Mastering QEEG: Clinical Interpretation for Advanced Neurofeedback (Full Replay)

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[00:00:08]I'm Ismill Rees. I'm a I have an appointment as a professor, psychology professor at the University of Puerto Rico in which I also uh am the head of a lab, a prime, one of the principal investigators of an EEG lab uh that we just built last year. Uh that lab received an NSF grant, National Sciences Foundation grant and uh we just built the lab with EEG stuff uh a lot of free caps, a lot of amplifiers and we conduct basic research uh like EEG traditional research but we also conduct some QEG stuff right there. Right now we are conducting some research related to internet gaming disorder and we are doing brain mapping pre and post after uh some uh gaming gaming experience. We are particularly uh targeting um adolescent who has problems with uh gaming or are addicted uh to gaming.

[00:01:12]Also in our research agenda we have uh a lot of uh research ongoing uh some of them are uh dissertation of projects of my students. Uh as you can see well one of my projects is very targeted to music. As you can see my background I'm a I am a musician. I'm a g uh I play guitar but my main instrument is is piano. My piano is right here uh on my side. uh and um my future research is it's going to be almost uh focused 100% on on music and EEG and uh doing something with narrow feedback EEG QEG well it's a lot of stuff it's going to be pretty exciting uh so for today we have a very short in uh introductory webinar to QEG which is titled from signal to meeting QEG in brain health clinical aspect treatment of of brain disorders. The purpose of this webinar is also to encourage you to register to our next QEG workshop which which is going to be held on April.

[00:02:26]Uh I I think it's it's going to be four a 4 day um workshop, >> right?

[00:02:32]>> If I'm not mistaken is uh um on April Oh my god. One uh uh April 11th and 12th and 1819. It's a 14.

[00:02:46]>> We divided it in two parts. Yes. Yeah.

[00:02:48]>> Yes. It's two parts. So we will we will have uh a more complete experience of of what is QEG. So let me let me start this quickly because after this I have some QEG uh appointments in in my office. Uh oh. All right. So, EEG I I like to uh tell to my students and uh and the student I supervise in QEG that uh one of the things that EEG help us and the QEG help us is to uh formulate articulate better questions to articulate very hypothesis of our patients or our participants uh complaint with the EEG we can map uh what is happening I mean if we found for example an abnormal brain function we can do that uh looking at the EEG we can also correlate that abnormal brain activity to a particular um p pathology that may be expressed as a physiological complaint or cognitive complaint. We can also have uh nowadays um a look of how uh optimal brain function uh looks looks like. The QEG helps help us to uh to see that. But also uh we have the opportunity to predict uh the brain functionality. This is pretty interesting. uh you might anticipate for example chronic cognitive decline uh uh doing some QEG uh and uh if you if you register to the to the workshop I will I will give you some examples of how in my office for example in my priv in my private practice I have look onto very young people with some uh phenotypes of EEG biomarkers that also um match the history the family history for of Alzheimer for example and how in the jung theories you can see some markers uh there and then you can decide what treatment or what type of intervention uh you will go with that people to uh to optimize that uh brain functionality.

[00:05:09]So when you when we do EEG uh we transform uh the signal we decompose the signal into frequencies and maybe uh you are here and you are you have some knowledge um about this u when you uh decompose the EEG signal you will find some frequencies one of them one of them is called gamma which is a really fast frequency of the brain It oscillates like this. Are you seeing the mouse moving?

[00:05:44]Okay. You may see something like this oscillating pretty fast. Uh which in an optimal state in a healthy individual might express something like like the like this and a state of highness, awareness, integration, insight.

[00:06:02]uh I believe uh Thomas Fener had done uh some research on meditators and how gamma express on on those type of of people. But uh on the other side if for example you are working with a unhealthy brain or or a brain that is that is not having uh healthy patterns you may also found that excess of gamma may produce or or or may uh correlate with some of the most common uh pathologies that we work anxiety hyperarousal panic OCD obsessive compulsive disorder rumination etc. Beta I hope you I hope you all are in beta state right now. Focus on me focus on the webinar alert active mind. Veta in an optimal state is good to have beta but in some people uh beta might be expressing a little bit uh beta can be a little bit disregulated and for example I have done a brain map on me and I have a little excess of beta high beta in my in my uh posterior singulate and that uh for example correlate with stress, worry, insomnia which is My main thing I'm working in rigid thinking obsesses obsessive behavior then when you uh close your eyes you may produce another frequency which is called alpha and when I teach QEG I I I I focus u I give a lot of attention on alpha. Alpha can give you a lot of information about the the the state of the default mode network and how the brain is switching from uh different networks. It's pretty interesting frequency to look at. It tells it tells a lot. Uh alpha in a healthy brain uh you will see like uh this type of correlates relax calm uh you will feel at the present moment. But for example if you have an excess of alpha in particular sites of the brain that may express as daydreaming, lack of focus. Indeed, this is one of the ADHD uh subtype having excess alpha, depression, brain fod, uh depending of what hemisphere is more has more alpha or less alpha, you might you might uh be looking to some avoidance behavior.

[00:08:40]pretty interesting theta for example. Hope I hope hope you are not in theta state right now because uh you will be like dreaming at this moment. Uh theta is important uh is a healthy fre all all of the frequencies are are healthy but when you present them in in in the incorrect moment that's where where pathology uh emerge.

[00:09:07]No, the theta uh is needed for to reach a uh uh to reach the the sleep state.

[00:09:16]When you fall asleep, you transition from alpha to theta to set the to delta.

[00:09:21]And in an ultimous brain state, it will represent creativity, deep state, inner journey. But in excess, you will have a dreamy brain like some subtype of ADHD.

[00:09:35]uh distractability, impulsivity, brain fog, learning difficulties. For example, if you found a lot of theta in the posterior part of the brain and delta, well, if you are in delta right now, you're sleeping. Uh so I hope you are not sleeping. You are alert. You're in better bed better state. Uh delta express when you are sleeping unconscious. um you're still uh but if for example you are in a in a awareness state or a conscious state you are alert but you present a lot of delta that could be an expression of learning disabilities depending of the location in the brain it usually very common on people who had TVIS or traumatic brain injuries for example I have I have just uh ended the research on a TVI. It was a case uh case study neuro feedback case study on TVI and people who have this type of of lesion on the brain could be TVI could be strobe who have may express a lot of delta uh it and it's related to the uh uh to the metabolism changes on on the synapsis. All right, that's why delta may show on on those type of patients. Severe fog, pure sleep quality, developmental delays. And why this is important? Because measuring the brain may give us uh an idea on how to train or where to train the brain with for example neuro feedback. Maybe maybe most of you are very familiar with with neuro feedback. Uh neuro feedback is one of the neuro out auto out neuro regulation techniques that some of us worry about but there are other techniques like um uh brain stimulation or deep stimulation or TD TDCS I believe uh transcranial direct current stimulation and all all other techniques also um uh nowadays measuring the brain doing a QEG may guide a better uh farm pharmacological planning treatment. Interesting.

[00:11:58]So when narrow feedback we have depending of what we were looking in a in a raw EG for example if you do that uh you may have a lot of options to target that this regulation for example uh there has been something it's a protocol a classical protocol which is called alpha training uh uh also there is another u like it's not a modification it's You just add another frequency which which is called alphatheta training which both of them is are really effective on anxiety disorder stress related disorders. Alpha theta training for example uh it was one of the classical protocols on on neuro feedback field which was first tested on PTSD um post-traumatic stress disorder population and and then uh applied on addiction people who have substant abuse and it was very interesting because uh people who has uh alcohol addiction for example they may present a lot of high beta and they use the alcohol to produce alpha.

[00:13:14]Um when you when you get into the psychopharmarmacology topics you will you will know that alcohol regulates or modulates GABA which is the principal inhibitor on our brain. And when you when you consume uh alcohol modulates GABA, GABA produce alpha.

[00:13:34]they uh they uh automaticate themselves with alcohol uh because they are because they are lacking of alpha for example in neuro feedback we can we can target that with with this kind of uh protocols. We also have in neuro feedback um uh like classical high beta down training which also works really good on GAD or generalized anxiety disorders obsessive uh obsessive behavior panic disorder. Another classic very very very prominent um neuro feedback protocol is called ASMR training which was first test on animal mother with cat uh with cats and then it was also tested on ADHD specifically on hyperactive type and we have done since the 70s I believe maybe maybe before that uh SMR training has been like the standard of traditional neuro feedback in combination with hybrid down and set down which is this uh right here.

[00:14:43]Another very classical training also uh very useful for ADHD uh inattentive sup daydreaming brain fog depression mild TBI. So, so when we see an EEG and we see a this list chaotic list of neuro feedback protocols, we can get like this very trouble. How can we manage all all this information? How can we plan a a treatment or a or a intervention that can target the brain with with a specificity?

[00:15:21]So there there there go the the QEG And and that is the the usefulness of getting familiar with QEG because it will it will enhance uh it will uh refine the way you may look uh onto the uh people's or your patients complain uh complaints and also it will it will open you into this other way to look at the EG for example a traditional EEG may look like this in your if you look at this image in your left side that is a a raw EEG trace a 19 channel raw EEG trace and you might uh identify in the course in the QEG course I I I show the student how to read 19 shad is it it is really important it is mandatory to learn how to read a raw EEG and and on different montage uh also But uh here uh well you can look on a few formologies uh EEG phenomena some type of activation spikes etc. But nowadays we have the opportunity to use a sophisticated procedure called quantitative electronography to uh transform to translate those signals into these beautiful graphics uh which tell us uh it it tells the same story but uh how can I say this it with within another perspective let's say it like that and then you have here what is called an EEG spectrum. This uh these signals here are are um extracted from the raw EEG. But here now you can see how uh the amplitudes amplitudes uh we will talk about that in the QEG uh workshop in April. how the amplitudes behave per frequency. All right, here in the in the x plane you will see the frequency from 0 to 5, 5 to 10, 10 to 15 and those frequencies are are defined uh like gamma for example which is right in the high frequencies beta, alpha right here at 10, theta at four, delta at zero to to three. So then you can see at the spectrum I see well the it seemed that in alpha there is a pic what means that pig well we'll speak about that in the in the workshop but also when you do eg you can also translate the in those uh in these beautiful brain maps which not only give me the activation expressed in in colors like red is a lot of activation U blue is less activation.

[00:18:29]Not only you have the activation variable, you have also the site or of the the brain side variable. So you can localize more or less localize where is the maximum expression of those uh excessive frequencies or or no or or where is the the locations that are not um um producing enough voltage like these uh blue uh blue sides that we we are seeing right here in the temporal sides. So QEG help us to to see to see other things to see other other ingredients of the of the overall raw EEG. QEG is also all about normative uh normative database. When we do QEG uh we use a term uh called CCORE. uh if you are in the uh psychology field, psychiatric field or anything uh or any uh field related to mental health or or physical health maybe we have here some physicians uh we are very uh familiar with this uh what we call c scores. So since the 80s uh there has some some companies some uh there's there has been some uh research that h that have uh record uh EEGs from different cohorts of age and gender and they have normalized it. Yeah.

[00:20:10]Well, if I'm going into details, you you have to wait to the QEG workshop to to uh to uh in order for me to give more details about how how is this done. But uh in general you have a database of a lot of uh brains and then you average them and the average is close to zero and whatever is deviated uh could be a brain side could be a frequency you will see the brain mat coloring different for example there is a common QEG cutoff whatever we see above negative ative two and plus two. We consider a significant a statistical significant deviation. In QEG, we just compare the uh brain performance in terms of activation uh frequency activation uh to a similar population uh a similar cohort to our individual.

[00:21:17]uh some we when we see a red line uh or a red I'm sorry a red dot in the maps we are seeing a deviation from the normal um and uh in QG uh sometimes the deviations are u a red flag of of the state of health for our participant or our subject some sometimes the red dots or the blue dots might be an exceptionality team maybe is good for in for the individual and in order to to discriminate from what is good what is not that good uh you need to you get familiar with the QEG and to and to take curses I I I've been in the in the field since in the QEG field since 2018 and I have been taking so much curse I I I don't stop to learn and and I'm also learned about my students usually in our workshop it's like uh it's eternal you you won't stop learning uh interpreting uh EEG and now nowadays I do more more things that are not that related to QEG I I do other measurements I I got really passionate hopefully you will get as passionate as me all right so right here on on your right side you may see the like a typical summary a QEG uh brain map summary in which uh is the limited on per frequency delta map. We have delta maps, theta maps, alpha maps, beta, high beta. And what we do uh reading uh this maps we identify where is the brain uh deviating and for example is in this uh illustration we see some red dots on the frontal lo in the low frequency that that that may have some meaning uh and definitely will have some meaning. We also uh can have a look on some uh connectivity measure measurements that we have nowadays and these are really important uh it's not only important how to read like the activation maps it's also really important uh to see how the brain is communicated with with other sides uh well uh when I teach and when I when I do like um uh private uh lessons or mentoring. Uh we focus a lot on how this on the upper side on the this uh this line right here in the for example uh may represent something in coherence and how they how how these two maps relate themsel and how this the faceike may relate to coherence and so on. Uh this type of measurement supports uh clinical diagnosis and provide objective neuroysiological data guides personal personalized neuro feedback on neurom modulation intervention and also it's very useful once once you got uh used to it. It's very it's pretty easy uh to conduct and brain mapping to track uh the recovery cognitive recovery of the of the or the performance of the individual over time. For example, if you're doing neuro feedback. So every 10 to 15 sessions then you do a brain map to see what's happening in the brain.

[00:24:57]And it is once you get to learn this uh it's kind of easy well easy quote unquote uh it it takes work but once you practice and practice and practice it it will become second nature for you.

[00:25:14]applications of QEG. Uh uh right now QEG is one of the EEG strategies uh or techniques are for me that this is my opinion mandatory.

[00:25:27]It's always if you have the technology do a map to see how the uh supposedly ADHD might express in the brain. Maybe ADHD I'm sorry maybe the ADHD just another symptom. And when you do the QEG you may found the the c the cost you you may found you may found other thing that uh open your eyes and oh wait ADHD is just an expression of other thing that it's in the b baseline the same with depression autism and many more uh q has been applied to obviously normal people and to people with some exceptionalities brain exceptionalities uh it give you detailed insight ites into individual brain function. It gave us a um a more uh precise look of on how to target brain site with neuro feedback and also in research uh which I I also do uh for example Thomas Fed have record a lot of people who who are in the uh who are meditators have look on some crazy things on those EEGs because it it give us information about the state of consciousness.

[00:26:44]general consciousness of the individual.

[00:26:50]Also uh now nowadays we have uh biomarkers. The the field have grown so much that uh research from uh I believe 15 years ago has identified a patterns that almost always correlate with a very common psychopathies and that is color that that is called biomarker match or phenotype match. Uh this is uh this is also a thing that that makes the QEG very useful. For example, we have uh our research have uh point out that for example alpha band have some patterns that uh are very visible in some neuroscychiatric disorder. For example, here we have a a disorder which is called depression. But in terms of QEG we have found that people who are vulnerable how I hope I am pronouncing uh berable you uh well that are prompt to uh get depression or low mood may have some left alpha expression excess alpha in the in the left side frontal frontal left side of the brain. We also have identified some um phenotypes of anxiety, general generalized anxiety disorder in which when you look at the alpha map, it may it may uh it may look like a blue map. Uh and often when you see a blue map in alpha, you may see a red map in beta that is an anxiety biomarker.

[00:28:41]We also have uh have seen pattern of uh um decreased posterior alpha in people who have cognitive decline. I have also seen this in uh PTSD and uh post-traumatic uh post-traumatic stress disorder. Uh ADHD has also an alpha uh alpha biomarker. Uh if you have frontal alpha that may correlate with ADHD subtype, inattentive subtype.

[00:29:16]Again, people who have has anxiety and stress may have like a blue a bluish uh alpha map in the QEG report. here have here we have a PTSD um uh biioarker in which we have less alpha in the right side of the brain that might be that might correlate with um uh like avoidance avoidance is one it's not here but that correlate with avoidance also link it to to vigilance anxiety uh we also have a chronic pain uh phenotype marker like which is look like this an excess of alpha in the sensory motor uh cortex. People who has uh like the the pain uh uh how how can I say this the pain is all the physical pain is is register in our homunculus. If you have that nervous right there altered, you may process pain a little bit different to typical people. For example, we also have uh QEG beta biomarkers like posterior high beta which is correl which correlated with anxiety. uh low SMR which is one of the things we look into ADHD uh uh hyperactive or hyper motor subtype uh high beta over alpha on frontal sides people who had chronic stress high beta theta beta ratio which correlates with ADHD inattentive subtype low theta beta ratio which uh is the same as this one.

[00:31:14]Uh people who who are overaroused, anxious, hyper vigilance. Um we also have uh the frontal beta symmetry which is very interesting uh because if it's in the uh in the right side but you will get like a withdrawal type of um effects negative effects etc etc. We also have neurobiomarkers for seta, ADHD, frontal theta, depression, some alteration in our anterior singula, uh anxiety, less posterior theta, cognitive decline, an elevation of global theta, PTSD, some alteration in our posterior singulate. And um in these cases that we see uh that we see some alteration in our temporal loes uh that may that might be related to uh epilepsy. And when you do QEG and you learn how to read the raw EEG, you might detect some of the uh epilepsy morphologies that are really quite interesting. Some people with ADHD or out or autism has uh has some spikes on the temporal loes and they might be respondent to uh antibaptics for for example and there's no way to know if you don't know how to map the brain and and you don't know how to uh read uh a QEG map or read a raw EG for example.

[00:32:45]So here uh we have an example of an 11year-old patient uh which has well the main symptoms were ADHD but also uh uh he was reporting insomnia no response to medication and also when we do this we don't we don't look at maps only we we look at the maps are maps are not people we need to uh arch uh well I'm a I am a psychologist this is part of our practice no we need to look at the context uh because the brain responds to the to to our context in this case uh the parent went to through a complicated divorce uh last year before the the mapping and when we have a look into the maps look at the partners right here uh they don't really match ADHD biomarkers from ADHD, they match better a pattern of traumatic stress and maybe the ADHD symptoms are just an expressions or or of something else. In this case is the traumatic stress and there has been some beautiful research that have been published very recently that relates traumatic stress to ADHD.

[00:34:10]And maybe this person may not uh this this kid may not be respondent to ADHD medication. Maybe he needs something else. And QEG might get might guide you to uh to whatever is appropriate to to uh to target this uh brain disregulation and in this case that maybe neuro feedback might be a better option uh for him.

[00:34:38]Why QEG should be important? I have been speaking about this in uh since I start uh the workshop. It help us to early detect uh whatever is happening because we have indicators of for example cognitive aging. And when you for example have a very young uh guy or woman and you see you see some patterns that may uh that might give you a guide and you may uh formulate hypothesis on of how that might evolutionate on his developmental uh when when when when the when that guy or girl start aging. It can help us early detect and also uh uh plan our more precise intervention to slow down that aging or that narrow um uh how is it called uh I don't have the the word in English right now neurodeenerative that that's the word uh neurodeenerative disorder in which the cognitive aging uh goes uh faster than in normal people and obviously u QEG is important because it just give us information about the state of consciousness and the consciousness resources is this is one of my favorite topics uh in the neuroscience field in general. So uh in the QEG workshop we are I'm going to present this very briefly but Thomas has been de uh developing with with my help this AI companion for uh QEG interpretation and I have to tell you it's it's pretty awesome. Um uh when we start that this project uh the AI was not that intelligent. Now it's more it's it's it's pretty precise. It's we are amazed. uh we have created monster and if you get to uh if you get to um uh register into the QEG workshop we we will present a little bit more more about this uh yeah network pathfinder which is an AI companion to um EEG interpretation QEG interpretation and this uh AI companion which is I have to clarify this this is this AI is must be used for educational and research purpose. Uh you need to you need to get knowledge about QEG to get help from the AI. If you don't know how to read EEG, uh AI may not help you a lot. But if you get to know how to conduct an EEG recording and and you know how to interpret that QEG, the the AI system may may reach enrich your interpretation. So we have a dual mode analysis on that AI companion. uh you have two options. For example, you may uh select a priority the if you want the interpretations based on symptoms but also like a ADHD symptoms and then the the interpretations may be locked into may be locked into that uh profile for example. But uh you can also uh select QEG first which is which is the way I I like to interpret the QEGs. I like to always do it blind. I usually do key. I don't know much about the person. Then when we when we meet and discuss the maps then uh we we do the matching of what I see what what I'm seeing in the mass what the per and what the person is living and the AI also do that it start blinds it just do QEG first and then it may discover uh within itself it algorithms where are the phenotypes uh where are the the what detects it it's It's awesome and we have developed this so you can upload for example some QEG pro data narrow guide data. It also I have done I haven't done this yet but it can also read esurated maps and help you how to interpret uh them as I said uh it can identify we have we have polished it on a way that it uh when I compare my reports to the AI report I get like 90% match and sometimes the AI might identified other phenotypes that I was blind. Uh uh so that that's why this uh this companion may enrich the way you you see the the QEG. It give you a confidence assess assessment is a percent uh how how sure your may uh that that detector for example uh is functioning. Uh and here you can see like an example illustration how how that look. For example, if you upload uh some QEG u uh document, we we you you must upload an Excel file that QEG pro uh or narrow guide uh gave you. Uh you put it right here and the and the AI companion can detect this phenotype for example generalized cortical over synchronization 75 confidence. It give you a confidence on how on how this phenotype match the u the EEG of the of the subject of the individual you just uh measure. Uh so I have tested uh I have tested tested a lot. It almost always match. uh sometimes maybe the the priority maybe it puts something at 75 confidence that I will have put on 70 or 60 but it's just a guide it is just a guide on how on how to identify uh uh the phenotypes and sometimes uh the AI might have looked something that I didn't look at first it it's awesome also we have some more uh professional uh science uh uh which responds to the highest clinical clinical standards. Um I believe uh this is more uh this is this is algorithm based machine learning based for example QEG pro can give you this type of reports very interesting reports uh that can assess hopefully you can see this picture well in your computer it can give you the the the brain state per networks here right here you're looking at the emotional regulation cortex network and how uh brain areas might might be hyperactive or high hyperactive. It give you a network connectivity esler connectivity.

[00:41:54]It can also um u point you if if you are seeing a path a possible pathology there and I need mark right here also have a m biioarker match that looks like this.

[00:42:05]The biomarker match just established the the possibility of you getting diagnosed with this typical um neuroscych neuroscychotic disorders like like you're seeing there and if you get some green u I don't know how to say this in English but some green some green colors pointing into the into the a psychiat a pathology that's a % of probability of diagnosis because the the EEG match that uh that symptotomatology it's pretty useful uh pretty interesting also QG pro give you an s lure maps uh that are also very informative it give you a 3D plane of the brain um like um different planes like horizontal plane coral plane sagittal plane Okay. So you can look at the uh the side of the brain with the major deviation and it give you the C score how how much deviate is that brain area to uh from the norm and also it give you the area the the number the brownman area number and the name of the area and the function of that area. also give you the possible symptoms uh people uh the person must be suffering if he has that deviation located in that in that part of the brain. Uh to do this to do uh brain mapping you must need a a 19 channel uh Q uh an anti- channelannel amplifier. Uh if you if you can get it this this is the best scenario. uh you cannot do like a full brain mapping with coherent values without a 19 channels uh EEG amplifier like this. This is the one I use in my prior practice and also in my lab that we have a lot of um well not not a lot. We have three uh brain master uh discovery amplifiers. We conduct different imper experiments with that but you will need that uh in order to do uh brain mapping. And if you if you have that you can also do everything else. One channel narrow feedback, two channels, four channel narrow feedback, ccore narrow feedback, sora and neuro feedback. So having 19 channel it is an advantage uh to have what is required. We need training.

[00:44:44]I told you that I start this on 2018 and I still receive training. I still consult my case with with uh other professional who has more experience than than me and QEG must be learned and it require experience practice practice and practice uh there's no way to learn this without uh taking uh classes and practice and practice with a mentor that guides you into the pro through the process. is right here. Oh, I have like seven minute left. Uh right here you will see like some of the recommended readings. Uh I'm not able to understand this. I believe this book is in is in German. I'm not sure. Uh but I definitely recommend this handbook which was edited by Thomas Kura and John Frederick. Start here. You may find this uh on Amazon I believe.

[00:45:50]All right. So in case just pretty quickly in case you don't have a 19 um channel amplifier there are other ways to uh do some brain maps uh which is called let me see where is the uh PowerPoint here. It is called wake Q clinical Q or shrinking Q. This is another way to map the brain. It has some advantage and some disadvantage. Uh but it's a pretty awesome way to measure uh the brain activity if you don't in case you only have an amplifiers with one channel and with one channel you can do a lot uh shingle which is this u researcher that you are looking at the photo have developed in the 80s uh a way to analyze let me see if I can find the process here u uh a way to analyze uh but for This you need to first record on a brain side for one minute then move the electro to other side for one minute and so on. You have to do this like 20 20 times and then when you have uh the 20 sides uh recorded then you can map.

[00:47:04]So the advantage of this is that you can get a an idea of how the brain looks in terms of activation but you may not be able to calculate coherence or connectivity variables. For connectivity variables you need QEG but if you are not interested on on getting connectivity variables you just do a clinical Q and you will be good. So, has also developed some um like platform in which you can uh upload your shingle shingle uh clinical Q data and it give you uh this beautiful reports. Um you may have some metrics like in F3 F4 better amplitude and they give you like like the amplitudes here F3 790 microvolts and on F4 760 then you have it give you a really important information about the ratio set of error ratios and so on so on. So if you don't have 19 channels, you may you may uh you might be good with a with a a clinical queue. Well, in summary, uh what QEG can reliably achieve today objective neurohysiology instead of symptoms cluster. This is something that psychiatry and psychology has been struggled lately. No because we we we are we are overconfident on the symptoms and symptoms may be the same for different pathologies. But when you look at the EEG you may you you are looking at the naral neal patterns specific and specific and localized maybe narrow patterns that may correlate better to that symptoms.

[00:48:58]subtyping of a theogenous disorder. Just what I said many mental illness are not neurobi biologically homogeneous. So when you do a QEG you may get more information about the subtypes of those uh of those uh disorder treatment prediction and monitoring bridge between clinical practice and system neurobiology. And this is my work on on my university is is this is trying to do research to inform the clinical uh practice where QEG is re revolutionizing our understanding is shifting is shifting focus from s symptoms to neural networks support for mechanism based psychiatry precision psychiatry and psychology uh early detection as and as as and as I said earlier real time connection between basic research and clinical practice integration with machine learning for pattern prediction and prediction analysis then with narrow feedback when you combine which is which I encourage you if you're doing narrow feedback uh without QEG well well this is your last day in doing that try to learn QEG because QEG may may may inform you about other things uh that with simple one-sizefits all neuro feedback may may mislead you. Uh and we are in a time of a personalized uh treatment to respond to a specific u brain pattern for example in the QEG field. So uh in neuro feedback we we just feedback the signal the EEG signal to the individual so he can uh implicitly implicitly and explicitly control uh the signal uh so he can gain some more uh neural regulation. Uh so if you do this blindly without a baseline it might work but it might also not work. So having a QEG guide neuro feedback practice is uh the best scenario uh to target to to to have more precise protocols uh to target a specific brain sites and you will know you will not know that if you don't if you don't if you don't brain map uh before doing narrow feedback boundaries not QEG is not a an independent diagnostic procedure here.

[00:51:38]It might get more significant when you do Q, but also you do the traditional psychometrics that we in psychiatry and psychology uh we use like uh an intelligence test or for example I do QEG but I also do uh uh ERPS potentials analysis and when you combine everything you combine the the neurosychological test to QE EG to ERPs and then you have a more uh very robust way to diagnose someone with with a a specific uh pathology. No also uh the QEG is highly dependent on data quality standard data.

[00:52:25]So in the QEG course if you have a a practice usually I teach the the the theoretical part but sometimes in Spain sometimes in Germany you may get some pract uh on life practice and if you can get on those then you can learn how to uh how to acquire data and how to standardize your acquisition which is really important. it it validates uh our data.

[00:52:57]So finally QEG do does not replace diagnosis but rather refineses then neurobiologically it makes it makes mental uh illness measurable differentiable and increas increasibly predictable and that's it for all. Thank you very much.

[00:53:21]Learn more about our neuro feedback research, training philosophy, and workshops.