Neuromarkers of Anxiety in a Patient with Suspected Schizophrenia and Tia: the Effect of Individually- Tailored Neurofeedback

The aim of the study was to evaluate the effectiveness of individually tailored neurofeedback protocol for the reduction of anxiety which was diagnosed in a patient with suspected schizophrenia and TIA. The neuromarkers in Quantitative EEG (QEEG) and Event-related potentials (ERPs) were utilized in the construction of the protocol and the evaluation of the effectiveness of neurofeedback. A 54-year-old patient, experienced a Transient Ischemic Attack (TIA) of the left brain hemisphere. He had been treated previously for more than 30 years for schizophrenia. After the episode of TIA, he suffered mild anomia, intensification in the severity of headaches, muscular tension, difficulties with sleeping as well as an inability to continue work in his given profession. Neuropsychological tests showed the presence of anxiety. The QEEG/ERP assessment of the patient did not find any ERPs neuromarkers of schizophrenia but instead there we found a neuromarker of anxiety. It is expressed by excessive central high beta rhythmicity. A suppression beta protocol of neurofeedback was suggested. After 20 sessions of neurofeedback found in the QEEG/ERP assessment a decrease of the central high beta activity without any significant changes in ERPs. Finally, the patient returned to work. The QEEG/ERP assessment provides a powerful tool for diagnosing the leading brain dysfunction and for constructing an individually tailored neurofeedback protocol. Presented above case study confirms the need for administering new neurotechnologies in the diagnosis of mental disorders with particular emphasis put on the schizophrenia spectrum. For a patients with cognitive problems the differential diagnosis should include carotid artery stenosis in which the Doppler Ultrasound (DUS) examination is gold standard.