Abstract
Neurofeedback training involves presenting an individual with a representation of their brain activity and instructing them to alter the activity using the feedback. One potential application of neurofeedback is for patients to alter neural activity to improve function. For example, there is evidence that greater laterality of movement-related activity is associated with better motor outcomes after stroke; so using neurofeedback to increase laterality may provide a novel route for improving outcomes. However, we must demonstrate that individuals can control relevant neurofeedback signals. Here, we performed two proof-of-concept studies, one in younger (median age: 26years) and one in older healthy volunteers (median age: 67.5years). The purpose was to determine if participants could manipulate laterality of activity between the motor cortices using real-time fMRI neurofeedback while performing simple hand movements. The younger cohort trained using their left and right hand, the older group trained using their left hand only. In both studies participants in a neurofeedback group were able to achieve more lateralized activity than those in a sham group (younger adults: F(1,23)=4.37, p<0.05; older adults: F(1,15)=9.08, p<0.01). Moreover, the younger cohort was able to maintain the lateralized activity for right hand movements once neurofeedback was removed. The older cohort did not maintain lateralized activity upon feedback removal, with the limitation being that they did not train with their right hand. The results provide evidence that neurofeedback can be used with executed movements to promote lateralized brain activity and thus is amenable for testing as a therapeutic intervention for patients following stroke.
Highlights
There are a range of neurorehabilitation techniques that have been developed to facilitate motor recovery after stroke such as physiotherapy, motor imagery and noninvasive brain stimulation (Allman et al, 2016; BarclayGoddard et al, 2011; French et al, 2007; Hao et al, 2013; Pollock et al, 2007; Sirtori et al, 2009; Thieme et al, 2013)
The aim of the current study was to determine whether adults can increase the laterality of activation between the motor cortices while executing movements when presented with a visual representation of a laterality index (LI) measured through real-time fMRI (rtfMRI) neurofeedback
We have shown in two different samples, that participants can use a NF signal to control the laterality of their brain activity while executing movements
Summary
There are a range of neurorehabilitation techniques that have been developed to facilitate motor recovery after stroke such as physiotherapy, motor imagery and noninvasive brain stimulation (Allman et al, 2016; BarclayGoddard et al, 2011; French et al, 2007; Hao et al, 2013; Pollock et al, 2007; Sirtori et al, 2009; Thieme et al, 2013). Worse motor function is associated with a more bilateral activation pattern (Johansen-Berg et al, 2002; Ward et al, 2003) rehabilitation interventions that rebalance brain activity to a more lateralized or contralateral pattern may enhance therapy outcomes (Ward and Cohen, 2004). Improvements in motor function with transcranial direct current stimulation (tDCS) are accompanied by increased activity in contralateral (ipsilesional) sensorimotor cortex (Stagg et al, 2012; Allman et al, 2016). An alternative intervention that may promote the lateralization of brain activity and lead to beneficial plasticity following stroke is neurofeedback. The individual can be asked to use this feedback display to alter their brain activity with the aim of inducing plasticity and improved function. There is potential for stroke patients to use neurofeedback training to lateralize brain activity following stroke
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