Assessing the Effects of DBS-Neurofeedback for Parkinson’s Disease Through IMU-Based UPDRS Movement Quality Metrics

Assessing the Effects of DBS-Neurofeedback for Parkinson’s Disease Through IMU-Based UPDRS Movement Quality Metrics | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Assessing the Effects of DBS-Neurofeedback for Parkinson’s Disease Through IMU-Based UPDRS Movement Quality Metrics Lena Salzmann, Oliver Bichsel, Manabu Rohr-Fukuma, Aileen C. Naef, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6668946/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 27 Nov, 2025 Read the published version in Scientific Reports → Version 1 posted 11 You are reading this latest preprint version Abstract Parkinson’s disease (PD) is characterized by progressive motor impairments, including lower-limb dysfunction, leading to reduced mobility and increased fall risk. To counteract these deficits, neurofeedback based on deep brain stimulation (DBS) electrodes has been proposed as a novel approach to mitigate motor symptoms via modulation of abnormal beta-oscillations in the subthalamic nucleus. However, its potential to improve motor symptoms has yet to be fully established. This study examined whether a single session of DBS-based neurofeedback could have a short term effect on movement quality, quantified through inertial measurement unit recordings. Ten PD patients performed two standardized motor tasks, foot stomping and hand pronation-supination, from the Unified Parkinson’s Disease Rating Scale. Movement quality metrics from inertial measurement units were extracted and compared before and after neurofeedback-induced beta-power downregulation. Beta-power was successfully reduced by -12.42% on average, and the reduction was associated with significant improvements in lower limb movement quality metrics, including acceleration magnitude (p = 0.037), movement speed (steps per second: p = 0.010; mean peak velocity: p = 0.002), and reduced halts (p = 0.020). No significant improvements were observed in upper limb movements. These findings indicate that neurofeedback‑driven downregulation of beta-power produces measurable enhancements in movement quality, captured through wearable sensor metrics. Future work should assess whether these improvements translate into lasting functional benefits and validate the clinical relevance of these metrics. Biological sciences/Neuroscience/Motor control Biological sciences/Neuroscience/Diseases of the nervous system/Parkinsons disease Health sciences/Medical research/Translational research Full Text Additional Declarations Competing interest reported. Imbach received honoraria for lectures or advisory board participation or consulting from UCB, Eisai, and Medtronic. Bichsel receives funding from the Prof. Dr. Max Cloëtta Foundation. Cite Share Download PDF Status: Published Journal Publication published 27 Nov, 2025 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 23 Jul, 2025 Reviews received at journal 23 Jun, 2025 Reviewers agreed at journal 23 Jun, 2025 Reviewers agreed at journal 23 Jun, 2025 Reviews received at journal 20 Jun, 2025 Reviewers agreed at journal 09 Jun, 2025 Reviewers invited by journal 08 Jun, 2025 Editor assigned by journal 06 Jun, 2025 Editor invited by journal 02 Jun, 2025 Submission checks completed at journal 30 May, 2025 First submitted to journal 15 May, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6668946","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":462846756,"identity":"23f0c6e3-7ef3-410b-a0db-9b41c06c0b23","order_by":0,"name":"Lena Salzmann","email":"data:image/png;base64,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","orcid":"","institution":"Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, 8092, Switzerland","correspondingAuthor":true,"prefix":"","firstName":"Lena","middleName":"","lastName":"Salzmann","suffix":""},{"id":462846757,"identity":"12bf1461-c5ab-43ee-b97f-32cbfbc15350","order_by":1,"name":"Oliver Bichsel","email":"","orcid":"","institution":"Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, 8091, Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Oliver","middleName":"","lastName":"Bichsel","suffix":""},{"id":462846758,"identity":"8ec3356b-a782-4af8-90d2-cebe2ec6e3e6","order_by":2,"name":"Manabu Rohr-Fukuma","email":"","orcid":"","institution":"Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, 8091, Switzerland","correspondingAuthor":false,"prefix":"","firstName":"Manabu","middleName":"","lastName":"Rohr-Fukuma","suffix":""},{"id":462846759,"identity":"8f5cbd93-15b2-4d27-83d9-40fa3d0defb9","order_by":3,"name":"Aileen C. 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Imbach received honoraria for lectures or advisory board participation or consulting from UCB, Eisai, and Medtronic. Bichsel\nreceives funding from the Prof. Dr. Max Cloëtta Foundation.","formattedTitle":"Assessing the Effects of DBS-Neurofeedback for Parkinson’s Disease Through IMU-Based UPDRS Movement Quality Metrics","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6668946/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6668946/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"Parkinson’s disease (PD) is characterized by progressive motor impairments, including lower-limb dysfunction, leading to reduced mobility and increased fall risk. To counteract these deficits, neurofeedback based on deep brain stimulation (DBS) electrodes has been proposed as a novel approach to mitigate motor symptoms via modulation of abnormal beta-oscillations in the subthalamic nucleus. However, its potential to improve motor symptoms has yet to be fully established. This study examined whether a single session of DBS-based neurofeedback could have a short term effect on movement quality, quantified through inertial measurement unit recordings. Ten PD patients performed two standardized motor tasks, foot stomping and hand pronation-supination, from the Unified Parkinson’s Disease Rating Scale. Movement quality metrics from inertial measurement units were extracted and compared before and after neurofeedback-induced beta-power downregulation. Beta-power was successfully reduced by -12.42% on average, and the reduction was associated with significant improvements in lower limb movement quality metrics, including acceleration magnitude (p = 0.037), movement speed (steps per second: p = 0.010; mean peak velocity: p = 0.002), and reduced halts (p = 0.020). No significant improvements were observed in upper limb movements. These findings indicate that neurofeedback‑driven downregulation of beta-power produces measurable enhancements in movement quality, captured through wearable sensor metrics. 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