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Sustained reduction of seizures in patients with intractable epilepsy after self-regulation training of slow cortical potentials - 10 years after.

Strehl U, Birkle SM, Wörz S, Kotchoubey B - Front Hum Neurosci (2014)

Bottom Line: The clinical significance of this result is considered medium to high.This success was achieved without booster sessions.Given such a long follow-up period, the possible impact of confounding variables should be taken into account.

View Article: PubMed Central - PubMed

Affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen , Tuebingen , Germany.

ABSTRACT
The aim of this study was to determine whether the reduction of seizures in patients with intractable epilepsy after self-regulation of slow cortical potentials (SCPs) was maintained almost 10 years after the end of treatment. Originally, 41 patients received training with SCP-neurofeedback. A control group of 12 patients received respiratory feedback while another group of 11 patients had their anticonvulsant medications reviewed. Nineteen patients in the experimental group participated at least in parts of the long-term follow-up, but only two patients from each control group agreed to do so. The follow-up participants completed the same seizure diaries as in the original study. Patients of the experimental group also took part in three SCP-training sessions at the follow-up evaluation. Due to the small sample size, the results of participants in the control groups were not considered in the analysis. A significant decrease in seizure frequency was found about 10 years after the end of SCP treatment. The clinical significance of this result is considered medium to high. All patients were still able to self-regulate their SCPs during the feedback condition. This success was achieved without booster sessions. This is the longest follow-up evaluation of the outcome of a psychophysiological treatment in patients with epilepsy ever reported. Reduced seizure frequency may be the result of patients continued ability to self-regulate their SCPs. Given such a long follow-up period, the possible impact of confounding variables should be taken into account. The small number of patients participating in this follow-up evaluation diminishes the ability to make causal inferences. However, the consistency and duration of improvement for patients who received SCP-feedback training suggests that such treatment may be considered as a treatment for patients with intractable epilepsy and as an adjunct to conventional therapies.

No MeSH data available.


Related in: MedlinePlus

Discontinuous feedback. Monitor screens during tasks (negativation and positivation) and conditions (feedback and transfer). If the cursor (in this example a “fish”) is moved in the direction as prompted (up, negativation; down, positivation) a “sun” is shown at the end of the trial. In the case of no success, the screen is empty as shown in the bottom line. Screen shots with friendly permission by neuroConn, Ilmenau, Germany.
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Figure 2: Discontinuous feedback. Monitor screens during tasks (negativation and positivation) and conditions (feedback and transfer). If the cursor (in this example a “fish”) is moved in the direction as prompted (up, negativation; down, positivation) a “sun” is shown at the end of the trial. In the case of no success, the screen is empty as shown in the bottom line. Screen shots with friendly permission by neuroConn, Ilmenau, Germany.

Mentions: The duration of each trial was 8 s. With the appearance of the triangle the trial started and the value taken during the 2 s baseline immediately preceding the trial was set to 0. If the patient succeeded in shifting the potential as required during last third of the trial the picture of a sun appeared on the screen (see Figure 2).


Sustained reduction of seizures in patients with intractable epilepsy after self-regulation training of slow cortical potentials - 10 years after.

Strehl U, Birkle SM, Wörz S, Kotchoubey B - Front Hum Neurosci (2014)

Discontinuous feedback. Monitor screens during tasks (negativation and positivation) and conditions (feedback and transfer). If the cursor (in this example a “fish”) is moved in the direction as prompted (up, negativation; down, positivation) a “sun” is shown at the end of the trial. In the case of no success, the screen is empty as shown in the bottom line. Screen shots with friendly permission by neuroConn, Ilmenau, Germany.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126150&req=5

Figure 2: Discontinuous feedback. Monitor screens during tasks (negativation and positivation) and conditions (feedback and transfer). If the cursor (in this example a “fish”) is moved in the direction as prompted (up, negativation; down, positivation) a “sun” is shown at the end of the trial. In the case of no success, the screen is empty as shown in the bottom line. Screen shots with friendly permission by neuroConn, Ilmenau, Germany.
Mentions: The duration of each trial was 8 s. With the appearance of the triangle the trial started and the value taken during the 2 s baseline immediately preceding the trial was set to 0. If the patient succeeded in shifting the potential as required during last third of the trial the picture of a sun appeared on the screen (see Figure 2).

Bottom Line: The clinical significance of this result is considered medium to high.This success was achieved without booster sessions.Given such a long follow-up period, the possible impact of confounding variables should be taken into account.

View Article: PubMed Central - PubMed

Affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen , Tuebingen , Germany.

ABSTRACT
The aim of this study was to determine whether the reduction of seizures in patients with intractable epilepsy after self-regulation of slow cortical potentials (SCPs) was maintained almost 10 years after the end of treatment. Originally, 41 patients received training with SCP-neurofeedback. A control group of 12 patients received respiratory feedback while another group of 11 patients had their anticonvulsant medications reviewed. Nineteen patients in the experimental group participated at least in parts of the long-term follow-up, but only two patients from each control group agreed to do so. The follow-up participants completed the same seizure diaries as in the original study. Patients of the experimental group also took part in three SCP-training sessions at the follow-up evaluation. Due to the small sample size, the results of participants in the control groups were not considered in the analysis. A significant decrease in seizure frequency was found about 10 years after the end of SCP treatment. The clinical significance of this result is considered medium to high. All patients were still able to self-regulate their SCPs during the feedback condition. This success was achieved without booster sessions. This is the longest follow-up evaluation of the outcome of a psychophysiological treatment in patients with epilepsy ever reported. Reduced seizure frequency may be the result of patients continued ability to self-regulate their SCPs. Given such a long follow-up period, the possible impact of confounding variables should be taken into account. The small number of patients participating in this follow-up evaluation diminishes the ability to make causal inferences. However, the consistency and duration of improvement for patients who received SCP-feedback training suggests that such treatment may be considered as a treatment for patients with intractable epilepsy and as an adjunct to conventional therapies.

No MeSH data available.


Related in: MedlinePlus