Different oscillatory entrainment of cortical networks during motor imagery and neurofeedback in right and left handers

Towards therapeutic electrophysiological neurofeedback in Parkinson's disease

Neurofeedback (NF) techniques support individuals to self-regulate specific features of brain activity, which has been shown to impact behavior and potentially ameliorate clinical symptoms. Electrophysiological NF (epNF) may be particularly impactful for patients with Parkinson's disease (PD), as evidence mounts to suggest a central role of pathological neural oscillations underlying symptoms in PD. Exaggerated beta oscillations (12-30 Hz) in the basal ganglia-cortical network are linked to motor symptoms (e.g., bradykinesia, rigidity), and beta is reduced by successful therapy with dopaminergic medication and Deep Brain Stimulation (DBS). PD patients also experience non-motor symptoms related to sleep, mood, motivation, and cognitive control. Although less is known about the mechanisms of non-motor symptoms in PD and how to successfully treat them, low frequency neural oscillations (1-12 Hz) in the basal ganglia-cortical network are particularly implicated in non-motor symptoms. Here, we review how cortical and subcortical epNF could be used to target motor and non-motor specific oscillations, and potentially serve as an adjunct therapy that enables PD patients to endogenously control their own pathological neural activities. Recent studies have demonstrated that epNF protocols can successfully support volitional control of cortical and subcortical beta rhythms. Importantly, this endogenous control of beta has been linked to changes in motor behavior. epNF for PD, as a casual intervention on neural signals, has the potential to increase understanding of the neurophysiology of movement, mood, and cognition and to identify new therapeutic approaches for motor and non-motor symptoms.

A Pursuit of the Degree of Nonlinearity for β Oscillations under Motor Imagery

The power of β oscillations is an essential pathological biomarker for movement disorders, parkinsonism in particular. Motor imagery training was reported to support self-regulate such β oscillations. Past studies had focused on the modulation of β oscillatory power per se, ignoring the intrinsic oscillatory characteristics-the nonlinearity of the waveform. This work applied ensemble empirical mode decomposition to decompose neural activities in multiple frequency bands without destroying the temporal characteristics of the raw signal at all scales. We explored the dynamics of the degree of nonlinearity plus the averaged power across all periods and frequency bands of interest and tested how motor imagery may or may not induce nonlinearities under various frequency bands. With motor imagery, the degree of nonlinearity for the β activity is significantly suppressed referenced to that without, of note, and the average power fails to present significant differences between segments with and without motor imagery training. Our results indicate that the degree of nonlinearity is a complementary and vital biomarker as the average power for β oscillations, thereby providing theoretical support for the possible application in motor imagery therapy. Clinical Relevance- This suggests that motor imagery can suppress irregular patterns of β oscillations for healthy, and the degree of nonlinearity is an effective feature in improving classification in training states for the MI-neurofeedback paradigm compared to that of the averaged power.

A Novel Online Action Observation-Based Brain-Computer Interface That Enhances Event-Related Desynchronization

Brain-computer interface (BCI)-based stroke rehabilitation is an emerging field in which different studies have reported variable outcomes. Among the BCI paradigms, motor imagery (MI)-based closed-loop BCI is still the main pattern in rehabilitation training. It can estimate a patient' motor intention and provide corresponding feedback. However, the individual difference in the ability to generate event-related desynchronization (ERD) and the low classification accuracy of the multi-class scenario restrict the application of MI-based BCI. In the current study, a novel online action observation (AO)-based BCI was proposed. The visual stimuli of four types of hand movements were designed to simultaneously induce steady-state motion visual evoked potential (SSMVEP) in the occipital region and to activate the sensorimotor region. Task-related component analysis was performed to identify the SSMVEP. Results showed that the amplitude of the induced frequency in the SSMVEP had a negative relationship with the stimulus frequency. The classification accuracy in the four-class scenario reached 72.81 ± 13.55% within 2.5s. Importantly, the AO-based closed-loop BCI, which provided visual feedback based on the SSMVEP, could enhance ERD compared with AO-alone. The increased attentiveness might be one key factor for the enhancement of the ERD in the designed AO-based BCI. In summary, the proposed AO-based BCI provides a new insight for BCI-based rehabilitation.

Functional Connectivity Analysis in Motor-Imagery Brain Computer Interfaces

Motor Imagery BCI systems have a high rate of users that are not capable of modulating their brain activity accurately enough to communicate with the system. Several studies have identified psychological, cognitive, and neurophysiological measures that might explain this MI-BCI inefficiency. Traditional research had focused on mu suppression in the sensorimotor area in order to classify imagery, but this does not reflect the true dynamics that underlie motor imagery. Functional connectivity reflects the interaction between brain regions during the MI task and resting-state network and is a promising tool in improving MI-BCI classification. In this study, 54 novice MI-BCI users were split into two groups based on their accuracy and their functional connectivity was compared in three network scales (Global, Large and Local scale) during the resting-state, left vs. right-hand motor imagery task, and the transition between the two phases. Our comparison of High and Low BCI performers showed that in the alpha band, functional connectivity in the right hemisphere was increased in High compared to Low aptitude MI-BCI users during motor imagery. These findings contribute to the existing literature that indeed connectivity might be a valuable feature in MI-BCI classification and in solving the MI-BCI inefficiency problem.

Brain Patterns During Single- and Dual-Task Leg Movements

The brain is able to engage in dual tasks such as motor imagery (MI) and action observation (AO) or motor execution (ME) with action observation. In this study, we have quantitatively compared event-related desynchronization (ERD) patterns during tasks of pure MI, MI with AO (O-MI), ME, and ME with AO (O-ME) of the leg to investigate the underlying neuronal mechanisms using EEG. Subjects were instructed to imagine or perform rhythmical actions while watching a video of leg movements during O-MI and O-ME tasks; In contrast, subjects imagined and performed the leg movements without observing any video during pure MI and ME tasks. We noticed that the amplitude of ERDs from MI, O-MI, ME and O-ME sequentially increases in central regions of the brain. These quantified ERD patterns in EEG were used to study the differences of brain oscillatory changes among the four tasks. We found that ERDs in motor area were more distinct in O-MI, compared with pure MI. These results suggest that O-MI produced stronger motor activations than MI. Plus, O-ME showed significantly greater activations than ME in the beta band. O-ME has produced stronger neurophysiological effects than MI, and stronger behavioral effects than ME. These empirical results do provide convincing evidence of the dual tasks such combined MI or ME with action observation on brain pattern changes. The video of the goal-directed leg movements is most likely able to improve the ability of performing or imagining movements. O-MI and O-ME may get better and closer therapeutic effects in leg rehabilitation and motor skill training. Furthermore, the extent analysis of ERD may provide the basis for evaluating the ability of O-MI and O-ME in leg rehabilitation and motor skill training.

Neurofeedback-Linked Suppression of Cortical β Bursts Speeds Up Movement Initiation in Healthy Motor Control: A Double-Blind Sham-Controlled Study

Abnormally increased β bursts in cortical-basal ganglia-thalamic circuits are associated with rigidity and bradykinesia in patients with Parkinson's disease. Increased β bursts detected in the motor cortex have also been associated with longer reaction times (RTs) in healthy participants. Here we further hypothesize that suppressing β bursts through neurofeedback training can improve motor performance in healthy subjects.

Abnormally increased β bursts in cortical-basal ganglia-thalamic circuits are associated with rigidity and bradykinesia in patients with Parkinson's disease. Increased β bursts detected in the motor cortex have also been associated with longer reaction times (RTs) in healthy participants. Here we further hypothesize that suppressing β bursts through neurofeedback training can improve motor performance in healthy subjects. We conducted a double-blind sham-controlled study on 20 human volunteers (10 females) using a sequential neurofeedback-behavior task with the neurofeedback reflecting the occurrence of β bursts over sensorimotor cortex quantified in real time. The results show that neurofeedback training helps healthy participants learn to volitionally suppress β bursts in the sensorimotor cortex, with training being accompanied by reduced RT in subsequent cued movements. These changes were only significant in the real feedback group but not in the sham group, confirming the effect of neurofeedback training over simple motor imagery. In addition, RTs correlated with the rate and accumulated duration of β bursts in the contralateral motor cortex before the go-cue, but not with averaged β power. The reduced RTs induced by neurofeedback training positively correlated with reduced β bursts across all tested hemispheres. These results strengthen the link between the occurrence of β bursts in the sensorimotor cortex before the go-cue and slowed movement initiation in healthy motor control. The results also highlight the potential benefit of neurofeedback training in facilitating voluntary suppression of β bursts to speed up movement initiation.

SIGNIFICANCE STATEMENT This double-blind sham-controlled study suggested that neurofeedback training can facilitate volitional suppression of β bursts in sensorimotor cortex in healthy motor control better than sham feedback. The training was accompanied by reduced reaction time (RT) in subsequent cued movements, and the reduced RT positively correlated with the level of reduction in cortical β bursts before the go-cue, but not with average β power. These results provide further evidence of a causal link between sensorimotor β bursts and movement initiation and suggest that neurofeedback training could potentially be used to train participants to speed up movement initiation.