The following examinations are carried out at the Laboratory for Psychophysiology:

• Long-term electroencephalography (long-term EEG)
• Examination of the autonomous nervous system and skin conduction response
• Actometry

Apart from diagnostics, we also provide two types of apparative therapy:

• Repetitive transcranial magnetic stimulation
• Biofeedback procedure

Long-term electroencephalography (long-term EEG)
Long-term electroencephalography is only used on particular problems connected with psychiatric disorders. These include confused, delirious states and the influence of psycho-drugs on electrical activity in the brain. A healthy brain exhibits well ordered rhythmical independence with different wave forms in sleeping or wakeful state. Once the scalp has been cleaned, a so-called electrode helmet is used to receive these and to amplify them by a factor of a million. A period of at least 18 hours is required. These sessions are conducted by medical technicians and supervised by doctors.

Examining the autonomous nervous system and skin conduction response
The autonomous nervous system / the vegetative nervous system is the earliest part of the nervous system in humans and animals in evolutionary terms. It controls and coordinates unconscious bodily functions such as heartbeat, breathing and digestion. If one or more of these automatic functions should be impaired, it could be an indication of psychiatric illness. All too often, this possibility is not considered at all or is only considered very late. Three simple examinations are sufficient to determine any problems with the autonomous nervous system. Moreover, autonomous nervous system diagnostics can be used to check drug tolerance and drug influence on the various bodily functions, making it possible to optimise drug treatment.

Examination of the autonomous nervous system can test the balance of the autonomous or vegetative nervous system. The autonomous nervous system consists of the sympathetic and parasympathetic nervous systems. Thus, for instance, the sympathetic nervous system is hyperactive when certain problems, such as anxiety, insomnia etc., are evident. The increased sympathetic activity is evident from increased heart rate, faster breathing, increased perspiration etc..

As regards drug tolerance, it is important to investigate the influence of psycho-drugs on the autonomous nervous system.

Tests:

• Heart rate variability
• Valsalva test
• Ewing test
• Skin reflex

Repetitive transcranial magnetic stimulation
More than one million people in Germany experience at least one depressive phase in their lives. Up to now, patients with depression have mostly been treated with drugs and psychotherapy. However, some patients respond inadequately to these therapies. This could be partly due to the fact that many patients exhibit altered metabolism in certain areas of the cerebral cortex during depressive phases.

Efficient magnetic stimulators have now been developed with which it is possible to activate the nerve cells of individual parts of the brain in a targeted way (and almost painlessly) through the skin and bone. However, only a limited number of depressive patients have been able to be successfully treated in this way up to now by having those areas of their brains stimulated that most frequently exhibited altered metabolism during the depressive phase.

At our clinic, we use such a magnetic stimulator with which we are able to apply a series of magnetic impulses to the cerebral cortex of the patient. The actual treatment consists of two or three 5-day sessions (10 to 15 days in all), consisting of several stimulation phases, the duration of which depends on the frequency of the magnetic impulse (1 to 10 Hz), giving a total 20 minutes stimulation time. This stimulation can stop, at any time, if you so wish.

At the start of the session, the magnetic coil is held above the part of the brain that controls the opposite hand. The magnetic field is slowly increased until the thumb of that hand slightly twitches, which is the upper limit. The optimum magnetic dose is then calculated and applied to the spot where the altered metabolism of depressive right-handed people is probably located.

One of the most significant though rather rare side effects of magnetic stimulation is twitching of the head and forehead muscles on the stimulation side during discharge, owing to neighbouring nerves and muscles in the head also undergoing stimulation. This twitching is uncomfortable, although, in my own experience, bearable. There can be some localised numbness lasting several hours, normally quickly remedied with a bag of ice. The clacking sounds occurring during magnetic discharge are so quiet that the sensitivity of the ears is not affected if earplugs are used.

High magnetic doses can trigger epileptic fits in some patients that have previously experienced a fit. In rare cases, such epileptic fits may occasion injury, especially a bitten tongue. Breathing can be interrupted by blood and saliva. Urine and faeces may be passed. Therefore we only treat those whose EEG is insignificant, and who have never to date experienced a fit (including fever convulsions during childhood).

Pregnant women and individuals using pacemakers, vascular clamps following cranial surgery or inner ear implants may also not be treated with such magnetic fields. These safety standards have been developed over many years of experience in diagnostic magnetic stimulation, especially in neurology.

Biofeedback method
Biofeedback is a scientific method used for making perceptible, through feedback, psychophysiological processes (e.g. pulse frequency, sweat secretion, muscle tone, breathing etc.) that normally function unconsciously. Step by step the patient ought then to learn to consciously control his or her physiological system. The fundamental principles are very old: they reflect the fact that feedback of information or results-based knowledge is essential to effective learning whatever the skill.

How does biofeedback work?
Sensors register bodily functions that cannot normally be consciously perceived or influenced. On your screen, you can see the processes taking place inside your body. During biofeedback training, your task is to consciously and knowingly influence these bodily functions. In this way, patients train to reduce their muscle tensions or, in the case of stressed individuals, to relax their vegetative nervous system. With many a complaint, it takes only a few sessions to obtain lasting success and no side effects. The biofeedback apparatus thus acts like a mirror, providing information about what goes on inside the body. This mirror is no longer necessary once self-regulation has been learned. The ability to influence psychological processes is retained by regular exercises, thus helping patients to achieve a healthy, balanced life.

Biofeedback is typically used for:

• Stress, consequences of stress, stress management
• Sleep disorders
• Sexual disorders
• Hyperactivity, attention deficits
• Anxiety, depression
• Posttraumatic stress syndrome
• Improving bodily awareness
• Psychogenic causes / psychogenic consequences of physical illnesses