Brain–Computer Interface Improves Symptoms of Isolated Focal Laryngeal Dystonia: A Single‐Blind Study

Abstract Background and objective Laryngeal dystonia (LD) is a focal task‐specific dystonia, affecting speaking but not whispering or emotional vocalizations. Therapeutic options for LD are limited. We developed and tested a non‐invasive, closed‐loop, neurofeedback, brain–computer interface (BCI) intervention for LD treatment. Methods Ten patients with isolated focal LD participated in the study. The personalized BCI system included visual neurofeedback of individual real‐time electroencephalographic (EEG) activity during symptomatic speaking compared to asymptomatic whispering, presented in the virtual reality (VR) environment of real‐life scenarios. During five consecutive days of intervention, patients used the BCI to learn to modulate their abnormally increased brain activity during speaking and match it to near‐normal activity of asymptomatic whispering. Changes in voice symptoms and EEG activity were quantified for the evaluation of BCI effects. Results Compared to baseline, LD patients had a statistically significant reduction of their voice symptoms on Days 1–5 of BCI intervention. Thi was paralleled by improved controllability of the visual neurofeedback and a significant reduction of left frontal delta power, including superior and middle frontal gyri, on Day 1 and left central gamma power, including premotor, primary sensorimotor, and inferior parietal areas, on Days 3 and 5. The majority of patients (70%) reported sustained positive effects of the BCI intervention on their voice quality 1 week after the study participation. Conclusion The closed‐loop BCI neurofeedback intervention specifically targeting disorder pathophysiology shows significant potential as a novel treatment option for patients with LD and likely other forms of task‐specific focal dystonia. © 2025 International Parkinson and Movement Disorder Society.