Effects of motor imagery based brain-computer interface on upper limb function and attention in stroke patients with hemiplegia: A randomized controlled trial

Objective: To investigate the effects of motor imagery-based brain-computer interface training (MI-BCI) on upper limb function and attention in stroke patients with hemiplegia . Methods: : Stroke patients with impairment of upper extremity function and decreased attention were randomly assigned to the conventional rehabilitation group or the BCI group (1:1 ratio). BCI group performed 20 minutes of MI-BCI training five times a week for 3 weeks (15 sessions) in addition to conventional rehabilitation. The primary outcome measures were the changes in Fugl-Meyer Motor Function Assessment for Upper Extremities (FMA-UE) and Attention Network Test (ANT) from baseline to 3 weeks. Results: : A total of 60 people participated in the study, and about 93% of the patients completed the allocated training. Compared with the conventional rehabilitation group, among those in the BCI group, FMA-UE was increased by 8.0 points (95%CI, 5.0 to 10.0; P <0.001). Alert network response time (32.4ms; 95%CI, 58.4 to 85.6; P <0.001), orienting network response (5.6ms; 95%CI, 29.8 to 55.8; P =0.010), and corrects number (8.0; 95%CI, 17.0 to 28.0; P <0.001) also increased in the BCI group compared with the conventional rehabilitation group. Additionally, the executive control network response time (-105.9ms; 95%CI, -68.3 to -23.6; P =0.002), the total average response time (-244.8ms; 95%CI, -155.8 to -66.2; P =0.002), and total time (-122.0ms; 95%CI, -80.0 to -35.0; P =0.001) were reduced in the BCI group compared with the conventional rehabilitation group. Conclusion: MI-BCI combined with conventional rehabilitation training could better enhance upper limb motor function and attention in stroke patients. This training method may be feasible and suitable for individuals with stroke. Trial registration This study was registered in the Chinese Clinical Trial Registry with Portal Number ChiCTR2100050430(27/08/2021).