Electroencephalographic neurofeedback: Level of evidence in mental and brain disorders and suggestions for good clinical practice
Neurophysiologie Clinique/Clinical Neurophysiology. 2015-12-01; 45(6): 423-433
DOI: 10.1016/j.neucli.2015.10.077
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1. Neurophysiol Clin. 2015 Dec;45(6):423-33. doi: 10.1016/j.neucli.2015.10.077. Epub
2015 Nov 6.
Electroencephalographic neurofeedback: Level of evidence in mental and brain
disorders and suggestions for good clinical practice.
Micoulaud-Franchi JA(1), McGonigal A(2), Lopez R(3), Daudet C(4), Kotwas I(5),
Bartolomei F(6).
Author information:
(1)Service d’explorations fonctionnelles du système nerveux, clinique du sommeil,
CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; USR CNRS 3413
SANPSY, CHU Pellegrin, université de Bordeaux, 33076 Bordeaux, France. Electronic
address: .
(2)Service de neurophysiologie clinique, centre hospitalo universitaire 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)Unité des troubles du sommeil, consultation TDA/H adulte, hôpital
Gui-de-Chauliac, Montpellier, France.
(4)Cabinet Saint-Augustin, psychiatrie, psychothérapie, Neurofeedback, 63, rue
Pelouse-de-Douet, 33000 Bordeaux, France; Université de Bordeaux, 33000 Bordeaux,
France.
(5)Laboratoire parole et langage, UMR 7309, Aix-Marseille université, Marseille,
France.
(6)Service de neurophysiologie clinique, centre hospitalo universitaire 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; Hôpital Henri-Gastaut, établissement hospitalier spécialisé dans le
traitement des épilepsies, 300, boulevard de Sainte-Marguerite, 13009 Marseille,
France.
The technique of electroencephalographic neurofeedback (EEG NF) emerged in the
1970s and is a technique that measures a subject’s EEG signal, processes it in
real time, extracts a parameter of interest and presents this information in
visual or auditory form. The goal is to effectuate a behavioural modification by
modulating brain activity. The EEG NF opens new therapeutic possibilities in the
fields of psychiatry and neurology. However, the development of EEG NF in
clinical practice requires (i) a good level of evidence of therapeutic efficacy
of this technique, (ii) a good practice guide for this technique. Firstly, this
article investigates selected trials with the following criteria: study design
with controlled, randomized, and open or blind protocol, primary endpoint related
to the mental and brain disorders treated and assessed with standardized
measurement tools, identifiable EEG neurophysiological targets, underpinned by
pathophysiological relevance. Trials were found for: epilepsies, migraine,
stroke, chronic insomnia, attentional-deficit/hyperactivity disorder (ADHD),
autism spectrum disorder, major depressive disorder, anxiety disorders, addictive
disorders, psychotic disorders. Secondly, this article investigates the
principles of neurofeedback therapy in line with learning theory. Different
underlying therapeutic models are presented didactically between two continua: a
continuum between implicit and explicit learning and a continuum between the
biomedical model (centred on “the disease”) and integrative biopsychosocial model
of health (centred on “the illness”). The main relevant learning model is to link
neurofeedback therapy with the field of cognitive remediation techniques. The
methodological specificity of neurofeedback is to be guided by biologically
relevant neurophysiological parameters. Guidelines for good clinical practice of
EEG NF concerning technical issues of electrophysiology and of learning are
suggested. These require validation by institutional structures for the clinical
practice of EEG NF.
Copyright © 2015 Elsevier Masson SAS. All rights reserved.
DOI: 10.1016/j.neucli.2015.10.077
PMID: 26553293 [Indexed for MEDLINE]