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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

Self-regulation of SCP. -x-, mean value and confidence interval for all sessions of patients without surgery; -o-, mean value and confidence interval for all sessions of patients with surgery. FB−, negativity tasks with feedback; FB+, Positivity tasks with feedback. FB diff, difference between shifts during negativity and positivity tasks with feedback. TF+, positivity tasks without feedback (transfer); TF−, negativity tasks without feedback (transfer); TF diff, difference between shifts during negativity and positivity tasks without feedback (transfer).
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Figure 3: Self-regulation of SCP. -x-, mean value and confidence interval for all sessions of patients without surgery; -o-, mean value and confidence interval for all sessions of patients with surgery. FB−, negativity tasks with feedback; FB+, Positivity tasks with feedback. FB diff, difference between shifts during negativity and positivity tasks with feedback. TF+, positivity tasks without feedback (transfer); TF−, negativity tasks without feedback (transfer); TF diff, difference between shifts during negativity and positivity tasks without feedback (transfer).

Mentions: As indicated by a significant main effect of task [F(1,10) = 5.46, p = 0.042, η2 = 0.35], patients successfully differentiated between the positivity and negativity tasks. The non-significant task by condition interaction (F < 1) shows that the correct trend to positive SCP with the positivity task and negative SCP with the negativity task was identical for both feedback and transfer conditions. However, when the data for each condition were analyzed separately, the effect of task was significant only in the feedback condition [F(1,10) = 5.73, p = 0.038, η2 = 0.36], but not in the transfer condition [F(1,10) = 2.48, p = 0.15]. Figure 3 depicts the performance in detail for both patients without surgery and with surgery. The interaction between sessions and tasks did not reach significance although for positivity tasks the best results were obtained in session 2. In the negativity task, the amplitudes increased from session to session during feedback but did not reach significance.


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)

Self-regulation of SCP. -x-, mean value and confidence interval for all sessions of patients without surgery; -o-, mean value and confidence interval for all sessions of patients with surgery. FB−, negativity tasks with feedback; FB+, Positivity tasks with feedback. FB diff, difference between shifts during negativity and positivity tasks with feedback. TF+, positivity tasks without feedback (transfer); TF−, negativity tasks without feedback (transfer); TF diff, difference between shifts during negativity and positivity tasks without feedback (transfer).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Self-regulation of SCP. -x-, mean value and confidence interval for all sessions of patients without surgery; -o-, mean value and confidence interval for all sessions of patients with surgery. FB−, negativity tasks with feedback; FB+, Positivity tasks with feedback. FB diff, difference between shifts during negativity and positivity tasks with feedback. TF+, positivity tasks without feedback (transfer); TF−, negativity tasks without feedback (transfer); TF diff, difference between shifts during negativity and positivity tasks without feedback (transfer).
Mentions: As indicated by a significant main effect of task [F(1,10) = 5.46, p = 0.042, η2 = 0.35], patients successfully differentiated between the positivity and negativity tasks. The non-significant task by condition interaction (F < 1) shows that the correct trend to positive SCP with the positivity task and negative SCP with the negativity task was identical for both feedback and transfer conditions. However, when the data for each condition were analyzed separately, the effect of task was significant only in the feedback condition [F(1,10) = 5.73, p = 0.038, η2 = 0.36], but not in the transfer condition [F(1,10) = 2.48, p = 0.15]. Figure 3 depicts the performance in detail for both patients without surgery and with surgery. The interaction between sessions and tasks did not reach significance although for positivity tasks the best results were obtained in session 2. In the negativity task, the amplitudes increased from session to session during feedback but did not reach significance.

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