The Theoretical Interpretation Of EEG

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Author: Gerald Ulrich, M.D.
Publisher: BMED Press LLC
Publish Date: May 21, 2013
Pages: 418
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The Theoretical Interpretation Of Electroencephalography (EEG): The Important Role of Spontaneous Resting EEG and Vigilance by Gerald Ulrich, M.D. is an essential guide to electroencephalography for Neuropsychiatrists, Psychiatrists, Neurologists, Clinical Psychologists, Neuropsychologists, Psychophysiologists, and Neuroscientists.

Hans Berger advocated the human electroencephalogram (EEG) as a central tool for psychiatric research and diagnosis. However, the empirical development of EEG was hampered from its beginning due to a negligence of theory to guide its interpretation.

It was not until the late 1950’s that psychiatric clinicians pursued the idea that all behavior and experience must have neuronal correlates which should be reflected by dynamic alterations of the EEG. These important developments led to a theory-driven model of EEG interpretation known as: “Berlin Psychiatry School Model of EEG-Vigilance.” This model was based in-part on neurologist Henry Head’s concept of “vigilance.” Dieter Bente later expanded vigilance to include the spatio-temporal changes of the spontaneous resting EEG as a systemic macroindicator of the cerebral global function and its dynamics.

The Berlin model is not well known in the United States. Instead, EEG is dominated by data-driven Q-EEG where one looks at mathematical correlations without a coherent theory to guide interpretation. Moreover, a general misunderstanding of “vigilance” and a lack of coherent theory to describe the EEG contributed to the publication of many textbooks with more than 50 partial aspects of EEG that lack any common thread.

Dr. Ulrich provides an authoritative, advanced guide to theory-based EEG interpretation based on “Berlin Psychiatry School Model of EEG-Vigilance.” This is the first known published book on this topic. The aim is to help the reader increase self-confidence in EEG assessment in clinical practice or research and to facilitate more reliable and valid EEG interpretations. The author provides a skilled synthesis of decades of EEG research alongside his expert insights from his 40 years of clinical experience and research with EEG. The reader will learn how to visually discern spatio-temporal patterns with 132 high-quality examples of EEG images – the majority within the course of spontaneous resting EEGs. Additionally, the EEG-pathology of psychiatric syndromes and the impact of common psychotropic medications on the EEG are described in detail. Another important contribution is the identification of a common type of biological artifact which has gone unnoticed in research that is likely responsible for the unsatisfactory test-retest reliability and questionable validity of the EEG; the author proposes a simple solution to this vexing artifact problem.

In the second part of the book, the reader is introduced to novel QEEG procedures, especially related to EEG dynamics. The author is careful to restrict these procedures to those that can be regarded as meaningful within the theory of EEG-vigilance.

Table of Contents


Chapter 1 : A critical review of the present status of the EEG in psychiatry

Chapter 2: The EEG in Psychiatry – Only Screening for Neurological Disorders or more?

Chapter 3: Conditions for the Development of a Psychiatric EEG
3.1 Framework
3.2 Methodology
3.3 Terminology
3.3.1 “Normal versus Abnormal
3.3.2 “Allgemeinveränderung” (General Slowing Down of Frequencies)
3.3.3 “Krampfbereitschaft” (Proneness to Epileptic Seizures)
3.3.4 One Feature – many Terms
3.4. Theoretical Foundations
3.4.1 Systems Physiology, Cybernetics and Biorhythms
3.4.2 The Spontaneous Resting EEG (SR-EEG) as a Non-Stationary Process
3.4.3 EEG and Vigilance
3.4.4 The Importance of the SR-EEG as a Macroindicator of Cerebral Global Function (CGF)
3.4.5 EEG and Maturation: General points of view
3.4.6 EEG and Maturation: Individual Indicators
3.4.7 EEG and Psychophysiology
3.4.8 About the Impossibility of an External Validation of Psychopathologically Defined Psychiatric Diagnoses

Chapter 4: Qualitative Changes of the Psychophysiological EEG. General Principles of Pathological Dissolution of the Organization of Brain Electical Activity (Pathologischer Funktionswandel)
4.1 From the Physiomorphic to the Diffuse Dysrhythmic EEG
4.2 From the Diffuse-Dysrhythmic EEG to Brain-Electrical Inactivity
4.3 Involutional Psychosyndromes and Healthy Aging
4.4 Dynamic Rigidity and Dynamic Lability in Exogenous Psychosyndromes
4.5 Dementia of the Alzheimer Type
4.6 Depressive Syndromes and Disturbed Dynamics of EEG-Vigilance
4.7 Manic Syndromes and Lowered EEG-Vigilance
4.8 Schizophrenic Psychoses
4.9 Epileptic Psychoses
4.10 The EEG in Meditation
4.11 Multiple Sclerosis

Chapter 5: Changes of the EEG as Induced by Psychotropic Substances: The Basics
5.1 Neuroleptics
5.2 Thymoleptics
5.3 Lithium
5.4 Carbamazepin
5.5 Tranqulizers, Hypnotics, Narcotics
5.6 Alcohol
5.7 Opioids, Psychoanaleptics, Psychodysleptics
5.8 Psychotomimetics
5.9 Nootropics

Chapter 6: The Quantified EEG (QEEG) – Its Present Scientific Fundamentals and Eddington’s Parable
6.1 Promises, Fictions, Disappointments: A Documentation from Literature
6.2 The Reasons for the Present Deadlock of QEEG
6.2.1 The “Normality”- Problem
6.2.2 The Deliberate Assumption of Stationarity of the SR-EEG and the Central Limit Theorem
6.2.3 The Unrecognized Arterial Pulse Impedance Artifact (APIA)- An unnoticed methodical impediment
6.2.4 The Non-consideration of the Dynamics of SR-EEG as a Macroindicator of Cerebral Global Function (CGF)
6.2.5 The misunderstanding of HEAD’S Theoretical Construct of Vigilance
6.2.6 The Primary Quantification of SR-EEG
6.2.7 The Abuse of EEG for neuroanatomical demarcation of Neophrenological moduls

Chapter 7: Limits and Possibilities of QEEG in Clinical Psychiatry
7.1 About the Quantification of Qualities: General Principles
7.2 Longitudinal, Serial, Dynamical or Ipsative Trend Assessment (ITA)
7.3 Validity and Reliability of ITA as well as examples of use
7.3.1 Senile Dementia (D) or Dementia of the Alzheimer Type (DAT)
7.3.2 Alcohol Withdrawal (detoxification)
7.3.3 Depressive Syndromes
7.3.4 Manic Syndromes
7.3.5 Schizophrenic Psychoses
7.3.6 Attention-Deficit-Hyperactivity-Disorder (ADHD)
7.3.7 Other Psychiatric Disturbances
7.4 The Non-Linear Complexity Analysis: An important supplement and extension to traditional linear q-EEG analysis

Chapter 8: Outlook



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1 review for The Theoretical Interpretation Of EEG

  1. U. Hegerl-MD

    Gerald Ulrich’s book, “The Theoretical Interpretation of Electroencephalography – The important Role of Spontaneous Resting EEG and Vigilance,“ is an enthusiastic, but still very reflected view on the usefulness and the pitfalls of electroencephalogram (EEG)-analysis for diagnostic and prognostic purposes in general and especially in psychiatric disorders.

    As a main goal, Ulrich provides an introduction on the interpretation of resting state EEG data with special emphasis on the dynamics of occurring EEG-patterns during the transition from wakefulness to sleep, reflecting different stages of brain function. He discusses this “EEG-vigilance” framework in the light of electrophysiological-research from its beginnings up to now. Further, he points out the advantages of such a hypothesis driven model for interpretation of EEG-data in comparison to the descriptive, sometimes even “neophrenological” approaches of quantitative EEG (qEEG) research that until now have failed to bring up clinical relevant tools for diagnosis or treatment prediction in psychiatric conditions. It is convincingly shown that the interpretation of topographical and spectral EEG findings in psychiatry requires careful consideration of vigilance stages and their regulation. Taking into account dynamic changes of EEG patterns over time within and between recordings of one subject is the key for Ulrich to bridge the gap between psychopathology and physiology.

    The work further provides a coarse overview of basic principles of EEG-analysis, enriched with refreshing glimpses of philosophical anecdotes and historical theories of nature sciences. The limitations of this book are the sometimes jotted-down illustrations and the missing of some more recent works on the EEG-vigilance model. Still, this work gives a compelling insight into EEG research from a different point of view, written by one of the experienced “EEGist” in the field of psychiatry.

    By U. Hegerl MD, Full Professor; Chair of Psychiatry and Psychotherapy of the University of Leipzig (Germany) and S. Olbrich MD, Psychiatrist.

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