Download BCIA NEUROFEEDBACK EXAM DEMOS STUDY GUIDE DAY 2 WITH 100% CORRECT ANSWERS 2025 and more Exams Nursing in PDF only on Docsity!
BCIA NEUROFEEDBACK EXAM
DEMOS STUDY GUIDE DAY 2 WITH
100% CORRECT ANSWERS 2025
Describe how electrical activity coming from the scalp is transformed into the EEG correct answers >> Electrodes detect signals (in microvolts) coming from the scalp that are amplified and transformed via digital or analog processing. The EEG is an analog representation of electrical activity coming from the scalp. Morphology correct answers >> The visible shapes and contours of the EEG waveform that give its visual appearance Name some important aspects of the EEG signal correct answers >> Amplitude, frequency distribution, patterns of waxing and waning, changes due to sensory stimulation or task, distribution across the scalp
Explain bandpass filters correct answers >> A way of letting some frequencies through while blocking others. They can be analog hardware or digital software. Explain Fast Fourier Transform (FFT) correct answers >> Like a prism- separates raw EEG into smaller parts - frequencies. There are many types of bandpass filters and many ways of implementing Fourier or other transforms. Explain bins correct answers >> A way of gathering outputs from transforms where the frequency data is organized into useful bands like the bandwidth of a digital filter Explain sampling rate correct answers >> Reflects how fast the signal is sampled. Optimum ratio is 4:1. For example if a system was recording 32 Hz activity, a sampling rate of 128 would be preferable. Name common bandwidths correct answers >> Delta, theta, alpha, beta, SMR, high beta, gamma Delta correct answers >> 1-4 hz. Sleep, repair, brain injury
Which biological factors can distort the EEG? correct answers >> Muscles anywhere in body, e.g. Blinking, clenched jaw, raised eyebrows, breathing, coughing What is electromyography (EMG)? correct answers >> Electrical activity coming from muscles What is surface electromyography (SEMG) biofeedback? correct answers >> Records the electrical activity of muscles coming from the surface of the skin. General range of SEMG is 20-200 hz. How can SEMG cause artifact? correct answers >> EEG and SEMG have some overlapping Hz in the beta range (EEG 0-40); (SEMG 20-200). Best way to identify EMG is by observing the analog EEG. Which areas of the scalp are most affected by SEMG? correct answers >> Prefrontal and temporal What is electro-ocular artifact (low frequency invasion)? correct answers >> Blinking or eye movements can show as high amplitudes of delta. Identify by looking at the EEG.
Explain the effect of sweating and salt bridges. correct answers >> Excessive sweating can cause large, slow, up and down movements of the EEG, perhaps due to the loosening of the electrodes. Salt bridges can come from sweating or clients who have wet or damp hair. A salt bridge refers to unwanted electrical conductivity between two or more scalp sensors. What is electrode pop? correct answers >> Loosening of the electrode can cause a spikelike signal. Make sure the surface has been properly cleaned , the connection is stable, and adequate electrolyte material is present. What is Ohm's Law? correct answers >> Voltage (E) = current (I) x resistance (R). E= IR. Or R = I/E. What is EKG (heartbeat) artifact? correct answers >> Rhythm of the heart beat can be observed in the analog EEG during QEEG evals. The artifact must be removed before processing the data. Describe equipment factors that may cause artifact. correct answers >> Damaged lead wires (check with ohmmeter)
What is the difference between an impedance meter and an ohmmeter? correct answers >> Ohmmeters measure resistance as it applies to direct current (DC) , and impedance meters measure resistance as it applies to alternating current (AC). What are typical impedance values? correct answers >> Between 5000 ohms (5k) and 50,000 ohms What does high impedance mean? correct answers >> Too much electrical resistance between the scalp and sensor. High impedances increase sensitivity to noise, interference, and artifact, and may render lower amplitude readings, resulting in unreliable recordings. You should not allow wide variations in impedance. What are electrode cups made of? correct answers >> Silver, gold, or tin How much resistance (in ohms) is standard for assessments? correct answers >> 5,000 ohms or less Even if you get low impedance readings, what else should be done before training? correct answers >> Inspect the raw
EEG waveforms and check the morphology of the raw EEG signal on the computer screen. Ensure that the signal does not appear too flat, fuzzy, and that it responds in real time with no visible delay to events like eyeblinks or muscle activity. What is a referential ( monopolar) montage? correct answers >> Only one active electrode on the scalp with a reference on a location such as an earlobe or mastoid bone. How does a referential montage render an absolute value? correct answers >> Because the reference earlobe placement is considered neutral or zero in value What is the major drawback to a monopolar (referential) montage? correct answers >> Most sensitive to large amplitudes of cranial EMG artifact and earlobe contamination. Each facial movement can cause significant distortion. A benefit is large amplitudes are easily measured, esp for dominant rhythms like alpha and theta. What is a bipolar (sequential) montage? correct answers >> Both the active and reference electrodes are mounted to the scalp, with the ground cup clipped to either earlobe.
What is common mode rejection? correct answers >> The effectiveness of a differential amplifier in rejecting identical electrical signals at the active and reference inputs What is an inhibit threshold? correct answers >> Decreasing the amplitude within a frequency bandwidth, e.g. Reducing excessive theta What is a reward threshold? correct answers >> Increasing the amplitude within a frequency bandwidth, e.g. Increasing alpha amplitudes How many thresholds can be set at a time? correct answers
One or more, up to one for each bandwidth. For example, beta/SMR training might: Inhibit theta 4-8 hz with a 15 microvolt threshold Reward beta 16-20 hz with a 3 microvolt threshold Inhibit high beta 20-30 hz with a 6 microvolt threshold What reinforcement range is sought? correct answers >> 50% to 80% with a single band pass filter
What reinforcement range is used for multiple bandpass filters? correct answers >> Commonly, 70% time over threshold for one reward filter ( e.g. Beta) 20% -percent time over threshold- for the primary inhibit (e.g. Theta) 10%- percent time over threshold- for the secondary inhibit (e.g., high beta) How are all thresholds targeted in most neurofeedback equipment? correct answers >> As time OVER threshold. So inhibits are seemingly reversed with e.g. 20% over threshold corresponding to an 80% success rate. How are sounds usually used for reinforcement? correct answers >> Discrete or continuous. Discrete are clicks, bells, or other sounds that can be presented as a single reward. Like a sound analog of a food pellet. Continuous sounds are sustained and may be modulated in pitch, amplitude, or other qualities. They can also be provided individually for component bands, like a chord. How is type of visual feedback related to the goals of neurofeedback training? correct answers >> One of main goals is to teach attention, relaxation, and focus in the
Describe discrete feedback correct answers >> All conditions of all the thresholds must be met before a traine receives visual or auditory reinforcement. Explain continuous feedback correct answers >> Most systems are programmed to allow for gradual auditory and visual reinforcement, e.g. amplitude or pitch variable sounds. Describe the effects of sleep deprivation on EEG. correct answers >> Excessive delta. General increase in slow wave activity seen in eyes open training. They generally fall asleep with eyes closed training. Describe clinical considerations when you see excessive delta correct answers >> High amplitude rhythmic delta in adults is an indication of TBI or other disorders. Referential montages may show high amplitude delta because widespread activity shows up at the earlobe contacts. A bipolar montage may be preferable. Some children with ADHD or learning disorders may have widespread (diffuse) delta as well as theta. Inhibiting part of the delta band with the theta band may be indicated (e.g. 2-7 hz instead of just 4-7 hz)
Explain clinical considerations regarding excessive theta. correct answers >> Children have higher theta amplitudes than adults. EEG slowing is associated with foggy thinking, slow reaction time, poor calculation, poor judgment and impulse control. Adult theta may have a different role than childhood theta- brain wave activity alters across the lifespan. Slow activity in children (e.g. 4-7 hz) may be equivalent to faster wave activity (e.g. 7-9 hz) in adults How does the posterior dominant frequency follow a developmental pattern? correct answers >> There is a gradual frequency increase- starting with 6-9 hz in preschool and reaching adulthood level of 8-12 hz by around 13 years. When might you downtrain theta? correct answers >> Any scalp location with a high theta/beta ratio. When would you avoid uptraining theta? correct answers
If there is any history of seizures If there is a history of PTSD uptraining theta may result in flashbacks
What inner states is alpha associated with? correct answers
Inner calm, peacefulness, a sense of inner and outer connectedness. What are some clinical implications of alpha? correct answers >> High anterior amplitudes are common in children known to be daydreamers High in anterior in cases of depression Normative amplitudes are asymmetrical: RH alpha > LH alpha In depression LH alpha amplitudes are commonly higher than RH amplitudes Alpha frequency itself is indicative of mental acuity, development, and aging Above average dominant alpha may reflect superior intelligence or possibly anxiety or insomnia Alpha frequency tends to slow with age and the wave morphology becomes more complex Describe occipital alpha. correct answers >> Associated with idleness of visual system, e.g. Eyes closed If it decreases with eyes open it usually means drowsiness
Amplitude decrease will usually be 20% - 80 %. On average, 50% - from 8 microvolts eyes open to 12 microvolts eyes closed. An increase less than 20% or more than 80% may suggest need for clinical evaluation How is alpha production related to peak performance? correct answers >> Some very effective people can maintain alpha even during work, indicating a state of relaxed focus and effortlessness (e.g. Einstein) Alpha training is often used for peak performance and personal effectiveness, particularly learning a concentration/relaxation cycle. This approach emphasizes flexibility and appropriateness, above and beyond controlling amplitudes Describe SMR (12-15 hz) correct answers >> May reflect a state of being internally oriented Sometimes called low beta True SMR predominates on in sensorimotor strip- C3, Cz, or C SMR reflect the brain 's intention to remain still
EMG can appear in this band Usually high beta is used as an inhibit because of EEG training and EMG Usually downtraining high beta is set at 10% over threshold to set a "guard band" to make sure extremely high values aren't rewarded Gamma ( 40 hz or 38-42 hz) correct answers >> Synchronous bursts of 40 hz are found during problem solving tasks This is increasingly used for peak performance and mental fitness How does the practitioner discuss medication issues with the client at the beginning of therapy? correct answers >> He has them sign a release explaining that neurofeedback can change the effects of prescription and non-prescription drugs. Prescribed , non-prescribed, and herbal medicine can change EEG What drug considerations might you make before beginning an assessment? correct answers >> Computerized performance tests, symptom checklists, or EEG are all
affected. Stimulant medications will likely improve cognitive performance, anti-anxiety meds, anti-depressants, and OTC pain meds will likely reduce cognitive performance. Marijuana will cause artificially high alpha. Trainees should stop smoking at least 3 days before an EEG When drugs can't be stopped prior to the EEG, it is essential to estimate the effect it will have Barbiturates correct answers >> Increases in the amount and amplitude of beta Beta may reach high amplitudes, and although diffuse, is often most prominent in the frontal regions Benzodiazepines correct answers >> Benzos produce prominent beta activity, even persisting several days after the last dose May see diffuse theta slowing May see slowing of dominant posterior alpha rhythm Neuroleptics (antipsychotics) correct answers >> Phenothiazines, thioxanthenes, and butyrophenones can cause slowing of posterior dominant rhythm (PDR)
