Movement Disorders and Neuromodulation Division, Department of Neurology, University of California San Francisco, CA, USA.
Movement Disorders and Neuromodulation Division, Department of Neurology, University of California San Francisco, CA, USA; Department of Psychology, University of California San Diego, CA, USA.
Parkinsonism Relat Disord. 2024 Apr;121:106010. doi: 10.1016/j.parkreldis.2024.106010. Epub 2024 Jan 14.
Neurofeedback (NF) techniques support individuals to self-regulate specific features of brain activity, which has been shown to impact behavior and potentially ameliorate clinical symptoms. Electrophysiological NF (epNF) may be particularly impactful for patients with Parkinson's disease (PD), as evidence mounts to suggest a central role of pathological neural oscillations underlying symptoms in PD. Exaggerated beta oscillations (12-30 Hz) in the basal ganglia-cortical network are linked to motor symptoms (e.g., bradykinesia, rigidity), and beta is reduced by successful therapy with dopaminergic medication and Deep Brain Stimulation (DBS). PD patients also experience non-motor symptoms related to sleep, mood, motivation, and cognitive control. Although less is known about the mechanisms of non-motor symptoms in PD and how to successfully treat them, low frequency neural oscillations (1-12 Hz) in the basal ganglia-cortical network are particularly implicated in non-motor symptoms. Here, we review how cortical and subcortical epNF could be used to target motor and non-motor specific oscillations, and potentially serve as an adjunct therapy that enables PD patients to endogenously control their own pathological neural activities. Recent studies have demonstrated that epNF protocols can successfully support volitional control of cortical and subcortical beta rhythms. Importantly, this endogenous control of beta has been linked to changes in motor behavior. epNF for PD, as a casual intervention on neural signals, has the potential to increase understanding of the neurophysiology of movement, mood, and cognition and to identify new therapeutic approaches for motor and non-motor symptoms.
神经反馈（NF）技术支持个体自我调节大脑活动的特定特征，这已被证明可以影响行为并潜在改善临床症状。电生理神经反馈（epNF）可能对帕金森病（PD）患者特别有影响，因为越来越多的证据表明，病理性神经振荡在 PD 症状中起着核心作用。基底节-皮层网络中过度的β振荡（12-30 Hz）与运动症状（如运动迟缓、僵硬）有关，并且通过多巴胺能药物治疗和深部脑刺激（DBS）成功治疗后β会减少。PD 患者还经历与睡眠、情绪、动机和认知控制相关的非运动症状。尽管对 PD 非运动症状的机制以及如何成功治疗这些症状知之甚少，但基底节-皮层网络中的低频神经振荡（1-12 Hz）特别与非运动症状有关。在这里，我们回顾了皮层和皮质下 epNF 如何用于靶向运动和非运动特定振荡，并可能作为一种辅助治疗方法，使 PD 患者能够自主控制自己的病理性神经活动。最近的研究表明，epNF 方案可以成功地支持皮质和皮质下β节律的随意控制。重要的是，这种β的内源性控制与运动行为的变化有关。作为对神经信号的偶然干预，PD 的 epNF 有可能增加对运动、情绪和认知的神经生理学的理解，并为运动和非运动症状确定新的治疗方法。
