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Closed-loop brain-machine-body interfaces for noninvasive rehabilitation of movement disorders.

Abstract
Traditional approaches for neurological rehabilitation of patients affected with movement disorders, such as Parkinson's disease (PD), dystonia, and essential tremor (ET) consist mainly of oral medication, physical therapy, and botulinum toxin injections. Recently, the more invasive method of deep brain stimulation (DBS) showed significant improvement of the physical symptoms associated with these disorders. In the past several years, the adoption of feedback control theory helped DBS protocols to take into account the progressive and dynamic nature of these neurological movement disorders that had largely been ignored so far. As a result, a more efficient and effective management of PD cardinal symptoms has emerged. In this paper, we review closed-loop systems for rehabilitation of movement disorders, focusing on PD, for which several invasive and noninvasive methods have been developed during the last decade, reducing the complications and side effects associated with traditional rehabilitation approaches and paving the way for tailored individual therapeutics. We then present a novel, transformative, noninvasive closed-loop framework based on force neurofeedback and discuss several future developments of closed-loop systems that might bring us closer to individualized solutions for neurological rehabilitation of movement disorders.
AuthorsFrédéric D Broccard, Tim Mullen, Yu Mike Chi, David Peterson, John R Iversen, Mike Arnold, Kenneth Kreutz-Delgado, Tzyy-Ping Jung, Scott Makeig, Howard Poizner, Terrence Sejnowski, Gert Cauwenberghs
JournalAnnals of biomedical engineering (Ann Biomed Eng) Vol. 42 Issue 8 Pg. 1573-93 (Aug 2014) ISSN: 1573-9686 [Electronic] United States
PMID24833254 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Review)
Topics
  • Animals
  • Brain (physiology)
  • Feedback, Physiological
  • Humans
  • Movement Disorders (therapy)
  • Neuronal Plasticity

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