Non-invasive brain-computer interfaces effectively improve motor function, sensory function, and activities of daily living in patients with spinal cord injury: a systematic review and meta-analysis

Abstract

After spinal cord injury (SCI), severe motor, sensory, and autonomic dysfunction of the limbs below the injury level occurs, significantly reducing the patient’s ability to perform activities of daily living (ADL) and quality of life. Brain-computer interface (BCI), as a new rehabilitation intervention, can extract brain signals, bypass the diseased segments, and translate them into commands to control external devices to restore the sensory and motor functions of SCI. However, the current high-quality research evidence for BCI treatment of SCI is insufficient, so this review aims to evaluate the effectiveness and feasibility of non-invasive BCI training for improving motor, sensory, and ADL in patients with SCI. The BCI-related trial literature was retrieved from seven databases (PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, WanFang database, and China Scientific Journals Full Text Database). A total of seven studies (n = 102 patients with SCI) were included for meta-analysis using a fixed-effect model, with effect sizes reported as standardized mean differences. BCI training effectively improve motor function in patients with SCI, especially those in the subacute phase, but to no significant effect in patients with chronic phase. Moreover, the treatment effect of BCI is better when the number of interventions is less than 30 times and a single session lasting longer than 60 minutes is more effective. BCI intervention also showed a positive impact for sensory function and ADL on patients with SCI, and improved quality of life in SCI patients. As a rehabilitation method, BCI has been proven to be effective in improving the motor function of patients with SCI. This provides more choices in future rehabilitation protocols for SCI.