Multimodal biofeedback for Parkinson’s disease motor and nonmotor symptoms

Parkinson’s disease(PD)is a neurodegenerative disordercharacterized by motor retardation,myotonia,quiescent tremor,and postural gait abnormality,as well as nonmotor symptoms such asanxiety and depression.Biofeedback improves motor and nonmotorfunctions of patients by regulating abnormal electroencephalogram(EEG),electrocardiogram(ECG),photoplethysmography(PPG),electromyography(EMG),respiration(RSP),or other physiologicalsignals.Given that multimodal signals are closely related to PDstates,the clinical effect of multimodal biofeedback on patientswith PD is worth exploring.Twenty-one patients with PD in Beijing Rehabilitation Hospital were enrolled and divided into threegroups:multimodal(EEG,ECG,PPG,and RSP feedback signal),EEG(EEG feedback signal),and sham(random feedback signal),and they received biofeedback training five times in two weeks.The combined clinical scale and multimodal signal analysis resultsrevealed that the EEG group significantly improved motor symptomsand increased Berg balance scale scores by regulatingβband activity;the multimodal group significantly improved nonmotorsymptoms and reduced Hamilton rating scale for depression scores by improvingθband activity.Our preliminary results revealed thatmultimodal biofeedback can improve the clinical symptoms of PD,but the regulation effect on motor symptoms is weaker than that ofEEG biofeedback.