of Southern VT LLC
55 Marlboro Rd.
Brattleboro, VT 05301
PO Box 325
Westminster, VT 05158
John N Demos, BCIA-EEG
COMPUTER ASSISTED TRAINING (CAT)
At last! : AUTOMATION COMES TO NEUROFEEDBACK
MINI-Q SOFTWARE FOR ASSESSMENT ONLY IS ALSO AVAILABLE:
Definitions and answers
1. WHAT IS CAT?
Computer Assisted Training (CAT) for Neurofeedback is a seamless integration of database-led-training & assessment via 8 bipolar montages (let the software set the thresholds).
Expensive QEEG hardware or MiniQ systems are not needed.
CAT software depends upon the EEG obtained from BrainMaster’s 4 channel Atlantis system for assessments. Only two channels are needed for training.
The development of CAT included creating a reference database to secure a bank of “average” EEG data via bipolar montages. From there a comprehensive assessment package was developed to process the data according to common training practices developed over the past 30 years. CAT training technology combines the wisdom and clinical knowledge developed by pioneers in the field as well as the recent development of z-score training.
The two critical phases of any data driven neurotherapy are
(2) Protocol Selection.
CAT generates an automated protocol solution for every assessment. It creates a “code” that activates live database training within BrainMaster’s Event Wizard. Feedback tones are heard when 16 distinct conditions are met. Clinicians no longer need to interpret maps, create protocols, select montages, adjust thresholds or tweak bandwidth ranges: CAT does it all via live-database training.
CAT is for clinicians looking for definitive direction. Many neurofeedback providers feel confused and overwhelmed by the highly technical field of neurofeedback. Most went to graduate school to conduct talk therapy or to provide medical direction to patients. In the past, becoming a competent EEG provider often took as long as 5 - 10 years. CAT can fill the inexperience gap by providing rationale protocol decisions based on concrete data. The new clinician’s job is to gather clean EEG data; CAT does the rest.
Even those with some experience in the field have felt less than confident in their protocol decisions. For many, finding the optimum neurofeedback protocol feels more like a fishing expedition than neuro-science: moving sensors and tweaking protocols based on trainee response. CAT is an objective computerized tool that automates the process of neurofeedback.
2. HOW CAT DIRECTS NEUROTHERAPY
Typical CAT therapy programs are as follows:
First session: Includes standard intake forms, goal setting, and the administering of appropriate assessment inventories to set a clinical baseline. Once the intake is complete, the client is briefed on how to prepare for an EEG evaluation.
Second session: client is assessed with 8 bipolar montages in about 15 minutes; CAT training codes are pasted directly into BrainMaster’s Event Wizard. The client begins training (no more than 25 minutes have elapsed). The client trains for 20 minutes. via two bipolar montages–assessment. The session concludes well within the therapy hour. No tweaking during session, no protocol adjustments. The clinicians job is to watch the progress graph and to avoid overtraining.
Only automation can produce rapid data-driven results. When the client leaves the first session it’s clear that key EEG bandwidths had been trained. No need to re-evaluate maps; the software did what was needed “in the moment.” The software determined what to do, how to do it and where to put the sensors.
A computer software program can never take the place of experienced practitioner who is well acquainted with the EEG and its many anomalies. However, many trained clinicians long for a program that will simply tell what to do and how to do it. Clinicians new to the field no longer have to feel that their first client is a “test case” or an experiment. Once the new person has learned to acquire good data, they can be confident that their clinical results will mirror that of the experienced clinician.
CAT users recognize that automation is not always in the client’s best interest. Training to conform to a reference database average is not for every client. CAT was designed to correct abnormalities; it is not a peak performance product. Those with superior intellects may not be candidates for CAT training. However, the majority of trainees have abnormal EEG patterns that reflect common problems. In most (not all) cases training to the “average” works well. CAT is limited to 8 bipolar montages; it was not meant to resolve every neurofeedback training issue.
3. SAMPLE REPORT (click here)
4. SAMPLE TOPOGRAPHICAL MAP (click here)
5. BIPOLAR MONTAGES:
Bipolar montages cover regions, they act as calipers that span two active International 10-20 locations. They provide common mode rejection and are less prone to sEMG artifact. Unlike linked ears or monopolar montages they examine the difference between two sites. Likely, under some circumstances, they are more reliable. One EEG pioneer, Margaret Ayers, only used bipolar montages; she asserted that other montages were inferior. Of course, over the years many successful neurofeedback therapies were delivered with monopolar montages. However, CAT is the first program that delivers active database training with bipolar montages.
6. CASE STUDY (first 5 sessions):
Client entered therapy the following symptoms:
Difficulty arising in the morning
First session: Nightmares stopped
Second—Fifth Session: 30-40% reduction in Anxiety, client reports able to get out of bed in morning and begin day (before CAT neurofeedback training it took client as much as one hour to get out of bed in morning). Energy is increasing
I present the above case study because many practitioners spend the first five sessions tweaking or fishing for the best protocol.
7. HOW TO USE (PowerPoint click here)
(1-minute to load, set “Browse” tab to full screen)
(The PowerPoint is a user guide)
(Don’t move your mouse while PowerPoint is being loaded)
Purchase through BrainMaster: www.brainmaster.com
Or call BrainMaster sales at 440-232-6000 (ext#1)
CAT software costs just ($495)
EEG recording cap: ($275-medium adult)***
BrainMaster 4 channel cable: pt#381-009 ($149.95)
NOTE: assessments are done with 4 channels; training is done with one or two channels. Support will be offered to users who have purchased PT#381-009 (and jumper) which is critical to the data-acquisition process.
CAT is currently limited to adults; data for a children’s database has already been acquired and plans have been made to process the data with bipolar montages.
***EEG recording cap is special; it was made for din connectors and allows for bipolar montages. Rapid assessments are much easier with the cap. Use of cap requires Electro-gel, syringe and 6”long Q-tips—NuPrep ® is seldom needed. After assessment the client can be trained while wearing the cap. Future training sessions do not require the use of the cap. Accurate sensor placement is a must. No ear clips needed when ground is placed at Cz.
The medium cap is suitable for most women and children above the age of 8. Most (but not all) men will need the “blue” or large cap size.