Loss of motor function is a common deficit following
stroke insult and often manifests as persistent upper extremity (UE) disability which can affect a survivor's ability to participate in
activities of daily living. Recent research suggests the use of
brain-computer interface (
BCI) devices might improve UE function in
stroke survivors at various times since
stroke. This randomized crossover-controlled trial examines whether intervention with this
BCI device design attenuates the effects of
hemiparesis, encourages reorganization of motor related brain signals (EEG measured sensorimotor rhythm desynchronization), and improves movement, as measured by the Action Research Arm Test (ARAT). A sample of 21
stroke survivors, presenting with varied times since
stroke and levels of UE impairment, received a maximum of 18-30 h of intervention with a novel electroencephalogram-based
BCI-driven functional electrical stimulator (EEG-
BCI-FES) device. Driven by spectral power recordings from contralateral EEG
electrodes during cued attempted grasping of the hand, the user's input to the EEG-
BCI-FES device modulates horizontal movement of a virtual cursor and also facilitates concurrent stimulation of the impaired UE. Outcome measures of function and capacity were assessed at baseline, mid-
therapy, and at completion of
therapy while EEG was recorded only during intervention sessions. A significant increase in r-squared values [reflecting Mu rhythm (8-12 Hz) desynchronization as the result of attempted movements of the impaired hand] presented post-
therapy compared to baseline. These findings suggest that intervention corresponds with greater desynchronization of Mu rhythm in the ipsilesional hemisphere during attempted movements of the impaired hand and this change is related to changes in behavior as a result of the intervention.
BCI intervention may be an effective way of addressing the recovery of a
stroke impaired UE and studying neuromechanical coupling with motor outputs. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02098265.