Foundation and practice of neurofeedback for the treatment of epilepsy

Department of Neurobiology, School of Medicine, UCLA, USA.
Applied Psychophysiology and Biofeedback (Impact Factor: 1.13). 04/2006; 31(1):21-35. DOI: 10.1007/s10484-006-9002-x
Source: PubMed

ABSTRACT This review provides an updated overview of the neurophysiological rationale, basic and clinical research literature, and current methods of practice pertaining to clinical neurofeedback. It is based on documented findings, rational theory, and the research and clinical experience of the authors. While considering general issues of physiology, learning principles, and methodology, it focuses on the treatment of epilepsy with sensorimotor rhythm (SMR) training, arguably the best established clinical application of EEG operant conditioning. The basic research literature provides ample data to support a very detailed model of the neural generation of SMR, as well as the most likely candidate mechanism underlying its efficacy in clinical treatment. Further, while more controlled clinical trials would be desirable, a respectable literature supports the clinical utility of this alternative treatment for epilepsy. However, the skilled practice of clinical neurofeedback requires a solid understanding of the neurophysiology underlying EEG oscillation, operant learning principles and mechanisms, as well as an in-depth appreciation of the ins and outs of the various hardware/software equipment options open to the practitioner. It is suggested that the best clinical practice includes the systematic mapping of quantitative multi-electrode EEG measures against a normative database before and after treatment to guide the choice of treatment strategy and document progress towards EEG normalization. We conclude that the research literature reviewed in this article justifies the assertion that neurofeedback treatment of epilepsy/seizure disorders constitutes a well-founded and viable alternative to anticonvulsant pharmacotherapy.

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Available from: Tobias Egner, Aug 14, 2015
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    • "The approach taken in the current study utilized neurofeedback training (NFT), an operant conditioning of brain electrical oscillations (Sterman and Egner 2006). NFT allows real-time information of brain activity to be fed back visually to a user by means of a computer in a closed loop, enabling control and natural operation of brain oscillations across cortical networks in vivo and in near real-time (Nowlis and Kamiya 1970; Wolpaw et al. 2002; Neuper et al. 2009). "
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    ABSTRACT: Neurofeedback training (NFT) approaches were investigated to improve behavior, cognition and emotion regulation in children with autism spectrum disorder (ASD). Thirteen children with ASD completed pre-/post-assessments and 16 NFT-sessions. The NFT was based on a game that encouraged social interactions and provided feedback based on imitation and emotional responsiveness. Bidirectional training of EEG mu suppression and enhancement (8-12 Hz over somatosensory cortex) was compared to the standard method of enhancing mu. Children learned to control mu rhythm with both methods and showed improvements in (1) electrophysiology: increased mu suppression, (2) emotional responsiveness: improved emotion recognition and spontaneous imitation, and (3) behavior: significantly better behavior in every-day life. Thus, these NFT paradigms improve aspects of behavior necessary for successful social interactions.
    Journal of Autism and Developmental Disorders 07/2015; DOI:10.1007/s10803-015-2523-5 · 3.06 Impact Factor
    • "Neurofeedback training, as a therapeutic treatment, improves the symptoms of the patients. Previous studies had been shown that NFT has positive therapeutic effects in various neurological disorders such as epilepsy (Sterman and Egner 2006; Tan et al. 2009), attention-deficit/hyperactivity disorder (ADHD) (Arns et al. 2009; Beauregard and Levesque 2006; Lubar 2003). "
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    ABSTRACT: The benefits of clinical neurofeedback training are well known, however, its adverse side-effects are less studied. This research focuses on the transient adverse side effects of neurofeedback training via a double-blind, sham/controlled methodology. Thirty healthy undergraduate students volunteers were randomly divided into three treatment groups: increasing a modified Sensory Motor Rhythm, increasing Upper Alpha, and Sham/control group who receive a random reward. The training sessions were administered for a total of ten sessions. Questionnaires of transient adverse side effects were completed by all volunteers before each session. The results suggest that similar to most medical treatments, neurofeedback can cause transient adverse side effects. Moreover, most participants reported experiencing some side effects. The side effects can be divided into non-specific side effect, associated with the neurofeedback training in general and specific ones associated with the particular protocol. Sensory Motor Rhythm protocol seems to be the most sensitive to side effects.
    Applied Psychophysiology and Biofeedback 05/2015; DOI:10.1007/s10484-015-9289-6 · 1.13 Impact Factor
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    • "Unlike these external stimulus driven methods, neurofeedback offers a noninvasive technique capable of manipulating endogenous brain activity. A developing literature supports the use of neurofeedback in the treatment of a range of clinical conditions, particularly ADHD (Arns et al., 2013, 2014) and epilepsy (Sterman and Egner, 2006; Tan et al., 2009). In addition, experimental neurofeedback enables the study of brain activity as the independent variable, providing a powerful method for studying the functional significance of endogenous brain activity (Weiskopf, 2012). "
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    ABSTRACT: A developing literature explores the use of neurofeedback in the treatment of a range of clinical conditions, particularly ADHD and epilepsy, whilst neurofeedback also provides an experimental tool for studying the functional significance of endogenous brain activity. A critical component of any neurofeedback method is the underlying physiological signal which forms the basis for the feedback. While the past decade has seen the emergence of fMRI-based protocols training spatially confined BOLD activity, traditional neurofeedback has utilized a small number of electrode sites on the scalp. As scalp EEG at a given electrode site reflects a linear mixture of activity from multiple brain sources and artifacts, efforts to successfully acquire some level of control over the signal may be confounded by these extraneous sources. Further, in the event of successful training, these traditional neurofeedback methods are likely influencing multiple brain regions and processes. The present work describes the use of source-based signal processing methods in EEG neurofeedback. The feasibility and potential utility of such methods were explored in an experiment training increased theta oscillatory activity in a source derived from Blind Source Separation (BSS) of EEG data obtained during completion of a complex cognitive task (spatial navigation). Learned increases in theta activity were observed in two of the four participants to complete 20 sessions of neurofeedback targeting this individually defined functional brain source. Source-based EEG neurofeedback methods using BSS may offer important advantages over traditional neurofeedback, by targeting the desired physiological signal in a more functionally and spatially specific manner. Having provided preliminary evidence of the feasibility of these methods, future work may study a range of clinically and experimentally relevant brain processes where individual brain sources may be targeted by source-based EEG neurofeedback.
    Frontiers in Behavioral Neuroscience 10/2014; 8:373. DOI:10.3389/fnbeh.2014.00373 · 4.16 Impact Factor
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