The application of brain-computer interface on cognitive function and activities of daily living in stroke patients: a systematic review and meta-analysis
- 1Department of Neurological Rehabilitation, Zhongnan Hospital of Wuhan University
- 2Rehabilitation Medicine Center, Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine
Abstract
Objective: Nonmotor dysfunction is a common sequela of stroke, affecting patients across acute, subacute, and chronic recovery stages and significantly impairing their functional independence, psychosocial adjustment, and overall Activities of Daily Living (ADL). Brain-computer interface (BCI) technology has demonstrated effectiveness in motor function rehabilitation. The primary objective of this study was to assess the efficacy of BCI technology on cognitive function (as the primary indicator of nonmotor dysfunction) and ADL in stroke patients through a systematic review and meta-analysis.
Methods: This review was conducted in accordance with the PRISMA guidelines and registered with PROSPERO (CRD420261453809). Systematic searches were conducted in PubMed, Web of Science, Google Scholar, CNKI, and Wanfang Data up to March 2026. Statistical analyses and the risk of bias were assessed using Review Manager 5.3. The quantitative synthesis focused on the effects of BCI on the cognitive function and ADL of patients with stroke.
Results: The meta-analysis reviewed 11 randomized controlled studies (RCTs) involving a total of 559 participants. Compared with conventional rehabilitation, BCI-based training significantly improved cognitive function (SMD = 0.634, 95% CI: 0.214, 1.055; p = 0.003) and ADL (SMD = 1.198, 95% CI: 0.079, 2.316; p = 0.036). Subgroup analyses suggested exploratory patterns of benefit in certain strata. However, subgroup analysis revealed no significant differences for most comparisons (including scale type, region, sample size, stroke type, BCI type, intervention intensity, and intervention duration; all p > 0.05), except for first-episode stroke in the ADL analysis ( p = 0.001).
Conclusion: BCI-based training shows preliminary promise for improving cognitive function and ADL in stroke patients. Current evidence remains insufficient to recommend BCI for emotion or speech rehabilitation. However, the GRADE certainty of evidence was rated as low for cognitive function and very low for ADL, indicating that further high-quality research is warranted.
Systematic review registration: https://www.crd.york.ac.uk/prospero/ , CRD420261453809.
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BibTeX
@article{luo2026application,
title = {{The application of brain-computer interface on cognitive function and activities of daily living in stroke patients: a systematic review and meta-analysis}},
author = {Zijie Luo and Lei Yu and Meiling Wu and Xuan Gong},
journal = {Frontiers in Neurology},
year = {2026},
month = oct,
doi = {10.3389/fneur.2026.1862193},
url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1862193/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The application of brain-computer interface on cognitive function and activities of daily living in stroke patients: a systematic review and meta-analysis
AU - Zijie Luo
AU - Lei Yu
AU - Meiling Wu
AU - Xuan Gong
PY - 2026
DA - 2026/10/19
JO - Frontiers in Neurology
DO - 10.3389/fneur.2026.1862193
UR - https://www.frontiersin.org/articles/10.3389/fneur.2026.1862193/full
AB - Objective: Nonmotor dysfunction is a common sequela of stroke, affecting patients across acute, subacute, and chronic recovery stages and significantly impairing their functional independence, psychosocial adjustment, and overall Activities of Daily Living (ADL). Brain-computer interface (BCI) technology has demonstrated effectiveness in motor function rehabilitation. The primary objective of this study was to assess the efficacy of BCI technology on cognitive function (as the primary indicator of nonmotor dysfunction) and ADL in stroke patients through a systematic review and meta-analysis. Methods: This review was conducted in accordance with the PRISMA guidelines and registered with PROSPERO (CRD420261453809). Systematic searches were conducted in PubMed, Web of Science, Google Scholar, CNKI, and Wanfang Data up to March 2026. Statistical analyses and the risk of bias were assessed using Review Manager 5.3. The quantitative synthesis focused on the effects of BCI on the cognitive function and ADL of patients with stroke. Results: The meta-analysis reviewed 11 randomized controlled studies (RCTs) involving a total of 559 participants. Compared with conventional rehabilitation, BCI-based training significantly improved cognitive function (SMD = 0.634, 95% CI: 0.214, 1.055; p = 0.003) and ADL (SMD = 1.198, 95% CI: 0.079, 2.316; p = 0.036). Subgroup analyses suggested exploratory patterns of benefit in certain strata. However, subgroup analysis revealed no significant differences for most comparisons (including scale type, region, sample size, stroke type, BCI type, intervention intensity, and intervention duration; all p > 0.05), except for first-episode stroke in the ADL analysis ( p = 0.001). Conclusion: BCI-based training shows preliminary promise for improving cognitive function and ADL in stroke patients. Current evidence remains insufficient to recommend BCI for emotion or speech rehabilitation. However, the GRADE certainty of evidence was rated as low for cognitive function and very low for ADL, indicating that further high-quality research is warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/ , CRD420261453809.
SN - 1664-2295
ER -