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帕金森病中感觉运动节律神经反馈的单病例可行性研究。

A Single Case Feasibility Study of Sensorimotor Rhythm Neurofeedback in Parkinson's Disease.

作者信息

Cook Alexander J, Pfeifer Kristina J, Tass Peter A

机构信息

Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States.

出版信息

Front Neurosci. 2021 Feb 4;15:623317. doi: 10.3389/fnins.2021.623317. eCollection 2021.

Abstract

Electroencephalographic activity over the sensorimotor cortex has been one of the best studied targets for neurofeedback therapy. Parkinson's disease patients display abnormal brain rhythms in the motor cortex caused by increased synchrony in the basal ganglia-cortical pathway. Few studies have examined the effects of sensorimotor-based neurofeedback therapy in humans with PD. In this pilot study, one patient, diagnosed with Parkinson's disease 10 years prior, participated in two consecutive days of EEG neurofeedback training to increase sensorimotor rhythm (SMR) power over the motor cortex. Using a visual display connected to ongoing EEG, the patient voluntarily manipulated SMR power, and he/she was awarded with points to positively reinforce successful increases over a predefined threshold. Recorded EEG data were source localized and analyzed for the occurrence of high amplitude bursts of SMR activity as well as bursts in the beta frequency band in the precentral cortex. The rate of SMR bursts increased with each subsequent training session, while the rate of beta bursts only increased on the final session. Relative power in the beta band, a marker of PD symptom severity, decreased over the motor cortex in the later session. These results provide first evidence for the feasibility of SMR neurofeedback training as a non-invasive therapy for reducing Parkinson's disease related activity and upregulating SMR in the human motor cortex.

摘要

感觉运动皮层的脑电图活动一直是神经反馈疗法研究得最为深入的靶点之一。帕金森病患者的运动皮层会出现异常脑节律,这是由基底神经节 - 皮层通路同步性增加所致。很少有研究考察基于感觉运动的神经反馈疗法对帕金森病患者的影响。在这项初步研究中,一名10年前被诊断为帕金森病的患者连续两天参与脑电图神经反馈训练,以增加运动皮层上的感觉运动节律(SMR)功率。通过连接实时脑电图的视觉显示器,患者自主操控SMR功率,若成功将其提高至预定义阈值之上,会获得积分作为积极强化。记录的脑电图数据进行了源定位,并分析了中央前回皮层中SMR活动的高振幅爆发以及β频段爆发的发生情况。SMR爆发率在随后的每次训练中都有所增加,而β爆发率仅在最后一次训练中增加。β频段相对功率是帕金森病症状严重程度的一个指标,在后期训练中运动皮层上有所下降。这些结果首次证明了SMR神经反馈训练作为一种非侵入性疗法来减少帕金森病相关活动并上调人类运动皮层SMR的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8d7/7890190/e41fc15bc506/fnins-15-623317-g001.jpg

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