Deep brain electrical neurofeedback allows Parkinson patients to control pathological oscillations and quicken movements

Abstract

Parkinsonian motor symptoms are linked to pathologically increased beta-oscillations in the basal ganglia. While pharmacological treatment and deep brain stimulation (DBS) reduce these pathological oscillations concomitantly with improving motor performance, we set out to explore neurofeedback as an endogenous modulatory method. We implemented deep brain electrical neurofeedback to provide real-time visual neurofeedback of pathological subthalamic oscillations measured through implanted DBS electrodes. All 8 patients volitionally controlled ongoing beta-oscillatory activity within minutes of training. During a single one-hour training session, the reduction of beta-oscillatory activity became gradually stronger and accelerated hand movements. Lastly, endogenous control over deep brain activity was possible even after removing visual neurofeedback, suggesting that neurofeedback-acquired strategies were retained in the short-term. We observed a similar motor improvement when the learnt mental strategies were applied 2 days later. Further improvement of deep brain neurofeedback might benefit Parkinson patients by improving symptom control, even in the absence of real-time neurofeedback.

Technology-Based Neurorehabilitation in Parkinson’s Disease—A Narrative Review

“…Accordingly, one study reported that neurofeedback can be used by bilaterally DBS-treated PD patients to downregulate pathological beta oscillations in the subthalamic nucleus [5]. Similar data were found by other authors [6]. Future studies should further explore the potential of BCI using cortical activity as a target signal for neurofeedback or as a control signal for MI-BCI.…”

Self‐regulation of the brain's right frontal Beta rhythm using a brain‐computer interface

“…Previous studies using implanted electrodes have reported that positive effects upon motor behavior could be achieved in macaques (Khanna & Carmena, 2017) and humans with Parkinson's disease (Bichsel et al, 2021) using BCI to train self‐regulation of the brain's Beta rhythm. Here, we build upon and extend these initial findings by making the advance to noninvasive scalp recorded EEG signals in humans, demonstrating that volitional modulation of Beta oscillations was achieved within 6 days of training.…”

Technology Integration Methods for Bi-directional Brain-computer Interfaces and XR-based Interventions

“…Sensorimotor rhythm neurofeedback training has been demonstrated to reduce MPTP-induced parkinsonian symptoms in nonhuman primates undergoing L-DOPA treatment [ 38 ]. In addition, neurofeedback training targeting beta band oscillations (13-30 Hz) in subthalamic nucleus (STN) have been investigated as a potential therapeutic target for PD in humans [ 27 ], [ 28 ].…”

“…Sensing systems such as brain-computer interfaces, in particular EEG-based BCI, have been applied to neurofeedback applications, which aim to train the user to self-modulate brain function [ 27 ], [ 28 ]. Nevertheless, attempts to integrate brain stimulation and virtual environments remain few [ 21 ], [ 24 ], [ 29 ], and are often uni-directional or require proprietary hardware, limiting their potential use and applications [ 24 ], [ 29 ], [ 30 ].…”