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Behavioral Psychophysiological Intervention in a Mentally Retarded Epileptic Patient with Brain Lesion

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Abstract

Behavioral psychophysiological treatment entailing Slow Cortical Potential (SCP) biofeed-back training and behavioral self-control training was conducted with a 27-year-old male epileptic patient (seizures for 23 years) with Wechsler IQ 64 who underwent callosotomy. The patient had 12/week secondary generalized tonic-clonic seizures. The treatment, consisting of 43 SCP training sessions and 22 behavioral control sessions, yielded a highly significant reduction of seizure frequency to about 7.5/week; such a decrease had never been observed after administration of new anticonvulsant drugs, nor after the callosotomy. During SCP feedback training, the patient was able to produce highly-significant cortical differentiation of SCPs of about 4 µV. In addition, he developed several new behaviors indicating growing ability of self-perception and self-regulation. These findings suggest that a combination of SCP biofeedback with behavioral treatment of epilepsy can be used even in mentally retarded patients with organic brain disorders.

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REFERENCES

  • Beck, A. T. (1972). Measuring depression: The depression inventory. In T. A. Williams, M. M. Katz, & J. A. Shield (Eds.), Recent Advances in the Psychobiology of the Depressive Illnesses. Washington, DC: US Government Printing Office.

    Google Scholar 

  • Birbaumer, N., Elbert, T., Canavan, A., & Rockstroh, B. (1990). Slow potentials of the cerebral cortex and behavior. Physiological Reviews, 70, 1–41.

    Google Scholar 

  • Birbaumer, N., Elbert, T., Rockstroh, B., Daum, I., Wolf, P., Canavan, A. (1991). Clinical-psychological treatment of epileptic seizures: A controlled study. In Ehlers, A., et al. (Eds.), Perspectives and Promises in Clinical Psychology. New York: Plenum Press, 81–96.

    Google Scholar 

  • Dahl, J. (1992). Epilepsy—A Behavior Medicine Approach to Assessment and Treatment in Children. Seattle, Toronto, Göttingen, Bern: Hogrefe & Huber.

    Google Scholar 

  • Dahl, J., Melin, L., & Lund, L. (1987). Effects of a contingent relaxation treatment program on adults with refractory epileptic seizures. Epilepsia, 28(2), 125–132.

    Google Scholar 

  • Dahl, J., Melin, L., & Leissner, P. (1988). Effects of a behavioral intervention on epileptic seizure behavior and paroxysmal activity: A systematic replication of three cases of children with intractable epilepsy. Epilepsia, 29(2), 172–183.

    Google Scholar 

  • Daum, I., Rockstroh, B., Birbaumer, N., Elbert, T., Canavan, A., Lutzenberger, W. (1993). Behavioral treatment of slow cortical potentials in intractable epilepsy: Neuropsychological predictors of outcome. Journal of Neurology, Neurosurgery, and Psychiatry, 56, 94–97.

    Google Scholar 

  • Elbert, T., Rockstroh, B. (1987). Threshold regulation—A key to the understanding of the combined dynamics of EEG and event-related potentials. Journal of Psychophysiology, 1, 33–69.

    Google Scholar 

  • Elbert, T., Rockstroh, B., Canavan, A., Birbaumer, N., Lutzenberger W., von Bülow I., & Linden A. (1990). Self-regulation of slow cortical potentials and its role in epileptogenesis. In J. Carlson and R. Seifert (Eds.), Biobehavioral Self-Regulation and Health. New York: Plenum Press.

    Google Scholar 

  • Elbert, T., Rockstroh, B., Lutzenberger W., & Birbaumer, N. (1980). Biofeedback of slow cortical potentials. Electroencephalography and Clinical Neurophysiology, 48, 293–301.

    Google Scholar 

  • Efron, R. (1956). The effect of olfactory stimuli in arresting uncinate fits. Brain, 79, 267–281.

    Google Scholar 

  • Efron, R. (1957). The conditioned inhibition of uncinate fits. Brain, 80, 251–262.

    Google Scholar 

  • Gates, J. R. (1992). EEG selection for corpus collosotomy. In W. H. Theodore (Ed.), Surgical Treatment of Epilepsy. Amsterdam: Elsevier, pp. 201–204.

    Google Scholar 

  • Goldstein, L. (1990). Behavioral and cognitive-behavioral treatments for epilepsy: A progress review. British Journal of Clinical Psychology, 29, 257–269.

    Google Scholar 

  • Gratton, G., Coles, M. G. H., & Donchin, E. (1983). A new method for off-line removal of ocular artifacts. Electroencephalography & Clinical Neurophysiology, 55, 468–484.

    Google Scholar 

  • Jacobson, E. (1938). Progressive Relaxation (revised), Chicago: University of Chicago Press.

    Google Scholar 

  • Kotchoubey, B., Schneider, D., Schleichert, H., Strehl, U., Uhlmann, C., Blankenhorn, V., Fröscher, W., & Birbaumer, N. (1996). Self-regulation of slow cortical potentials in epilepsy: A retrial with analysis of influencing factors. Epilepsy Research, 25, 269–276.

    Google Scholar 

  • Kraak, B., & Rüdiger, D. (1989). Fragebogen zu Lebenszielen und zur Lebenszufriedenheit. Göttingen: Hogrefe.

    Google Scholar 

  • Lantz, D. L., & Sterman, M. B. (1988). Neuropsychological assessment of subjects with uncontrolled epilepsy: Effects of EEG feedback training. Epilepsia, 29, 163–171.

    Google Scholar 

  • Lubar, J. F. (1984). Application of operant conditioning of the EEG for the management of epileptic seizures. In T. Elbert, B. Rockstroh, W. Lutzenberger, and N. Birbaumer (Eds.), Self-Regulation of the Brain and Behavior. Berlin: Springer, pp. 107–125.

    Google Scholar 

  • Mostofsky, D. I., & Balaschak, B. A. (1977). Psychobiological control of seizures. Psychological Review, 84, 723–750.

    Google Scholar 

  • Nelson, H. E. (1976) A modified card sorting test sensitive to frontal lobe defects. Cortex, 12, 313–324.

    Google Scholar 

  • Rockstroh, B., Birbaumer, N., Elbert, T., & Lutzenberger, W. (1984). Operant control of EEG and event-related potentials and slow brain potentials. Biofeedback and Self-Regulation, 9, 139–160.

    Google Scholar 

  • Rockstroh, B., Elbert, T., Canavan, A., Lutzenberger, W., & Birbaumer, N. (1989). Slow Cortical Potentials and Behavior. Baltimore: Urban & Schwartzenberg.

    Google Scholar 

  • Rockstroh, B., Elbert, T., Birbaumer, N., Wolf, P., Düchting-Röth, A., Reker, M., Daum, I., Lutzenberger, W., & Dichgans, J. (1993). Cortical self-regulation in patients with epilepsies. Epilepsy Research, 14, 63–72.

    Google Scholar 

  • Spencer, S. S., Spencer, D. D., Williamson, P. D., Sass, K. J., Novelly, R. A., & Mattson, R. H. (1988). Corpus callosotomy for epilepsy: Seizure effects. Neurology, 38, 19–24.

    Google Scholar 

  • Sterman, M. B., & Shouse, M. N. (1980). Quantitative analysis of training, sleep EEG and clinical response to EEG operant conditioning in epileptics. Electroencephalography and Clinical Neurophysiology, 49, 558–576.

    Google Scholar 

  • Sterman, M. B. (1982). EEG biofeedback in the treatment of epilepsy: An overview circa 1980. In L. White and B. Tursky (Eds.), Clinical Biofeedback. New York: Guilford Press, pp. 311–330.

    Google Scholar 

  • Sterman, M. B. (1984). The role of sensorimotor rhythmic EEG activity in the etiology and treatment of generalized motor seizures. In T. Elbert, B. Rockstroh, W. Lutzenberger, and N. Birbaumer (Eds.), Self-Regulation of the Brain and Behavior. Berlin: Springer, pp. 95–106.

    Google Scholar 

  • Sterman, M. B. (1996). Physiological origins and functional correlates of EEG rhythmic activities: Implications for self-regulation. Biofeedback and Self-Regulation, 21, 3–33.

    Google Scholar 

  • Torres, F., & French, L. A. (1973). Acute effects of section of the corpus callosum upon independent epileptiform activity. Acta Neurologica Scandinavica, 49, 47–62.

    Google Scholar 

  • Whitsett, S. F., Lubar, J. F., Holder, G. S., Pamplin, W. E., & Shabsin, H. S. (1982). A double-blind investigation of the relationship between seizure activity and the sleep EEG following EEG biofeedback training. Biofeedback and Self-Regulation, 7, 193–209.

    Google Scholar 

  • Tewes, U. (1994). HAWIE-R. Hamburg-Wechsler Intelligenztest für Erwachsene, Revision 1991. (2. korrigierte Auflage). Bern: Huber.

    Google Scholar 

  • Wechsler, D. (1987). Wechsler Memory Scale (Revised Manual), New York: The Psychological Corporation.

    Google Scholar 

  • Weiss, R. H. (1987). Grundintelligenztest Skala 2-CFT 20. Göttingen, Toronto, Zürich: Hogrefe.

    Google Scholar 

  • Wolf, P. (1994). Aura interruption: How does it become curative. In P. Wolf (Ed.), Epileptic Seizures and Syndromes. London: John Libbey & Co, pp. 667–673.

    Google Scholar 

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Holzapfel, S., Strehl, U., Kotchoubey, B. et al. Behavioral Psychophysiological Intervention in a Mentally Retarded Epileptic Patient with Brain Lesion. Appl Psychophysiol Biofeedback 23, 189–202 (1998). https://doi.org/10.1023/A:1022299422116

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