How Useful Is a Quantitative Electroencephalogram (qEEG)?
Stephen Barrett, M.D.
A quantitative electroencephalogram (qEEG) is a test that analyzes the electrical activity of the brain to measure and display patterns that may correspond to diagnostic information and/or cognitive deficits. The qEEG procedure is also referred to as "brain mapping," brain electrical activity mapping (BEAM,), and topographic EEG. It uses more surface electrodes than a standard electroencephalogram (EEG), gathering data from 24 or more areas of the brain. The the raw electrical measurements are then "mapped" onto a stylized picture of the head or brain with the values represented as different colors or shades of colors. (Note: qEEG differs from and has no direct relationship to standard neuroimaging procedures or with functional cortical brain mapping where the effects of electrical stimulation of the brain are recorded.) A search for "qEEG" with Google Images indicates that many of the test reports are very colorful.
The FDA has cleared the software used for six qEEG systems as a Class II medical devices for clinical use by qualified medical or clinical professionals for statistical evaluation of the human electroencephalogram (EEG). 
qEEG has a few medically accepted uses (most notably in some cases of epilepsy), but some practitioners go far beyond what has been proven or even suggested by mainstream researchers. In 1997, the American Academy of Neurology and the American Clinical Neurophysiology Society noted that "qEEG techniques are very predisposed to false-positive errors" and concluded that qEEG should be considered investigational for clinical use in post-concussion syndrome, mild-to-moderate head injury, learning disability, attention disorders, schizophrenia, depression, alcoholism, and drug abuse . Aetna, which periodically reviews the status of qEEG, now says:
- No current guidelines from leading medical professional organizations recommend the use of qEEG as a screening test for neurological and psychiatric conditions.
- Clinical studies have demonstrated distinctive forms of brain electrical activity in a few psychiatric conditions, but the clinical significance of these distinctive patterns of brain wave activity is unknown. No published peer-reviewed studies of the use of qEEG screening for these conditions show that management is altered such that clinical outcomes are improved.
- Much of the literature focuses on the use of qEEG in the early detection of dementia. Although several markers of early dementia have been reported, there is a lack of evidence that early detection of dementia alters clinical management such that outcomes are improved, especially given the lack of robust treatments available.
- An assessment by the Swedish Office of Health Technology Assessment found insufficient evidence to support the use of qEEG in dementia. Its assessment stated that there is limited evidence that that qEEG helps the diagnostic workup differentiate Alzheimer's disease patients from controls or from other dementia disorders .
One prolific user of qEEG testing is Eric R. Braverman, M.D., who operates PATH Medical in New York City. Braverman has been using and promoting this test—which he refers to as BEAM—for more than 25 years. In a 1990 magazine column, he described it as "the most exciting neurobiological research tool ever developed."  More recently he said that, "BEAM is considered the stress test of the brain, and . . . . can help to detect Alzheimer's and memory loss even before symptoms present. It can also uncover, diagnose, and treat the imbalances associated with depression, insomnia, and schizophrenia."  PATH Medical's Web site includes a list of more than 50 symptoms, diseases, and disease groups that he claims are "neurotransmitter deficiency symptoms" that are amenable to "natural treatment" with foods, dietary supplements and exercise. I do not believe he has scientific support for his approach . The current price of the test is $2,000.
In 2011, Andrew W. Campbell M.D., surrendered his Texas medical license in the wake of repeated charges of unprofessional conduct. One of the charges involved the ordering of expensive and unnecessary tests. During the proceedings, an administrative law judge concluded that Campbell's use of qEEG was "below the standard of care." 
- Product classification: Normalizing Quantitative Electroencephalograph Software. FDA 510O(k) database, Feb 9, 2014.
- Nuwer, M. Assessment of digital EEG, quantitative EEG, and EEG brain mapping: Report of the American Academy of Neurology and the American Clinical Neurophysiology Society. Neurology 49:277-292, 1997.
- Quantitative EEG (brain mapping). Aetna Clinical Policy Bulletin No. 221, effective 4/6/98, revised 9/20/14.
- Braverman ER. New techniques for diagnosis. Total Health, Feb 1990, pp 15-16.
- Braverman ER. Detecting silent diseases before they strike. Huffington Post, Nov 17, 2011.
- Barrett S. Some notes on Dr. Eric Braverman. Quackwatch, Feb 13, 2015.
- Keeper P. Amended proposed findings of fact. Texas State Board of Medical Examiners v. Andrew William Campbell, M.D., SOAH Docket No. 503-04-5717,March 29, 2007.
This article was posted on February 13, 2015.