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I understood part of the question related

to doing NF when a client has a metal plate in place of skull bone.  This has been a question I’ve wondered

about for awhile myself.  Would there be

any reason to suspect that the readings would be different if a site to be

worked was right were the metal is.  In

other words, does more or less eeg

energy come through the metal plate (as opposed to bone) and then would one

have to interpret in light of this?  For

example, if a metal plate allows more eeg

energy through, then there would seem to be a higher amplitude coming through,

and appear to be a problem, when in reality all it could be is a factor of the

plate.  Or, conversely, if the plate

allows less eeg energy to

come through you’d have the opposite issue.

Any thoughts on this?  Or has anyone actually

worked with a person with a plate?

Wigton

plate

issues

Gerald,

No reason not to work around the area with the

slow activity. It would probably be a good idea to try to gain some

activation there before training down much of the fast activity. I

imagine that you have high coherence in the fast activity as well; that often

follows head injury.

Pete

Van Deusen

BrainTrainer ()

16246 SW 92nd Ave, Miami, FL 33157

305/321-1595

plate effects on NF

I am working with a client who sustained a

moderate TBI with impact occipitally but most of the injury to cerebral

structures occurring frontally. He had a craniotomy in the right

anterotemporal area, had a section of bone removed for a period of time, then

reinserted. He also had a small plate inserted in this area. His

assessment shows significant slow wave activity everywhere in the front.

(Interestingly, he also shows excessive fast activity in the parietals and

temporal areas, leading me to think his brain has been accommodating for the

injury by moving its processing demands to more posterior structures). I

am curious to know what the implications might be for neurofeedback in this

situation. Should the area around the plate be avoided altogether, or

might there still be something to gain by training down the slow wave activity

in this area? Thanks for your help. Gerald Showalter

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Hi, et al.

An electrically conductive plate will behave in a fairly specific way. By

virture of being a conductor, all points on the plate will be at the same

potential (voltage) all the time at EEG frequencies. The whole plate may

move up and down in voltage, but all points on the plate will change

voltage together. Said another way, there will not be any potential

(voltage) differences between any points on the plate at any given

instant.

If we put an electrode " on top of " the plate, the electrode

signal will be influenced by the plate. The plate will serve as a kind of

averaging device, so our electrode will detect primarily the larger

amplitude influences in the region near the plate. A lot will depend upon

the size of the plate compared to the electrode. If the plate is much

larger, then this averaging effect will be more profound. If they are of

about the same size, the electrode will report some averaging directly

" in front " of itself, but will also receive signals from tissue

lying near (but outside) the metal edge. If the plate were large enough

to enclose the whole brain, we would see no EEG outside that

shell.

One of our clients had a cerebral aneurism that was repaired using some

type of needle-shaped metal device to pinch off the distended part of the

blood vessel. The pin remains in place, but our client is so

scared, there is no ongoing discussion about doing QEEG. This client now

tolerates neurofeedback, but even that was a leap of faith.

Dave Myer

Boston Neurofeedback

At 08:21 PM 2/5/2004 -0700, you wrote:

I

understood part of the question related to doing NF when a client has a

metal plate in place of skull bone. This has been a question Ive

wondered about for awhile myself. Would there be any reason to

suspect that the readings would be different if a site to be worked was

right were the metal is. In other words, does more or less eeg

energy come through the metal plate (as opposed to bone) and then would

one have to interpret in light of this? For example, if a metal

plate allows more eeg energy through, then there would seem to be a

higher amplitude coming through, and appear to be a problem, when in

reality all it could be is a factor of the plate. Or, conversely,

if the plate allows less eeg energy to come through youd have the

opposite issue.

Any thoughts on this? Or

has anyone actually worked with a person with a plate?

Wigton

plate issues

Gerald,

No reason not to work around the area with the slow

activity. It would probably be a good idea to try to gain some

activation there before training down much of the fast activity. I

imagine that you have high coherence in the fast activity as well; that

often follows head

injury.

Pete

Van

Deusen

BrainTrainer

()

16246 SW 92nd Ave, Miami, FL

33157

305/321-1595

plate effects on

NF

I am working with a client who sustained a moderate TBI with

impact occipitally but most of the injury to cerebral structures

occurring frontally. He had a craniotomy in the right

anterotemporal area, had a section of bone removed for a period of time,

then reinserted. He also had a small plate inserted in this

area. His assessment shows significant slow wave activity

everywhere in the front. (Interestingly, he also shows excessive

fast activity in the parietals and temporal areas, leading me to think

his brain has been accommodating for the injury by moving its processing

demands to more posterior structures). I am curious to know what

the implications might be for neurofeedback in this situation.

Should the area around the plate be avoided altogether, or might there

still be something to gain by training down the slow wave activity in

this area? Thanks for your help. Gerald

Showalter

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Gerald, I think a plastic " plate " would be hard to detect. That

is, it would have only very subtle effects even if we got real fussy

about our measurements in the lab. At low frequencies where EEG waveforms

live, essentially all electrically conductive materials would behave

about the same way. This would include some esoteric stuff like some

carbon fiber composites, aluminum, stainless steel, and titanium. Metals

that react with water (e.g. sodium) are not included in this thought

process.

If you imagine holding a flashlight whose illumination is a cone

projecting from the bulb, and imagine that you shine it on your client's

head, there would be portions of the cortex that would be in the shadow

of the metal plate. There would also be regions not in the shadow. The

signal from the plate would be the average of all the cortical activity

in the shadowed area; the EEG signal would all have to come from the

regions illuminated by the flashlight. So, I would expect the plate

signal to be mostly low frequencies, declining in frequency and amplitude

as the plate got larger and larger.

What may be pretty important, is that this perspective should be

reversible. That would mean that it might be pretty difficult to train

higher frequency activity using the plate as an intermediary for your

electrode. I suspect you would make out better by placing your electrode

near the edge of the plate.

Dave Myer

Boston Neurofeedback

At 09:40 AM 2/6/2004 -0500, you wrote:

Dave, and

Pete,

Thanks very much for your

responses. I am also curious whether the type of plate might be an

influencing factor, and to what extent. I believe my client's plate

is titanium. I would think training over the plate with him might

be substantially different than training over a plate constructed of a

type of plastic, for instance.

plate issues

Gerald,

No reason not to work around the area with the slow

activity. It would probably be a good idea to try to gain some

activation there before training down much of the fast activity. I

imagine that you have high coherence in the fast activity as well; that

often follows head

injury.

Pete

Van

Deusen

BrainTrainer

()

16246 SW 92nd Ave, Miami, FL

33157

305/321-1595

plate effects on

NF

I am working with a client who sustained a moderate TBI with

impact occipitally but most of the injury to cerebral structures

occurring frontally. He had a craniotomy in the right

anterotemporal area, had a section of bone removed for a period of time,

then reinserted. He also had a small plate inserted in this

area. His assessment shows significant slow wave activity

everywhere in the front. (Interestingly, he also shows excessive

fast activity in the parietals and temporal areas, leading me to think

his brain has been accommodating for the injury by moving its processing

demands to more posterior structures). I am curious to know what

the implications might be for neurofeedback in this situation.

Should the area around the plate be avoided altogether, or might there

still be something to gain by training down the slow wave activity in

this area? Thanks for your help. Gerald

Showalter

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Dave,Thanks for your response and helpful analogy. Will give your suggestion a try. Gerald

plate issues

Gerald,

No reason not to work around the area with the slow activity. It would probably be a good idea to try to gain some activation there before training down much of the fast activity. I imagine that you have high coherence in the fast activity as well; that often follows head injury.

Pete

Van Deusen

BrainTrainer ()

16246 SW 92nd Ave, Miami, FL 33157

305/321-1595

plate effects on NF

I am working with a client who sustained a moderate TBI with impact occipitally but most of the injury to cerebral structures occurring frontally. He had a craniotomy in the right anterotemporal area, had a section of bone removed for a period of time, then reinserted. He also had a small plate inserted in this area. His assessment shows significant slow wave activity everywhere in the front. (Interestingly, he also shows excessive fast activity in the parietals and temporal areas, leading me to think his brain has been accommodating for the injury by moving its processing demands to more posterior structures). I am curious to know what the implications might be for neurofeedback in this situation. Should the area around the plate be avoided altogether, or might there still be something to gain by training down the slow wave activity in this area? Thanks for your help. Gerald Showalter

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