4-CHANNEL Z-SCORE NEUROFEEDBACK: A SINGLE CASE STUDY.pdf

4-CHANNEL Z-SCORE NEUROFEEDBACK: A SINGLE CASE STUDY POSTER.pdf

Disclaimer: The content below was generated with the assistance of AI and then reviewed and edited by BrainMaster Technologies, Inc. It is provided for educational and informational purposes only and does not constitute medical advice.

Overview #

This document presents a detailed single-case study evaluating 4-channel Z-Score Neurofeedback (NF) delivered through BrainMaster hardware and the NeuroGuide Z-Score DLL. The case explores whether real-time normative EEG training can improve symptoms, QEEG deviations, and objective performance measures in a complex clinical presentation.
Based on the findings reported, the author concludes that Z-Score NF appeared effective in this individual case, demonstrating rapid improvements in QEEG patterns, attention metrics, and self-reported functioning.

Case Summary #

The participant was a 44-year-old male with long-standing issues related to attention, mood dysregulation, and a history suggestive of prior head injury. Pre-intervention testing included QEEG and the IVA CPT, both showing extensive abnormalities—including severe coherence and phase irregularities and extremely impaired attentional performance.

Methods & Training Approach #

Assessment Tools #

• 19-channel QEEG with artifact reduction and high reliability (split-half: 0.98; test–retest: 0.92).

• IVA CPT administered at each QEEG time point.

• Clinical interview documenting symptoms, history, and functioning.

Neurofeedback Setup #

Training used:

• BrainMaster Atlantis I 4×4 hardware

• NeuroGuide Z-Score DLL

• Percent Z-OK (%ZOK) protocols, training 94–95% of all 248 real-time normative variables.

• SD target zone dynamically adjusted to maintain a 20–50% reward rate.

• Two 15–20-minute protocols per session across 5–6 scalp sites.

Page 3 includes electrode-site diagrams illustrating the multi-site 4-channel configurations.

Results #

Medication Changes #

During the first 25 sessions, the treating psychiatrist titrated the client off all medications, and the client remained off medication at reassessment.

QEEG Improvements #

Across eyes-open, eyes-closed, linked-ears, and Laplacian montages (pages 8–11), the study reports:

• Marked reductions in coherence abnormalities (especially theta and beta).

• Improved phase lag patterns.

• Increased organization in alpha activity, including emerging alpha peak in eyes-closed recordings.

• Better hemispheric symmetry in frontal and central regions.

IVA CPT Performance #

As shown in the charts on page 7:

• Response Control Quotient improved from 29 → 94.

• Attention Quotient improved from 0 → 88.

• Behavioral issues dropped from 50+ → 11.

Self-Reported Outcomes #

The client reported:

• Greater ability to stay focused and complete tasks.

• Improved participation in business meetings.

• Overall functioning increased from “1–2” pre-NF (with medication) to “2–5” post-NF (without medication).

Remaining Challenges #

After 25 sessions, some mild residual issues remained—primarily low-frequency delta abnormalities, frontal alpha coherence issues, and mild mood dysregulation.
The client later completed nine more sessions before discontinuing due to financial reasons.

Discussion & Interpretation #

The clinician concludes that Z-Score NF:

• Appeared effective in this individual case, producing rapid symptom and neurophysiological improvement.

• May offer advantages over non-Z-Score methods—particularly when multiple QEEG abnormalities require simultaneous amplitude and connectivity training.

• Enables safer coherence and phase training due to continuous comparison to normative values.

However, results are limited by N=1, and the author emphasizes the need for larger, controlled studies.

Key Takeaways #

• 4-channel Z-Score Neurofeedback provided measurable improvements across QEEG parameters, objective performance, and subjective functioning.

• Percent Z-OK training allowed comprehensive, multi-domain feedback control (amplitude, asymmetry, coherence, phase).

• Connectivity measures were a major area of improvement and may benefit from the 4-channel Z-Score method.

• Case highlights the potential value of real-time normative EEG training but calls for broader research.