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Biofeedback for Epilepsy

Neurofeedback was discovered as a treatment for epilepsy in the late 1960s by Barry Sterman, a UCLA physiological psychologist.  He was asked to determine why fighter pilots sometimes went into seizures while flying their planes, and discovered that it was a chemical in the jet fuel (hydrazine) which triggered the seizures.  In working on this project, he tried to induce seizures in some cats he had in his lab; some cats went into seizures but others did not.  He learned that the cats who did not go into seizures (when they should have) were ones which had been trained previously to increase certain brain waves in previous experiments.  Sterman concluded that the place and frequency he had trained the cats (12-15hz at C4) seemed to be protective of seizures.  His continued work led to eventually working with people, helping many to eliminate seizures in their life.  The scientific details, theory and references of this work can be found in other sources (Sterman, 2000; Egner & Sterman, 2006; Thompson & Thompson, 2003).  Neurofeedback continues to be a viable method of treatment for epilepsy (Yucha & Montgomery, 2008; Monastra, 2003).

I am sometimes asked if there is research supporting the use of neurofeedback for epilepsy.  Below are some references.  If you can add to this list or have corrections, please e mail me at Dr. Thomas.

Andrews, D & Schonfeld, W (1992). Predictive factors for controlling seizures using a behavioural approach. Seizure, 1(2), 111-116.

Ayers, M (1988). Long-term clinical treatment follow-up of EEG neurofeedback for epilepsy. Epilepsy Support Program Newsletter, 3(2), 8-9.

Ayers, M (1995). Long-term follow-up of EEG neurofeedback with absence seizures. Biofeedback & Self-Regulation, 20(3), 309-310.

Birbaumer, N, Elbert, T, Rockstroh, B, Daum, I. Wolf, P & Canavan, A (1991). Clinical psychological treatment of epileptic seizures: A controlled study. Chap in A. Ehlers et al. (Eds.), Perspectives and Promises of Clinical Psychology. NY: Plenum Press.

Cott, A, Pavloski, R & Black, A (1979). Reducing epileptic seizures through operant conditioning of central nervous system activity: Procedural variables. Science, 203, 73-75.

Daum, I, Rockstroh, B, Birbaumer, N, Elbert, T, Canavan, A & Lutzenberger, W (1993). Behavioral treatment of slow cortical potentials in intractable epilepsy: Neuropsychological predictors of outcome. Journal of Neurosurgery & Psychiatry, 56 94-97.

Elbert, T, Rockstroh, B, Canavan, A, Birbaumer, N, Lutzenberger, W, von Bulow, I & Linden, A (1990). Self-regulation of slow cortical potentials and its role in epileptogenesis. Chapter in J. Carlson & R. Seifert (Eds.), Biobehavioral Self-Regulation and Health. NY: Plenum Press.

Elbertsen, B & Klove, H (1976). Clinical application of biofeedback training in epilepsy. Scandinavian Journal of Behavior Therapy, 5, 133-144.

Engel, J, Troupin, A, Crandall, P, Sterman, M & Wasterlain, C (1982). Recent developments in the diagnosis and therapy of epilepsy. Annals of Internal Medicine, 97, 584-598.

Finley, W (1976). Effects of sham-feedback following successful SMR training in an epileptic: A follow-up study. Biofeedback & Self-Regulation, 1, 227-235.

Finley, W (1977). Operant conditioning of the EEG in two patients with epilepsy: Methodologic and clinical considerations. Pavlovian Journal of Biological Science, 12(2), 93-111.

Finley, W, Smith, H & Etherton, M (1975). Reduction of seizures and normalization of the EEG in a severe epileptic following sensorimotor biofeedback training: Preliminary study. Biological Psychiatry, 2, 189-203.

Fischer-Williams, M & Clifford, B (1988). Biofeedback treatment of patients with seizures: A pilot study of EEG feedback. Electroencephalography & Clinical Neurophysiology, 70(1), 18.

Hanson, L, Trudeau, D & Grace, D (1996). Neurotherapy and drug therapy in combination for adult ADHD, personality disorder, and seizure disorder: A case report. Journal of Neurotherapy, 2, 6-14.

Kaplan, B (1975). Biofeedback in epileptics: Equivocal relationship of reinforced EEG frequency to seizure reduction. Epilepsia, 16, 477-485.

Kotchoubey, B, Busch, S, Strehl, U & Birbaumer, N (1999). Changes in EEG power spectra during biofeedback of slow cortical potentials in epilepsy. Applied Psychophysiology & Biofeedback, 24(4), 213-233.

Kotchoubey, B, Strehl, U, Uhlmann, C, Holzapfel, S, Konig, M, Froscher, W, Blankenhorn, V & Birbaumer, N (2001). Modification of slow cortical potentials in patients with refractory epilepsy: A controlled outcome study. Epilepsia, 42(3), 406-416.

Kuhlman, W (1978). EEG feedback training of epileptic patients: Clinical and electroencephalographic analysis. Electroencephalography & Clinical Neurophysiology, 45(6), 699-710.

Kuhlman, W & Allison, T (1977). EEG feedback training in the treatment of epilepsy: Some questions and some answers. Pavlovian Journal of Biological Science, 12(2), 112-122.

Lantz, D & Sterman, M (1988). Neuropsychological assessment of subjects with uncontrolled epilepsy: Effects of EEG biofeedback training. Epilepsia, 29(2), 163-171.

Lubar, J & Bahler, W (1976). Behavioral management of epileptic seizures following EEG biofeedback training of the sensorimotor rhythm. Biofeedback & Self-Regulation, 7, 77-104.

Lubar, J, Shabsin, H, Natelson, S, et al. (1981). EEG operant conditioning in intractable epileptics. Archives of Neurology, 38, 700-704.

Lubar, J & Shouse, M (1977).  Use of biofeedback in the treatment of seizure disorders and hyperactivity.  Advances in Clinical Child Psychology, 1, 204-251.

Monderer, R, Harrison, D & Haut, S (2002). Review: Neurofeedback and epilepsy. Epilepsy & Behavior, 3, 214-218.

Quy, R, Hutt, S & Forrest, S (1979). Sensorimotor rhythm feedback training and epilepsy: Some methodological and conceptual issues. Biological Psychology, 9, 129-149.

Rockstroh, B, Elbert, T, Birbaumer, N, Wolf, P, Duchting-Roth, A, Reker, M, Daum, I, Lutzenberger, W & Dichgans, J (1993). Cortical self-regulation in patients with epilepsies. Epilepsy Research, 14. 63-72.

Rudrud, E & Striefel, S (1981). Eight to twelve hertz occipital EEG training with moderate and severely retarded epileptic individuals. Australian Journal of Developmental Disabilities, 7(4), 173-179.

Seifert, A & Lubar, J (1975). Reduction of epileptic seizures through EEG biofeedback training. Biological Psychology, 3, 157-184.

Sterman, M (1973a). Neurophysiological and clinical studies of sensorimotor EEG biofeedback training: Some effects on epilepsy. Seminars in Psychiatry, 5(4), 507-525.

Sterman, M (1973b). Neurophysiological and clinical studies of sensorimotor EEG biofeedback training: Some effects on epilepsy. Chap in L. Birk (Ed.), Biofeedback: Behavioral Medicine. NY: Grune & Stratton, 147-165.

Sterman, M (1977). Sensorimotor EEG operant conditioning: Experimental and clinical effects. Pavlovian Journal of Biological Sciences, 12(2), 63-92.

Sterman, M (1986). Epilepsy and its treatment with EEG feedback therapy. Annals of Behav Medicine, 8, 21-25.

Sterman, M (1997). The challenge of EEG biofeedback in the treatment of epilepsy: A view from the trenches. Biofeedback, 25(1), 6-7, 20-21, 23.

Sterman, M (2000). Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning. Clinical Electroencephalography, 31(1), 45-55.

Sterman, M & Friar, L (1972). Suppression of seizures in epileptics following sensorimotor EEG feedback training. Electroencephalography & Clinical Neurophysiology, 33, 89-95.

Sterman, M & Lantz, D (2001). Changes in lateralized memory performance in subjects with epilepsy following neurofeedback training. Journal of Neurotherapy, 5, 63-72.

Sterman, M & Macdonald, L (1978). Effects of central cortical EEG feedback training on incidence of poorly controlled seizures. Epilepsia, 19(3), 207-222.

Sterman, M, Macdonald, L & Stone, R (1974). Biofeedback training of the sensorimotor electroencephalogram rhythm in man: Effects on epilepsy. Epilepsia, 15(3), 395-416.

Sterman, M & Shouse, M (1980). Quantitative analysis of training, sleep EEG and clinical response to EEG operant conditioning in epileptics. Electroencephalography & Clinical Neurophysiology, 49, 558-576.

Swingle, P (1998). Neurofeedback treatment of pseudo-seizure disorder. Biological Psychiatry, 44(11), 1-4.

Tansey, M (1985). The response of a case of petit mal epilepsy to EEG sensorimotor rhythm biofeedback training. International Journal of Psychophysiology, 3, 81-84.

Tozzo, C, Elfner, L & May, J (1988). Biofeedback and relaxation training in the control of epileptic seizures. International Journal of Psychophysiology, 6, 185-194.

Uhlmann, C & Froscher, W (2001). Biofeedback treatment in patients with refractory epilepsy: Changes in depression and control orientation. Seizure, 10(1), 34-38.

Upton, A & Longmere, D (1975). The effects of feedback on focal epileptic discharges in man: A preliminary report. Canadian Journal of Neurological Sciences, 2, 153-167.

Walker, J & Kozlowski, G (2005). Neurofeedback treatment of epilepsy. Child & Adolescent Psychiatric Clinics of North America, 14(1), 163-176.

Whitsett, S, Lubar, J, Holder, G et al. (1982). A double-blind investigation of the relationship between seizure activity and the sleep EEG following EEG biofeedback training. Biofeedback & Self-Regulation, 7, 193-209.

Wyler, A, Robbins, C & Dodrill, C (1979). EEG operant conditioning for control of epilepsy. Epilepsia, 20, 279-286.

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