---
title: "Neurofeedback with Implanted DBS Electrodes in Parkinson’s Disease: Multi-Day Explorative Study"
id: "pubmed-42342023"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42342023"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42342023/"
doi: "10.1016/j.neuroscience.2026.06.016"
published_at: "2026-09-11T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Neurofeedback with Implanted DBS Electrodes in Parkinson’s Disease: Multi-Day Explorative Study
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42342023
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42342023/)
- **DOI:** [10.1016/j.neuroscience.2026.06.016](https://doi.org/10.1016%2Fj.neuroscience.2026.06.016)
- **Published At:** 2026-09-11T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This study explored multi-day **neurofeedback** delivered via a fully implanted **deep brain stimulation (DBS)** system in patients with **Parkinson’s disease (PD)**, using beta-band activity recorded from the **subthalamic nucleus (STN)** as the feedback signal. - Eight patients with PD participated in three separate neurofeedback sessions conducted on different days; tasks required both downregulation and upregulation of beta power (13–35 Hz; two exceptions at 12.7 Hz and 8.78 Hz). - Neurofeedback produced a significant reduction in beta power in the first and third sessions; the second session showed a less pronounced regulation effect. - Exploratory analyses associated increased dopaminergic medication with worse downregulation performance, whereas active stimulation improved the ability to downregulate beta power. - Neurofeedback targeting beta oscillations also induced changes in **gamma** power, suggesting pro-kinetic electrophysiological effects linked to the intervention. - The study demonstrated feasibility of multi-day, fully implanted DBS-guided neurofeedback but did not find a significant cumulative improvement across sessions. - Authors note limitations inherent to exploratory design and recommend improving the experimental setup and testing longer or outpatient training periods with implanted-electrode-guided neurofeedback. - Key technical and clinical terms: **beta oscillations**, **subthalamic nucleus**, **implanted DBS system**, down-/upregulation tasks, and medication/stimulation as potential modulators of neurofeedback performance.
## Clinical Analysis & Structured Key Points
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Epub 2026 Jun 24. # Explorative investigation on effects of multi-day neurofeedback with implanted electrodes in patients with Parkinson's disease [Manabu Rohr-Fukuma](https://pubmed.ncbi.nlm.nih.gov/?term=Rohr-Fukuma+M&cauthor_id=42342023)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#full-view-affiliation-1 "Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: manabu.rohr@usz.ch."), [Lennart H Stieglitz](https://pubmed.ncbi.nlm.nih.gov/?term=Stieglitz+LH&cauthor_id=42342023)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#full-view-affiliation-2 "Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland."), [Bartosz Bujan](https://pubmed.ncbi.nlm.nih.gov/?term=Bujan+B&cauthor_id=42342023)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#full-view-affiliation-3 "Neurorehabilitation, Klinik Lengg, Switzerland."), [Lukas L Imbach](https://pubmed.ncbi.nlm.nih.gov/?term=Imbach+LL&cauthor_id=42342023)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#full-view-affiliation-4 "Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Swiss Epilepsy Center, Klinik Lengg, Switzerland; Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland."), [Roger Gassert](https://pubmed.ncbi.nlm.nih.gov/?term=Gassert+R&cauthor_id=42342023)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#full-view-affiliation-5 "Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland."), [Oliver Bichsel](https://pubmed.ncbi.nlm.nih.gov/?term=Bichsel+O&cauthor_id=42342023)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#full-view-affiliation-6 "Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland.") Affiliations Expand ### Affiliations * 1 Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: manabu.rohr@usz.ch. * 2 Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. * 3 Neurorehabilitation, Klinik Lengg, Switzerland. * 4 Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Swiss Epilepsy Center, Klinik Lengg, Switzerland; Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland. * 5 Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland. * 6 Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland. * PMID: **42342023** * DOI: [ 10.1016/j.neuroscience.2026.06.016 ](https://doi.org/10.1016/j.neuroscience.2026.06.016) Free article Item in Clipboard # Explorative investigation on effects of multi-day neurofeedback with implanted electrodes in patients with Parkinson's disease Manabu Rohr-Fukuma et al. Neuroscience. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Neuroscience Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Neuroscience%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Neuroscience%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42342023/) . 2026 Sep 11:611:196-205. doi: 10.1016/j.neuroscience.2026.06.016. Epub 2026 Jun 24. ### Authors [Manabu Rohr-Fukuma](https://pubmed.ncbi.nlm.nih.gov/?term=Rohr-Fukuma+M&cauthor_id=42342023)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#short-view-affiliation-1 "Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: manabu.rohr@usz.ch."), [Lennart H Stieglitz](https://pubmed.ncbi.nlm.nih.gov/?term=Stieglitz+LH&cauthor_id=42342023)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#short-view-affiliation-2 "Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland."), [Bartosz Bujan](https://pubmed.ncbi.nlm.nih.gov/?term=Bujan+B&cauthor_id=42342023)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#short-view-affiliation-3 "Neurorehabilitation, Klinik Lengg, Switzerland."), [Lukas L Imbach](https://pubmed.ncbi.nlm.nih.gov/?term=Imbach+LL&cauthor_id=42342023)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#short-view-affiliation-4 "Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Swiss Epilepsy Center, Klinik Lengg, Switzerland; Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland."), [Roger Gassert](https://pubmed.ncbi.nlm.nih.gov/?term=Gassert+R&cauthor_id=42342023)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#short-view-affiliation-5 "Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland."), [Oliver Bichsel](https://pubmed.ncbi.nlm.nih.gov/?term=Bichsel+O&cauthor_id=42342023)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42342023/#short-view-affiliation-6 "Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland.") ### Affiliations * 1 Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: manabu.rohr@usz.ch. * 2 Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland. * 3 Neurorehabilitation, Klinik Lengg, Switzerland. * 4 Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Swiss Epilepsy Center, Klinik Lengg, Switzerland; Neural Control of Movement Lab, Department of Health Sciences and Technology, ETH Zurich, Switzerland. * 5 Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland. * 6 Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland. * PMID: **42342023** * DOI: [ 10.1016/j.neuroscience.2026.06.016 ](https://doi.org/10.1016/j.neuroscience.2026.06.016) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Neurofeedback, which consists of recording and visualizing neural activity in real-time, is a method currently being investigated as a supplementary treatment for Parkinson's disease (PD). By using implanted deep brain stimulation (DBS) electrodes with interleaved sensing capability, previous studies have demonstrated the efficacy of neurofeedback based on beta oscillations in the basal ganglia. Herein, for the first time, we explored short-term neurofeedback ability over the course of multiple sessions with a fully implanted DBS system. Eight patients with PD participated in the study. Neurofeedback was established with a fully internalized DBS system using beta oscillations (13-35 Hz, exceptions at 12.7 Hz and 8.78 Hz) from the subthalamic nucleus as visual feedback. Down- and upregulation tasks were performed. Three sessions were conducted on separate days. Neurofeedback induced a significant decline in beta power in the first and third session, while the regulation ability was less pronounced in the second session. In an explorative analysis, an increase in dopaminergic medication induced deterioration of downregulation performance, while stimulation improved the downregulation ability. Changes in the power of gamma oscillations were also induced through beta oscillation neurofeedback, further implying pro-kinetic changes through neurofeedback. This study demonstrated the feasibility of multiple sessions of neurofeedback training with a fully implanted DBS system over several days, however a significant improvement over the cumulative sessions remained absent. Our explorative investigation on possible influencing factors indicates potential improvements of the experimental setup and motivates the use of DBS electrode-guided neurofeedback over extended periods and possibly in an outpatient setting. **Keywords:** Deep brain stimulation; Movement disorder; Neurofeedback; Neurophysiology; Parkinson disease; Subthalamic Nucleus. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ## Similar articles * [ Real-Time Neurofeedback to Modulate β-Band Power in the Subthalamic Nucleus in Parkinson's Disease Patients. ](https://pubmed.ncbi.nlm.nih.gov/30627648/) Fukuma R, Yanagisawa T, Tanaka M, Yoshida F, Hosomi K, Oshino S, Tani N, Kishima H.Fukuma R, et al.eNeuro. 2018 Dec 21;5(6):ENEURO.0246-18.2018. doi: 10.1523/ENEURO.0246-18.2018. eCollection 2018 Nov-Dec.eNeuro. 2018.PMID: 30627648Free PMC article. * [ Lower limb motor effects of DBS neurofeedback in Parkinson's disease assessed through IMU-based UPDRS movement quality metrics. ](https://pubmed.ncbi.nlm.nih.gov/41310106/) Salzmann L, Bichsel O, Rohr-Fukuma M, Naef AC, Stieglitz L, Oertel MF, Bujan B, Jedrysiak P, Lambercy O, Imbach LL, Gassert R.Salzmann L, et al.Sci Rep. 2025 Nov 27;15(1):44579. doi: 10.1038/s41598-025-28378-8.Sci Rep. 2025.PMID: 41310106Free PMC article. * [ Modulation of Cerebellar Oscillations with Subthalamic Stimulation in Patients with Parkinson's Disease. ](https://pubmed.ncbi.nlm.nih.gov/39331106/) Bosch TJ, Cole RC, Vuong SM, Flouty O, Singh A.Bosch TJ, et al.J Parkinsons Dis. 2024;14(7):1417-1426. doi: 10.3233/JPD-240065.J Parkinsons Dis. 2024.PMID: 39331106Free PMC article. * [ Sixty-hertz stimulation improves bradykinesia and amplifies subthalamic low-frequency oscillations. ](https://pubmed.ncbi.nlm.nih.gov/27859579/) Blumenfeld Z, Koop MM, Prieto TE, Shreve LA, Velisar A, Quinn EJ, Trager MH, Brontë-Stewart H.Blumenfeld Z, et al.Mov Disord. 2017 Jan;32(1):80-88. doi: 10.1002/mds.26837. Epub 2016 Nov 8.Mov Disord. 2017.PMID: 27859579Review. * [ Towards therapeutic electrophysiological neurofeedback in Parkinson's disease. ](https://pubmed.ncbi.nlm.nih.gov/38245382/) Ubeda Matzilevich E, Daniel PL, Little S.Ubeda Matzilevich E, et al.Parkinsonism Relat Disord. 2024 Apr;121:106010. doi: 10.1016/j.parkreldis.2024.106010. Epub 2024 Jan 14.Parkinsonism Relat Disord. 2024.PMID: 38245382Review. 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