Shouse M N, Lubar J F
Biofeedback Self Regul. 1979 Dec;4(4):299-312. doi: 10.1007/BF00998960.
Enhanced voluntary motor inhibition regularly accompanies conditioned increases in the sensorimotor rhythm (SMR), a 12--14-Hz Rolandic EEG rhythm in cats.A similar rhythm, presumably SMR, has also been identified in the human EEG. The clinical effectiveness of SMR operant conditioning has been claimed for epilepsy, insomnia, and hyperkinesis concurrent with seizure disorders. The present report attempts to follow up and replicate preliminary findings that suggested the technique's successful application to hyperkinesis uncomplicated by a history of epilepsy. SMR was defined as 12--14-Hz EEG activity in the absence of high-voltage slow-wave activity between 4 and 7 Hz. Anticipated treatment effects were indexed by systematic behavioral assessments of undirected motor activity and short attention span in the classroom. EEG and behavioral indices were monitored in four hyperkinetic children under the following six conditions: (1) No Drug, (2) Drug Only, (3) Drug and SMR Training I, (4) Drug and SMR Reversal Training, (5) Drug and SMR Training II, (6) No Drug and SMR Training. All hyperkinetic subjects were maintained on a constant drug regimen throughout the phases employing chemotherapy. Contingent increases and decreases in SMR occurred in three of four training subjects and were associated with similar changes in classroom assessments of motor inactivity. Combining medication and SMR training resulted in substantial improvements that exceeded the effects of drugs alone and were sustained with SMR training after medication was withdrawn. In contrast, these physiological and behavioral changes were absent in one highly distractible subject who failed to acquire the SMR task. Finally, pretraining levels of SMR accurately reflected both the seve-ity of original motor deficits and the susceptibility of hyperkinetic subjects to both treatments. Although the procedure clearly reduced hyperkinetic behavior, a salient, specific therapeutic factor could not be identified due to the dual EEG contingency imposed combined with associated changes in EMG. Despite these and other qualifying factors, the findings suggested the prognostic and diagnostic value of the SMR in the disorder when overactivity rather than distractibility is the predominant behavioral deficit.
在猫中，增强的自主运动抑制通常伴随着感觉运动节律（SMR）的条件性增加，SMR是一种12 - 14赫兹的中央区脑电图节律。在人类脑电图中也发现了类似的节律，推测为SMR。SMR操作性条件反射已被宣称对癫痫、失眠以及与癫痫并发的多动症具有临床疗效。本报告试图跟进并重复初步研究结果，这些结果表明该技术成功应用于无癫痫病史的多动症。SMR被定义为在4至7赫兹之间不存在高电压慢波活动时的12 - 14赫兹脑电图活动。预期的治疗效果通过对课堂上无定向运动活动和注意力短暂的系统行为评估来衡量。在以下六种条件下对四名多动症儿童的脑电图和行为指标进行了监测：（1）无药物，（2）仅药物，（3）药物与SMR训练I，（4）药物与SMR反向训练，（5）药物与SMR训练II，（6）无药物与SMR训练。在整个采用化疗的阶段，所有多动症受试者都维持恒定的药物治疗方案。四名训练受试者中有三名出现了SMR的偶然增加和减少，并且与课堂上对运动不活跃的评估中的类似变化相关。药物治疗和SMR训练相结合带来了显著改善，超过了单独药物治疗的效果，并且在停药后通过SMR训练得以维持。相比之下，一名高度易分心的受试者未能掌握SMR任务，未出现这些生理和行为变化。最后，SMR的预训练水平准确反映了最初运动缺陷的严重程度以及多动症受试者对两种治疗的易感性。尽管该程序明显减少了多动行为，但由于脑电图的双重偶然性以及肌电图的相关变化，无法确定一个显著的、特定的治疗因素。尽管存在这些及其他限定因素，但研究结果表明，当过度活跃而非易分心是主要行为缺陷时，SMR在该疾病中具有预后和诊断价值。
