Evaluation of Neurofeedback Training in the Treatment of Parkinson's Disease: A Pilot Study

Abstract

We assess the effects of EEG biofeedback training on levodopa-induced dyskinesia (LID) in patients with Parkinson's disease (PD) using a sham feedback controlled study design. Nine subjects were randomized into either a treatment group or control group and underwent 24 sessions of either active feedback training or sham feedback. The training protocol aimed at increasing 8–15 Hz activity while inhibiting excess 4–8 Hz and 23–34 Hz activity at the C3-C4 derivation. There were no statistically significant differences baseline to post-active neurofeedback training as compared to sham feedback training in primary outcome measures assessing change in dyskinesia severity, nor in secondary outcome measures assessing change in clinical features of PD. Nonsignificant trends were observed in subjects’ PD home diaries indicating a decrease in the severity of motor fluctuations. Baseline to post-training comparisons of secondary outcome measures in quantitative EEG analysis showed significant interaction effects within and between frontal and posterior regions, accompanied by decreases in 25–30 Hz (high beta) relative power, cross spectral power and phase resets per second activity, and significant increases in 8–12 Hz (alpha) relative power, cross spectral power, and coherence activity. These results indicate that EEG biofeedback training can affect the spectral EEG topography of individuals with PD and LID and that training to increase 8–15 Hz activity and decrease 23–34 Hz activity may have been associated with a nonsignificant decrease in dyskinesia severity and an improved sense of well-being.

Notes

Note. AIMS = Modified Abnormal Involuntary Movement Scale performed at rest (AIMS Rest) and with cognitive load (AIMS CogLoad); OFF = average number of hours per day “off” medication; ONNODYS = average hours per day “on” medication with no dyskinesia; SOMEDYS = average number of hours per day “on” medication with nontroublesome dyskinesia; TROUBDYS = average hours per day “on” medication with troublesome dyskinesia; H&Y = modified Hoehn and Yahr Staging; UPDRS = Unified Parkinson's Disease Rating Scale (sections I, II, III, IV & TOTAL scores).

^a n = 5.

^b n = 4.

^c n = 9.

Additional information

Notes on contributors

John S. Anderson

John Anderson owns and operates the Minnesota Neurotherapy Institute (St. Louis Park, MN), where he practices as a neurofeedback specialist. He also teaches a 3-day QEEG course once per year sponsored by Stens Corporation, the sole distributor for the EEG systems used in this study. This work was supported by Struthers Parkinson's Center