EEG-based sensorimotor neurofeedback for motor neurorehabilitation in children and adults: A scoping review
Elena Cioffi1, Anna Hutber1, Rob Molloy2
1Department of Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Paediatric Neurosciences, Evelina London Children's Hospital, London, UK.
Objective:
Therapeutic interventions for children and young people with dystonia and dystonic/dyskinetic cerebral palsy are limited. EEG-based neurofeedback is emerging as a neurorehabilitation tool. This scoping review maps research investigating EEG-based sensorimotor neurofeedback in adults and children with neurological motor impairments, including augmentative strategies.
Methods:
MEDLINE, CINAHL and Web of Science databases were searched up to 2023 for relevant studies. Study selection and data extraction were conducted independently by at least two reviewers.
Results:
Of 4380 identified studies, 133 were included, only three enrolling children. The most common diagnosis was adult-onset stroke (77%). Paradigms mostly involved upper limb motor imagery or motor attempt. Common neurofeedback modes included visual, haptic and/or electrical stimulation. EEG parameters varied widely and were often incompletely described. Two studies applied augmentative strategies. Outcome measures varied widely and included classification accuracy of the Brain-Computer Interface, degree of enhancement of mu rhythm modulation or other neurophysiological parameters, and clinical/motor outcome scores. Few studies investigated whether functional outcomes related specifically to the EEG-based neurofeedback.
Conclusions:
There is limited evidence exploring EEG-based sensorimotor neurofeedback in individuals with movement disorders, especially in children. Further clarity of neurophysiological parameters is required to develop optimal paradigms for evaluating sensorimotor neurofeedback.
Significance:
The expanding field of sensorimotor neurofeedback offers exciting potential as a non-invasive therapy. However, this needs to be balanced by robust study design and detailed methodological reporting to ensure reproducibility and validation that clinical improvements relate to induced neurophysiological changes.
