The First Annual Z-Score Training Conference
The Ritz Carlton Cancun Resort, Cancun, Mexico

Friday May 25 to Sunday May 27, 2012
Pre-Conference Workshops;
Monday 5/21 Thru Thursday 5/24, 2012

Register by phone, mail or online.

For nearly six years, the clinical neurofeedback community has been exploring and evolving the use of QEEG normative database-referenced z-scored training. The pioneering efforts of Dr. Robert Thatcher, Brainmaster and Thought Technologies have set the stage for a present-day environment of intense innovation and refinement of methods. Building upon the principles of operant conditioning and norm-referenced QEEG database modeling of normal brain function, we are now seeing the multichannel EEG treatment of surface (cortex-based) disorders integrated with EEG source localization/visualization (LORETA) and brain stimulation methods (e.g., NeuroField).

This event is designed to address the training needs of the clinical neurofeedback community as well as a detailing of the present scientific status of these treatment innovations. Towards that end, the three day conference will be preceded by four days of hands-on workshops, dedicated to instilling both competence and confidence in the use of cutting edge, z-score based training methods. The event will be held at the internationally renowned Ritz Carlton Cancun Resort, a 5-star property boasting one of the most beautiful beaches in the world. We are proud to offer our conference attendees a greatly reduced room rate that transforms this event into an affordable vacation you won’t soon forget.

Conference Faculty;

Robert Thatcher, Ph.D
Joel Lubar, Ph.D
Thomas Collura, Ph.D
Marty Wuttke
Mark Smith, LCSW
Nick Dogris, Ph.D
Mike Gismondi, LMHC

Main Conference and Pre-Conference Workshop Curriculum

Friday, May 25, 2012

9:00am-10:00am:

Keynote Address; Dr Robert Thatcher

QEEG Database-Referenced Z-Score Training;
History, Present Capacities and Future Directions

Abstract;

In this address we review my perspective on the development of normative database referenced z-score biofeedback, starting with events as early as the 1960s to its rapid evolution in the present. We review the uses of this technology. We then shift to the scientific and even economic implications of this approach that will be unfolding in the near future. Finally, we chart the future of z-score biofeedback, and how we can all be a part of it.

10:00am-12:30pm;

Formal Case Studies of Surface and LORETA Z-Score-based Interventions; Establishing a Format for Practical Clinical Research

Moderators; Dr. Robert Thatcher with Dr. Joel Lubar

Abstract;

We have reached out to a number of experienced clinician-scientists to participate in presenting more structured case studies of Surface and LORETA Z-Scored interventions. We have asked that there is consistency in pre-post measures and client history documentation. We have also asked that there is great transparency and ease of replication of the interventions used. It is our hope that this series of case studies will give the neurofeedback community a scientifically compelling look at what can do with challenging clinical conditions.

Lunch and Beach Break; 12:30 pm to 4:00pm

4:00pm to 7:00pm;

Z-score Training Clinic; Describing and Addressing Treatment Impasses and Plateaus

Moderators; Joel Lubar, Marty Wuttke, Mark Smith and Mike Gismondi, with assistance from the entire Conference Faculty

Abstract;

It speaks to the very integrity of a clinical community when it can openly and frankly examine treatment impasses and plateaus rather than only presenting “success stories”. We will take advantage of the enormous clinical expertise and resourcefulness of our conference faculty to engage in clinical “troubleshooting” and group problem solving. Clinicians are encouraged to present cases where surface and LORETA z-score methods were used and in some way fell short. While we not ask clinicians to present data or assessment measures they are not accustomed to using in their practices, it goes without saying “the more data the better” and preference will be given to more well documented case presentations that include multiple QEEG mappings, trend data, client response to various interventions, and adequate client background. We all stand to become wiser in the process.

8:30pm to 9:30pm;

Z-Score Training Users’s “Town Meeting”

Moderators; Joel Lubar, Marty Wuttke and Mike Gismondi

Abstract

The methods used by the practicing neurotherapist must be considered from the larger context of one’s practice patterns and opportunities. So saying;

1) how has z-scored treatment interventions impacted your practice in terms of populations served, success rates, depth or extent of symptom resolution and/or performance enhancement?
2) When are z-scored treatment methods the “treatment of choice” and why?
3) When should z-score methods be augmented by other approaches or not used at all?

Saturday, May 26, 2112

9:00am to 12:00pm

Overview and Update of the Neuroguide Approach to Neurofeedback

Presenter; Dr Robert Thatcher

Abstract;

In this presentation we will cover our latest thinking on these inter-locking components of optimal clinical practice;

1) Linking Symptoms to Functional Networks; The neuroscientific basis of our reasoning.

2) Activation of optimal Z score biofeedback

3) Separating the “compensatory” from the “weak” systems; theory and practice

4) Utilizing the fundamentals of operant conditioning

5) Progress chart uses in building learning curves and patient monitoring in general

6) Intra-session monitoring; what is changing, what is not, and what to do about it as you train.

7) Inter-session evaluation; how to best motivate the client and capture true client progress and “effect sizes”;

8) Pre vs post statistical maps; How to best visualize and represent change, and implications for treatment plan updating.

Lunch and Beach Break; 12:00pm to 4:00pm

4:00pm to 6:00 pm

Expert Clinician-Driven Treatment Planning and Monitoring in NeuroGuide: How to utilize what you know about the Brain, EEG and Your Client

Presenter; Dr. Joel Lubar

Abstract;

Experienced clinicians who possess a good working knowledge of neurophysiology and clinical EEG have the ability to customize and tailor their NeuroGuide neurofeedback protocols to unique client presentations. Presenting symptoms can have unusual, episodic, or multiple causalities. It is the responsibility of the clinician to integrate and leverage everything known (or suspected) that could be driving client symptoms as they move through treatment. We will review, via actual case studies, how to confirm or modify the automated treatment protocols in NeuroGuide.

7:00pm to 9:00pm

Exploring the Neurotherapy of the Future; Integrating Neurotransmitter Testing/Balancing with Z-scored Neurofeedback And Psychotherapy in the Treatment of Auto-Immune Disorders

Presenter: Marty Wuttke

Abstract;

It makes good intuitive sense, especially in the realm of Mind-Body-Brain medicine, to look for interactional effects between 1) neurochemistry, especially neurotransmitters like dopamine and serotonin 2) it’s relationship to EEG values, 3) the impact of psychodynamics on both client neurochemistry and electrophysiology. In this presentation, I try to describe a large portion of my current approach to neurotherapy by highlighting my work with “intractable” auto-immune disorders; including chronic fatigue, adrenal fatigue, HIV-based disease, and so on. On one level, this type of thinking is not new; the field of psycho-neuro–immunology has embraced this type of “systems” thinking for decades, but they were without the tools we have today. Traditionally, neurofeedback based approaches to auto immune disorders focused mainly upon the reduction of stress, including traumatic stress. Research demonstrates that exposure to pathogens, toxicities, marital/family conflict, depression and/or grief can suppress immune function. Conversely, vitamins/supplements, sleep, stimulating positive experiences, physical fitness, exposure to light, helps boost immune function. To date, more than 20 hormones and neurotransmitters have known immunological modulation potential. Likewise, many neurotransmitters either increase or decrease in response to stress. But can we now go beyond “mere” stress reduction (and disregulated threat perception) to addressing the precise networks of immune function/dysfunction on its own terms, ie, it’s specific neurochemistry, it’s specific electrophysiology and it’s psychology? I think we can.

Sunday, May 27, 2012

9:00am to 12:00

The Brainmaster Approach To Z-Scored Database Training: Innovations in Thresholding, Data Visualization and in Addressing Individual Differences

Presenter; Dr. Thomas Collura

Abstract;

Brainmaster was the first to incorporate live Z-Score training using a normative database, and almost immediately developed a more global as opposed to more localized training approach, now known as “PZOK.” This approach asserts that the brain works well when provided with complex information that facilitates flexibility, and allows “outliers” to exist outside the target areas. This approach facilitated the “co-existence” of compensatory mechanisms that were not allowed by approaches that require all or most z-scores to fit inside the target area at once. This provided a significant amount of sensitivity and flexibility when choosing z-score targets, and revealed unanticipated mechanisms of brain adaptation that were reported in ongoing clinical results. Further refinements led to the development of “Z-Plus,” which introduced new metrics reflecting the state and dynamic change of outlying z-scores in the form of the “momentum” and overall “size” as compared to the full complement of z-scores. Furthermore the new ”Z-Bars” and Z-maps” displays give greater visual oversight over the unfolding clinical process at hand with our clients.

BrainMaster has introduced an innovative approach to computing, displaying, and training the cortex using sLORETA-based information at the level of voxels and regions of interest (ROI’s). Our unique implementation provides instantaneous, high-resolution sLORETA images of over 6,000 voxels at a rate of 32 frames per second, in raw EEG as well as up to 15 frequency bands. This provides, for the first time, a resolution of 5 millimeters, and real-time representation of the activity of all voxels in the brain, without the use of averaging or “innermost voxels”. Each voxel is computed in true current-source density, providing an “analog” readout from every voxel. Our Live LORETA Projector (LLP) thus provides instantaneous proportional (“how much”, not simply “yes/no”) visual and auditory information, enabling the immediate awareness of the level of activity in the brain. A given voxel, or region of interest, can be viewed with unprecedented spatial and time resolution. With a visual representation scheme comparable to an fMRI, and speed far in excess of any non-EEG imaging system, the trainee can literally see and hear brain activity “at the speed of thought.” Initial work with this system has demonstrated single-session changes comparable to those previously only seen over many sessions, if at all. A client can, for example, literally watch his posterior cingulate gyrus “light up” in real time, and observe changes within 30 milliseconds of their occurrence. Our LLP system provides direct sLORETA-based training at the level of individual brain voxels or regions (e.g. “train down 12-20 Hz in the anterior cingulate”). When used alone, or combined with surface 19 channel LZT training as a “global inhibit”, early experience with this system is both dramatic and clinically powerful.

We have come to realize that live Z-Score training does not always require a normative database, but simply some reference of targets and standard deviations, from which live Z-Scores can be computed. We are now introducing a new concept in z-score biofeedback, that of “template-based” training. This adjunctive approach allows users to create and use a wider range of references, which can include individual EEG profiles, e.g., profiles of “peak performers”, the trainee’s own EEG, or databases constructed by users themselves. To a large segment of the neurofeedback community, the very idea of training everyone to a normative database is not without controversy or limitations. For example, many normal individuals, peak performers or not, do not have anything like a “normal” EEG. Posterior alpha rhythms with a dominant frequency of 11 or 12 Hz, or higher, are not as uncommon as one might expect. Normal individuals may also show significantly “abnormal” connectivity values which do not reflect pathology, but do reflect individual, perhaps genetically driven differences, above and beyond the “anomalous” differences found in highly successful yet well adjusted peak performers.

Thus, we have introduced a new concept known as “Z-Builder,” which permits the construction of LZT targets for surface as well as sLORETA data from a variety of sources. In its simplest form, an identified segment of EEG can be instantaneously converted into reference norms for amplitude, coherence, phase, spectral correlation, and comodulation, for up to 15 frequency bands. Therefore, it is now possible for the first time to use a client’s own “best case” EEG as a reference, or to train them to a designated EEG profile. In time, Z-Builder will be used to construct reference sets that do not have to reflect “average” in the pursuit of normal, but can adapt and conform to other EEG profiles that may reflect specific cognitive styles, and particular modes of brain function, perhaps observed only in specialized contexts. Most experienced clinicians have encountered the senior air traffic controller or insurance corporation risk manager whose seeming “pathological” hyper vigilance is in fact their very livelihood! Peak performers, athletes, artists, and others who do not have “normal” EEG’s can now use LZT training . This takes us beyond a “disease” model, and moves us into the realm of optimal functioning, regardless of any symptoms or disorders which may or may not exist in any given individual. In the future, “nontraditional” LZT training will become better understood and accepted, as the value of individual differences and personalized medicine take center stage. This approach has potential value in assessing the effects of interventions and medications, for example, in real time and with individual differences incorporated directly. With the introduction of 1) a suite of z-score thresholding techniques, 2) the Live sLORETA Projector and 3) Z-Builder, we continue to produce implementations that are not even anticipated in other systems.

Lunch Break; 12:00pm to 1:30pm

1:30pm to 3:30pm

Neuromodulation Methods Guided by Database Referenced Dynamic Z-Scores; A Review of the NeuroField Approach and Future Directions

Presenter; Dr. Nick Dogris, President, NeuroField Inc.

In any brain stimulation or “neuromodulation” based system, the question of how to best target and “guide” the stimulation is paramount. In previous attempts such as repetitive Transcranial Magnetic Stimulation (rTMS), simplistic, non-dynamic, but at times powerful (and surprisingly robust) targeting schemes have been used. Part of our mission at NeuroField has been to utilize the clients dynamic or “live” EEG, and it’s real time response to treatment, as input to a system that decides what to do next to guide the brain to normalcy, health or enhanced performance. Towards that end, Dr. Robert Thatcher’s “real time” version of his normative QEEG database has provided us with an intriguing framework. The basic strategy is simple;

1) establish targets in real time as we detect clinically significant deviations from normal,
2) present frequency-indexed electromagnetic stimulation designed to move the brain to more balanced or “normalized” function,
3) observe “hits” or the identification of what frequencies were responsible for moving live z-score values towards more normal ranges,
4) use those frequencies iteratively until no more frequencies “work”
5) remap and re-evaluate.

We presently have our Neurofield stimulation units fitted with two channel EEG capability, and have been encouraged by the results. Before the end of this year, Neurofield will be beta-testing a 24 channel EEG unit that seamlessly integrates 19 channel QEEG data acquisition with “whole head” surface and LORETA neurofeedback AND flexible multichannel electromagnetic stimulation. The theory is that whatever is targeted and fed back to the client will in fact change much faster and more completely if it is aided by accurate real time electromagnetic stimulation to enhance (entrain) and/or diminish (disentrain) different EEG power values. We will discuss the implications of such a system and how clinicians can participate in the future of Neurofeedback.

3:30pm to 5:00pm

Integration Panel; Conference Faculty

End of Event; Safe travels home!

Pre Conference Workshops

Workshop One; Monday, May 21 and Tuesday, May 22, 2012
9:00am to 1:00pm and 4pm to 7:30pm

NeuroField; Introductory and Intermediate Skills

Abstract

Since its introduction in 2008, Neurofield has demonstrated it’s clinical effectiveness with a variety of conditions, including insomnia, inflammation, chronic pain, anxiety and many mood disorders. Our technology has encouraged neurofeedback providers to think more broadly and inclusively about the cellular health (or dysfunction) that underlies the generation of the human EEG.

In this special edition of the Neurofield introductory/intermediate skills workshop, we will tailor the presentation to the skill level of the attendees. If necessary, we can use a break out group for complete beginners, while concurrently addressing the concerns of more experienced users. Apart from the procedures and mechanics of using the equipment, all attendees will become conversant with the following topics and skills;

1) Understanding the origin and use of the basic Neurofield protocols and the various electromagnetic and sound stimulation delivery systems we have developed.
2) The evolving philosophy of Neurofield in light to current efforts to achieve basic FDA clearance and beyond.
3) Randomized vs. repetitive stimulation
4) What our built-in HRV capabilities tell us about the impact of Neurofield.
5) What our built-in two channel EEG capabilities tell us about clinical impacts.
6) Other topics will be addressed as per time available and attendee interests.

This workshop will prepare attendees to understand and appreciate the latest evolutions of NeuroField, utilizing “live” norm referenced Z-score training guidance, as will be covered in my lecture on Sunday as part of the main conference.

Workshops Two and Three; Wednesday and Thursday, May 23 and 24
9:00am to 1:00pm and 4pm to 7:30pm

(running concurrently)

Workshop Two;

Mastering NeuroGuide 19 Channel Surface/LORETA Z-Score Neurofeedback

Instructors; Joel Lubar, Ph.D, with Robert Thatcher, Ph.D and Marty Wuttke

Abstract;

The purpose of this two day workshop is to give participants the ability to begin using the Neuroguide neurofeedback software with competence and confidence, and to have the resources in place to appropriately manage progressively more challenging cases via on-going consulting or mentoring. Some experience with acquiring and basic interpreting of QEEG maps/reports is desirable, but not assumed of all participants. This is primarily a “hands-on” training; most of the history, theory and the scientific underpinnings of this form of z-score training will be covered either at the conference or in subsequent workshops given by the instructors. Participants will seamlessly transition from a) QEEG 19 channel data acquisition, b) basic and more advanced artifacting using both automated and visual inspection methods, c) report generation and basic interpretation, d) using the LORETA viewer to decide when and how to use surface vs. LORETA neurofeedback, e) using Neuroguide to help differentiate between real vs. spurious findings, f) use of the Neuroguide symptom checklists to establish an automated treatment plan, g) understanding some of the assumptions that drive the symptom checklist and verifying the appropriateness of the treatment recommendations to individual clients based upon your understanding of the QEEG report and the client as a whole, h) basic management of treatment recommendations from the symptom checklist, including the selections of symptoms, the sequencing of symptom selection, how and when to combine or partition symptoms, i) strategies for managing the number and type of EEG metrics to be worked on at any one time, j) setting up, documenting and supporting client learning curves, both within and between sessions, in accordance with the principles of operant conditioning, k) how to select client displays to establish and sustain learning, including the use of Neuroguide’s new DVD feedback capabilities, Deymed’s “3-D Engine” graphic displays, and other options, l) an evaluation of available thresholding options, m) discussion of the clinical implications of Neuroguide’s emphasis upon target localization vs. more “global” targeting strategies.

Throughout the training, the clinical experiences of the instructors and their consulting clinicians are used to illustrate how to best make use of this powerful software.

Workshop Three

Wednesday and Thursday, May 23 and May 24

Integrating Brainmaster’s 19 Channel Z-Score Surface Training with sLORETA and Brain Avatar 3-D LORETA Projector

Instructors; Mark Smith with Tom Collura

Brainmaster continues to develop and refine its own unique approach to database-referenced z-score training. Initially, the treatment plan is established via careful review of the NeuroGuide report and the LORETA Viewer. We then elect to combine, in real time, surface and source (sLORETA) training. The deeper brain structures targeted via the LORETA viewer can be trained as we observe it’s impact upon surface z-scored values, and vice versa. In addition, we chose to “cast a wider net” in defining the three-dimensional region of interest to be trained; opting to train larger regions rather than targeting central-most voxels, while simultaneously offering the fastest feedback processing times in the business. We have experienced a greater immediacy and robustness of results via this design philosophy. At the same time, there appears to be great clinical power in offering the client a means to visualize, in real time, the actual anatomical structures and networks being trained. Finally, we offer flexible and varied approaches to thresholding, recognizing the importance of more incremental and “proportional” vs more “all or none” feedback thresholding strategies.

The sLORETA workshop with prepare the attendee to assess and train the brain using Brainmaster's Avatar software that includes sLORETA and the Live LORETA Projector. With plenty of hands on experience in the workshop students will learn to combine 19 Channels of Z score training with sLORETA and discover the clinical benefit of using 19 channels of Z score training as a “global inhibit”. Learners will become skilled at utilizing the LORETA analytic software from the Key Institute to define regions of interest (ROI) or Brodmann Areas functionally related to client complaints and train and monitor EEG parameters specific to those areas. Students will also be introduced to ZBuilder, a new functionality that allows clinicians to build individual Z score templates for certain types of clients that are frequently seen in your practice. Attendees will gain knowledge of designing individual templates of Z scores with ZBuilder and utilizing a modified version to train targeted EEG activity in desired directions.

Registration Information

The cost for attending the main conference, Friday May 25th thru Sunday, May 27th is $1,050.

The two-day workshops cost $550 each. The two-day pre-conference workshops are;

NeuroField; Monday 5/21 and Tuesday 5/22

NeuroGuide NeuroFeedback (Surface and LORETA);
Wednesday May 23 and Thursday 5/24

Brainmaster Avatar/sLORETA; Wednesday 5/23 and Thursday 5/24

Register online or phone or email Mike Gismondi (mikegismondi@frontiernet.net or call 845 497 7836 or 845 551 6472. Please provide the following information;

1) Name and professional designation
2) Full contact information, including address, phone/cell, and email.
3) If paying with credit card, please leave credit card number, expiration date, and name as it appears on the card (Master Charge, VISA or Am EX only)
4) If paying by check, please make out to “Michael Gismondi” and mail to me at;

10 York Place
Washingtonville, New York 10992
USA

Note there are a limited number of oceanfront rooms available at the reduced conference rate, please register as soon as possible to avoid the possibility that normal rates will prevail!

Hotel Accommodations

Attendees will contact the Cancun Ritz Carlton Resort directly to make their reservations. The event is known by the hotel as “the Z-score Conference” The special conference rate for an ocean front room (single or double occupancy) is $180.26 (USD). This includes a full gourmet breakfast each day, and free in-room internet. Any hotel-related concerns can be directed to myself or Mr. Antonio Lizarraga at (55) 5207-1197 or email him at antonio.lizarraga@ritzcarlton.com

Hotel Events

Currently planned are 1) The Chef’s Table (Friday night) and 2) A Gourmet Tequila Tasting (Saturday night). I can personally vouch for the Tequila Tasting, where I drank nearly $400 of top sheft Tequila for $75. We will see if we can do that again! See the Resort website for details.

Workshop Equipment

While we encourage attendees who already have Neuroguide, Braimaster or Neurofield systems to bring then to the training, for those who do not yet own the equipment they will be trained on, it is our goal to have one workstation shared by two, and no more than three students, thus insuring adequate training to begin seeing clients almost immediately.

Cancelations and Refunds

Due to my contractual obligations with the hotel, no cancellations will be accepted or refunds processed after 4/21/12, short of an act of God. Full credit can be extended to future events (any many are planned!).