BCIwiki (bciwiki.com) — Brain-computer interface (BCI) rehabilitation improved upper-extremity motor function in stroke patients compared with control interventions, with a dose-response analysis suggesting a peak effect near 48 min per session, according to a meta-analysis of 26 randomized controlled trials covering 1100 patients reported in Neurotherapeutics on September 30, 2026. The authors are affiliated with the Department of Neurosurgery at The Second Affiliated Hospital of Nanchang University and other institutions in Jiangxi Province, China.
The researchers searched Medline, EMBASE and Web of Science for RCTs published from January 1, 1990, to January 30, 2026, pooled data using random- or fixed-effects models, and assessed risk of bias with the Cochrane Risk of Bias 2 tool. A restricted cubic spline (RCS) method was used to estimate the dose-response relationship between BCI training intensity and upper-extremity motor function.
Compared with controls, BCI-based rehabilitation showed significant improvement in the Fugl-Meyer Assessment for Upper Extremity (FMA-UE; 24 studies, 1042 participants; mean difference 1.11, 95% CI 0.63 to 1.60), the Action Research Arm Test (ARAT; 8 studies, 524 participants; MD 0.21, 95% CI 0.04 to 0.39), the Wolf Motor Function Test (WMFT; 5 studies, 425 participants; MD 0.94, 95% CI 0.32 to 1.55), the Modified Barthel Index (MBI; 4 studies, 153 participants; MD 1.17, 95% CI 0.29 to 2.06) and the Berg Balance Scale (BBS; 2 studies, 35 participants; MD 0.54, 95% CI 0.02 to 1.07).
No significant benefit was found for the Fugl-Meyer Assessment for Lower Extremity (FMA-LE; 2 studies, 78 participants; MD -0.12, 95% CI -0.79 to 0.55) or the Timed Up and Go Test (TUGT; 2 studies, 35 participants; MD -0.40, 95% CI -1.15 to 0.34).
The dose-response analysis suggested a non-linear, inverted U-shaped relationship between BCI rehabilitation intensity and FMA-UE scores. The authors wrote that BCI rehabilitation may be an effective strategy for upper-extremity recovery after stroke, but that its efficacy for lower-extremity recovery remains inconclusive and warrants further investigation.