Some people with epilepsy can be trained to think themselves out of having a seizure. The technique may work by strengthening nerve pathways that can damp down overactive parts of the brain.
Epileptic seizures happen when brain cells become too excitable and start firing out of control. This sometimes starts in just a small region, and then spreads over a wider area.
Most people with epilepsy can keep it under control with medicines, but this doesn’t work in around a third of cases. This has prompted a growing interest in psychological approaches to controlling or alleviating the disorder – not least because stress is known to worsen epilepsy – such as mindfulness training, yoga, and taking up a sport.
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Several studies have suggested that by a form of biofeedback training – techniques that give people information about their body, such as their blood pressure, to help them try to control it. The use of biofeedback training in medicine is controversial though, with some suspecting it works mainly through a placebo effect.
In epilepsy, such training has been designed to teach people to raise their level of mental alertness – a factor that is linked to how much we sweat. People have pads put on their hands that are connected to a computer monitor, giving them feedback on their sweat gland activity.
Fewer seizures
How this training works is unclear, but it uses the fact that many people can tell beforehand that they are going to have a seizure, often because of a strange sensation such as an odd taste or a feeling of déjà vu. Biofeedback training seems to give people the ability to deliberately raise their alertness when they sense such an aura. It also cuts seizures in those who don’t get warning signs, perhaps by raising general alertness levels.
When of Brighton and Sussex Medical School, UK, tested this technique in a study involving 38 people, nearly half of those who received the training saw a decrease in the number of seizures over a month of more than 50 per cent.
Brain scans revealed that those who benefited the most showed an increased connectivity between the temporal lobes down the side of the brain – where these people’s seizures usually start – and parts of the prefrontal cortex, at the front of the brain. The prefrontal cortex is involved in higher cognitive functions, including attention, planning and decision making.
Previous research has suggested that the nerve bundle that joins these two regions is the main highway through which seizures spread from the temporal lobes to the rest of the brain. When people have this connection surgically removed, it can reduce seizures.
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The brain scan data helps to confirm that biofeedback training provokes a measurable response in the brain, says of Timone University Hospital in Marseille, France, who provides the training at her clinic. But some may remain sceptical because the control group in this study were not given a sham biofeedback treatment, she says.
It’s possible that some of the benefit of the training arises simply from having contact with the trainer, as a form of psychological therapy, says of Aix-Marseille University in France.
, also of Brighton and Sussex Medical school, UK, who worked with Nagai on the study, says it’s important that people don’t get blamed for not being able to control their epilepsy. “Not everyone can do a series of training exercises and benefit from it,” he says.
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