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Electrodermal Activity Biofeedback Alters Evolving Functional Brain Networks in People With Epilepsy, but in a Non-specific Manner

Schach, Sophia, Rings, Thorsten, Bregulla, Madeleine, Witt, Juri-Alexander, Bröhl, Timo, Surges, Rainer, Von Wrede, Randi, Lehnertz, Klaus, Helmstaedter, Christoph (2022) · Frontiers in Neuroscience

There is evidence that biofeedback of electrodermal activity (EDA) can reduce seizure frequency in people with epilepsy. Prior studies have linked EDA biofeedback to a diffuse brain activation as a potential functional mechanism. Here, we investigated whether short-term EDA biofeedback alters EEG-derived large-scale functional brain networks in people with epilepsy. In this prospective controlled trial, thirty participants were quasi-randomly assigned to one of three biofeedback conditions (arousal, sham, or relaxation) and performed a single, 30-min biofeedback training while undergoing continuous EEG recordings. Based on the EEG, we derived evolving functional brain networks and examined their topological, robustness, and stability properties over time. Potential effects on attentional-executive functions and mood were monitored via a neuropsychological assessment and subjective self-ratings. Participants assigned to the relaxation group seemed to be most successful in meeting the task requirements for this specific control condition (i.e., decreasing EDA). Participants in the sham group were more successful in increasing EDA than participants in the arousal group. However, only the arousal biofeedback training was associated with a prolonged robustness-enhancing effect on networks. Effects on other network properties were mostly unspecific for the different groups. None of the biofeedback conditions affected attentional-executive functions or subjective behavioral measures. Our results suggest that global characteristics of evolving functional brain networks are modified by EDA biofeedback. Some alterations persisted after the single training session; however, the effects were largely unspecific across the different biofeedback protocols. Further research should address changes of local network characteristics and whether multiple training sessions will result in more specific network modifications.

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The use of EEG neurofeedback in the rehabilitation of childhood epilepsy

Kopańska, Marta, Ochojska, Danuta (2022) · Neuropsychiatria i Neuropsychologia

Epilepsy is one of the most common serious neurological disorders. Epilepsy is characterized by a long-term risk of recurring seizures. The most common are seizures. These seizures can be of different types, depending on which part of the brain is involved and the age of the person affected. People suffering from epilepsy have an increased risk of death. Various treatments are used, but the results are not always effective. Neurofeedback is used in the treatment of many diseases, thanks to this therapy the patient learns to consciously control the functions of the body. The aim of this study is to determine the state of the literature on the effectiveness of EEGv (electroencephalography) biofeedback on patients with childhood epilepsy. Epilepsy is a chronic, incurable disease involving disruptions of electrical discharges in the brain. Neurofeedback therapy, based on brain wave training, is fully justified in this matter. The English-language literature from 2014-2021 was reviewed to illustrate the state of knowledge on the above-mentioned topic. 51 papers focused on various aspects of the science of the brain and its disorders, especially epilepsy, were qualified for further analysis. It was found that the state of the literature is satisfactory to conduct independent research on its basis and it was assumed that the development of this form of therapy is an expected issue.

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The Efficacy of Neurofeedback for Pediatric Epilepsy

Nigro, Sarah E. (2019) · Applied Psychophysiology and Biofeedback

Approximately 470,000 children (birth to 18 years old) are afected by Epilepsy (CDC in Epilepsy. https://www.cdc.gov/epile psy/index.html, 2018). Since the initial fndings in the 1970s, Sensorimotor Rhythm (SMR) has been continuously utilized for the treatment of seizures. Studies have consistently demonstrated that SMR reduces the frequency and severity of seizure activity. Although a mix of pediatric cases, adolescents and adults have been sampled in previous studies, no age efects have been reported. There continues to be a lack of research in the area of neurofeedback for the treatment of epilepsy in the pediatric population. To date, no randomized control trial specifc to pediatric epilepsy has been published. The existing research regarding the use of neurofeedback in the treatment of epilepsy provides strong evidence that neurofeedback training might be an efective treatment for pediatric epilepsy. However, existing studies are not specifc to the pediatric population. Moreover, there is a lack of rigor in the studies in which the efects of neurofeedback in children and adolescents with epilepsy are documented. Therefore, based on the current literature, there is not enough evidence to state that neurofeedback is efcacious for the treatment of pediatric epilepsy. However, the APBB criteria for evidence-based practices indicate that neurofeedback for pediatric epilepsy is Possibly Efcacious (Level 2). Future research in which a randomized controlled trial approach is utilized will greatly help to increase support for the use of neurofeedback as an efcacious treatment for epilepsy.

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Aging and the Epidemiology of Epilepsy

Beghi, Ettore, Giussani, Giorgia (2018) · Neuroepidemiology

BACKGROUND: Epilepsy is a chronic disorder affecting all ages but with a peak in the elderly. The association of epilepsy with age can be explained by the predominance of brain diseases with epileptogenic potential (mostly stroke and dementia) and by the effects of the aging process through a number of molecular mechanisms involving networks of neurons with focal or diffuse distribution. SUMMARY: The prevalence of active epilepsy is 6.4 per 1,000 and the lifetime prevalence is 7.6 per 1,000. The prevalence tends to increase with age, with peaks in the oldest age groups and in socially deprived individuals. The incidence of epilepsy is 61.4 per 100,000 person-years. Epilepsy has a bimodal distribution according to age with peaks in the youngest individuals and in the elderly. The increased incidence of seizures and epilepsy in the elderly can be attributed to the increase of age-related and aging-related epileptogenic conditions. Key Messages: As the world population is steadily growing with parallel increase in the number of aged subjects, in the future, epilepsy will represent a huge burden for the society. Measures must thus be taken to prevent seizures and epilepsy through the reduction of preventable epileptogenic factors.

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Impact of sensorimotor rhythm neurofeedback on quality of life in patients with medically-refractory seizures

Frey, Lauren (2016) · NeuroRegulation

Introduction: Published studies suggest that augmentation of the sensorimotor rhythm (SMR), a commonlyused neurofeedback protocol for patients with epilepsy, changes thalamocortical regulatory systems and increases cortical excitation thresholds. Recent meta-analyses showed that at least 50% of patients with medically refractory epilepsy had a post-therapy reduction in seizure frequency after neurofeedback training. However, data on neurofeedback outcomes outside of seizure frequency are limited. Methods: The records for all consecutive patients trained using SMR neurofeedback in the University of Colorado Neurofeedback Clinic prior to March 2015 (n = 9) were retrospectively reviewed, abstracted, and analyzed. Patients completed the Quality of Life in Epilepsy-31 (QOLIE-31) survey as a part of their clinic intake interview and at intervals throughout their training. Results: 214 total training sessions were reviewed. The average total QOLIE-31 baseline score in our patients was 49.3 ± 8.8. Seven patients completed follow-up QOLIE-31 surveys with an average score of 54.9 ± 6.5. Seventy-eight percent of the patients had improvement in their QOLIE-31 scores with training. The largest absolute improvements were in the seizure worry and cognitive subscores of the QOLIE-31. Conclusion: In this small case series, SMR neurofeedback training modestly improved short-term follow-up QOLIE-31 scores in patients with epilepsy

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Neurofeedback in ADHD and insomnia: Vigilance stabilization through sleep spindles and circadian networks

Arns, Martijn, Kenemans, J. Leon (2014) · Neuroscience & Biobehavioral Reviews

In this review article an overview of the history and current status of neurofeedback for the treatment of ADHD and insomnia is provided. Recent insights suggest a central role of circadian phase delay, resulting in sleep onset insomnia (SOI) in a sub-group of ADHD patients. Chronobiological treatments, such as melatonin and early morning bright light, affect the suprachiasmatic nucleus. This nucleus has been shown to project to the noradrenergic locus coeruleus (LC) thereby explaining the vigilance stabilizing effects of such treatments in ADHD. It is hypothesized that both Sensori-Motor Rhythm (SMR) and Slow-Cortical Potential (SCP) neurofeedback impact on the sleep spindle circuitry resulting in increased sleep spindle density, normalization of SOI and thereby affect the noradrenergic LC, resulting in vigilance stabilization. After SOI is normalized, improvements on ADHD symptoms will occur with a delayed onset of effect. Therefore, clinical trials investigating new treatments in ADHD should include assessments at follow-up as their primary endpoint rather than assessments at outtake. Furthermore, an implication requiring further study is that neurofeedback could be stopped when SOI is normalized, which might result in fewer sessions.

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