Deep brain electrical neurofeedback allows Parkinson patients to control pathological oscillations and quicken movements

AbstractParkinsonian motor symptoms are linked to pathologically increased beta-oscillations in the basal ganglia. While pharmacological treatment and deep brain stimulation (DBS) reduce these pathological oscillations concomitantly with improving motor performance, we set out to explore neurofeedback as an endogenous modulatory method. We implemented real-time processing of pathological subthalamic beta oscillations through implanted DBS electrodes to provide deep brain electrical neurofeedback. Patients volitionally controlled ongoing beta-oscillatory activity by visual neurofeedback within minutes of training. During a single one-hour training session, the reduction of beta-oscillatory activity became gradually stronger and we observed improved motor performance. Lastly, endogenous control over deep brain activity was possible even after removing visual neurofeedback, suggesting that neurofeedback-acquired strategies were retained in the short-term. Moreover, we observed motor improvement when the learnt mental strategies were applied 2 days later without neurofeedback. Further training of deep brain neurofeedback might provide therapeutic benefits for Parkinson patients by improving symptom control using strategies optimized through neurofeedback.

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Deep brain electrical neurofeedback allows Parkinson patients to control pathological oscillations and quicken movements

10.1101/2020.06.10.20127829 ◽

2020 ◽

Author(s):

Oliver Bichsel ◽

Lennart H. Stieglitz ◽

Markus F. Oertel ◽

Christian R. Baumann ◽

Roger Gassert ◽

...

Keyword(s):

Real Time ◽

Motor Performance ◽

Brain Activity ◽

Symptom Control ◽

Training Session ◽

Oscillatory Activity ◽

Short Term ◽

Similar Motor ◽

Motor Improvement ◽

Deep Brain

AbstractParkinsonian motor symptoms are linked to pathologically increased beta-oscillations in the basal ganglia. While pharmacological treatment and deep brain stimulation (DBS) reduce these pathological oscillations concomitantly with improving motor performance, we set out to explore neurofeedback as an endogenous modulatory method. We implemented deep brain electrical neurofeedback to provide real-time visual neurofeedback of pathological subthalamic oscillations measured through implanted DBS electrodes. All 8 patients volitionally controlled ongoing beta-oscillatory activity within minutes of training. During a single one-hour training session, the reduction of beta-oscillatory activity became gradually stronger and accelerated hand movements. Lastly, endogenous control over deep brain activity was possible even after removing visual neurofeedback, suggesting that neurofeedback-acquired strategies were retained in the short-term. We observed a similar motor improvement when the learnt mental strategies were applied 2 days later. Further improvement of deep brain neurofeedback might benefit Parkinson patients by improving symptom control, even in the absence of real-time neurofeedback.

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14 Pathological oscillatory activity in Parkinson’s disease; what does it mean and how should we treat it?

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-bnpa.14 ◽

2020 ◽

Vol 91 (8) ◽

pp. e6.1-e6

Author(s):

Peter Brown

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Basal Ganglia ◽

Side Effects ◽

Brain Stimulation ◽

Neural Circuit ◽

Symptom Control ◽

Oscillatory Activity ◽

Deep Brain

Professor Peter Brown is Professor of Experimental Neurology and Director of the Medical Research Council Brain Network Dynamics Unit at the University of Oxford. Prior to 2010 he was a Professor of Neurology at University College London.For decades we have had cardiac pacemakers that adjust their pacing according to demand and yet therapeutic adaptive stimulation approaches for the central nervous system are still not clinically available. Instead, to treat patients with advanced Parkinson’s disease we stimulate the basal ganglia with fixed regimes, unvarying in frequency or intensity. Although effective, this comes with side-effects and in terms of sophistication this treatment approach could be compared to having central heating system on all the time, regardless of temperature. This talk will describe recent steps being taken to define the underlying circuit dysfunction in Parkinson’s and to improve deep brain stimulation by controlling its delivery according to the state of pathological activity.Evidence is growing that motor symptoms in Parkinson’s disease are due, at least in part, to excessive synchronisation between oscillating neurons. Recordings confirm bursts of oscillatory synchronisation in the basal ganglia centred around 20 Hz. The bursts of 20 Hz activity are prolonged in patients withdrawn from their usual medication and the dominance of these long duration bursts negatively correlates with motor impairment. Longer bursts attain higher amplitudes, indicative of more pervasive oscillatory synchronisation within the neural circuit. In contrast, in heathy primates and in treated Parkinson’s disease bursts tend to be short. Accordingly, it might be best to use closed-loop controlled deep brain stimulation to selectively terminate longer, bigger, pathological beta bursts to both save power and to spare the ability of underlying neural circuits to engage in more physiological processing between long bursts. It is now possible to record and characterise bursts on-line during stimulation of the same site and trial adaptive stimulation. Thus far, this has demonstrated improvements in efficiency and side-effects over conventional continuous stimulation, with at least as good symptom control in Parkinsonian patients.

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Does unilateral basal ganglia activity functionally influence the contralateral side? What we can learn from STN stimulation in patients with Parkinson's disease

Journal of Neurophysiology ◽

10.1152/jn.00254.2012 ◽

2012 ◽

Vol 108 (6) ◽

pp. 1575-1583 ◽

Cited By ~ 12

Author(s):

Yohann Brun ◽

Carine Karachi ◽

Sara Fernandez-Vidal ◽

Nicolas Jodoin ◽

David Grabli ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

High Frequency ◽

Single Cells ◽

Contralateral Side ◽

Oscillatory Activity ◽

High Frequency Stimulation ◽

Frequency Stimulation ◽

Motor Improvement ◽

Deep Brain

In humans, the control of voluntary movement, in which the corticobasal ganglia (BG) circuitry participates, is mainly lateralized. However, several studies have suggested that both the contralateral and ipsilateral BG systems are implicated during unilateral movement. Bilateral improvement of motor signs in patients with Parkinson's disease (PD) has been reported with unilateral lesion or high-frequency stimulation (HFS) of the internal part of the globus pallidus or the subthalamic nucleus (STN-HFS). To decipher the mechanisms of production of ipsilateral movements induced by the modulation of unilateral BG circuitry activity, we recorded left STN neuronal activity during right STN-HFS in PD patients operated for bilateral deep brain stimulation. Left STN single cells were recorded in the operating room during right STN-HFS while patients experienced, or did not experience, right stimulation-induced dyskinesias. Most of the left-side STN neurons (64%) associated with the presence of right dyskinesias were inhibited, with a significant decrease in burst and intraburst frequencies. In contrast, left STN neurons not associated with right dyskinesias were mainly activated (48%), with a predominant increase 4–5 ms after the stimulation pulse and a decrease in oscillatory activity. This suggests that unilateral neuronal STN modulation is associated with changes in the activity of the contralateral STN. The fact that one side of the BG system can influence the functioning of the other could explain the occurrence of bilateral dyskinesias and motor improvement observed in PD patients during unilateral STN-HFS, as a result of a bilateral disruption of the pathological activity in the corticosubcortical circuitry.

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Intraoperative localization of spatially and spectrally distinct resting-state networks in Parkinson’s disease

Journal of Neurosurgery ◽

10.3171/2018.11.jns181684 ◽

2020 ◽

Vol 132 (4) ◽

pp. 1234-1242 ◽

Cited By ~ 1

Author(s):

Paolo Belardinelli ◽

Ramin Azodi-Avval ◽

Erick Ortiz ◽

Georgios Naros ◽

Florian Grimm ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Network Effects ◽

Brain Activity ◽

Dynamic Imaging ◽

Oscillatory Activity ◽

Network Information ◽

Novel Approach ◽

Electrophysiological Recordings ◽

Intraoperative Localization

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for symptomatic Parkinson’s disease (PD); the clinical benefit may not only mirror modulation of local STN activity but also reflect consecutive network effects on cortical oscillatory activity. Moreover, STN-DBS selectively suppresses spatially and spectrally distinct patterns of synchronous oscillatory activity within cortical-subcortical loops. These STN-cortical circuits have been described in PD patients using magnetoencephalography after surgery. This network information, however, is currently not available during surgery to inform the implantation strategy.The authors recorded spontaneous brain activity in 3 awake patients with PD (mean age 67 ± 14 years; mean disease duration 13 ± 7 years) during implantation of DBS electrodes into the STN after overnight withdrawal of dopaminergic medication. Intraoperative propofol was discontinued at least 30 minutes prior to the electrophysiological recordings. The authors used a novel approach for performing simultaneous recordings of STN local field potentials (LFPs) and multichannel electroencephalography (EEG) at rest. Coherent oscillations between LFP and EEG sensors were computed, and subsequent dynamic imaging of coherent sources was performed.The authors identified coherent activity in the upper beta range (21–35 Hz) between the STN and the ipsilateral mesial (pre)motor area. Coherence in the theta range (4–6 Hz) was detected in the ipsilateral prefrontal area.These findings demonstrate the feasibility of detecting frequency-specific and spatially distinct synchronization between the STN and cortex during DBS surgery. Mapping the STN with this technique may disentangle different functional loops relevant for refined targeting during DBS implantation.

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Applying a Sensing-Enabled System for Ensuring Safe Anterior Cingulate Deep Brain Stimulation for Pain

Brain Sciences ◽

10.3390/brainsci9070150 ◽

2019 ◽

Vol 9 (7) ◽

pp. 150 ◽

Cited By ~ 5

Author(s):

Yongzhi Huang ◽

Binith Cheeran ◽

Alexander L. Green ◽

Timothy J. Denison ◽

Tipu Z. Aziz

Keyword(s):

Deep Brain Stimulation ◽

Pain Relief ◽

Brain Stimulation ◽

Brain Activity ◽

Anterior Cingulate ◽

Chronic Therapy ◽

Provide Pain Relief ◽

Surgical Options ◽

Effective Pain Relief ◽

Deep Brain

Deep brain stimulation (DBS) of the anterior cingulate cortex (ACC) was offered to chronic pain patients who had exhausted medical and surgical options. However, several patients developed recurrent seizures. This work was conducted to assess the effect of ACC stimulation on the brain activity and to guide safe DBS programming. A sensing-enabled neurostimulator (Activa PC + S) allowing wireless recording through the stimulating electrodes was chronically implanted in three patients. Stimulation patterns with different amplitude levels and variable ramping rates were tested to investigate whether these patterns could provide pain relief without triggering after-discharges (ADs) within local field potentials (LFPs) recorded in the ACC. In the absence of ramping, AD activity was detected following stimulation at amplitude levels below those used in chronic therapy. Adjustment of stimulus cycling patterns, by slowly ramping on/off (8-s ramp duration), was able to prevent ADs at higher amplitude levels while maintaining effective pain relief. The absence of AD activity confirmed from the implant was correlated with the absence of clinical seizures. We propose that AD activity in the ACC could be a biomarker for the likelihood of seizures in these patients, and the application of sensing-enabled techniques has the potential to advance safer brain stimulation therapies, especially in novel targets.

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An Analysis of the External Validity of EEG Spectral Power in an Uncontrolled Outdoor Environment during Default and Complex Neurocognitive States

Brain Sciences ◽

10.3390/brainsci11030330 ◽

2021 ◽

Vol 11 (3) ◽

pp. 330

Author(s):

Dalton J. Edwards ◽

Logan T. Trujillo

Keyword(s):

External Validity ◽

Spectral Power ◽

Brain Activity ◽

Outdoor Environment ◽

Oscillatory Activity ◽

Brain State ◽

Beta Band ◽

Eeg Spectral Power ◽

Eeg Power ◽

Human Participants

Traditionally, quantitative electroencephalography (QEEG) studies collect data within controlled laboratory environments that limit the external validity of scientific conclusions. To probe these validity limits, we used a mobile EEG system to record electrophysiological signals from human participants while they were located within a controlled laboratory environment and an uncontrolled outdoor environment exhibiting several moderate background influences. Participants performed two tasks during these recordings, one engaging brain activity related to several complex cognitive functions (number sense, attention, memory, executive function) and the other engaging two default brain states. We computed EEG spectral power over three frequency bands (theta: 4–7 Hz, alpha: 8–13 Hz, low beta: 14–20 Hz) where EEG oscillatory activity is known to correlate with the neurocognitive states engaged by these tasks. Null hypothesis significance testing yielded significant EEG power effects typical of the neurocognitive states engaged by each task, but only a beta-band power difference between the two background recording environments during the default brain state. Bayesian analysis showed that the remaining environment null effects were unlikely to reflect measurement insensitivities. This overall pattern of results supports the external validity of laboratory EEG power findings for complex and default neurocognitive states engaged within moderately uncontrolled environments.

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Visual predictions, neural oscillations and naïve physics

Scientific Reports ◽

10.1038/s41598-021-95295-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Blake W. Saurels ◽

Wiremu Hohaia ◽

Kielan Yarrow ◽

Alan Johnston ◽

Derek H. Arnold

Keyword(s):

Brain Activity ◽

Dynamic Environment ◽

Predictive Performance ◽

Brain Regions ◽

Internal Models ◽

Oscillatory Activity ◽

Alpha Band ◽

Core Property ◽

Ball Tracking ◽

Band Activity

AbstractPrediction is a core function of the human visual system. Contemporary research suggests the brain builds predictive internal models of the world to facilitate interactions with our dynamic environment. Here, we wanted to examine the behavioural and neurological consequences of disrupting a core property of peoples’ internal models, using naturalistic stimuli. We had people view videos of basketball and asked them to track the moving ball and predict jump shot outcomes, all while we recorded eye movements and brain activity. To disrupt people’s predictive internal models, we inverted footage on half the trials, so dynamics were inconsistent with how movements should be shaped by gravity. When viewing upright videos people were better at predicting shot outcomes, at tracking the ball position, and they had enhanced alpha-band oscillatory activity in occipital brain regions. The advantage for predicting upright shot outcomes scaled with improvements in ball tracking and occipital alpha-band activity. Occipital alpha-band activity has been linked to selective attention and spatially-mapped inhibitions of visual brain activity. We propose that when people have a more accurate predictive model of the environment, they can more easily parse what is relevant, allowing them to better target irrelevant positions for suppression—resulting in both better predictive performance and in neural markers of inhibited information processing.

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