Efficacy of brain-computer interfaces on upper extremity motor function rehabilitation after stroke: A systematic review and meta-analysis

Rehabilitation with brain-computer interface and upper limb motor function in ischemic stroke: A randomized controlled trial

BACKGROUND

Upper limb motor dysfunction is a major problem in the rehabilitation of patients with stroke. Brain-computer interface (BCI) is a kind of communication system that converts the "ideas" in the brain into instructions and has been used in stroke rehabilitation. This study aimed to investigate the efficacy and safety of BCI in rehabilitation training on upper limb motor function among patients with ischemic stroke.

METHODS

This was an investigator-initiated, multicenter, randomized, open-label, blank-controlled clinical trial with blinded outcome assessment conducted at 17 centers in China. Patients were assigned in a 1:1 ratio to the BCI group or the control group based on traditional rehabilitation training. The primary efficacy outcome is the difference in improvement of the Fugl-Meyer Assessment upper extremity (FMA-UE) score between two groups at month 1 after randomization. The safety outcomes were any adverse events within 3 months.

FINDINGS

A total of 296 patients with ischemic stroke were enrolled and randomly allocated to the BCI group (n = 150) and the control group (n = 146). The primary efficacy outcomes of FMA-UE score change from baseline to 1 month were 13.17 (95% confidence interval [CI], 11.56-14.79) in the BCI group and 9.83 (95% CI, 8.19-11.47) in the control group (mean difference between groups was 3.35; 95% CI, 1.05-5.65; p = 0.0045). Adverse events occurred in 33 patients (22.00%) in the BCI group and in 31 patients (21.23%) in the control group.

CONCLUSIONS

BCI rehabilitation training can further improve upper limb motor function based on traditional rehabilitation training in patients with ischemic stroke. This study was registered at ClinicalTrials.gov: NCT04387474.

FUNDING

This work was supported by the National Key R&D Program of China (2018YFC1312903), the National Key Research and Development Program of China (2022YFC3600600), the Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University (CCMU2022ZKYXZ009), the Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), the Fund for Young Talents of Beijing Medical Management Center (QML20230505), and the high-level public health talents (xuekegugan-02-47).

Effectiveness of Syrebo's Glove Rehabilitation Program in a Patient With Middle Cerebral Artery Infarct: A Case Report

In India, stroke is a significant health concern, with an estimated prevalence of around 1.54% in adults over 20 years old. The incidence of stroke in India varies regionally but is generally high due to factors like hypertension and lifestyle changes. Ischemic strokes comprise the majority, particularly in the middle cerebral artery (MCA) territory. MCA stroke presents with diverse symptoms such as weakness, speech difficulties, and vision problems, emphasizing the need for comprehensive rehabilitation. Physiotherapy plays a vital role in addressing these challenges, focusing on strength, coordination, mobility, and independence through tailored interventions. Additionally, soft robotic gloves, such as Syrebo's rehabilitation, offer promising advancements in neurorehabilitation by enhancing motor recovery and functional abilities, particularly in improving grip strength and hand functionality, thus improving outcomes for stroke patients. This case describes a 66-year-old female presenting with sudden left-sided weakness, slurred speech, and facial deviation indicative of bilateral MCA territory infarct. After admission requiring ventilation and medication, imaging confirmed the diagnosis. Following stabilization, she underwent neurophysiotherapy for rehabilitation. Neurological examination revealed deficits in muscle tone, reflexes, cranial nerve function, language, and swallowing. Outcome measures indicated progress in rehabilitation. The case underscores the significance of timely diagnosis and personalized rehabilitation in optimizing outcomes for MCA territory stroke patients.

The Desirable Effects of Edoxaban on Thrombi in the Left Atrium Are Seemingly Connected to Pulmonary Vein Thrombi

Ischemic stroke (IS) causes various degrees of disability that sometimes induce social problems: therefore, preventing the occurrence and recurrence of IS is important. The recovery of motor function has been extensively studied. The characteristics of retrieved thrombi have become clearer; however, it is unclear what thrombi cause IS. Pulmonary vein thrombi (PVTs), such as those of the IS, can cause systemic thrombosis, by releasing several sizes of particles. PVTs are common but are underrated and can be detected via enhanced computed tomography (CT) and transesophageal echocardiography (TEE). PVTs often extend to the left atrium (LA) and can be mainly diagnosed using not enhanced CT but rather TEE. Extended LA thrombi are characterized by a lack of periodic movement with heartbeats. Direct oral anticoagulants (DOACs) are useful for preventing IS. We reported that rivaroxaban partially dissolved LA thrombi and PVTs using enhanced CT and TEE; however, the effects of edoxaban on LA thrombi and PVTs are unclear. We checked the images using enhanced CT and TEE and treated them with edoxaban. The patient was a 73-year-old female with easy fatigability. Edoxaban desirably affected the LA thrombi, and edoxaban partially dissolved the thrombi in the right lower pulmonary vein (RLPV). A decreased dose of edoxaban (15 mg, once a day) had similar effects on LA thrombi and RLPV thrombi, suggesting that this treatment could be useful for preventing IS.