Tinnitus Management: Treatment with magnetic brain stimulation (rTMS) and Mindfulness

The client undertakes non-invasive electrical brain function tests - or a quantative EEG (QEEG) and Neuropsychological tests in one of our laboratories. Measurements of brain function are recorded simultaneously during each experimental session. These measures include: standardized electrodermal arousal (SCL, SCR or GSR) and electrocortical measures (QEEG, ERP - Event Related Potentials) in addition to measures of ANS function (heart rate, respiratory rate) and motor response (reaction time).

The experimental Activation Tasks are designed to tap a profile of the brain's primary neural networks. Measures of electrical brain function provide information on automatic information processing over a fraction of a second time scale. The battery of tests was specifically selected to tap the brain's major functions.

Both procedures can be used for stand-alone assessment, or as an assessment for neurofeedback treatment.

The paradigms are:	The test reflects:
Resting QEEG eyes open and closed	A baseline and overall stability
Auditory habituation	Automatic learning
Auditory oddball task (ERP)	Efficiency in processing relevant information
Visual tracking	Automatic tracking
A Go/No-go task	Extent of impulsivity
Visual working memory	Working memory
Conscious and sub-conscious faces	Processing of facial emotions
Electronic maze	Capacity to plan
The startle response	Body's 'fight or flight' reflex

The electrical brain function (QEEG) and the cognitive profiles - or neuropsychological tests each take less than one hour to perform. The task instructions are simple and the tests are straightforward. This allows young children as well as the elderly to perform these tests. It also means that the database is assumption free - the same tests are used for all age groups, which allows you to analyze how a subject's performance may change during life span and across disorders. Validity and Reliability of tests have been found to be very good.

For a description of the psychophysiological tests please see below:

	Resting EEG - A red dot is presented on the screen. The subject is asked to rest quietly for 3 minutes and focus on the red dot (eyes open). The subject is then asked to close their eyes and remain resting quietly for a further 3 minutes (eyes closed). *Reflects* - A baseline of brain and body measures.
	Habituation - A red dot is presented on the screen. The subject is asked to rest quietly and focus on the red dot, whilst passively listening to repeated audio stimuli. *Reflects* - Brain-body response decrements to novel stimuli, indicative of automatic learning.
	Auditory oddball - A red dot is presented on the screen. The subject is asked to rest quietly and focus on the red dot whilst audio stimuli of differing tones are presented. The subject is required to ignore low tones, and press a button when they hear infrequent high "target" tones. *Reflects* - Capacity to process relevant whilst ignoring irrelevant information.
	Visual tracking - A red dot moves smoothly back and forth (horizontally) on the screen at a frequency of 0.4Hz. The subject is required to visually track the dot as it moves. *Reflects* - Eye movement and brain function during an automatic tracking task.
	Go-No Go - The word "PRESS" is presented on the screen at regular intervals. The colour of the word "PRESS" is randomly either red or green. The subject is required to press a button when they see the word "PRESS" in green, but not press the button when the word "PRESS" is in red.Reflects - Capacity for suppressing well-learned, automatic responses.
	Conscious and subconscious processing of facial emotions - A series of facial expressions across a range of emotions is presented, which the subject is required to process and rate. *Reflects* - Brain and body function in response to emotions.
	Visual working memory - A series of letters is presented on the screen one by one. The subject is required to press a button if the same letter appears twice in a row, and at no other time. Novel stimuli are also sporadically presented. *Reflects* - Sustained attention and working memory.
	Executive maze - A dot-based maze is presented on the screen. Using a directional button box, the subject is required to discover (by trial and error) a hidden path through a maze and remember it. *Reflects* - Planning, foresight, self monitoring, visuospatial learning and memory.
	Startle - A red dot is presented on the screen. The subject is asked to focus on the red dot. A series of loud tones are presented, half without warning, half with a pre-pulse. *Reflects* - The body's "fight or flight" response.

Overview of the QEEG and Neuropsychological assessment