Neurofeedback for precision rehabilitation of Parkinson’s patients
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Date
2023-01
Publication Type
Other Journal Item
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yes
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Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative disease in the elderly population. It is caused by a progressive loss of dopaminergic neurons in the basal ganglia, leading to impaired motor function. Deep Brain Stimulation (DBS) is a possible treatment for PD, but its success differs significantly among patients.
As an adjunct personalized therapeutic approach, we study how the DBS electrode can be alternatively used to provide closed-loop neurofeedback in PD patients. Local field potentials (LFPs) from the subthalamic nucleus are recorded, and a digitally processed version of these signals is visually presented to the patients. Observing their neural oscillations in real-time allows patients to develop a mental strategy to actively regulate their pathological brain activity. We hypothesized that a decrease in pathological brain activity could have a positive short-term influence on motor performance.
Preliminary results from a pilot study in 8 patients confirm that down-regulation of pathological beta-activity via DBS-neurofeedback is feasible and possible from the first training session on. Effects of beta-power down-regulation on lower limb motor performance are currently under investigation. Additionally, further neural markers associated with gait features will be identified in an exploratory study with Parkinson’s patients and healthy controls involving electroencephalography and DBS-LFP recordings. We expect that personalization by selecting the most appropriate neural biomarker for closed-loop neurofeedback may result in enhanced motor performance. Within a prospective sham-controlled clinical trial, we also investigate the feasibility of personalized closed-loop neurofeedback with a focus on gait rehabilitation in Parkinson’s patients via multi-session neurofeedback training.
Beyond demonstrating a proof-of-concept for novel methods of precision sensory-motor rehabilitation, positive results in this project may inspire novel treatments by providing an understanding of neural activity during gait as well as the mechanisms of personalized neurofeedback.
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published
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Journal / series
Volume
16 (1)
Pages / Article No.
292
Publisher
Elsevier
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Software
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Date created
Subject
DBS; Parkinson's disease; Neurofeedback; Gait
Organisational unit
03827 - Gassert, Roger / Gassert, Roger
03994 - Taylor, William R. / Taylor, William R.