... 1998; Hamilton, 2000; McCandless, 2005; Sicile-Kira, 2004; Siegel, 1996). NEUROPATHOLOGY IN A... more ... 1998; Hamilton, 2000; McCandless, 2005; Sicile-Kira, 2004; Siegel, 1996). NEUROPATHOLOGY IN AUTISM ... Kemper and Bauman (1993) investigated alterations in limbic areas by reviewing the findings of several case reports. ...
This study was the first to investigate the efficacy of long wave infrared (LWIR) imaging as a di... more This study was the first to investigate the efficacy of long wave infrared (LWIR) imaging as a diagnostic tool for ADHD. This study was conducted to assess the sensitivity and specificity of LWIR imaging as a method of diagnosis among 190 patients (ages 4.4-57 years) with various diagnoses, including ADHD, who came into our office for neuropsychological evaluation. LWIR imaging demonstrated a moderate level of sensitivity (65.71%) in identifying patients with ADHD and a high level of specificity (94%) in discriminating those with ADHD from those with other diagnoses. The overall classification rate was 73.16%. This was indicative of a high level of discriminant validity in distinguishing between patients with and without ADHD. There was a moderate level of agreement between LWIR imaging and multiple other diagnostic tests for ADHD. LWIR imaging demonstrated high sensitivity and specificity as a diagnostic tool for ADHD. These results provide evidence for the efficacy of a novel, quick, and effective way to investigate the physiological basis of one of the most prevalent childhood psychiatric disorders.
equation. This suggests that the neuropsychological abilities measured by these tests may be rela... more equation. This suggests that the neuropsychological abilities measured by these tests may be related to unawareness of deficits. Based on these findings, a new neuropsychological theory is postulated that suggests that some variants of anosognosia are related to impairments in executive functioning. The cognitive determinants of unawareness are likely related to cognitive estimation, planning, and verbal agility/mediation. Directions for future research, theoretical and neuropsychological practice implications are discussed.
Neuroimaging technologies and research has shown that autism is largely a disorder of neuronal co... more Neuroimaging technologies and research has shown that autism is largely a disorder of neuronal connectivity. While advanced work is being done with fMRI, MRI-DTI, SPECT and other forms of structural and functional connectivity analyses, the use of EEG for these purposes is of additional great utility. were the first to examine the utility of pairwise coherence measures for depicting connectivity impairments in autism. Since that time research has shown a combination of mixed over and under-connectivity that is at the heart of the primary symptoms of this multifaceted disorder. Nevertheless, there is reason to believe that these simplistic pairwise measurements under represent the true and quite complicated picture of connectivity anomalies in these persons. We have presented three different forms of multivariate connectivity analysis with increasing levels of sophistication (including one based on principle components analysis, sLORETA source coherence, and Granger causality) to present a hypothesis that more advanced statistical approaches to EEG coherence analysis may provide more detailed and accurate information than pairwise measurements. A single case study is examined with findings from MR-DTI, pairwise and coherence and these three forms of multivariate coherence analysis. In this case pairwise coherences did not resemble structural connectivity, whereas multivariate measures did. The possible advantages and disadvantages of different techniques are discussed. Future work in this area will be important to determine the validity and utility of these techniques. Using quantitative and analytic EEG methods in the understanding of connectivity in autism spectrum disorders: a theory of mixed
There is a need for effective interventions to address the core symptoms and problems associated ... more There is a need for effective interventions to address the core symptoms and problems associated with autistic spectrum disorder (ASD). Behavior therapy improves communication and behavioral functioning. Additional treatment options include psychopharmacological and biomedical interventions. Although these approaches help children with autistic problems, they may be associated with side effects, risks or require ongoing or long-term treatment. Neurofeedback is a noninvasive approach shown to enhance neuroregulation and metabolic function in ASD. We present a review of the literature on the application of Neurofeedback to the multiple problems associated with ASD. Directions for future research are discussed.
Autism is a neurodevelopmental disorder characterized by deficits in communication, social intera... more Autism is a neurodevelopmental disorder characterized by deficits in communication, social interaction, and a limited range of interests with repetitive stereotypical behavior. Various abnormalities have been documented in the brains of individuals with autism, both anatomically and functionally. The connectivity theory of autism is a recently developed theory of the neurobiological cause of autisic symptoms. Different patterns of hyper-and hypo-connectivity have been identified with the use of quantitative electroencephalogray (QEEG), which may be amenable to neurofeedback. In this study, we compared the results of two published controlled studies examining the efficacy of neurofeedback in the treatment of autism. Specifically, we examined whether a symptom based approach or an assessment/connectivity guided based approach was more effective. Although both methods demonstrated significant improvement in symptoms of autism, connectivity guided neurofeedback demonstrated greater reduction on various subscales of the Autism Treatment Evaluation Checklist (ATEC). Furthermore, when individuals were matched for severity of symptoms, the amount of change per session was significantly higher in the Coben and Padolsky (J Neurother 11:5-23, 2007) study for all five measures of the ATEC. Our findings suggest that an approach guided by QEEG based connectivity assessment may be more efficacious in the treatment of autism. This permits the targeting and amelioration of abnormal connectivity patterns in the brains of people who are autistic.
Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the e... more Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine, and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections, immunomodulation, and neurofeedback treatments. Although specific treatments may be more appropriate for specific genetic and metabolic syndrome...
... 1998; Hamilton, 2000; McCandless, 2005; Sicile-Kira, 2004; Siegel, 1996). NEUROPATHOLOGY IN A... more ... 1998; Hamilton, 2000; McCandless, 2005; Sicile-Kira, 2004; Siegel, 1996). NEUROPATHOLOGY IN AUTISM ... Kemper and Bauman (1993) investigated alterations in limbic areas by reviewing the findings of several case reports. ...
This study was the first to investigate the efficacy of long wave infrared (LWIR) imaging as a di... more This study was the first to investigate the efficacy of long wave infrared (LWIR) imaging as a diagnostic tool for ADHD. This study was conducted to assess the sensitivity and specificity of LWIR imaging as a method of diagnosis among 190 patients (ages 4.4-57 years) with various diagnoses, including ADHD, who came into our office for neuropsychological evaluation. LWIR imaging demonstrated a moderate level of sensitivity (65.71%) in identifying patients with ADHD and a high level of specificity (94%) in discriminating those with ADHD from those with other diagnoses. The overall classification rate was 73.16%. This was indicative of a high level of discriminant validity in distinguishing between patients with and without ADHD. There was a moderate level of agreement between LWIR imaging and multiple other diagnostic tests for ADHD. LWIR imaging demonstrated high sensitivity and specificity as a diagnostic tool for ADHD. These results provide evidence for the efficacy of a novel, quick, and effective way to investigate the physiological basis of one of the most prevalent childhood psychiatric disorders.
equation. This suggests that the neuropsychological abilities measured by these tests may be rela... more equation. This suggests that the neuropsychological abilities measured by these tests may be related to unawareness of deficits. Based on these findings, a new neuropsychological theory is postulated that suggests that some variants of anosognosia are related to impairments in executive functioning. The cognitive determinants of unawareness are likely related to cognitive estimation, planning, and verbal agility/mediation. Directions for future research, theoretical and neuropsychological practice implications are discussed.
Neuroimaging technologies and research has shown that autism is largely a disorder of neuronal co... more Neuroimaging technologies and research has shown that autism is largely a disorder of neuronal connectivity. While advanced work is being done with fMRI, MRI-DTI, SPECT and other forms of structural and functional connectivity analyses, the use of EEG for these purposes is of additional great utility. were the first to examine the utility of pairwise coherence measures for depicting connectivity impairments in autism. Since that time research has shown a combination of mixed over and under-connectivity that is at the heart of the primary symptoms of this multifaceted disorder. Nevertheless, there is reason to believe that these simplistic pairwise measurements under represent the true and quite complicated picture of connectivity anomalies in these persons. We have presented three different forms of multivariate connectivity analysis with increasing levels of sophistication (including one based on principle components analysis, sLORETA source coherence, and Granger causality) to present a hypothesis that more advanced statistical approaches to EEG coherence analysis may provide more detailed and accurate information than pairwise measurements. A single case study is examined with findings from MR-DTI, pairwise and coherence and these three forms of multivariate coherence analysis. In this case pairwise coherences did not resemble structural connectivity, whereas multivariate measures did. The possible advantages and disadvantages of different techniques are discussed. Future work in this area will be important to determine the validity and utility of these techniques. Using quantitative and analytic EEG methods in the understanding of connectivity in autism spectrum disorders: a theory of mixed
There is a need for effective interventions to address the core symptoms and problems associated ... more There is a need for effective interventions to address the core symptoms and problems associated with autistic spectrum disorder (ASD). Behavior therapy improves communication and behavioral functioning. Additional treatment options include psychopharmacological and biomedical interventions. Although these approaches help children with autistic problems, they may be associated with side effects, risks or require ongoing or long-term treatment. Neurofeedback is a noninvasive approach shown to enhance neuroregulation and metabolic function in ASD. We present a review of the literature on the application of Neurofeedback to the multiple problems associated with ASD. Directions for future research are discussed.
Autism is a neurodevelopmental disorder characterized by deficits in communication, social intera... more Autism is a neurodevelopmental disorder characterized by deficits in communication, social interaction, and a limited range of interests with repetitive stereotypical behavior. Various abnormalities have been documented in the brains of individuals with autism, both anatomically and functionally. The connectivity theory of autism is a recently developed theory of the neurobiological cause of autisic symptoms. Different patterns of hyper-and hypo-connectivity have been identified with the use of quantitative electroencephalogray (QEEG), which may be amenable to neurofeedback. In this study, we compared the results of two published controlled studies examining the efficacy of neurofeedback in the treatment of autism. Specifically, we examined whether a symptom based approach or an assessment/connectivity guided based approach was more effective. Although both methods demonstrated significant improvement in symptoms of autism, connectivity guided neurofeedback demonstrated greater reduction on various subscales of the Autism Treatment Evaluation Checklist (ATEC). Furthermore, when individuals were matched for severity of symptoms, the amount of change per session was significantly higher in the Coben and Padolsky (J Neurother 11:5-23, 2007) study for all five measures of the ATEC. Our findings suggest that an approach guided by QEEG based connectivity assessment may be more efficacious in the treatment of autism. This permits the targeting and amelioration of abnormal connectivity patterns in the brains of people who are autistic.
Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the e... more Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine, and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections, immunomodulation, and neurofeedback treatments. Although specific treatments may be more appropriate for specific genetic and metabolic syndrome...
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