Hemoencephalography for
Autistic Spectrum Disorder
Robert Coben, PhD
Presented at ISNR, 2006
Atlanta, Georgia
Methods
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28 Autistics seen in our practice for at least 20 sessions
of HEG (nir or pirHEG).
All patients had already received 20 sessions of EEG
Biofeedback.
This was assessment guided HEG in that all patients
were deemed to have frontal system dysfunction based
on NP, IR and QEEG data.
Pre and Post ATEC, GADS, BRIEF, PIC-2.
Pre and Post NP testing.
Pre and Post Infrared Imaging surrounding each
session.
Pre and Post QEEG.
HEG Procedures
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nirHEG or pirHEG – therapy remained the
same over the entire course of 20
sessions.
Sessions were 15 – 25 minutes
depending on tolerance.
Done twice weekly.
Therapy was done with DVD and/or
Gamecube video games.
Patient Sample
30
20
10
0
30
Age in Months
24
15
10
5
4
male
0
female
20
30
20
10
10
0
26
1
Caucasian
1
African
Asian
American American
0
50-100 100150
150200
250300
23
right
3
2
left
mixed
Patient Sample
Medications
15
10
12
9
5
0
●
10
6
1
none
1
2
18
20
3
0
10
nirheg
pirheg
Comparison of nir and pir groups for gender,
age, race, handedness, and medications were all
ns.
Control Sample
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12 subjects in wait list control group.
Matched for gender, age, race,
handedness, other treatments, initial
ATEC score.
No new treatment during study design.
Pre-post testing showed no significant
changes on any measure.
ATEC distribution
3
6
2
Frequency
4
3
2
1
Normal Quantile
5
1
0
-1
-2
0 10 20 30 40 50 60 70
0
PreATEC TOT
Results: ATEC ratings
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Total – p<.0001 – 42% reduction
Communication – p<.017- 47% reduction
Socialization – p<.022 – 43% reduction
Sensory/Cognition – p<.004 – 44%
reduction
Behavior – p<.0001 – 39% reduction
Results – Rating Scales
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GADS Aspergers Disorder Quotient – p<.002
GADS Social Interaction – p<.015
GADS Restricted Patterns of Behavior – p<.012
GADS Cognitive Patterns – p<.0002
BRIEF Working Memory – p<.045
PIC-2 ADHD – p<.0113
PIC-2 Delinquency – p<.038
PIC-2 Family Relations – p<.047
PIC-2 Psychological Discomfort – p<.05
PIC-2 Social Skills – p<.05
Results: Neuropsychological
Incices
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Attention – p<.0002
Executive Functioning – p<.0001
Language – p<.024
Visuospatial – p<.0008
Infrared Imaging: nirHEG and pirHEG
Results: Infrared Imaging
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1st session – minimum temp – p<.0025
1st session – temp range – p<.003
Last session – minimum temp – p<.024
Last session – temp range – p<.026
Results: QEEG changes
Predictors of Response to
HEG
y = -1.7778x + 18.778
50
50
60
50
30
20
10
0
20
10
0
-10
-10
-20
-20
-30
-0.5
0.8
1.3
Nir (1) or Pir (2)
1.8
ATECTOTALCHANGE
ATECTOTALCHANGE
30
y = 0.1435x - 2.5442
70
40
40
ATECTOTALCHANGE
y = -4.3417x + 19.528
40
30
20
10
0
-10
-20
0.5
1.5
# Meds.
2.5
3.5
60
110
160
210
Age (months)
R2 = .28;p<.036
260
nirHEG/pirHEG Comparisons
nir
8
7.1
7
6
pir
●
7.8
5
4
3
2
1
0
3.2
1.78
0.4
0.57
pragmatics emotional social skills
control
0.82
0.12
IR 1st
range
No significant difference
for ATEC scores, GADS
ADQ, BRIEF Working
Memory, PIC-2 ADH,
Deliquency, Family
relations, Psychological
discomfort, or any
Neuropsychological
index.
nirHEG/pirHEG Comparisons –
Relative Power
nirHEG
pirHEG
nirHEG/pirHEG Comparisons –
Connectivity - NIRHEG
Connectivity – NIRHEG
nirHEG/pirHEG Comparisons –
Connectivity - PIRHEG
Connectivity - PIRHEG