Results of a pilot study suggest that decreases in prefrontal cordance, a combined measure of absolute and relative EEG power, may predict response in patients with depression who do not respond to conventional antidepressants.9 Cordance may also be a useful indicator when planning treatment for cocaine addiction. Patients who had abused cocaine and had high cordance were much more likely to complete treatment programs than matched patients with low cordance.20 QEEG analyses can be used to distinguish between those with mild dementia and depression and those with depression who complain of cognitive impairments.21,22 Many patients with bipolar disorder start treatment after experiencing a single major depressive episode but before having a manic episode. In these cases, a QEEG map provides valuable diagnostic information that can guide the clinician to the most appropriate treatment choice.
There are no clear correlations between specific QEEG abnormalities and different mood disorders; however, reduced a activity and increased b activity suggest a relatively higher probability of bipolar disorder.23 In contrast, a finding of increased a or u activity suggests that the most likely diagnosis is unipolar depression, allowing for the aggressive start of appropriate treatment. Abnormal EEG findings are more common in persons with mania than in those with depressed moods.15 Global disturbances in EEG synchronization are similar in those with schizophrenia and bipolar disorder. In contrast to patients with schizophrenia, patients with bipolar disorder do not show disorganization in the superior temporal lobes. In patients with schizophrenia, EEG activity can be categorized into discrete patterns that may prove to be more specific indicators of diagnostic subtypes than specific positive or negative symptoms of psychosis.24
Nonmedicated patients who are manic frequently exhibit lower EEG amplitudes in the left anterior and temporal brain regions.25 Specific abnormal findings may predict differential response rates of patients to different classes of conventional mood stabilizing or antipsychotic medications. Nonresponders had significantly more diffuse u activity than responders, and (similar to nonmedicated persons with mania) they had overall higher EEG activity in the left temporoparietal region.25,26 Nonresponders to conventional medictions are more likely to have diffuse u activity at baseline and higher amplitudes in the left temporoparietal regions during treatment. Inpatients who are acutely manic and respond to conventional medications are more likely to have abnormalities on the left side of the brain. The significance of these findings is limited by the low rate of cooperation of hospitalized patients who are acutely manic in studies completed to date.
Abnormal EEG or ECG findings are often seen in patients with anxiety disorders. ECG findings in patients with general anxiety typically reveal increased sympathetic activity and decreased parasympathetic activity. QEEG findings may predict differential response rates to conventional medications in patients with OCD. In one series, approximately 80% of patients with OCD who exhibited increased a activity responded to SSRIs compared with 80% of patients with OCD with increased a activity who failed to respond to SSRIs.27 Specialized software that interpolates subcortical EEG activity from surface scalp electrodes (variable resolution electromagnetic tomography) found excess a activity in the orbitofrontal and temporofrontal regions of untreated patients with OCD, which normalized in patients who responded to treatment with paroxetine(Drug information on paroxetine) (Paxil).28
These findings were consistent with functional-imaging data using positron emission tomography and suggest that EEG may provide a cost-effective way to evaluate neurobiological abnormalities in patients with OCD. Abnormal QEEG findings that are associated with other anxiety disorders are highly inconsistent, and the future role of QEEG in the clinical assessment of anxiety disorders remains unclear.
Detecting biophotons and "subtle" energy. All living organisms emit ultraweak photons, and under certain conditions such biophotons are emitted as highly ordered or "coherent" light.29-32 Findings of studies on biophoton emissions from the human body have led to speculation about "light channels" that regulate energy and information transfer within the body, biological rhythms associated with the intensity and patterns of biophoton emissions, and diseases related to energetic "asymmetries" between the left and right sides of the body.33,34 Studies conducted on biophoton emissions associated with acupoints suggest that subtle differences in photon count, wavelength, and coherence may correspond with energetic "imbalances" in yin and yang associated with neurological and psychiatric disorders.35
Many alternative medical practitioners use assessment approaches that purport to detect subtle energetic clues about the causes of mental illness. Highly refined diagnostic skills grounded in ancient roots of traditional Chinese and Ayurvedic medicine, as well as modern technology-based approaches, are being used in outpatient clinics to evaluate responses to acupuncture and qigong. Skilled Chinese medical practitioners obtain empirical and intuitive information about the balance between the complementary energetic principles yin and yang, the 2 postulated forms of "qi" that contribute to health and illness. Future studies are needed to determine whether clinicians who claim to intuitively mea- sure subtle energies are somehow able to detect ultraweak biophotons, electromagnetic fields, or other classically described forms of energy associated with living organisms.
Measuring electrodermal potentials at acupoints following acupuncture or qigong treatment may provide useful information about changes in the quality of bioelectrical activity.36-38 The findings of a recent double-blind study suggest that skilled Chinese medical practitioners are able to reliably estimate changes in yin and yang energy following acupuncture treatment.39 Machines that measure small differences in electrical skin resistance have been shown to reliably identify acupoints.40 Clinical methods used to detect subtle characteristics of the human pulse have been refined over millennia in Western, Chinese, Ayurvedic, and Tibetan medicine. Case reports suggest that certain pulse characteristics described in Chinese, Ayurvedic, or Tibetan medical assessment correspond with energetic imbalances manifesting as particular cognitive or affective symptoms.41 For example, mild to moderate symptoms of anxiety, depressed mood, or irritability are often associated with a "tight" or rapid rate when the patient's pulse is taken at the pericardium position and "smooth vibration" over the entire pulse at all depths. In contrast, severe psychiatric symptoms are more often associated with a "rough vibration" over the entire pulse and "slipperiness" in certain aspects of the pulse. The most severe symptoms are often associated with the most erratic or abnormal energetic qualities of the pulse, resulting in a "pulse picture" that is "overwhelmed" by "chaos in the circulation."41 Analysis of the VAS is an emerging technology-based approach that complements assessment methods used in traditional Chinese medicine. The VAS is a postulated reflex that brings the endocrine, immune, and autonomic nervous systems into optimum energetic balance in response to external and internal physiological and energetic stressors. Acupuncturists use the VAS reflex to assess the energetic imbalances associated with medical and psychiatric disorders. Findings from Doppler imaging studies suggest that subtle changes in arterial wall tone, consistent with the hypothesized VAS reflex, may occur almost instantaneously in response to energetic stimuli that affect the physical and psychological state of the body but do not enter into conscious awareness.42 According to the theory, particular substances induce specific resonance patterns that trigger changes in autonomic arousal. More studies are needed to determine whether the VAS reflex can be used to determine optimum acupuncture or conventional treatments for energetic imbalances associated with specific psychiatric disorders.