Real-Time Neurofeedback to Modulate β-Band Power in the Subthalamic Nucleus in Parkinson's Disease Patients
Real-Time Neurofeedback to Modulate β-Band Power in the Subthalamic Nucleus in Parkinson's Disease Patients
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DOI：
10.1523/eneuro.0246-18.2018
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发表时间：
2018-11-01
期刊：
影响因子：
3.4
通讯作者：
Kishima, Haruhiko
中科院分区：
文献类型：
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作者：
Fukuma, Ryohei;Yanagisawa, Takufumi;Kishima, Haruhiko
丘脑底核 (STN) 的 β 波段振荡是帕金森病的治疗靶点。先前的研究表明，L-DOPA 可减少 β 波段（13-30 Hz）振荡，改善运动症状。然而，帕金森病患者是否能够自主控制β带振荡尚未阐明。在这里，我们假设控制 STN 中 β 带功率的神经反馈训练会引起帕金森病患者 STN 的可塑性变化。我们记录了手术期间 STN 深部脑刺激电极的信号，以用双侧电极替换 8 名人类患者（3 名男性）的植入式脉冲发生器。四名患者在反馈训练期间被诱导降低β带功率（下调训练条件），而其他患者则被诱导增加β带功率（上调训练条件）。所有患者对其指定的病情均不知情。选择表现出最高β带功率的相邻触点进行反馈。在 10 分钟的训练期间，向患者展示一个圆圈，其直径由所选触点的 β 波段功率控制。比较反馈之前和之后记录的 5 分钟休息时段内 beta 频段的功率。在向下训练条件下，所有四名患者的反馈后，所选触点的 β 波段功率均显着下降 (p < 0.05)。相比之下，四分之二的患者在上行训练条件下进行反馈后，β带功率显着增加。总体而言，患者可以通过神经反馈按照指示方向（p < 0.05）自愿控制 STN 中的 β 带功率。
The beta-band oscillation in the subthalamic nucleus (STN) is a therapeutic target for Parkinson's disease. Previous studies demonstrated that L-DOPA decreases the beta-band (13-30 Hz) oscillations with improvement of motor symptoms. However, it has not been elucidated whether patients with Parkinson's disease are able to control the beta-band oscillation voluntarily. Here, we hypothesized that neurofeedback training to control the beta-band power in the STN induces plastic changes in the STN of individuals with Parkinson's disease. We recorded the signals from STN deep-brain stimulation electrodes during operations to replace implantable pulse generators in eight human patients (3 male) with bilateral electrodes. Four patients were induced to decrease the beta-band power during the feedback training (down-training condition), whereas the other patients were induced to increase (up-training condition). All patients were blinded to their assigned condition. Adjacent contacts that showed the highest beta-band power were selected for the feedback. During the 10 min training, patients were shown a circle whose diameter was controlled by the beta-band power of the selected contacts. Powers in the beta-band during 5 min resting sessions recorded before and after the feedback were compared. In the down-training condition, the beta-band power of the selected contacts decreased significantly after feedback in all four patients (p < 0.05). In contrast, the beta-band power significantly increased after feedback in two of four patients in the up-training condition. Overall, the patients could voluntarily control the beta-band power in STN in the instructed direction (p < 0.05) through neurofeedback.