Toward Brain-Computer Interface motor rehabilitation for people with Multiple Sclerosis

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Multiple Sclerosis (MS) is a chronic neurodegenerative disease impacting myelin, leading to symptoms like pain, fatigue, cognitive issues, and mobility loss.
• Current MS treatments aim to slow progression and manage symptoms, but a cure remains elusive.
• A preliminary study explored a novel intervention for people with MS (pwMS) to address gait impairments.

Purpose of the Study:

• To evaluate the efficacy of a motor-imagery brain-computer interface (MI-BCI) combined with functional electrical stimulation (FES) and virtual reality for improving gait in pwMS.
• To assess the durability of treatment effects up to six months post-intervention.

Main Methods:

• A single-arm, preliminary study enrolled 26 pwMS, with 24 completing 30 MI-BCI + FES sessions.
• Outcomes including walking endurance (6-minute walking test), mobility/speed (TUG, T25FW), spasticity (MAS), and patient-reported outcomes (MSIS-29, MFIS) were assessed at baseline, post-treatment, and follow-up (up to 37 weeks).
• Statistical analysis used mixed models for repeated measures to analyze changes from baseline.

Main Results:

• Significant improvements were observed in walking endurance (37.3m increase on 6MWT, p < 0.001), exceeding the minimal clinically important difference.
• Mobility and speed showed significant improvements (TUG and T25FW times decreased by -15.5% and -16.4%, respectively, p < 0.001).
• Spasticity decreased by approximately 1 point on the MAS scale, and patient-reported outcomes improved significantly (MSIS-29: 10.18 points, MFIS: 7.29 points), with benefits sustained for 6 months.

Conclusions:

• The MI-BCI + FES system demonstrated statistically significant and clinically meaningful improvements in gait, mobility, spasticity, and patient-reported outcomes in pwMS.
• These positive effects were sustained for up to six months after the intervention period.
• The findings suggest this novel intervention is a promising, hypothesis-generating approach for MS rehabilitation.