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Article Review: Quantitative EEG Neurometric Analysis–Guided Neurofeedback Treatment in Postconcu...

Article Review: Quantitative EEG Neurometric Analysis–Guided Neurofeedback Treatment in Postconcussion Syndrome (PCS): Forty Cases. How Is Neurometric Analysis Important for the Treatment of PCS and as a Biomarker?


Surmeli, T., Eralp, E., Mustafazade, I., Kos, I. H., Özer, G. E., & Surmeli, O. H. (2017). Quantitative EEG Neurometric Analysis–Guided Neurofeedback Treatment in Postconcussion Syndrome (PCS): Forty Cases. How Is Neurometric Analysis Important for the Treatment of PCS and as a Biomarker?. Clinical EEG and neuroscience, 48(3), 217-230.


Article Review By: Mark J. Stern, Ph.D., Kristy Snyder Colling, Ph.D. and Robert Coben, Ph.D.


Article Link: https://journals.sagepub.com/doi/abs/10.1177/1550059416654849


Traumatic brain injuries (TBI) can result in long-term complications, even in mild injuries. Symptoms that persist longer than 12 months following a mild TBI (mTBI), are commonly referred to as post-concussion syndrome (PCS). Patients with PCS often report psychiatric changes, such as sadness or anxiety, and changes in cognitive functioning, such as reduced attentional abilities. Symptoms of PCS are frequently misdiagnosed as psychiatric disorders. In fact, Surmeli and colleagues (2017) found that 39 of their 40 participants were diagnosed with a psychiatric disorder, including major depression, anxiety, and obsessive-compulsive disorders. All of these patients reported not being asked at the time of diagnosis if they had suffered a head injury. Treatment usually entails psychotropic medication, such as anti-depressants or even antipsychotics, as was the case for 27% of the study’s participants at the time of admission. However, research suggests that managing symptoms of PCS with medication may not yield long-lasting results, if any, and may cause adverse side-effects. Neurofeedback (NFB), on the other hand, has shown great promise in treating emotional and cognitive symptoms associated with TBI and PCS, as well as the underlying changes in brain functioning. NFB is a treatment modality that utilizes operant conditioning to help individuals learn to better regulate their own brain waves.

Surmeli and colleagues (2017) used quantitative electroencephalography (QEEG) brain maps to successfully help differentiate patients with history of TBI from those with other diagnoses using a special TBI probability index. Individualized brain maps were then used to develop NFB treatment plans that were tailored to each patient. The study treated 40 participants with an average of 48 sessions of QEEG-guided NFB. After NFB, participants showed significantly reduced psychiatric and emotional symptoms associated with PCS and, to some extent, improvements in visual and auditory attention. Long-term follow up (average = 3.1 years) with 39 of the original participants indicated that 95% reported “being fine with no complications” and without any further psychiatric intervention. Furthermore, none of the participants reported any adverse reactions. This study highlights the importance of personalized interventions that target underlying pathological brain functioning associated with TBI.

We at Integrated Neuropsychological Services use neuropsychological testing and quantitative EEG to help provide patients with more accurate diagnoses and develop treatment plans specific to each patient’s needs. If you or someone you know has suffered from a TBI and is still experiencing symptoms, please contact us to learn more about how we might be able to help.


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