Academic Journal
Brain-computer interface for post-stroke upper-limb recovery: a systematic review integrating clinical efficacy with neuroplasticity evidence.
| Τίτλος: | Brain-computer interface for post-stroke upper-limb recovery: a systematic review integrating clinical efficacy with neuroplasticity evidence. |
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| Συγγραφείς: | Wu Y; Department of Sports Science, Zhejiang University, Hangzhou, China.; Physical Education and Sports Science Department, National Institute of Education, Nanyang Technological University, Singapore, Singapore., Zhu F; School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China., Dong Q; School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China., Zhang M; Department of Physical Therapy, The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, China. |
| Πηγή: | Frontiers in neurology [Front Neurol] 2026 Sep 03; Vol. 17, pp. 1895484. Date of Electronic Publication: 2026 Sep 03 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article; Systematic Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Frontiers Research Foundation Country of Publication: Switzerland NLM ID: 101546899 Publication Model: eCollection Cited Medium: Internet ISSN: 1664-2295 (Electronic) Linking ISSN: 16642295 NLM ISO Abbreviation: Front Neurol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Lausanne : Frontiers Research Foundation, 2010]- |
| Ιατρικοί όροι (MeSH): | Stroke Rehabilitation*/methods , Neuronal Plasticity*/physiology , Upper Extremity*/physiopathology , Recovery of Function*/physiology , Stroke*/physiopathology , Stroke*/therapy , Brain-Computer Interfaces*, Humans ; Randomized Controlled Trials as Topic |
| Περίληψη: | Objective: Over 20 systematic reviews have evaluated brain-computer interface (BCI) training for post-stroke upper-limb rehabilitation, but published syntheses have focused predominantly on clinical efficacy, and the neuroplasticity mechanisms remain comparatively underexplored. This review integrates pooled clinical efficacy with a structured synthesis of neuroplasticity evidence from the same trials. Methods: PubMed, Embase, CINAHL via EBSCO, Web of Science, Scopus, and Cochrane CENTRAL were searched from inception to May 2026. Randomized controlled trials (RCTs) of BCI-based training for post-stroke upper-limb recovery were eligible. Two parallel syntheses were conducted. A random-effects meta-analysis pooled mean differences for three upper-limb motor outcomes, RoB 2 risk-of-bias assessment, GRADE certainty-of-evidence grading, and publication-bias diagnostics. Neuroplasticity evidence was synthesized qualitatively following the Synthesis Without Meta-analysis (SWiM) guideline. Results: Thirty-five RCTs (n = 1,188) were included. BCI training improved Fugl-Meyer Assessment-Upper Extremity [FMA-UE; MD = 4.55, 95% CI (2.84, 6.25), P < 0.001], Action Research Arm Test [ARAT; MD = 3.90, 95% CI (1.31, 6.50), P = 0.003], and Wolf Motor Function Test [WMFT; MD = 8.53, 95% CI (3.01, 14.04), P = 0.002]. Comparator type significantly moderated the effect [Q-between(3) = 13.43, P < 0.01], ranging from MD = 6.70 against usual care to MD = 1.97 against sham-contingent controls; stroke stage, signal strategy, and feedback modality did not. Qualitative synthesis of 22 trials identified multi-level neuroplastic changes spanning corticospinal excitability, sensorimotor rhythm modulation, and network reorganization. A subset of studies reported correlations between neuroplastic changes and motor improvement. Conclusion: This systematic review found that BCI-based multimodal rehabilitation improves post-stroke upper-limb motor function, with the estimated effect varying by comparator type. Neuroplasticity outcomes were examined across electrophysiological, hemodynamic, and structural modalities, but the current evidence is too heterogeneous and sparse to support a mechanistic account of recovery. Further research is needed to determine how training-associated neural changes relate to functional improvement. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/view/CRD420251053630, identifier: CRD420251053630. (Copyright © 2026 Wu, Zhu, Dong and Zhang.) |
| Competing Interests: | The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. |
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| Contributed Indexing: | Keywords: brain-computer interface; meta-analysis; neuroplasticity; stroke; upper limb |
| Entry Date(s): | Date Created: 20260918 Date Completed: 20260918 Latest Revision: 20260919 |
| Update Code: | 20260919 |
| PubMed Central ID: | PMC13581672 |
| DOI: | 10.3389/fneur.2026.1895484 |
| PMID: | 42755662 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1664-2295 |
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| DOI: | 10.3389/fneur.2026.1895484 |