Abstract
Abstract

Brain‐computer interfaces (
BCI
s) can provide sensory feedback of ongoing brain oscillations, enabling stroke survivors to modulate their sensorimotor rhythms purposefully. A number of recent clinical studies indicate that repeated use of such
BCI
s might trigger neurological recovery and hence improvement in motor function. Here, we provide a first meta‐analysis evaluating the clinical effectiveness of
BCI
‐based post‐stroke motor rehabilitation. Trials were identified using
MEDLINE
,
CENTRAL
,
PED
ro and by inspection of references in several review articles. We selected randomized controlled trials that used
BCI
s for post‐stroke motor rehabilitation and provided motor impairment scores before and after the intervention. A random‐effects inverse variance method was used to calculate the summary effect size. We initially identified 524 articles and, after removing duplicates, we screened titles and abstracts of 473 articles. We found 26 articles corresponding to
BCI
clinical trials, of these, there were nine studies that involved a total of 235 post‐stroke survivors that fulfilled the inclusion criterion (randomized controlled trials that examined motor performance as an outcome measure) for the meta‐analysis. Motor improvements, mostly quantified by the upper limb Fugl‐Meyer Assessment (
FMA

UE
), exceeded the minimal clinically important difference (
MCID
=5.25) in six
BCI
studies, while such improvement was reached only in three control groups. Overall, the
BCI
training was associated with a standardized mean difference of 0.79 (95%
CI
: 0.37 to 1.20) in
FMA

UE
compared to control conditions, which is in the range of medium to large summary effect size. In addition, several studies indicated
BCI
‐induced functional and structural neuroplasticity at a subclinical level. This suggests that
BCI
technology could be an effective intervention for post‐stroke upper limb rehabilitation. However, more studies with larger sample size are required to increase the reliability of these results.
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References
77
[1]
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[2]
Association S. State of the Nation Stroke Statistics.2016; Available from:https://www.stroke.org.uk/sites/default/files/stroke_statistics_2015.pdf
[5]
Taub E "Constraint‐induced movement therapy: a new family of techniques with broad application to physical rehabilitation–a clinical review" J Rehabil Res Dev (1999)
[16]
Rösser N "Pharmacological enhancement of motor recovery in subacute and chronic stroke" NeuroRehabilitation (2008) 10.3233/nre-2008-23110
[38]
Young BM "Changes in functional connectivity correlate with behavioral gains in stroke patients after therapy using a brain‐computer interface device" Front Neuroengineering (2014)
[44]
Fugl‐Meyer AR "The post‐stroke hemiplegic patient. 1. a method for evaluation of physical performance" Scand J Rehabil Med (1974) 10.2340/1650197771331
[50]
SterneJ.2009.Meta‐Analysis In Stata: An Updated Collection From The Stata Journal. CRC PRESS.

Showing 50 of 77 references

Cited By
473
Journal of Clinical Medicine
Chemical Engineering Journal
CNS Neuroscience & Therapeutics
Advances in Stroke Neurorehabilitation

Muhammed Enes Gunduz, Bilal Bucak · 2023

Journal of Clinical Medicine
Biosensors and Bioelectronics
Interdisciplinary Neurosurgery
Metrics
473
Citations
77
References
Details
Published
Mar 25, 2018
Vol/Issue
5(5)
Pages
651-663
License
View
Funding
Deutsche Forschungsgemeinschaft
European Commission Award: 645322
H2020 European Research Council Award: 759370
Bundesministerium für Bildung und Forschung
Japan Agency for Medical Research and Development
Baden-Württemberg Stiftung Award: NEU007/1
Brain and Behavior Research Foundation
Cite This Article
María A. Cervera, Surjo R. Soekadar, Junichi Ushiba, et al. (2018). Brain‐computer interfaces for post‐stroke motor rehabilitation: a meta‐analysis. Annals of Clinical and Translational Neurology, 5(5), 651-663. https://doi.org/10.1002/acn3.544
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