Neurofeedback Improves Motor Skills in Parkinson’s Patients

Researchers from Cardiff University and Trinity College, UK, and Maastricht University, Netherlands, conducted a pilot to determine the impact of Neurofeedback, as compared with Motor Training (MOT) alone, on motor and non-motor functions in Parkinson's Disease (PD).

In this 10-week, randomized, controlled trial, 30 patients with Parkinson's Disease were randomly assigned to two groups.  Group 1 (N = 15) received Real Time Functional MRI – Neurofeedback with Motor Training; Group 2 (N = 15) received Motor Training alone.

The primary outcome measure was the Movement Disorder Society-Unified PD Rating Scale-Motor scale (MDS-UPDRS-MS), administered pre- and post-intervention "off-medication". The secondary outcome measures were the "on-medication" MDS-UPDRS, the PD Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks.

The investigators found that the patients in the NF group were able to upregulate activity in the supplementary motor area (SMA) by using motor imagery. They improved by an average of 4.5 points on the MDS-UPDRS-MS in the "off-medication" state (95% confidence interval: -2.5 to -6.6), whereas the MOT group improved only by 1.9 points (95% confidence interval +3.2 to -6.8).

The improvement in the intervention group meets the minimal clinically important difference which is also on par with other non-invasive therapies such as repetitive Transcranial Magnetic Stimulation (rTMS).

However, the improvement did not differ significantly between the groups. No adverse events were reported in either group.

They conclude that these results suggest that NF combined with MOT is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions.

Citation: Subramanian L, Morris MB, et al. Functional Magnetic Resonance Imaging Neurofeedback-guided Motor Imagery Training and Motor Training for Parkinson's Disease: Randomized Trial. Frontiers in Behavioral Neuroscience. 2016 Jun 8; pp. 10:111. doi: 10.3389/fnbeh.2016.00111. eCollection 2016.

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