What the Heck are They Talking About: Neurological CFS: How squiggles and colored brain maps may change how we view CFS and Fibromyalgia

Of all the things I’ve lost, I miss my mind the most!

Ever find yourself trying to start your car from the passenger seat? Maybe you spend your day walking in endless circles trying to remember where you were going and why. Or maybe you just stare at your child’s math homework in panic because you can’t do the calculations either. Worse yet, the other day you had to hand the store clerk your cash so that they could count out the correct amount because you could not figure it out for the life of you. Has the concept of multi-tasking become a joke?

Hmmm, what could it be? Depression, personality disorder, maybe Alzheimer’s? No, you probably don’t have Alzheimer’s and it has nothing to do with your mental health either. What you are experiencing are some very common cognitive dysfunctions, which are part and parcel of Fibromyalgia and Chronic Fatigue Syndrome. The medical term for what is happening is encephalopathy.

This is brain damage. Before you panic, CFS researchers currently classify it as one of the reversible encephalopathies although they have yet to come up with a cure.

How do researchers know it is encephalopathy? And how do you personally obtain objective medical evidence of this?

As there is a great deal of heavy-duty research and scads of unpronounceable terms related to following testing, I’m going to try to stick with the “cliff notes” version for this column.

The key to understanding and quantifying this baffling constellation of symptoms is a quantitative EEG (qEEG) also known as brain mapping. Generally, EEGs detect electrical changes associated with epilepsy, sleep disturbances, and metabolic or structural encephalopathies.

Essentially, an EEG is the recording of electrical patterns at the surface of the scalp that primarily reflect cortical electrical activity or "brainwaves." A quantitative EEG (qEEG) is the digital reading of an EEG. Instead of squiggly lines on paper, a computer image is then generated. The advantage of brain mapping is that the brain waves can be sampled much more frequently (usually 128 or 256 samples per second) and then compared to a normative database. Whew! Say that ten times fast.

Basically, there are four types of brain waves: beta, alpha, theta, and delta.

Beta waves (16-40 Hz or higher) are fast, spiky waves seen when the healthy subject is alert and thinking with focused attention. Alpha waves aren’t quite as fast as beta (8-13 Hz), but they are seen in healthy subjects who are awake but not engaged in substantial mental activity.

In healthy subjects, the brain uses 13Hz (high alpha or low beta) for "active" intelligence. Information processing occurs at a higher frequency approximately 40 Hz.

Theta waves (4-7 Hg) are slower and more rolling and in healthy subjects seen either in deep meditation states (high theta) or in the beginning stages of drowsiness and sleep. Delta waves (1-4 Hz) are extremely slow waves normally found only in deep sleep and coma states in adults.

VERY IMPORTANT! RED LIGHT ALERT! The presence of Delta waves in waking adults is pathological and a clinical sign of brain dysfunction and damage.

And a growing body of research shows that patients with Chronic Fatigue Syndrome and Fibromyalgia have these in spades nor is it random. Research shows a distinct pattern of abnormally slow brain wave activity that is virtually unique to CFS, as well as the patterns found in Fibromyalgia. It is this pattern that substantially cripples cognitive function, particularly in the domains of attention, focus, executive function and memory.

These documented patterns of abnormalities in electrical relationships amongst various areas of brain are made by comparing the patients eyes closed recording with a normative database in addition to the added component of functional testing. This "Functional" qEEG testing includes recording under cognitive challenges, allowing for the examination of the brain's “cognitive” responses to reading, listening, math or other cognitive demands.

A number of neurophysiologists believe that some of this damage can be reversed by the use of neurotherapy, a treatment that helps the patient recognize the patterns and redirect brain waves. Results however show considerable variations. The greatest success is, and isn’t this always the case, with those patients more moderate symptoms.

Whether you need objective testing of cognitive dysfunction to back up a disability claim or you want to be tested to determine the suitability of neurotherapy for your individual circumstances, qEEG is a promising field.

Even as I write this, an SSDI judge has ruled that the results of my qEEG testing will be the basis he uses for deciding whether my claim for SSDI disability will be denied or not. My entire life hangs in the balance dependent on pretty pictures from a computer. In my book, that makes qEEG testing both relevant and critical.

Other sources of information:

http://www.arthritis.org/communities/Chapters/UTI/Archives/FM_Connect/Brain_Mapping_and_Neurofeedback.asp

http://www.cfsdoc.org/eeg.htm

http://www.snr-jnt.org/journalnt/vol7/jntvol7.htm

http://start.eegspectrum.com/Newsletter/dec2002.htm

http://www.cinda.org/support/pamphlets/Preston2.pdf

http://www.cfids.org/archives/2003/2003-1-article07.asp

What the Heck are They Talking About: Neurological CFS

How squiggles and colored brain maps may change how we view CFS and Fibromyalgia

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