UCL Huntington's Disease Centre, Institute of Neurology, University College London, London, United Kingdom.
Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
Hum Brain Mapp. 2018 Mar;39(3):1339-1353. doi: 10.1002/hbm.23921. Epub 2017 Dec 13.
Novel methods that stimulate neuroplasticity are increasingly being studied to treat neurological and psychiatric conditions. We sought to determine whether real-time fMRI neurofeedback training is feasible in Huntington's disease (HD), and assess any factors that contribute to its effectiveness. In this proof-of-concept study, we used this technique to train 10 patients with HD to volitionally regulate the activity of their supplementary motor area (SMA). We collected detailed behavioral and neuroimaging data before and after training to examine changes of brain function and structure, and cognitive and motor performance. We found that patients overall learned to increase activity of the target region during training with variable effects on cognitive and motor behavior. Improved cognitive and motor performance after training predicted increases in pre-SMA grey matter volume, fMRI activity in the left putamen, and increased SMA-left putamen functional connectivity. Although we did not directly target the putamen and corticostriatal connectivity during neurofeedback training, our results suggest that training the SMA can lead to regulation of associated networks with beneficial effects in behavior. We conclude that neurofeedback training can induce plasticity in patients with Huntington's disease despite the presence of neurodegeneration, and the effects of training a single region may engage other regions and circuits implicated in disease pathology.
越来越多的新型方法被用于研究刺激神经可塑性，以治疗神经和精神疾病。我们旨在确定实时功能性磁共振成像神经反馈训练在亨廷顿病（HD）中的可行性，并评估有助于其有效性的任何因素。在这项概念验证研究中，我们使用该技术对 10 名 HD 患者进行训练，使其能够自主调节补充运动区（SMA）的活动。我们在训练前后收集了详细的行为和神经影像学数据，以检查大脑功能和结构以及认知和运动表现的变化。我们发现，患者总体上学会了在训练期间增加目标区域的活动，但对认知和运动行为的影响不同。训练后认知和运动表现的改善预示着前 SMA 灰质体积增加、左壳核 fMRI 活动增加以及 SMA-左壳核功能连接增加。尽管我们在神经反馈训练期间没有直接针对壳核和皮质纹状体连接，但我们的结果表明，训练 SMA 可以导致相关网络的调节，从而对行为产生有益影响。我们得出结论，尽管存在神经退行性变，但神经反馈训练可以诱导亨廷顿病患者的可塑性，而且训练单个区域的效果可能会涉及到疾病病理中涉及的其他区域和回路。
