Brain-Computer Interface-Controlled Exoskeleton Training for Lower-Limb Rehabilitation in Spinal Cord Injury: A Pilot...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Spinal cord injury (SCI) significantly impairs lower-limb function and quality of life.
• Conventional rehabilitation offers limited recovery for many SCI patients.
• Novel therapeutic approaches are needed to enhance functional recovery and neural plasticity.

Purpose of the Study:

• To evaluate the efficacy of brain-computer interface (BCI)-controlled exoskeleton training compared to exoskeleton-only training for lower-limb functional recovery in SCI patients.
• To assess the impact on psychological outcomes and neural plasticity.
• To explore BCI-exoskeleton integration as a rehabilitation strategy.

Main Methods:

• A single-center, prospective, randomized, single-blind pilot trial involving 21 SCI patients.
• Participants were assigned to either a BCI-exoskeleton group (B+E) or an exoskeleton-only group (E).
• Both groups underwent 4 weeks of conventional rehabilitation plus 30 minutes of daily training, with outcomes assessed using various functional scales, psychological questionnaires, EEG, and MRI.

Main Results:

• The B+E group showed significant improvements in Lambert-Eaton myasthenic syndrome (LEMS) and greater reductions in anxiety and depression (HADS scores).
• Both groups improved in the International Association of Neurorestoratology Spinal Cord Injury Functional Rating Scale (IANR-SCIFRS).
• EEG revealed enhanced cortical plasticity (μ/β desynchronization, increased network efficiency) in the B+E group, while MRI showed no structural changes.

Conclusions:

• BCI-controlled exoskeleton training demonstrated superior efficacy in enhancing motor function, walking performance, and psychological well-being compared to exoskeleton training alone.
• The observed benefits are likely mediated by enhanced cortical reorganization and plasticity.
• BCI-exoskeleton integration represents a promising and potentially synergistic rehabilitation strategy for individuals with SCI.