Real-Time Functional Magnetic Resonance Imaging Neurofeedback for Treatment of Parkinson's Disease
Real-Time Functional Magnetic Resonance Imaging Neurofeedback for Treatment of Parkinson's Disease
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DOI：
10.1523/jneurosci.3498-11.2011
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发表时间：
2011-11-09
影响因子：
5.3
通讯作者：
Linden, David
中科院分区：
文献类型：
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作者：
Subramanian, Leena;Hindle, John V.;Linden, David
基于功能磁共振成像(FMRI)信号的实时反馈的人类大脑活动的自我调节正在成为一种潜在的强大的新技术。在这里，我们评估了帕金森氏病(PD)患者是否能够改变局部大脑活动来改善运动功能。5名患者在两个fMRI疗程中学会了使用运动想象增加辅助运动复合体的活动。在定位过程中，它们在这个目标脑区获得了与明显运动一样多的激活。同时，他们在运动速度(手指敲击)和运动症状的临床评分(统一帕金森氏病评定量表的运动评分改善37%)方面显示出改善。神经反馈时的激活也见于其他皮质运动区和基底神经节，包括丘脑底核和苍白球，它们与辅助运动区(SMA)和帕金森病病理生理学中的关键节点相连。帕金森病对照组有5名患者，临床严重程度和药物治疗相匹配，接受了同样的手术，但没有收到关于他们SMA活动的反馈。这一组没有SMA激活的控制，也没有表现出运动改善。这些发现表明，帕金森病患者可以通过神经反馈实现皮质-皮质下运动神经回路的自我调节，并可能产生仅靠运动想象无法实现的临床益处。
Self-regulation of brain activity in humans based on real-time feedback of functional magnetic resonance imaging ( fMRI) signal is emerging as a potentially powerful, new technique. Here, we assessed whether patients with Parkinson's disease (PD) are able to alter local brain activity to improve motor function. Five patients learned to increase activity in the supplementary motor complex over two fMRI sessions using motor imagery. They attained asmuchactivation in this target brain region as during a localizer procedure with overt movements. Concomitantly, they showed an improvement in motor speed (finger tapping) and clinical ratings of motor symptoms (37% improvement of the motor scale of the Unified Parkinson's Disease Rating Scale). Activation during neurofeedback was also observed in other cortical motor areas and the basal ganglia, including the subthalamic nucleus and globus pallidus, which are connected to the supplementary motor area (SMA) and crucial nodes in the pathophysiology of PD. A PD control group of five patients, matched for clinical severity and medication, underwent the same procedure but did not receive feedback about their SMA activity. This group attained no control of SMA activation and showed no motor improvement. These findings demonstrate that self-modulation of cortico-subcortical motor circuits can be achieved by PD patients through neurofeedback and may result in clinical benefits that are not attainable by motor imagery alone.