Academic Journal
Comparative Effectiveness of Noninvasive Brain-Computer Interface-Based Interventions for Upper Limb Rehabilitation in Poststroke Hemiplegia: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.
| Τίτλος: | Comparative Effectiveness of Noninvasive Brain-Computer Interface-Based Interventions for Upper Limb Rehabilitation in Poststroke Hemiplegia: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. |
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| Συγγραφείς: | Xu J; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259., Gao Y; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259., Xie S; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259., Jiang W; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259., Zhang H; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259., Qiu L; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259., Jiang M; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259., Zhou L; College of Nursing, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China, 86 21-5132-2259.; Key Laboratory of Geriatric Long-term Care, Naval Medical University, Shanghai, China. |
| Πηγή: | Journal of medical Internet research [J Med Internet Res] 2026 Aug 28; Vol. 28, pp. e92940. Date of Electronic Publication: 2026 Aug 28. |
| Τύπος έκδοσης: | Journal Article; Systematic Review; Network Meta-Analysis; Comparative Study; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: JMIR Publications Country of Publication: Canada NLM ID: 100959882 Publication Model: Electronic Cited Medium: Internet ISSN: 1438-8871 (Electronic) Linking ISSN: 14388871 NLM ISO Abbreviation: J Med Internet Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2011- > : Toronto : JMIR Publications Original Publication: [Pittsburgh, PA? : s.n., 1999- |
| Ιατρικοί όροι (MeSH): | Stroke Rehabilitation*/methods , Hemiplegia*/rehabilitation , Hemiplegia*/etiology , Upper Extremity*/physiopathology , Stroke*/complications , Brain-Computer Interfaces*, Humans ; Randomized Controlled Trials as Topic |
| Περίληψη: | Background: Noninvasive brain-computer interface (BCI)-based interventions show promise for poststroke motor recovery. However, the intrinsic complexity of BCI-based interventions limits the determination of their comparative efficacy. Objective: Guided by the International Classification of Functioning, Disability and Health framework, this review evaluated the effectiveness of BCI-based interventions in poststroke upper limb rehabilitation and identify the optimal intervention. Methods: We searched PubMed, Cochrane Library, EBSCOhost, Web of Science, Embase, Wiley Online Library,CNKI, Wanfang, VIP, and SinoMed through July 2026. Randomized controlled trials (RCTs) assessing BCI-based interventions for poststroke upper limb rehabilitation were included. Outcomes were body functions and structures (Fugl-Meyer Assessment of Upper Extremity [FMA-UE]) and activities and participation (Action Research Arm Test [ARAT], Wolf Motor Function Test [WMFT], and Modified Barthel Index [MBI]). Risk of bias was assessed using Cochrane RoB 2, and evidence quality was graded using the Grading of Recommendations, Assessment, Development, and Evaluation framework. We used pairwise meta-analyses to evaluate the overall effectiveness of BCI-based interventions vs controls and network meta-analysis to compare the interventions. Results: Seventy-two RCTs involving 2906 patients with stroke were included, evaluating 12 BCI-based interventions. Pairwise meta-analyses demonstrated that, compared with control groups, BCI-based interventions improved FMA-UE (mean difference [MD] 5.33, 95% CI 4.28 to 6.38; 95% prediction interval [PI] -1.76 to 12.43), ARAT (MD 5.26, 95% CI 3.90 to 6.62; 95% PI 0.41 to 10.11), WMFT (MD 7.25, 95% CI 5.06 to 9.44; 95% PI 0.71 to 13.79), and MBI (MD 8.18, 95% CI 6.04 to 10.32; 95% PI -1.87 to 18.23). Network meta-analysis revealed that BCI-motor imagery-transcutaneous electrical acupoint stimulation (BCI-MI-TEAS) achieved the highest surface under the cumulative ranking curve (SUCRA; 95.5%) in improving FMA-UE. For ARAT, BCI-MI-end-effector robots and transcranial direct current stimulation (tDCS; 86.3%) alongside BCI-MI-TEAS (86.3%) yielded the highest SUCRA. BCI-MI-exoskeleton robot showed the highest SUCRA for WMFT (92.7%), whereas BCI-MI-TEAS (85.3%) and BCI-MI-exoskeleton robot (81.7%) ranked highest for MBI. The evidence quality ranged from very low to high across these interventions. Conclusions: This study represents the first network meta-analysis comparing the efficacy of different BCI-based interventions. Unlike previous reviews, interventions were categorized by experimental paradigms, external feedback devices, and adjunctive noninvasive brain stimulation, to enable clinically meaningful comparisons. Overall, BCI-based interventions significantly improved poststroke upper limb rehabilitation. Among evaluated interventions, BCI-MI-TEAS demonstrated the most performance across body functions, structures, and activities and participation, whereas BCI-MI-end-effector robot + tDCS showed advantages for fine motor dexterity and BCI-MI-exoskeleton robot improved activities of daily living.Given low to moderate evidence certainty and substantial heterogeneity, these findings remain exploratory. High-quality trials are needed to establish the clinical utility of these interventions. (© Jiabin Xu, Yitian Gao, Siqi Xie, Weikang Jiang, Huiqing Zhang, Lin Qiu, Mengxue Jiang, Lanshu Zhou. Originally published in the Journal of Medical Internet Research (https://www.jmir.org).) |
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| Contributed Indexing: | Keywords: brain-computer interface; hemiplegia; network meta-analysis; rehabilitation; stroke; upper limb |
| Entry Date(s): | Date Created: 20260902 Date Completed: 20260902 Latest Revision: 20260914 |
| Update Code: | 20260914 |
| PubMed Central ID: | PMC13524221 |
| DOI: | 10.2196/92940 |
| PMID: | 42684273 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1438-8871 |
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| DOI: | 10.2196/92940 |