SEARCH WITHIN CONTENT
Citation Information : Journal of Epileptology. Volume 24, Issue 2, Pages 173-180, DOI: https://doi.org/10.1515/joepi-2016-0013
License : (CC BY 4.0)
Received Date : 14-November-2016 / Accepted: 28-November-2016 / Published Online: 17-December-2016
Background. Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed.
Aim. To present the current status of biofeedback methods applied to patients with epilepsy.
Material and Methods. With a literature search up to 10/2016 we screened publications containing the search terms "biofeedback", "neurofeedback" or "neurotherapy" and "epilepsy" or "seizure" for intervention and population search terms respectively.
Results. Four different techniques of biofeedback were used to improve seizure frequency in patients with epilepsy. Three of these techniques, measuring EEG (slow cortical potentials and sensory motor rhythm) or electrodermal activity (galvanic skin response, GSR) seem to be promising methods for successful seizure control. Nevertheless, methodological standards in the conducted trials were too low for assured empirical evidence in their efficacy.
Conclusions. Biofeedback methods could be applied to patients to a greater extent. Probably due to the missing empirical evidence of efficacy and the high demand on patients’ and therapists’ time and commitment and therefore low cost effectiveness, these methods are hardly offered. Especially the relatively new approach of GSR biofeedback represents a promising option here.
Andrews D.J., Schonfeld W.H.: Predictive factors for controlling seizures using a behavioral approach. Seizure, 1992, 1: 111–116.
Bandura A.: Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 1977, 84: 191–215.
Birbaumer N., Dockery C., Strehl U.: Psychophysiological treatment of epilepsy. Epileptologia, 2007, 15: 57–65.
Birbaumer N., Elbert T,. Canavan A., Rockstroh B.: Slow cortical potentials of the brain. Physiological Reviews, 1990, 70: 1–41.
Birbaumer N., Elbert T., Rockstroh B., Lutzenberger W.: Biofeedback of event-related slow potentials of the brain. International Journal of Psychology, 1987, 16: 389–415.
Center for Reviews and Dissemination: Meta-Analysis of EEG biofeedback in treating epilepsy (structured abstract). Database of abstracts of reviews of effect (DARE), issue 2, 2015.
Cross H.: Epilepsy: behavioural, psychological and ketogenic diet treatments. Systematic review 1214. BMJ Clinical Evidence, 2015, 07: 1214.
Fried R., Rubin S.R., Carlton R.M., Fox M.C.: Behavioral control of intractable idiopathic epileptic seizures: I. Self-regulation of end-tidal carbon dioxide. Psychosomatic Medicine, 1984, 46: 315–332.
Gaume A., Vialette A., Mora-Sanchez A., Ramdini C., Vialette F.B.: A psychoengineering paradigm for the neurocognitive mechanisms of biofeedback and neurofeedback. Neuroscience and Biobehavioral Reviews, 2016, 68: 891–910.
Kotchoubey B., Strehl U., Uhlmann C., Holzapfel S., König M., Fröscher W. et al.: Modification of slow cortical potentials in patients with refractory epilepsy: a controlled outcome study. Epilepsia, 2001, 42: 406–416.
Kotwas I., McGonigal A., Trebuchon A., Bastien-Toniazzo M., Nagai Y., Bartolomei F., Micoulaud-Franchi J.A.: Self-control of epileptic seizures by nonpharmacological strategies. Epilepsy and Behavior, 2016, 55: 157–164.
Kwan P., Schachter S.C., Brodie M.J.: Drug-resistant epilepsy. New England Journal of Medicine, 2011, 365: 919–926.
Lantz D., Sterman M.B.: Neuropsychological assessment of subjects with uncontrolled epilepsy: effects of EEG feedback training. Epilepsia, 1988, 29: 163–171.
Maguire M., Marson A.G., Ramaratnam S.: Epilepsy (partial). BMJ Clinical Evidence, 2011, 05: 1214.
Marzbani H., Marateb H.R., Mansourian M.: Methodological note: Neurofeedback: A comprehensive review on system design, methodology and clinical applications. Basic and Clinical Neuroscience, 2016, 7: 143–157.
Meichenbaum D.: Cognitive factors in biofeedback therapy. Biofeedback and Self-Regulation, 1976, 29: 373–404.
Michaelis R., Tang V., Wagner J.L., Modi A.C., LaFrance W., Goldstein L.H. et al.: Psychological treatments for people with epilepsy (Protocol). Cochrane Database of Systematic Reviews, 2016, Issue 2, Art. No.: CD012081. DOI: 10.1002/14651858.CD012081.
Micoulaud-Franchi J.-A., Kotwas I., Lanteaume L., Berthet C., Bastien M., Vion-Dury J. et al.: Skin conductance biofeedback training in adults with drug-resistant temporal lobe epilepsy and stress-triggered seizures: A proof-of-concept-study. Epilepsy and Behavior, 2014, 41: 244–250.
Monderer R.S., Harrison D.M., Haut S.R.: Neurofeedback and epilepsy. Epilepsy and Behavior, 2002, 3: 214–218.
Nagai Y.: Biofeedback and Epilepsy. Current Neurology and Neuroscience Reports, 2011, 11: 443–450.
Nagai Y., Critchley H.D., Rothwell J.C., Duncan J.S., Trimble R.: Changes in cortical potential associated with modulation of peripheral sympathetic activity in patients with epilepsy. Psychosomatic Medicine, 2009, 71: 84–92.
Nagai Y., Goldstein L.H., Critchley H.D., Fenwick P.B.C.: Influence of sympathetic autonomic arousal on cortical arousal: implications for a therapeutic intervention in epilepsy. Epilepsy Research, 2004a, 58: 185–193.
Nagai Y., Goldstein L.H., Fenwick P.B.C., Trimble R.: Clinical efficacy of galvanic skin response biofeedback training in reducing seizures in adult epilepsy: a preliminary randomized controlled study. Epilepsy and Behavior, 2004b, 5: 216–223.
Nagai Y., Trimble R.: Long-term effects of electrodermal biofeedback training on seizure control in patients with drug-resistant epilepsy: Two case reports. Epilepsy Research, 2014, 108: 149–152.
Perucca P., Hesdorffer D.C., Gilliam F.G.: Response to first antiepileptic drug trial predicts health outcome in epilepsy. Epilepsia, 2011, 52: 2209–2215.
Picot M.-C., Baldy-Moulinier M., Daurès J.P., Dujols P., Crespel A.: The prevalence of epilepsy and pharmacoresistant epilepsy in adults: A population-based study in a western european country. Epilepsia, 2008, 49: 1230–1238.
Ramaratnam S., Baker G.A., Goldstein L.H.: Psychological treatments for epilepsy. Cochrane Database of Systematic Reviews, 2008, Issue 3, Art. No.: CD002029. DOI: 10.1002/14651858.CD002029.pub3
Rockstroh B., Elbert T., Birbaumer N., Wolf P., Düchting-Röth A., Reker M. et al.: Cortical self-regulation in patients with epilepsies. Epilepsy Research, 1993, 14: 63–72.
Schmidt-Schönbein C., Heinen G.: Neurofeedback-eine neue Komponente in der Epilepsie-Therapie. In: U. Strehl (ed.), Neurofeedback. Kohlhammer, Stuttgart 2013, 166–185.
Strehl U., Birkle S., Wörz S., Kotchoubey B.: Sustained reduction of seizures in patients with intractable epilepsy after selfregulation training of slow cortical potentials – 10 years after. Frontiers in Human Neuroscience, 2014, 8: 604.
Strehl U., Kotchoubey B., Trevorrow T., Birbaumer N.: Predictors of seizure reduction after self-regulation of slow cortical potentials as a treatment of drug-resistant epilepsy. Epilepsy and Behavior, 2005, 6: 156–166.
Strehl U., Trevorrow T., Veit R., Hinterberger T., Kotchoubey B., Erb M., Birbaumer N.: Deactivation of brain areas during self-regulation of slow cortical potentials in seizure patients. Applied Psychophysiology and Biofeedback, 2006, 31: 85–94.
Sterman M.B.: Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning. Clinical Electroencephalography, 2000, 31: 45–55.
Sterman M.B., Egner T.: Foundation and practice of neurofeedback for the treatment of epilepsy. Applied Psychophysiology and Biofeedback, 2006, 31: 21–35.
Tan G., Thornby J., Hammond D.C., Strehl U., Canady B., Arnemann K., Kaiser D.A.: Meta-Analysis of EEG biofeedback in treating epilepsy. Clinical EEG and Neuroscience, 2009, 40: 173–179.
Uhlmann C.: Verhaltenstherapeutische Ansätze in der Epilepsietherapie – Wunsch und Wirklichkeit. Psychologische Medizin, Abstractband, 2012: 105.
Uhlmann C., Fröscher W.: Biofeedback and behavior therapy of drug-resistant partial epilepsy: What are the effective mechanisms in seizure reduction? Epileptologia, 1997, 5: 94.
Uhlmann C., Fröscher W.: Biofeedback treatment in patients with refractory epilepsy: Changes in depression and control orientation. Seizure, 2001, 10: 34–38.
Wampold B.E.: How important are common factors in psychotherapy? An update. World Psychiatry, 2015, 14: 270–277.