Parkinsonian Disorders

Research Papers

Involvement of the Red Nucleus in the Compensation of Parkinsonism may Explain why Primates can develop Stable Parkinson's Disease

Philippens, Ingrid H. C. H. M., Wubben, Jacqueline A., Franke, Sigrid K., Hofman, Sam, Langermans, Jan A. M. (2019) · Scientific Reports

Neurological compensatory mechanisms help our brain to adjust to neurodegeneration as in Parkinson's disease. It is suggested that the compensation of the damaged striato-thalamo-cortical circuit is focused on the intact thalamo-rubro-cerebellar pathway as seen during presymptomatic Parkinson, paradoxical movement and sensorimotor rhythm (SMR). Indeed, the size of the red nucleus, connecting the cerebellum with the cerebral cortex, is larger in Parkinson's disease patients suggesting an increased activation of this brain area. Therefore, the red nucleus was examined in MPTP-induced parkinsonian marmoset monkeys during the presymptomatic stage and after SMR activation by neurofeedback training. We found a reverse significant correlation between the early expression of parkinsonian signs and the size of the parvocellular part of the red nucleus, which is predominantly present in human and non-human primates. In quadrupedal animals it consists mainly of the magnocellular part. Furthermore, SMR activation, that mitigated parkinsonian signs, further increased the size of the red nucleus in the marmoset monkey. This plasticity of the brain helps to compensate for dysfunctional movement control and can be a promising target for compensatory treatment with neurofeedback technology, vibrotactile stimulation or DBS in order to improve the quality of life for Parkinson's disease patients.

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Neurofeedback Control in Parkinsonian Patients Using Electrocorticography Signals Accessed Wirelessly With a Chronic, Fully Implanted Device

Khanna, Preeya, Swann, Nicole C., de Hemptinne, Coralie, Miocinovic, Svjetlana, Miller, Andrew, Starr, Philip A., Carmena, Jose M. (2017) · IEEE transactions on neural systems and rehabilitation engineering: a publication of the IEEE Engineering in Medicine and Biology Society

Parkinson's disease (PD) is characterized by motor symptoms such as rigidity and bradykinesia that prevent normal movement. Beta band oscillations (13-30 Hz) in neural local field potentials (LFPs) have been associated with these motor symptoms. Here, three PD patients implanted with a therapeutic deep brain neural stimulator that can also record and wirelessly stream neural data played a neurofeedback game where they modulated their beta band power from sensorimotor cortical areas. Patients' beta band power was streamed in real-time to update the position of a cursor that they tried to drive into a cued target. After playing the game for 1-2 hours each, all three patients exhibited above chance-level performance regardless of subcortical stimulation levels. This study, for the first time, demonstrates using an invasive neural recording system for at-home neurofeedback training. Future work will investigate chronic neurofeedback training as a potentially therapeutic tool for patients with neurological disorders.

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