Rehabilitation of patients with post-stroke cognitive impairment using the P300-based brain-computer interface: results of a randomized controlled trial

Abstract

To study the effects of a 10-day cognitive training using the brain-computer interface (BCI) technology at the P300 wavelength on the recovery of cognitive functions in poststroke patients. The study included 30 patients, aged 22-82 years, with ischemic stroke less than 3 months old and moderate cognitive impairment (<26 points on the Montreal Cognitive Assessment Scale (MoCA)). All patients underwent neuropsychological testing, assessment of the presence of depression, assessment of activity in daily life. Patients were randomized into two groups: patients of group 1 (main) underwent a 10-day course of cognitive rehabilitation in the form of daily exercises in the BCI environment at the P300 wave equipped with a headset for recording an electroencephalogram (EEG). Patients of group 2 (control) received a standard set of rehabilitation measures. There was an increase in the mean score of the MoCA «Attention» domain in the main group of patients (2.3±1.24 to 5.2±1.16 points) compared with the control group (5.9±1.00 to 4.2±0.94 points, p<0.05). The results of covariance analysis with repeated measures, taking into account the factors «Visit» and «Group», the covariate «Depression» and «Number of training sessions» revealed significant effects for the MoCA domains «Naming» (p<0.05), «Attention» (p<0.05), «Abstraction» (p<0.05). By the end of the 10-day cognitive training using BCI, patients of the main group showed a significant increase in the number of entered letters (20.8±2.01 to 25.9±1.7 characters (p=0.02) compared with the control group (21.9±1.9 to 23.1±1.8, p=0.06). When comparing the number of words entered by patients after 10 days, a significant difference was found between the main and control groups (p<0.05). Rehabilitation of patients with post-stroke cognitive impairment using P300 BCI has a significant positive effect on the restoration of cognitive functions, primarily attention.