Does motor-imagery-contingent BCI feedback help chronic stroke?
In 25 people with chronic stroke, 4 weeks of BCI-FES with MI-contingent feedback improved wrist extensor strength more than matched MI-independent (sham-like) feedback.
Source
Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial
Study at a glance
- Design
- RCT — Double-blinded, parallel-group RCT; 1:1 MI-contingent vs MI-independent BCI-FES; assessors and participants blinded.
- N
- N=25 · 27 chronic-stroke participants enrolled; 2 dropouts; 12 contingent vs 13 independent analyzed.
- Population
- Adults with first-ever chronic hemiplegic stroke (≥6 months), wrist extensor MRC ≤2.
- Outcome
- MRC-WE and AROM-WE plus resting-state EEG connectivity after 20 sessions over 4 weeks.
Structured fields used in claim comparison tables when every cited study has a complete layer.
What they did
Double-blind RCT at one rehab hospital (2020–2022). recoveriX-PRO delivered 20 × 60-min sessions, 5 days/week for 4 weeks. Contingent group got FES/avatar only when EEG detected the correct-hand motor imagery; independent group got three calibration runs with FES regardless of MI.
What they found
MRC-WE improved more with contingent feedback (adjusted mean difference 0.52, 95% CI 0.03–1.00, p=0.036). Within contingent, AROM-WE rose by week 4 (p=0.019). Affected-hemisphere connectivity increased and correlated with MRC-WE and FMA-distal. FMA-total did not favor contingent.
The limits
What it doesn't show
Pilot n=25, single center, no long-term follow-up after W4; FMA-total was not superior, so gains are mainly wrist-level and may not generalize to all upper-limb function or acute stroke.
Key terms
- BCI
- Brain-computer interface translating EEG motor imagery into device feedback such as FES.
- MI-contingent feedback
- FES/avatar fires only when the classifier detects imagery of the instructed hand.
- MI-independent feedback
- Feedback always on during calibration-style runs, uncoupled from correct MI.
- MRC-WE
- Medical Research Council strength grade for the paretic wrist extensor (primary outcome).
- AROM-WE
- Active range of motion in wrist extension (co-primary).
- FES
- Functional electrical stimulation of wrist extensors paired with BCI in recoveriX-PRO.
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Common questions
How many people finished?
25 of 27 (12 contingent, 13 independent); two transferred hospitals.
What was the dose?
20 sessions of 60 minutes, 5 days a week for 4 weeks.
Primary strength result?
MRC-WE +0.52 vs independent feedback (95% CI 0.03–1.00, p=0.036).
Trial registration?
CRIS KCT0009013.
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