eVox® Qualitative EEG

eVox® Brain Mapping uses Electrophysiology Biomarkers to Aid in Diagnosis: ERP and EEG Memory Loss Biomarkers.

“Protect the brain function you have and grow to your full potential.” ~Studio Team

No two brains are alike. So, when it comes to obtaining and maintaining a healthy mind and body, it is important for the Studio Team to understand your unique brain function. The eVox Brain Map helps us look beyond your symptoms to see the brain activity that may be at the root of the cause.

    Getting the eVox® Brain Map is simple, painless, and only takes about 40 minutes in the office.

    During the assessment, you will wear an EEG cap, similar to a swim cap. You then complete a series of simple exercises while your brain activity is recorded. The resulting Brain Map reveals brain and heart measurements that help us understand what is causing your symptoms.

    The Memory Loss Conundrum

    Upwards of 20% of those aged 65 years and older already have detectable symptoms of mild cognitive impairment. Yet diagnosing the cause of memory loss can prove challenging. Historically, we have relied on self-report questionnaires and effort-based computerized testing for determining a diagnosis. Yet even when applied optimally, these assessments often fall short in the detection of early or less severe disease presentations.

    Additionally, current tools often lack the sensitivity and objectivity needed to develop accurate diagnoses, resulting in a segment of the population that is misdiagnosed and under-diagnosed.

    eVox® Brain Mapping Benefits:

    • Early detection of Mild Cognitive Decline.
    • Differentiate between cognitive decline and stress-related memory changes.
    • Monitor treatment efficacy.
    • Track memory and brain function data over time.

    Electroencephalography (EEG)

    Electroencephalography (EEG) has been employed extensively in clinical research and provides a noninvasive and office-based solution for objectively measuring brain function. Leading research agrees that clinical evaluation along with other supportive diagnostic techniques such as functional neuroimaging may be necessary to substantiate memory loss diagnoses. But, due to expensive and sensitive equipment along with difficult and time-consuming data interpretation, EEG has historically been out of reach from practicing physicians. 

    The highest standard of care for patients with memory loss includes assessments of brain electrophysiology, biochemical labs, and effort-based screeners.

    Brain Mapping Biomarkers

    Normal and productive brain function relies heavily on a complex array of interconnected networks that facilitate communication within and across brain structures. With regard to detecting and diagnosing memory loss, three electrophysiology biomarkers are particularly pertinent: 1) the P300 component of event-related potentials, 2) thalamic-generated peak alpha frequency (posterior dominant rhythm), and 3) quantitative EEG brain function scoring against a normal reference group. These biomarkers are fast and easy to obtain with the eVox® System.

    Event-Related Potentials

    Memory functions and cognitive processes within the brain can be measured using event-related potentials (ERPs). These waveforms represent time-locked neuronal responses generated in response to specific events or stimuli. The time delay or latency, between stimulus onset and a patient’s physical response, reflects brain processing speed, while waveform amplitude reflects neuronal recruitment and subsequent activation (i.e., how many neurons are successfully working together to process information).

    Fundamental elements of memory involve the degree of attention to a stimulus and the subsequent encoding of information for storage and retrieval. Two ERP components that are useful to measure these aspects of memory are P300a and P300b. The P300b component has been exceptionally well-studied with regard to memory loss disorders such as Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD). Longer P300b latency measures and low amplitudes have been observed in subjects with mild AD compared to age-matched controls. P300b latency and amplitude have also been shown to predict the progression of mild cognitive impairment. Additionally, P300b metrics demonstrate superior sensitivity over conventional assessments such as the MMSE in detecting early pre-clinical memory loss.

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    Grand average ERPs for patients with MCI who progressed in dementia symptoms and, patients with MCI who did not progress, and control subjects. MCI Progressors show elongated P300b latency and reduced P300b amplitude.

    Peak Alpha Frequency

    The alpha frequency band (8 – 12 Hz), is the most dominant EEG frequency found in the brain. The peak frequency within this frequency band, fittingly termed Peak Alpha Frequency (PAF) or posterior dominant rhythm, is largely generated by the thalamus and reflects thalamocortical network activity. PAF can therefore be conceptualized as the pacemaker of the brain and is known to be a good measure of information processing capacity.

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    EEG studies have found that PAF rises from childhood to adolescence, and then decreases slowly with age11. Regardless of age, individuals with strong working memory abilities have faster PAF compared to inferior memory performers12. Abnormally low PAF (< 8 Hz) can be found in patients with cognitive disturbances and dementia and slowed PAF is correlated with loss of hippocampal volume in many posterior regions of interest in patients with MCI14. The PAF electrophysiology biomarker can therefore be used to help identify patients with pre-clinical dementia and monitor patients’ overall cognitive capacity over time

    EEG spectral features discriminate between AD, VaD, and controls. Demented patients show hallmark qEEG slowing and reduced PAF.

    Quantitative EEG

    Quantitative EEG (qEEG) moves beyond the conventional visual inspection of EEG to perform a strictly objective analysis of brain function. Individual digital EEG data are statistically analyzed and can be compared to normative database reference values to provide insight into differential diagnosis and treatment effects. Distinct differences in resting-state qEEG profiles exist between people with dementia diagnoses and age-matched controls.

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    Research has shown that some people with dementia present with slowing of the alpha rhythm and a general decrease in beta power. This qEEG pattern and others may be especially useful in distinguishing dementia from pseudo-dementia.

    Moreover, qEEG brain maps can provide information relevant to discriminate between specific dementia diagnoses, such as AD and vascular dementia. The sensitivity of qEEG, therefore, allows for a useful assessment measure when considering memory impairment etiology.

    Conclusion

    The eVox® system is a convenient and accessible medical device that delivers objective memory loss biomarkers to support the recognition of pre-clinical dementia conditions, identifying the root cause of memory loss, and performing a differential diagnosis.

    You can not fix a problem you don’t understand. Advanced diagnostics is often necessary to get at the root cause. Once the root cause is identified, the solution becomes possible.

    Dr. Lisbeth Roy, D.O.

    Founder of Doctors Studio

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