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Epilepsy, Headache, Vertigo

開催日 2014/9/11
時間 16:00 - 17:00
会場 Poster / Exhibition(Event Hall B)

Seizure suppression by means of self-regulation of scalp-recorded slow cortical potentials: treatment trial in intractable partial epilepsy

  • P1-354
  • 文室 知之 / Tomoyuki Fumuro:1,2,3 松本 理器 / Riki Matsumoto:3 木下 真幸子 / Masako Kinoshita:4 松橋 眞生 / Masao Matsuhashi:2,5 下竹 昭寛 / Akihiro Shimotake:1 人見 健文 / Takefumi Hitomi:1,6,7 高橋 良輔 / Ryosuke Takahashi:1 福山 秀直 / Hidenao Fukuyama:2 池田 昭夫 / Akio Ikeda:3 
  • 1:京都大院医臨床神経 / Dept Neurol, Kyoto Univ, Kyoto, Japan 2:京都大・C-PIER・LIMS / LIMS, C-PIER, Kyoto Univ, Kyoto, Japan 3:京都大院医てんかん運動異常生理 / Dept Epilepsy, Movement Disordors and Physiol, Kyoto Univ, Kyoto, Japan 4:宇多野病院神経内科 / Dept Neurol, Utano Hp, Kyoto, Japan 5:京都大院医高次脳機能統合研究セ / HBRC, Kyoto Univ, Kyoto, Japan 6:京都大院医呼吸管理睡眠制御 / Dept Respir Care and Sleep Contr Med, Kyoto Univ, Kyoto, Japan 7:京都大院医臨床病態検査 / Dept Clin Lab Med, Kyoto Univ, Kyoto, Japan 

Seizure suppression by means of neuro-feedback (NFB) training of slow cortical potential (SCP) has been reportedly effective for intractable partial epilepsy patients. However, the details of association between clinical effects and NFB control remain to be solved.
We recruited 12 patients with intractable partial epilepsy. 5 electrodes were fixed on the scalp (C3, C1, Cz, C2 and C4). Right mastoid electrode was employed as a reference. Each trial lasted for 8 seconds, and in each trial the patients were told to control negativation or positivation of SCP upon the instruction symbols. During this feedback trial, the real-time SCP amplitude at Cz was continuously shown to the patients as a moving fish on a computer screen. One session had 156 to 208 trials, and one NFB training course consisted of 35 sessions. After the first phase of 20 sessions for 2 weeks, patients had a break for 2-5 months before the second phase of 15 training sessions.
10 patients completed the whole 35 sessions of NFB. 5 patients became well trained for NFB, while 5 patients were poorly trained. Follow-up period of more than three months revealed that in 4 of 5 well-NFB trained and 1 of 5 poor-NFB trained patients, seizure frequency decreased or subjective intensity score decreased by more than 50%.
It is most likely that seizure frequency deceases in more than 50% of patients with intractable partial epilepsy mainly by effective NFB control of SCP. Since one poor trainee had significant seizure decrease, the mechanism of seizure decrease was probably produced not only by a single mechanism, i.e., NFB SCP control.

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