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... Bien que le neurofeedback soit une technique « psychophysiologique » utilisé e depuis plus de 30 ans dans la prise en charge de l'é pilepsie [25], elle reste trè s peu connue et dé veloppé e dans le champ de l'é pilepsie [26]. Les causes principales sont des é tudes sur des é chantillons de petite taille et le faible nombre d'é tudes contrô lé es [12], bien que des é tudes ré centes de qualité permettent d'envisager un renouveau de ces approches [18,27]. ...
Biofeedback is a complementary non-pharmacological and non-surgical therapeutic developed over the last thirty years in the management of drug-resistant epilepsy. Biofeedback allows learning cognitive and behavioral strategies via a psychophysiological feedback loop. Firstly, this paper describes the different types of biofeedback protocols used for the treatment of drug-refractory epilepsy and their physiological justifications. Secondly, this paper analyzes the evidence of effectiveness, from a medical point of view, on reducing the numbers of seizures, and from a neurophysiological point of view, on the changing brain activity. Electroencephalography (EEG) biofeedback (neurofeedback) protocol on sensorimotor rhythms (SMR) has been investigated in many studies, the main limitation being small sample sizes and lack of control groups. The newer neurofeedback protocol on slow cortical potential (SCP) and galvanic skin response (GSR) biofeedback protocols have been used in a smaller number of studies. But, these studies are more rigorous with larger sized samples, matched control groups, and attempts to control the placebo effect. These protocols also open the way for innovative neurophysiological researches and may predict a renewal of biofeedback techniques. Biofeedback would have legitimacy in the field of clinical drug-resistant epilepsy at the interface between therapeutic and clinical neurophysiology.
... Bien que le neurofeedback soit une technique « psychophysiologique » utilisé e depuis plus de 30 ans dans la prise en charge de l'é pilepsie [25], elle reste trè s peu connue et dé veloppé e dans le champ de l'é pilepsie [26]. Les causes principales sont des é tudes sur des é chantillons de petite taille et le faible nombre d'é tudes contrô lé es [12], bien que des é tudes ré centes de qualité permettent d'envisager un renouveau de ces approches [18,27]. ...
Biofeedback is a complementary non-pharmacological and non-surgical therapeutic developed over the last thirty years in the management of drug-resistant epilepsy. Biofeedback allows learning cognitive and behavioral strategies via a psychophysiological feedback loop. Firstly, this paper describes the different types of biofeedback protocols used for the treatment of drug-refractory epilepsy and their physiological justifications. Secondly, this paper analyzes the evidence of effectiveness, from a medical point of view, on reducing the numbers of seizures, and from a neurophysiological point of view, on the changing brain activity. Electroencephalography (EEG) biofeedback (neurofeedback) protocol on sensorimotor rhythms (SMR) has been investigated in many studies, the main limitation being small sample sizes and lack of control groups. The newer neurofeedback protocol on slow cortical potential (SCP) and galvanic skin response (GSR) biofeedback protocols have been used in a smaller number of studies. But, these studies are more rigorous with larger sized samples, matched control groups, and attempts to control the placebo effect. These protocols also open the way for innovative neurophysiological researches and may predict a renewal of biofeedback techniques. Biofeedback would have legitimacy in the field of clinical drug-resistant epilepsy at the interface between therapeutic and clinical neurophysiology.
... NF is a non-invasive technique that enables an individual to learn the cognitive strategies required to change neurophysiological activity (i.e., EEG), for the purposes of improving health and performance (Yucha and Montgomery, 2008). The originality of NF is that it gives patients a more active role in there own health care (Yucha and Montgomery, 2008) and comprises a holistic conception in which cognitive and brain activities are modified together (Rémond, 1997; Cherici and Barbara, 2007; Coben and Evans, 2011 ). For this reason, NF is also referred to as " psychoneurotherapy " (Paquette et al., 2009), " brain psychotherapy " (Franchi and Vion-Dury, 2011) or " neuroimagery therapy " (deCharms, 2008). ...
Neuromodulation therapeutics—as repeated Transcranial Magnetic Stimulation (rTMS) and neurofeedback—are valuable tools for psychiatry. Nevertheless, they currently face some limitations: rTMS has confounding effects on neural activation patterns, and neurofeedback fails to change neural dynamics in some cases. Here we propose how coupling rTMS and neurofeedback can tackle both issues by adapting neural activations during rTMS and actively guiding individuals during neurofeedback. An algorithmic challenge then consists in designing the proper recording, processing, feedback, and control of unwanted effects. But this new neuromodulation technique also poses an ethical challenge: ensuring treatment occurs within a biopsychosocial model of medicine, while considering both the interaction between the patients and the psychiatrist, and the maintenance of individuals' autonomy. Our solution is the concept of Cyborg psychiatry, which embodies the technique and includes a self-engaged interaction between patients and the neuromodulation device.
In order to establish the legitimacy of neurofeedback as a treatment and to better inform patients about this therapeutic, classical efficacy studies (double-blind randomized controlled trials) are essential but are only one aspect among many. We therefore proposed to apply the Duruz's criteria to the emblematic case of neurofeedback for the treatment of attention-deficit/hyperactivity disorder (ADHD). On the one hand, we applied five scientific criteria of relevance and evidence to the neurofeedback. On the other hand, we analysed the epistemology initiated by the model of neurofeedback according to a neurophenomenological perspective. Finally, we note that, in France, the creation of a scientific community, attached to the existing international scholarly societies on neurofeedback, is needed.
Le « neurofeedback » est une technique de biofeedback, appelée également « EEG biofeedback », utilisant l’enregistrement électroencéphalographique (EEG). Cette technique existe depuis près de 30 ans. Deux grands types de protocoles de neurofeedback en fonction du type de traitement en temps réel réalisé sur le signal EEG sont retrouvés. Dans le premier, la puissance spectrale d’une bande fréquentielle EEG en regard d’une région cérébrale est calculée. Il peut être par exemple demandé au sujet d’augmenter la puissance spectrale de la bande bêta ou de diminuer celle de la bande thêta enregistrées sur l’électrode Cz, donc en regard de la région centrale médiale. Dans le second, l’amplitude d’un potentiel lent, appelé SCP pour Slow Cortical Potential, en Cz est calculé. Il est alors demandé au sujet soit d’augmenter, soit de diminuer l’amplitude du SCP. Le neurofeedback permet principalement de favoriser les capacités attentionnelles et d’éveil d’un sujet. Ainsi son application thérapeutique est principalement le trouble déficit de l’attention avec hyperactivité (TDAH), où il s’agit d’une technique désormais considérée comme valide. Il est également utilisé comme thérapeutique complémentaire non pharmacologique dans la prise en charge des troubles envahissant du développement et dans les épilepsies pharmacorésistantes. Ces applications dans d’autres troubles psychiatriques restent plus marginales. Le neurofeedback est très peu connu et développé en France. Pourtant, il permet un renouveau de la neurophysiologie clinique en psychiatrie en proposant une approche thérapeutique et ouvre des voies de recherches neurophysiologiques novatrices.
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