[Biofeedback and drug-resistant epilepsy: back to an earlier treatment?].
Revue Neurologique. 2014-03-01; 170(3): 187-196
DOI: 10.1016/j.neurol.2013.10.011
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1. Rev Neurol (Paris). 2014 Mar;170(3):187-96. doi: 10.1016/j.neurol.2013.10.011.
Epub 2014 Feb 24.
[Biofeedback and drug-resistant epilepsy: back to an earlier treatment?].
[Article in French]
Micoulaud-Franchi JA(1), Lanteaume L(2), Pallanca O(3), Vion-Dury J(4),
Bartolomei F(2).
Author information:
(1)Unité de neurophysiologie, psychophysiologie et neurophénoménologie (UNPN),
Solaris, pôle de psychiatrie universitaire, hôpital Sainte-Marguerite, 270,
boulevard de Sainte-Marguerite, 13009 Marseille, France; UMR CNRS 7291,
laboratoire de neurosciences cognitives (LNC), 31 Aix-Marseille université, site
Saint-Charles, 3, place Victor-Hugo, 13331 Marseille cedex 3, France. Electronic
address: .
(2)Service de neurophysiologie clinique, CHU de la Timone, 264, rue Saint-Pierre,
13005 Marseille, France; Unité mixte Inserm épilepsie et cognition UMR 751, 27,
boulevard Jean-Moulin, 13385 Marseille cedex 05, France.
(3)Centre médical veille-sommeil, SCMVS, 10, rue Edouard-Detaille, 75017 Paris,
France; Service de neurophysiologie clinique, CHU de la Pitié-Salpêtrière, 48,
boulevard de l’Hôpital, 75013 Paris, France.
(4)Unité de neurophysiologie, psychophysiologie et neurophénoménologie (UNPN),
Solaris, pôle de psychiatrie universitaire, hôpital Sainte-Marguerite, 270,
boulevard de Sainte-Marguerite, 13009 Marseille, France; UMR CNRS 7291,
laboratoire de neurosciences cognitives (LNC), 31 Aix-Marseille université, site
Saint-Charles, 3, place Victor-Hugo, 13331 Marseille cedex 3, France.
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.
Copyright © 2014 Elsevier Masson SAS. All rights reserved.
DOI: 10.1016/j.neurol.2013.10.011
PMID: 24576530 [Indexed for MEDLINE]