Biofeedback and epilepsy

Biofeedback is a noninvasive behavioral treatment that enables a patient to gain volitional control over a physiological process. As a treatment for epilepsy, biofeedback interventions were explored from as early as the 1970s, concentrating on sensory motor rhythm (SMR) as a neurophysiologic parameter. Whereas SMR biofeedback aims to modulate frequency components of the electroencephalography (EEG), slow cortical potential (SCP) biofeedback (which was introduced in the 1990s) focuses on the regulation of the amplitude of cortical potential changes (DC shift). In its application to epilepsy, biofeedback using galvanic skin response (GSR), an electrodermal measure of sympathetic activity, is a relatively new cost-effective methodology. The present article first reviews biofeedback using SMR and SCP, for which efficacy and neural mechanisms are relatively well characterized. Then recent data regarding promising applications of GSR biofeedback will be introduced and discussed in detail.