Motor imagery-based brain-computer interface training for post-stroke upper limb dysfunction: systematic review and...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Motor imagery-based brain-computer interfaces (MI-BCI) leverage electroencephalographic signals for controlling external devices.
• MI-BCI shows promise in clinical trials for aiding upper limb recovery after stroke.
• Post-stroke hemiplegia presents significant challenges for upper limb motor function.

Purpose of the Study:

• To systematically evaluate the effectiveness of MI-BCI on upper limb motor function in post-stroke hemiplegia patients.
• To synthesize current evidence on MI-BCI's impact on various aspects of motor function.
• To identify areas where MI-BCI shows significant benefits and limitations.

Main Methods:

• A systematic review and meta-analysis were conducted.
• Searched major databases (PubMed, Cochrane, Web of Science, Embase) through March 2026.
• Included randomized controlled trials assessing MI-BCI for upper limb motor impairments post-stroke.

Main Results:

• 24 studies with 846 participants were included in meta-analyses.
• MI-BCI training demonstrated statistically significant improvements in isolated limb movement and fine motor control.
• Specific improvements noted in Fugl-Meyer Assessment (s.m.d. 0.31) and Wolf Motor Function Test (s.m.d. 0.45).

Conclusions:

• MI-BCI training effectively enhances upper limb motor function, especially isolated movements and fine motor skills, in stroke survivors.
• Current evidence does not show significant effects of MI-BCI on complex activities, daily living, or spasticity.
• Heterogeneity in control groups prevents definitive conclusions on MI-BCI's superiority over traditional rehabilitation.