Functional Magnetic Resonance Imaging Neurofeedback-guided Motor Imagery Training and Motor Training for Parkinson’s Disease: Randomized Trial

Article


Subramanian, Leena, Busse-Morris, Monica, Brosnan, Meadhbh, Turner, D., Morris, Huw R. and Linden, David E. J. 2016. Functional Magnetic Resonance Imaging Neurofeedback-guided Motor Imagery Training and Motor Training for Parkinson’s Disease: Randomized Trial. Frontiers in Behavioural Neuroscience. 10, p. Art.111.
AuthorsSubramanian, Leena, Busse-Morris, Monica, Brosnan, Meadhbh, Turner, D., Morris, Huw R. and Linden, David E. J.
Abstract

Objective: Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback (NF) uses feedback of the patient’s own brain activity to self-regulate brain networks which in turn could lead to a change in behaviour and clinical symptoms. The objective was to determine the effect of neurofeedback and motor training and motor training (MOT) alone on motor and non-motor functions in Parkinson’s disease (PD) in a 10-week small Phase I randomised controlled trial.
Methods: 30 patients with PD (Hoehn & Yahr I-III) and no significant comorbidity took part in the trial with random allocation to two groups. Group 1 (NF: 15 patients) received rt-fMRI-NF with motor training. Group 2 (MOT: 15 patients) received motor training alone. The primary outcome measure was the Movement Disorder Society – Unified Parkinson’s Disease 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 Parkinson’s disease Questionnaire-39, and quantitative motor assessments after 4 and 10 weeks.
Results: Patients in the NF group were able to upregulate activity in the supplementary motor area 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). However, the improvement did not differ significantly between the groups. No adverse events were reported in either group.
Interpretation: This Phase I study suggests that NF combined with motor training is safe and improves motor symptoms immediately after treatment, but larger trials are needed to explore its superiority over active control conditions.

Clinical Trial website : Unique Identifier: NCT01867827
URL: https://clinicaltrials.gov/ct2/show/NCT01867827?term=NCT01867827&...

JournalFrontiers in Behavioural Neuroscience
Journal citation10, p. Art.111
ISSN1662-5153
Year2016
PublisherFrontiers Media
Publisher's version
License
CC BY
Digital Object Identifier (DOI)doi:10.3389/fnbeh.2016.00111
Publication dates
Print08 Jun 2016
Publication process dates
Deposited31 May 2016
Accepted23 May 2016
Accepted23 May 2016
FunderWellcome Trust Institutional Strategic Support Fund
European Union Seventh Framework Programme
Wellcome Trust
Seventh Framework Programme
Copyright information© 2016 The authors. This Document is Protected by copyright and was first published by Frontiers. All rights reserved. it is reproduced with permission.
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