A review of the progression and future implications of brain-computer interface therapies for restoration of distal upper extremity motor function after stroke

ABSTRACT

Stroke is a leading cause of acquired disability resulting in distal upper extremity functional motor impairment. Stroke mortality rates continue to decline with advances in healthcare and medical technology. This has led to an increased demand for advanced, personalized rehabilitation. Survivors often experience some level of spontaneous recovery shortly after their stroke event, yet reach a functional plateau after which there is exiguous motor recovery. Nevertheless, studies have demonstrated the potential for recovery beyond this plateau. Non-traditional neurorehabilitation techniques, such as those incorporating the brain-computer interface (BCI), are being investigated for rehabilitation. BCIs may offer a gateway to the brain’s plasticity and revolutionize how humans interact with the world. Non-invasive BCIs work by closing the proprioceptive feedback loop with real-time, multi-sensory feedback allowing for volitional modulation of brain signals to assist hand function. BCI technology potentially promotes neuroplasticity and Hebbian-based motor recovery by rewarding cortical activity associated with sensory-motor rhythms through use with a variety of self-guided and assistive modalities.

KEYWORDS:

• Brain-computer interface
• BCI therapy
• UE motor recovery
• MI
• EEG
• Hebbian-learning
• sensory-motor regions

Declaration of interest

V. Prabhakaran and J. Williams have a pending US patent on the closed-loop neurofeedback used for BCI-facilitated intervention, application number 12/715090. The patent was filed jointly by both V. Prabhakaran and J. Williams. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.