Association pour la Diffusion du Neurofeedback en France

 Le neurofeedback pour les migraines

Pourcentage de praticiens de neurofeedback dynamique rapportant une amélioration d'au moins 40% concernant les migraines et maux de tête :

43 % au bout de 10 séances.
86 % au-delà de 20 séances.

Résultats d'un rapport indépendant effectué en 2014 par Shane Parkhill, Bsc. Eng. sous la supervision de Charlène Zietsma, Ph. D (Next Delta Consulting). Sondage réalisé auprès de plusieurs centaines de praticiens utilisant le logiciel NeurOptimal de la société Zengar Institute, totalisant près de 3 millions d'heures de séances de neurofeedback en 2014. Pour accéder au rapport complet, cliquez ici (français) ou ici (anglais).
La valeur de 40% d'amélioration est retenue comme étant un niveau d'amélioration suffisamment satisfaisant pour justifier d'entreprendre une série de séances de neurofeedback.
 

 Recherches scientifiques sur le neurofeedback et les migraines, répertoriées dans la base PubMed

PubMed est le principal moteur de recherche des publications scientifiques de biologie et de médecine. Concernant le neurofeedback, les conclusions des études publiées sont souvent prudentes par principe, un peu dépassées (cf. date de l'étude), et bien en deçà de ce qui est observé aujourd'hui sur le terrain. La technologie mise en œuvre chez les praticiens est en effet bien plus avancée que celle utilisée pour les études scientifiques de validation qui s'appuient sur des protocoles de neurofeedback déjà bien connus, donc anciens. Dans le domaine du neurofeedback, c'est la technologie qui "tire" la science officielle en avant, et non pas l'inverse.

Les sociétés qui développent les équipements de neurofeedback n'ont pas les moyens financiers des laboratoires qui produisent les médicaments, et elles ne peuvent financer ces études officielles, ce qui explique leur nombre restreint. Pour le développement et l'amélioration constante des équipements de neurofeedback, ces sociétés s'appuient plutôt sur leurs recherches internes et sur les résultats cliniques rapportés par les praticiens.

Dans la base PubMed (interrogée en avril 2014, mais de nombreuses études ont été effectuées depuis cette date), les quatre études résumées ci-dessous concluent :

1.	"Le neurofeedback [...] se révèle extrêmement efficace pour supprimer ou réduire de façon significative la fréquence des maux de tête chez les patients ayant des migraines récurrentes."
2.	"[Les interventions de neurofeedback et de biofeedback] semblent prometteuses pour les migraines réfractaires au traitement médicamenteux et pour empêcher l'évolution de migraines passagères vers des migraines chroniques."
3.	"Ce type de neurofeedback [...] se révèle efficace cliniquement."
4.	"Les séances de neurofeedback résultèrent en une réduction significative de l'excitabilité corticale. Ceci fut probablement la cause de l'efficacité des séances; on a pu observer une réduction significative du nombre de jours de migraine et d'autres paramètres liés aux maux de tête."

Liste des études :

 1. QEEG-guided neurofeedback for recurrent migraine headaches.
Walker JE.
Neurotherapy Center of Dallas, 12870 Hillcrest, Suite 201, Dallas, Texas 75230, USA. admin@neurotherapydallas.com
Clin EEG Neurosci. 2011 Jan;42(1):59-61.

Abstract
Seventy-one patients with recurrent migraine headaches, aged 17-62, from one neurological practice, completed a quantitative electroencephalogram (QEEG) procedure. All QEEG results indicated an excess of high-frequency beta activity (21-30 Hz) in 1-4 cortical areas. Forty-six of the 71 patients selected neurofeedback training while the remaining 25 chose to continue on drug therapy. Neurofeedback protocols consisted of reducing 21-30 Hz activity and increasing 10 Hz activity (5 sessions for each affected site). All the patients were classified as migraine without aura. For the neurofeedback group the majority (54%) experienced complete cessation of their migraines, and many others (39%) experienced a reduction in migraine frequency of greater than 50%. Four percent experienced a decrease in headache frequency of < 50%. Only one patient did not experience a reduction in headache frequency. The control group of subjects who chose to continue drug therapy as opposed to neurofeedback experienced no change in headache frequency (68%), a reduction of less than 50% (20%), or a reduction greater than 50% (8%). QEEG-guided neurofeedback appears to be dramatically effective in abolishing or significantly reducing headache frequency in patients with recurrent migraine.

PMID: 21309444 [PubMed - indexed for MEDLINE]

 2. Neurofeedback and biofeedback with 37 migraineurs: a clinical outcome study.
Stokes DA, Lappin MS.
The Better Brain Center, Inc, 2121 Eisenhower Ave Suite 604 Alexandria, VA 22314, USA. DStokes@neuronew.com
Behav Brain Funct. 2010 Feb 2;6:9.

Abstract
BACKGROUND: Traditional peripheral biofeedback has grade A evidence for effectively treating migraines. Two newer forms of neurobiofeedback, EEG biofeedback and hemoencephalography biofeedback were combined with thermal handwarming biofeedback to treat 37 migraineurs in a clinical outpatient setting.

METHODS: 37 migraine patients underwent an average of 40 neurofeedback sessions combined with thermal biofeedback in an outpatient biofeedback clinic. All patients were on at least one type of medication for migraine; preventive, abortive or rescue. Patients kept daily headache diaries a minimum of two weeks prior to treatment and throughout treatment showing symptom frequency, severity, duration and medications used. Treatments were conducted an average of three times weekly over an average span of 6 months. Headache diaries were examined after treatment and a formal interview was conducted. After an average of 14.5 months following treatment, a formal interview was conducted in order to ascertain duration of treatment effects.

RESULTS: Of the 37 migraine patients treated, 26 patients or 70% experienced at least a 50% reduction in the frequency of their headaches which was sustained on average 14.5 months after treatments were discontinued.

CONCLUSIONS: All combined neuro and biofeedback interventions were effective in reducing the frequency of migraines with clients using medication resulting in a more favorable outcome (70% experiencing at least a 50% reduction in headaches) than just medications alone (50% experience a 50% reduction) and that the effect size of our study involving three different types of biofeedback for migraine (1.09) was more robust than effect size of combined studies on thermal biofeedback alone for migraine (.5). These non-invasive interventions may show promise for treating treatment-refractory migraine and for preventing the progression from episodic to chronic migraine.

See complete free article.

PMID: 20205867 [PubMed - in process]PMCID: PMC2826281 Free PMC Article

 3. On the pathophysiology of migraine--links for "empirically based treatment" with neurofeedback.
Kropp P, Siniatchkin M, Gerber WD.
Institute of Medical Psychology, University of Kiel, Niemannsweg 147, D-24105 Kiel, Germany. kropp@med-psych.uni-kiel.de
Appl Psychophysiol Biofeedback. 2002 Sep;27(3):203-13.

Abstract
Psychophysiological data support the concept that migraine is the result of cortical hypersensitivity, hyperactivity, and a lack of habituation. There is evidence that this is a brain-stem related information processing dysfunction. This cortical activity reflects a periodicity between 2 migraine attacks and it may be due to endogenous or exogenous factors. In the few days preceding the next attack slow cortical potentials are highest and habituation delay experimentally recorded during contingent negative variation is at a maximum. These striking features of slow cortical potentials are predictors of the next attack. The pronounced negativity can be fed back to the patient. The data support the hypothesis that a change in amplitudes of slow cortical potentials is caused by altered habituation during the recording session. This kind of neurofeedback can be characterized as "empirically based" because it improves habituation and it proves to be clinically efficient.

PMID: 12206051 [PubMed - indexed for MEDLINE]

 4. Self-regulation of slow cortical potentials in children with migraine: an exploratory study.
Siniatchkin M, Hierundar A, Kropp P, Kuhnert R, Gerber WD, Stephani U.
Department of Medical Psychology, Neurological Clinic of Kiel University, Germany. siniatchkin@med-psych.uni-kiel.de
Appl Psychophysiol Biofeedback. 2000 Mar;25(1):13-32.

Abstract
Migraine patients are characterized by increased amplitudes of slow cortical potentials (SCPs), representing pronounced excitability of cortical networks. The present study investigated the efficiency of biofeedback training of SCPs in young migraineurs. Ten children suffering from migraine without aura participated in 10 feedback sessions. They were compared with 10 healthy children for regulation abilities of cortical negativity and with 10 migraineurs from the waiting list for clinical efficacy. During the first two sessions, the migraine children were characterised by lacking ability to control cortical negativity, especially during transfer trials, compared with healthy controls. However, there was no difference following 10 sessions of training. Feedback training was accompanied by significant reduction of cortical excitability. This was probably responsible for the clinical efficacy of the training; a significant reduction of days with migraine and other headache parameters was observed. It is suggested that normalization of the threshold regulation of cortical excitability during feedback training may result in clinical improvement.

PMID: 10832507 [PubMed - indexed for MEDLINE]

Cliquez ici pour la liste des études concernant le neurofeedback répertoriées dans la base PubMed.
 

 Autres publications scientifiques non répertoriées dans la base PubMed

Tansey, M. A. (1991). A neurobiological treatment for migraine: The response of four cases of migraine to EEG biofeedback training. Headache Quarterly: Current Treatment & Research, 90-96.

Source : International Society for Neurofeedback & Research.

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