Bichsel Oliver, Imbach Lukas, Gassert Roger
Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
J Neuroeng Rehabil. 2025 Jul 18;22(1):166. doi: 10.1186/s12984-025-01701-0.
Neurological and psychiatric disorders are among the leading causes of disability worldwide. With our increasing understanding of brain circuit malfunctions leading to clinical manifestations, neuromodulation techniques intervening directly at the circuit level have gained popularity as a complement to pharmacological intervention. These approaches include deep brain stimulation (DBS) and, more recently, neurofeedback. Currently, neurofeedback mainly relies on non-invasive neuroimaging but is either confined to the experimental setting or only provides nebulous cortical feedback. Interestingly, some recent DBS systems can stream electrophysiological recordings, providing a unique opportunity for neurofeedback to self-regulate ongoing brain activity at deep brain targets. Herein, we review recent studies showing rapid learning of DBS electrode-guided neurofeedback in individuals with Parkinson's disease, with some studies supporting improved motor outcome. We provide a perspective on further applications of DBS electrode-guided neurofeedback, which encompass a wide range of disorders currently investigated with neurofeedback, focusing on other movement disorders, epilepsy, stroke and pain. The successful translation of this novel therapy approach to clinical practice still depends on technological hurdles that need to be overcome as well as larger cohorts demonstrating a meaningful benefit. As an adjunct treatment, this technique could ultimately alleviate symptoms and reduce long-term dependence on medication and DBS.
神经和精神疾病是全球致残的主要原因之一。随着我们对导致临床表现的脑回路功能障碍的认识不断加深，直接在回路水平进行干预的神经调节技术作为药物干预的补充已越来越受欢迎。这些方法包括深部脑刺激（DBS），以及最近的神经反馈。目前，神经反馈主要依赖于非侵入性神经成像，但要么局限于实验环境，要么只提供模糊的皮层反馈。有趣的是，一些最新的DBS系统可以传输电生理记录，为神经反馈提供了一个独特的机会，使其能够自我调节深部脑靶点的正在进行的脑活动。在此，我们回顾了最近的研究，这些研究表明帕金森病患者能够快速学习DBS电极引导的神经反馈，一些研究支持运动结果得到改善。我们对DBS电极引导的神经反馈的进一步应用提出了一种观点，其涵盖了目前用神经反馈研究的广泛疾病，重点关注其他运动障碍、癫痫、中风和疼痛。这种新型治疗方法成功转化为临床实践仍取决于需要克服的技术障碍以及能证明有显著益处的更大规模队列研究。作为一种辅助治疗，该技术最终可能减轻症状，并减少对药物和DBS的长期依赖。
