Zhao Xiaoqi, Huang Tinglan, Jin Mengyue, Zhao Hongbo, Shi Yu, Wang Yanlin, Shen Xiao, Li Zhen, Shi Qingqing, Zhu Xiaodong, Meng Lin
IEEE Trans Neural Syst Rehabil Eng. 2025;33:2814-2822. doi: 10.1109/TNSRE.2025.3591134.
Functional electrical stimulation (FES) and sensory electrical stimulation (SES) are widely used in tremor suppression for Parkinson's disease (PD), however, their therapeutic efficacy varies significantly across individuals. This study investigated the differential cortical effects of FES and SES during closed-loop tremor suppression in PD patient, aiming to identify neurophysiological biomarkers for guiding personalized neuro modulation strategies. We developed an inertial based closed-loop tremor suppression system that delivers out-of-phase FES and continuous SES based on real-time tremor detection. Fifteen PD patients were recruited in tremor suppression trials while surface electroencephalography (EEG) and inertial-based movements of hand and forearm were measured. Both FES and SES significantly reduced tremor amplitude, with FES showing overall greater suppression (hand suppression rate: 60.72% vs. 48.31%, p >0.05; forearm suppression rate: 62.25% vs. 54.41%, p >0.05) where substantial inter-individual variability was observed. EEG analysis revealed that FES induced contralateral beta-band event-related desynchronization ( $\beta $ -ERD), whereas SES elicited beta-band event-related synchronization ( $\beta $ -ERS). These distinct cortical response patterns were significantly correlated with tremor suppression performance (FES $\beta $ -ERD: r = -0.629, p = 0.012; SES $\beta $ -ERS: r = 0.679, p = 0.005). Resting-state spectral analysis further revealed modality-specific changes in alpha power across sensorimotor regions. These findings revealed functional neurodynamic signatures associated with individual responsiveness to stimulation. The observed $\beta $ -band oscillatory responses may serve as candidate biomarkers for predicting individual treatment outcomes, offering a potentially biomarker-guided approach for personalized neuromodulation for PD tremor.
功能性电刺激（FES）和感觉性电刺激（SES）被广泛用于帕金森病（PD）的震颤抑制，然而，它们的治疗效果在个体间差异显著。本研究调查了PD患者在闭环震颤抑制过程中FES和SES对皮质的不同影响，旨在识别神经生理学生物标志物以指导个性化神经调节策略。我们开发了一种基于惯性的闭环震颤抑制系统，该系统根据实时震颤检测提供异相FES和连续SES。15名PD患者参与了震颤抑制试验，同时测量了表面脑电图（EEG）以及手部和前臂基于惯性的运动。FES和SES均显著降低了震颤幅度，FES总体上表现出更大的抑制效果（手部抑制率：60.72%对48.31%，p>0.05；前臂抑制率：62.25%对54.41%，p>0.05），但观察到个体间存在显著差异。EEG分析显示，FES诱发对侧β波段事件相关去同步化（β-ERD），而SES诱发β波段事件相关同步化（β-ERS）。这些不同的皮质反应模式与震颤抑制表现显著相关（FES的β-ERD：r=-0.629，p=0.012；SES的β-ERS：r=0.679，p=0.005）。静息态频谱分析进一步揭示了感觉运动区域α功率的模态特异性变化。这些发现揭示了与个体对刺激反应性相关的功能性神经动力学特征。观察到的β波段振荡反应可能作为预测个体治疗结果的候选生物标志物，为PD震颤的个性化神经调节提供一种潜在的基于生物标志物的方法。
