Operant Conditioning of Single Neurons in Monkeys and Its Theoretical Application to EEG Operant Conditioning in Human Epilepsy

Abstract

Physicians who treat patients with epilepsy are frequently frustrated by the fact that many seizure disorders are refractory to control with standard anticonvulsive drugs. For some patients surgical resection of their focus is an option, but 20%—30% do not derive significant benefit from surgery. Therefore, the idea that some seizure disorders may be controlled by means of noninvasive, low-risk psychophysiological techniques is appealing. Daily encounters with epileptic patients reinforce the concept that such therapy may be possible. For example, epileptics who have seizures precipitated by stress may often find their seizures better controlled if they change employment to a less stressful job. Forster (1966) has demonstrated that for many of the rare “reflex epilepsies” desensitization training can be effective in eliminating the ictal response to the provocative stimulus. A unique case was reported by Efron (1957). His patient’s seizures could be aborted by a strong olfactory stimulus presented during the aura. The patient learned to pair the odor of jasmine with the sight of a silver bracelet, and thus became able to stop the progression of the seizure by looking at the bracelet. However, the above examples are with patients who are not representative of the general population of epileptics. Therefore, a more general paradigm which could be used to treat a larger number of patients is desirable.