Department of Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Paediatric Neurosciences, Evelina London Children's Hospital, London, UK.
Islington Paediatric Occupational Therapy, Whittington Hospital NHS Trust, London, UK; Barts Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK.
Clin Neurophysiol. 2024 Nov;167:143-166. doi: 10.1016/j.clinph.2024.08.009. Epub 2024 Aug 20.
Therapeutic interventions for children and young people with dystonia and dystonic/dyskinetic cerebral palsy are limited. EEG-based neurofeedback is emerging as a neurorehabilitation tool. This scoping review maps research investigating EEG-based sensorimotor neurofeedback in adults and children with neurological motor impairments, including augmentative strategies.
MEDLINE, CINAHL and Web of Science databases were searched up to 2023 for relevant studies. Study selection and data extraction were conducted independently by at least two reviewers.
Of 4380 identified studies, 133 were included, only three enrolling children. The most common diagnosis was adult-onset stroke (77%). Paradigms mostly involved upper limb motor imagery or motor attempt. Common neurofeedback modes included visual, haptic and/or electrical stimulation. EEG parameters varied widely and were often incompletely described. Two studies applied augmentative strategies. Outcome measures varied widely and included classification accuracy of the Brain-Computer Interface, degree of enhancement of mu rhythm modulation or other neurophysiological parameters, and clinical/motor outcome scores. Few studies investigated whether functional outcomes related specifically to the EEG-based neurofeedback.
There is limited evidence exploring EEG-based sensorimotor neurofeedback in individuals with movement disorders, especially in children. Further clarity of neurophysiological parameters is required to develop optimal paradigms for evaluating sensorimotor neurofeedback.
The expanding field of sensorimotor neurofeedback offers exciting potential as a non-invasive therapy. However, this needs to be balanced by robust study design and detailed methodological reporting to ensure reproducibility and validation that clinical improvements relate to induced neurophysiological changes.
针对脑瘫伴肌张力障碍和运动障碍/运动障碍的儿童和青少年,治疗干预手段有限。基于脑电图的神经反馈正在成为一种神经康复工具。本研究旨在对成人和患有神经运动障碍的儿童进行基于脑电图的感觉运动神经反馈的研究进行综述,包括增强策略。
对 MEDLINE、CINAHL 和 Web of Science 数据库进行了检索,检索时间截至 2023 年,以寻找相关研究。研究选择和数据提取由至少两名评审员独立进行。
在 4380 项已识别的研究中,有 133 项被纳入,其中只有 3 项纳入了儿童。最常见的诊断是成人发病的中风(77%)。范式主要涉及上肢运动想象或运动尝试。常见的神经反馈模式包括视觉、触觉和/或电刺激。脑电图参数差异很大,且往往描述不完整。两项研究应用了增强策略。结果测量指标差异很大,包括脑-机接口的分类准确性、mu 节律调制或其他神经生理参数的增强程度,以及临床/运动结果评分。很少有研究调查功能结果是否与基于脑电图的神经反馈有特定关系。
针对运动障碍患者,尤其是儿童,基于脑电图的感觉运动神经反馈的研究证据有限。需要进一步明确神经生理参数,以开发评估感觉运动神经反馈的最佳范式。
感觉运动神经反馈这一不断发展的领域作为一种非侵入性治疗方法具有令人兴奋的潜力。然而,这需要通过稳健的研究设计和详细的方法学报告来平衡,以确保临床改善与诱导的神经生理变化相关。