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Physiology is the organizing principle of the medical model. This is the
reason that illness is defined as a physiological variance from a normal
range. Physicians use laboratory tests of organ function to identify if
there is any physical disorder and to differentiate the type of
abnormality. Physical measurement is necessary to justify medical
therapy that is intended to change physiology. Measuring physiology
permits individualized therapeutic recommendations that are logical and
likely to yield a favorable clinical outcome.
Contrasting with the physiological organizing principle
of the medical model, treatment selection in naturalistic psychiatry is
based primarily on symptoms and behaviors. These are sorted and
classified by a list of syndromes called DSM-IV (DSM) disorders.
Psychiatrists use interviews, rating scales and performance measures to
describe a patient’s behavioral syndrome and as the basis for selection
of medical treatment. However, clinical experience makes obvious that
there is no consistent relation between these symptoms and behaviors and
response to neuroactive medications. Particular symptoms and behaviors
may suggest a mental disorder, but do not characterize individual
neurobiology or likely neuroactive response.
This explains the diverse medication outcomes that are
currently observed in naturalistic psychiatry. Lacking a measure of
individual brain function in these disorders, psychiatric medication
selection remains educated guessing and medication response a chance
occurrence.
To improve the random nature of psychiatric
therapeutics, in 1986 our laboratory began electroencephalographic (EEG)
and quantitative EEG (QEEG) medical research. We sought to distinguish
differences in individual brain function and improve psychiatric
therapeutics in populations who suffer with mental disorders. This work
has evolved into a referenced EEG method that characterizes features of
brain function underlying a broad range of psychiatric syndromes. In
this procedure, a prospective patient’s EEG data is compared with a
large, clinical outcome database of heterogeneous EEG/QEEG’s and their
diverse medication responses. The prospective patient’s EEG data is then
mathematically classified and correlated with neuroactive medication(s)
likely to improve their particular brain function.
Our laboratory has retrospective, double blind
prospective and unblinded prospective medical research, which
demonstrates the ability of individual EEG data to improve medication
selection and treatment outcomes in certain DSM disorders. Our growing
EEG/QEEG database includes children (from six years of age), teenagers
and adults (to ninety years of age) with a broad range of DSM diagnoses.
Diagnoses involving mood (depression), attention, learning, eating (anorexia and
bulimia), chemical dependency or substance abuse, anxiety, panic,
insomnia, chronic fatigue or fibromyalgia, various tic disorders, obsessions and compulsions are represented.
The database also contains patients with chronic headaches, including
refractory migraine headache and/or other
pain disorders.
Our therapeutic EEG method has been licensed to Central
Nervous System Response, Inc. (CNSR), a medical information technology
company. CNSR is conducting a successful pilot program in Atlanta,
Georgia with a US healthcare company. In this ongoing program, patients
with eating disorders, substance abuse disorders, mood disorders and/or
attention deficit disorders, who previously did not respond to two or
more medication trials, were eligible to receive EEG testing with
referenced EEG medication correlation. Psychiatrists who are using CNSR
rEEG medication correlation have achieved favorable treatment outcomes
in more than 70% of these previously treatment non-responsive patients.
This robust outcome demonstrates that psychiatric physicians using rEEG
analysis within the medical model – physical measurement directs
selection of medical intervention – can improve therapeutic outcomes of
biologically heterogeneous samples of patients within and across diverse
DSM disorders.
An introductory literature on the scientific basis and
utility of rEEG medication correlation is listed in the Psychiatric EEG
Research section.
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