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XR-integrated brain-computer interfaces for augmentative and alternative communication: a systematic review
Peiran Zhang1, Petra Karlsson2,3, Darryl Chiu2,3
1Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Frontiers in Human Neuroscience
|July 30, 2026
Summary
Immersive extended reality (XR) integrated with brain-computer interfaces (BCIs) shows potential for augmentative and alternative communication (AAC). However, current evidence is limited, with usability challenges for BCI-based AAC systems.
Area of Science:
- Assistive Technology
- Neurotechnology
- Human-Computer Interaction
Background:
- Communication is a fundamental right, with technology advancing augmentative and alternative communication (AAC) possibilities.
- Immersive technologies like virtual, augmented, and mixed reality (XR) offer new avenues for communication.
- Brain-computer interfaces (BCIs) present a potential pathway for individuals with severe communication impairments.
Purpose of the Study:
- To systematically review the integration of XR with BCIs for AAC.
- To evaluate the existing evidence on the usefulness and usability of such integrated systems.
Main Methods:
- Searches conducted in five databases, with searches completed on June 30, 2021, and November 18, 2025.
- Inclusion of two eligible studies with heterogeneous methodologies.
- Analysis of distinct integration pathways: P300 speller and wearable mixed-reality AAC.
Main Results:
- Limited evidence base with two distinct integration pathways identified.
- P300 speller in XR showed comparable performance to conventional displays.
- Wearable XR AAC: non-BCI (eye-gaze) was more usable than BCI-based access, which remained challenging.
- Immersive XR platforms can technically support BCI-mediated interaction for communication.
Conclusions:
- Current evidence on BCI-enabled immersive AAC is sparse and heterogeneous.
- Usability and usefulness vary significantly based on application and evaluation.
- Further research is needed to prioritize design and evaluation for practical BCI-enabled immersive AAC implementation.
