BCIwiki (bciwiki.com) — An associative brain-computer interface (BCI) raised corticospinal excitability whether participants actually extended the wrist or only imagined doing so, with no significant difference between the two, researchers reported in Neuromodulation: Technology at the Neural Interface on September 25, 2026 (DOI: 10.1016/j.neurom.2026.09.011).
Associative BCIs pair the brain's outgoing motor command with matching sensory feedback. Earlier work cited by the authors showed that pairing activity from executed or imagined movements with somatosensory feedback such as electrical stimulation can increase corticospinal excitability and support motor recovery after stroke, but the two movement modes had not been directly compared within the same paradigm.
Seventeen able-bodied participants each completed 2 interventions: executed wrist extension paired with peripheral electrical stimulation of the radial nerve, and imagined wrist extension paired with the same stimulation. Each session paired 100 visually cued movements with stimulation, timed to the peak negativity of the movement-related cortical potential. Motor-evoked potentials elicited by transcranial magnetic stimulation were measured before, immediately after and 30 minutes after each session.
Maximal motor-evoked potential amplitudes rose 45 ± 63% after executed movement and 41 ± 63% after imagined movement immediately post-intervention, and 35 ± 54% and 55 ± 83% respectively at 30 minutes (all p values ≤ 0.03). The two interventions did not differ significantly.
The authors concluded that both forms of motor activity are viable, letting clinicians choose based on a user's capability or clinical context. All participants were healthy, and the wide standard deviations point to large individual variation; whether the effect holds in stroke patients remains untested.