Brain-Computer Interfaces for upper limb motor rehabilitation of stroke patients

Abstract

Brain-Computer Interfaces (BCI) decode users' intentions from the central nervous system and could be applied for upper limb motor rehabilitation of patients that have suffered stroke, one of the main causes of disability worldwide. Despite that research groups have reported the efficacy of these systems, a consensus has not yet been reached regarding their true potential. For this reason, a review of up-to-date assessments of BCI for upper limb stroke rehabilitation is presented from the perspective of analyzing common and different design variables presented across studies. Clinical and pilot studies with a control group were included in the review. Most BCI interventions assessments were performed with robotic assistive devices as feedback, followed by neuromuscular electrical stimulation (NMES) and visual feedbacks. Compared to other experimental interventions, the effects of a BCI intervention have been reported in a low number of patients. In addition, high variability between studies' designs such as stroke etiology and interventions' duration, do not allow to assess the potential of BCI for stroke rehabilitation. However, a trend towards significant rehabilitation outcomes with BCI systems can be highlighted, encouraging research groups to better coordinate in order to make valuable contributions to the field.

Hemiplegia in acute ischemic stroke: A comprehensive review of case studies and the role of intravenous thrombolysis and mechanical thrombectomy

“…Acute ischemic stroke has been the focus of research on detection, 36,37 effective treatment strategies, 38 and improved recovery 39,40 . Endovascular therapy improves outcomes and recanalizes cerebral arteries; yet, its superiority over standard intravenous tPA for disability‐free survival at 3 months is debated 41 .…”

“…Acute ischemic stroke has been the focus of research on detection, 36 , 37 effective treatment strategies, 38 and improved recovery. 39 , 40 Endovascular therapy improves outcomes and recanalizes cerebral arteries; yet, its superiority over standard intravenous tPA for disability‐free survival at 3 months is debated. 41 Moreover, the study of Fischer et al 42 found that thrombectomy alone was not as effective as the combination of intravenous alteplase plus thrombectomy in achieving successful reperfusion and improving outcomes in patients with acute ischemic stroke.…”

Literature review: User interface of system functional electrical stimulation (FES) and arm robotic rehabilitation

“…The decrease in motor skills reduces quality of life and hinders carrying out life activities. The drop that occurs is influenced by residue in the muscles of the upper limbs [2]. Post-stroke rehabilitation is the main focus in restoring neuromuscular function and restoring independence to stroke sufferers [3].…”

Desarrollo de modelos para evaluación y pronóstico de la recuperación motora de la mano de pacientes con enfermedad vascular cerebral subsecuente a terapia con interfaz cerebro-computadora

“…Esto denota la dificultad de obtener información clínica y fisiológica de pacientes con EVC durante su proceso de recuperación. También muestra la gran dificultad y necesidad de recursos humanos y tecnológicos especializados necesarios para brindar alternativas terapéuticas a pacientes con EVC usando BCI acopladas a sistemas robóticos, ya que se estima que únicamente 111 pacientes con EVC han recibido una intervención con este tipo de sistemas, principalmente en países como China (Hong Kong), Alemania, y Rusia [134]. Sin embargo, también se observa que una muestra de 10 pacientes significaría cerca de un 10% de la muestra total que se ha analizado a nivel global y, por lo tanto, asumiendo las limitaciones correspondientes, puede aportar información de relevancia.…”