Three of these studies included a control group and a positive therapeutic effect of biofeedback was reported in each of these. Results: Out of 21 articles retrieved for GSR/EDA/Skin conductance biofeedback, four studies were identified as interventional trials, involving 99 patients with drug-resistant epilepsy in total. We also compare and contrast study design with relevance to the interpretation of outcomes. Using percentage seizure reduction as an indicator of therapeutic efficacy induced by GSR biofeedback, we used meta-analytic methods to summarize extant findings. Method: We searched published literature pertaining to interventional studies of GSR biofeedback for epilepsy, through MEDLINE and Cochrane databases (1950-2018). In this review, we analyse current evidence of efficacy with GSR biofeedback and evaluate the methodology of each study. Evidence is accumulating for the clinical efficacy of GSR biofeedback training in the management of drug resistant epilepsy. Theoretically, control of psychophysiological arousal may be harnessed as a therapy for epilepsy, to mitigate pre-ictal states. Biofeedback training can enable an individual to gain voluntary control over this autonomic response and its central correlates. This activity can be measured as tonic and phasic fluctuations in electrodermal activity. Objectives: Dynamic changes in psychophysiological arousal are directly expressed in the sympathetic innervation of the skin.
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