEEG technique was higher in patients compared to non-patients.
Cordance studies, on the other hand, indicate new predictive results in Depression.
Cordance is a quantitative EEG (QEEG) measure that integrates absolute and relative powers in EEG channels. Cordance calculation is done with a 3-stage algorithm. The first publication containing relevant details and the calculation and use of cordance was published in the journal Psychiatry Research in 1999. Studies have shown that cordance values demonstrate a high level of correlation with local cerebral blood flow (perfusion) and can be accepted as an indirect index of this blood flow. Cordance studies are predominantly conducted at UCLA (University of California), one of the world's most reputable neuroscience centers. The results of many studies have shown that the average prefrontal cordance values of theta waves in EEG can be used as a predictor for depression treatments (pharmacological, somatic, and psychotherapy applications).”
Also at the congress, Prof. Dr. Kemal Arıkan, Head of the Department of Mental Health and Diseases, Faculty of Medicine, Üsküdar University, presented “The History of QEEG and Brain Mapping in Turkish Psychiatry”,
Prof. Dr. Sermin Kesebir, Psychiatrist at Üsküdar University NPİSTANBUL Brain Hospital, presented “Mood and QEEG”,
Neurology Specialist Assoc. Prof. Dr. Barış Metin presented his talk titled “Brain Connectivity in Psychiatric Disorders.”