qEEG: The Test That Precedes Your rTMS Treatment
Why do I have to wear a cap with electrodes before the treatment? The answer is simple: We want to know how your brain works before we stimulate it.
The measurement takes about six minutes. It’s not uncomfortable; nothing is altered, and nothing is sent into your head. We’re just listening.
6 minutes
30–60 Min.
CHF 400
What Is a qEEG?
qEEG stands for quantitative electroencephalogram. Electrodes placed on the scalp record the brain’s electrical activity, which is then analyzed using computer algorithms. The crucial step comes next: Your results are compared with data from neurotypical, healthy individuals in the same age group.
Unlike an MRI or CT scan, the qEEG does not show how the brain is structured, but rather how it functions.
How it differs from the traditional EEG
An EEG performed by a neurologist answers a different question than a qEEG performed by us.
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Classic EEG (Neurology)
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QEEG (Neuro-Spa Group)
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Searches for neurological abnormalities, such as epilepsy-typical patterns
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Shows how strongly the brain function deviates from the pattern of neurotypical healthy ones
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Visual assessment of curves
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Calculated evaluation, comparison with age-related reference group, processing by own AI software (neo TMS®)
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Question: Is there a neurological disease?
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Question: Where does the function deviate, and what follows from this for therapy planning?
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Health Insurance Coverage
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Self-paying service, no refund
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The two are not mutually exclusive
A qEEG is not a diagnostic tool for epilepsy and does not replace a standard neurological EEG. Conversely, a standard EEG does not answer the questions that are crucial for rTMS planning.
What the qEEG Reveals
Four key metrics are evaluated in particular:
What is meaningful here is never the individual value, but rather the pattern when compared to the reference group. It is precisely this pattern that forms the basis for everything that follows.
From Measurement to Treatment Protocol: neo TMS®
The qEEG data alone does not constitute treatment. We feed it into neo TMS®, the analysis algorithm developed by Dr. Oliver Seemann.
neo TMS® compares your measurement values with published studies and uses them to calculate probabilities for specific combinations of findings. Based on this, the system determines which stimulation protocol is appropriate for your case: which area is stimulated and at what frequency. Instead of a standard protocol, you receive a recommendation tailored to your measurement data.
Study Comparison, Probabilities
Protocol:
Area + Frequency
We are continuing to refine the evaluation. In the future, Dr. Seemann’s 25 years of clinical experience will also be incorporated into the analysis, particularly for complex clinical presentations and so-called off-label use, for which there has been little or no research to date.
When a qEEG Is Recommended
- Before rTMS treatment, as a basis for selecting the protocol
- For monitoring progress (rTMS/TPS, etc.): We take measurements before and after the treatment series. The comparison shows whether the therapy is effective or whether the protocol should be adjusted
- For unclear clinical presentations, as a supplement to the physician’s assessment (e.g., early diagnosis of Alzheimer’s-type dementia, ADHD, post-COVID, etc.)
Even people without acute symptoms choose to have a qEEG. Functional changes may become apparent earlier than structural ones—that is, before they become visible in some imaging procedures (e.g., MRI). A diagnosis cannot be definitively determined from a qEEG, nor can a disease be ruled out based on it.
For symptoms that are difficult to pinpoint
Some symptoms are difficult to quantify objectively, such as those associated with post-COVID or ADHD. Those affected often find that their symptoms are met with skepticism. In such situations, a qEEG can provide additional, measurable, and quantifiable information that is independent of self-reported symptoms.
Procedure and Duration of a qEEG
1. Create a profile in the system · approx. 2 min.
2. Put on the measuring cap · about 2 min.
3. Optimize electrode positions · 2–10 min.
4. The actual measurement · approx. 6 min.
5. Remove the cap, analyze the data · approx. 10 min.
6. Discussing the results with the doctor
Our assistant will perform the measurement. The doctor will interpret the results and discuss them with you. You should plan on spending 30 to 60 minutes for the entire appointment, including the discussion.
The qEEG takes place after the initial consultation and before treatment begins.
How to Prepare
No caffeine
Medications
Head size
Coffee, tea, and other caffeinated beverages can affect the test results. If possible, avoid them the evening before, and definitely avoid them on the morning of your appointment.
Please do not stop taking any medications on your own. Instead, tell us what you are taking before the test. We will take this into account during the evaluation. Medications that are not absolutely necessary should generally be discontinued before the test. However, to be on the safe side, please consult with our medical team.
There is one technical limitation: The measurement cap must fit the patient’s head size. For this reason, a qEEG is generally possible for children starting at around five to six years of age.
What You'll Be Holding in Your Hands Afterward
You will receive the qEEG report as well as the neo TMS® analysis, which includes explanations of the findings and the resulting treatment recommendations. We will discuss both with you, and then you can take them with you.
What a qEEG Does Not Do
- The qEEG does not provide a definitive diagnosis. It offers probabilities and indications that are only meaningful when considered in conjunction with a medical and psychiatric evaluation. No single qEEG finding stands on its own.
- Furthermore, it does not replace a neurological EEG and is not a diagnostic tool for epilepsy.
- And it is a snapshot. It measures the patient’s state on the day of the examination. Experience shows that, in cases of long-standing symptoms, the pattern does not change significantly from one day to the next; however, it does change in response to short-term factors such as sleep deprivation.
What the Research Shows
We believe it is important to be open about how well-established the procedure is and where the limitations of the existing research lie.
Differences Even Before Treatment Begins
A Critical Look
In a 2019 meta-analysis, Widge and colleagues evaluated 76 studies involving 81 quantitative biomarkers, 14 of which were designed to predict rTMS response. Across all methods, the results showed a sensitivity of 72 percent, a specificity of 68 percent, and an AUC of 0.76.
At the same time, the authors pointed out methodological weaknesses, publication bias, and a lack of independent validation. Their conclusion: The available data is insufficient to select a treatment based solely on qEEG. This is precisely why, for us, qEEG is one component of the decision-making process and not the decision itself.
qEEG-Guided TMS in Clinical Practice
In 2022, Gordon and colleagues reported on 210 patients whose stimulation site and frequency were individually determined based on qEEG phenotypes. Forty-seven percent saw their depression scores halved, while another 29 percent experienced an improvement of between 30 and 50 percent, on average after just over seven sessions.
It is important to note that this was an open-label observational study without a randomized control group. The results therefore cannot be equated with the proof of efficacy from a controlled study.
Integration into the Health Care System
The qEEG has been an established part of neurofeedback for years. It has not yet become widely used in standard medical care, in part because the associated costs are not covered by insurance providers.
Cost of a qEEG
The qEEG costs CHF 400. It is a service that patients must pay for out of pocket and is not covered by health insurance.
Frequently Asked Questions (FAQ) About qEEG
Does the test hurt?
No. The electrodes simply pick up the electrical activity that your brain generates anyway. You’ll feel the damp cap—which has been soaked in salt water beforehand to improve the electrodes’ conductivity—but nothing else. Your hair will be damp afterward.
Does this cause any changes in the brain?
No. The qEEG is purely a measurement. Nothing is stimulated, nothing is induced, and nothing is manipulated.
How long does the whole thing take?
The actual measurement takes about six minutes. You should plan on 30 to 60 minutes for the entire appointment, including preparation, evaluation, and discussion.
What is the difference between this and an EEG performed by a neurologist?
A standard EEG looks for neurological abnormalities, such as patterns typical of epilepsy. A qEEG uses computational methods to compare your brain function with that of neurotypical, healthy individuals, thereby providing the basis for treatment planning. One does not replace the other.
Can dementia or Alzheimer's disease be detected using qEEG?
No, a definitive diagnosis cannot be made based on this. Even though the test has relatively high sensitivity for detecting dementia or the onset of dementia, the result is nonspecific in this context. The qEEG reveals functional abnormalities, and functional changes can appear earlier than structural ones. Further medical testing (e.g., blood tests) will determine whether an underlying condition is present and, if so, which one.
Does the qEEG measure a steady-state condition?
It measures your condition on the day of the examination. Experience has shown that the pattern remains stable for long-standing symptoms, whereas short-term factors such as lack of sleep or caffeine can alter it. That is why we ask that you prepare accordingly.
At what age can a qEEG be performed?
The measuring cap must fit the child's head size. This is usually the case starting around ages five to six.
Does health insurance cover the costs?
No. The qEEG is a service that patients must pay for out of pocket and costs CHF 400.
Your Next Step
We'll determine whether a qEEG is appropriate for your situation during the initial consultation. Afterward, you can make your decision at your own pace.
Arrange an initial consultation
The initial consultation is a free phone call, Monday to Thursday between 17:00 and 19:00. We go through your situation and the question of whether rTMS is a sensible next step for you. If you would rather not call, you can book an appointment directly instead.
Treatment takes place at our main practice in Zurich or at a partner practice of the Neuro-Spa Group: in Germany, among others in Munich and Schwäbisch Hall, with further practices internationally. If you would rather go to a partner practice, please contact it directly – all addresses and phone numbers are listed in the location overview.