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Neurofeedback treatment of epilepsy: from basic rationale to practical application
Tobias Egner1, M Barry Sterman
1Functional MRI Research Center, Columbia University, Neurological Institute, Box 108, New York, NY 10032, USA. te2111@columbia.edu
Expert Review of Neurotherapeutics
|February 10, 2006
Summary
Operant conditioning of sensorimotor rhythm electroencephalogram (SMR EEG) neurofeedback trains the brain to increase inhibitory states, reducing seizure susceptibility. This non-pharmacological epilepsy treatment shows clinical benefits, especially for treatment-resistant patients.
Area of Science:
- Neuroscience
- Clinical Psychology
- Epileptology
Background:
- Epilepsy treatment has a 35-year history of using operant conditioning of sensorimotor rhythm (SMR) electroencephalogram (EEG).
- SMR oscillations reflect an inhibitory state within the sensorimotor system.
- This neurofeedback training has demonstrated clinical benefits, particularly for patients unresponsive to pharmacotherapy.
Purpose of the Study:
- To review the neurophysiological underpinnings and clinical efficacy of SMR EEG operant conditioning for epilepsy.
- To highlight the potential of neurofeedback as a viable treatment alternative for epilepsy.
Main Methods:
- Operant learning principles applied to SMR EEG production.
- Neurophysiological analysis of SMR oscillations and their relation to excitation thresholds.
- Review of clinical data documenting benefits in non-responsive epilepsy patients.
Main Results:
- Operant learning of SMR production upregulates excitation thresholds in thalamocortical circuitry.
- This upregulation is associated with a reduced susceptibility to seizures.
- Clinical benefits have been documented across multiple independent laboratories.
Conclusions:
- SMR EEG neurofeedback is a promising, non-pharmacological treatment for epilepsy.
- Advances in technology make high-quality neurofeedback equipment accessible and affordable.
- This offers a viable alternative for clinicians treating epilepsy, especially in pharmacotherapy-resistant cases.