Background Hand rehabilitation is core to helping stroke survivors regain activities of daily living. Recent studies have suggested that the use of electroencephalography-based brain-computer interfaces (BCI) can promote this process. Here, we report the first systematic examination of the literature on the use of BCI-robot systems for the rehabilitation of fine motor skills associated with hand movement and profile these systems from a technical and clinical perspective. Methods A search for January 2010–October 2019 articles using Ovid MEDLINE, Embase, PEDro, PsycINFO, IEEE Xplore and Cochrane Library databases was performed. The selection criteria included BCI-hand robotic systems for rehabilitation at different stages of development involving tests on healthy participants or people who have had a stroke. Data fields include those related to study design, participant characteristics, technical specifications of the system, and clinical outcome measures. Results 30 studies were identified as eligible for qualitative review and among these, 11 studies involved testing a BCI-hand robot on chronic and subacute stroke patients. Statistically significant improvements in motor assessment scores relative to controls were observed for three BCI-hand robot interventions. The degree of robot control for the majority of studies was limited to triggering the device to perform grasping or pinching movements using motor imagery. Most employed a combination of kinaesthetic and visual response via the robotic device and display screen, respectively, to match feedback to motor imagery. Conclusion 19 out of 30 studies on BCI-robotic systems for hand rehabilitation report systems at prototype or pre-clinical stages of development. We identified large heterogeneity in reporting and emphasise the need to develop a standard protocol for assessing technical and clinical outcomes so that the necessary evidence base on efficiency and efficacy can be developed.

Objectives:Sleep disturbance is often associated with migraine. However, there is a paucity of research investigating objective and subjective measures of sleep in migraine patients. This meta-analysis aims to determine whether there are differences in subjective sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI), and objective sleep architecture measured using polysomnography between adult and pediatric patients, and healthy controls.Methods:This review was pre-registered on PROSPERO (CRD42020209325). A systematic search of five databases (Embase, MEDLINE®, Global Health, APA PsycINFO, APA PsycArticles, last searched: 12/17/2020) was conducted to find case-controlled studies which measured polysomnography and/or PSQI in patients with migraine. Pregnant participants and those with other headache disorders were excluded. Effect sizes (Hedges’ g) were entered into a random effects model meta-analysis. Study quality was evaluated with the Newcastle Ottawa Scale, and publication bias with Egger’s regression test.Results:32 studies were eligible, of which 21 measured PSQI and/MIDAS in adults, 6 measured PSG in adults and 5 in children. The overall mean study quality score was 5/9, and this did not moderate any of the results, and there was no risk of publication bias. Overall, adults with migraine had higher PSQI scores than healthy controls (g=0.75, p < .001, 95% confidence interval [95%CI]: 0.54 - 0.96). This effect was larger in those with chronic rather than episodic condition (g=1.03, p < .001, 95%CI: 0.37 - 1.01, g = 0.63, p < .001, 95%CI: 0.38 - 0.88 respectively). For polysomnographic studies, adults and children with migraine displayed a lower percentage of REM sleep (g=-0.22, p = 0.017, 95%CI: -0.41 - -0.04, g = -0.71, p = 0.025, 95%CI: -1.34 - -0.10 respectively) than controls. Pediatric patients displayed less total sleep time (g=-1.37, p = 0.039, 95%CI: -2.66 - -0.10), more wake (g=0.52, p < .001, 95%CI: 0.08 – 0.79) and shorter sleep onset latency (g=-0.37, p < .001, 95%CI: -0.54 - -0.21) than controls.Discussion:People with migraine have significantly poorer subjective sleep quality and altered sleep architecture compared to healthy individuals. Further longitudinal empirical studies are required to enhance our understanding of this relationship.