Sunday, August 22, 2010

Quantitative electroencephalographic abnormalities in fibromyalgia patients

Note: Dr. Frank Duffy, considered the "father" of the qEEG, also found significant abnormalities in the brains of CFS patients unrelated to depression as has Dr. Myra Preston. Use of the Beck Depression Inventory can be problematic if medical symptoms are misinterpreted as being symptoms of depression or symptoms represent both medical abnormalities and depression normal to having an organic disease.

Clin EEG Neurosci. 2010 Jul;41(3):132-9.

Quantitative electroencephalographic abnormalities in fibromyalgia patients.

Hargrove JB, Bennett RM, Simons DG, Smith SJ, Nagpal S, Deering DE.

Department of Medicine, Michigan State University College of Human
Medicine, Kettering University, Flint, Michigan 48504, USA.
[email protected]

There is increasing acceptance that pain in fibromyalgia (FM) is a
result of dysfunctional sensory processing in the spinal cord and
brain, and a number of recent imaging studies have demonstrated
abnormal central mechanisms.

The objective of this report is to statistically compare quantitative
electroencephalogram (qEEG) measures in 85 FM patients with age and
gender matched controls in a normative database.

A statistically significant sample (minimum 60 seconds from each
subject) of artifact-free EEG data exhibiting a minimum split-half
reliability ratio of 0.95 and test-retest reliability ratio of 0.90
was used as the threshold for acceptable data inclusion. FM subject
EEG data was compared to EEGs of age and gender matched healthy
subjects in the Lifespan Normative Database and analyzed using
NeuroGuide 2.0 software. Analyses were based on spectral absolute
power, relative power and coherence. Clinical evaluations included the
Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory and
Fischer dolorimetry for pain pressure thresholds.

Based on Z-statistic findings, the EEGs from FM subjects differed from
matched controls in the normative database in three features: (1)
reduced EEG spectral absolute power in the frontal International 10-20
EEG measurement sites, particularly in the low- to mid-frequency EEG
spectral segments; (2) elevated spectral relative power of high
frequency components in frontal/central EEG measurement sites; and (3)
widespread hypocoherence, particularly in low- to mid-frequency EEG
spectral segments, in the frontal EEG measurement sites.

A consistent and significant negative correlation was found between
pain severity and the magnitude of the EEG abnormalities. No
relationship between EEG findings and medicine use was found.

It is concluded that qEEG analysis reveals significant differences
between FM patients compared to age and gender matched healthy
controls in a normative database, and has the potential to be a
clinically useful tool for assessing brain function in FM patients.
* * *
I'll add to the above note that my chiropractor uses a computer-scored bubble test but does not rely exclusively on the totals.  He went back to my answers and noted that the reason the computer said I'm depressed is because I answered Yes to questions on the Depression scale that have matching questions scored under the Pain scale.  Remove "I can't do the things I enjoy" because it's the same question as "I can't do things I enjoy because of pain", and other such almost-identical questions, and I got a zero for depression.
Unfortunately, most doctors either don't know enough about the test to realize that or don't take the extra time to review the answers, only the computer-generated scores, so they may wrongly be treating you for depression when you're not depressed at all.

There are times you may need to argue with a doctor.  This is one of them.  Know what symptoms occur in CFS/fibro that don't occur in depression, and keep pressing him on those symptoms.  "Since when does depression cause a rash?"  "If I have fever/swollen glands/etc., doesn't that prove there's a physical illness at work, not just depression?"  And if he keeps insisting all you need is counseling and Prozac, find another doctor and tell the first one why!

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