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Journal of Neurorestoratology  2020, Vol. 8 Issue (1): 12-25    doi: 10.26599/JNR.2020.9040001
Review Article     
State-of-the-art non-invasive brain–computer interface for neural rehabilitation: A review
Miaomiao Zhuang1,5, Qingheng Wu2,5, Feng Wan3, Yong Hu4,5,(✉)
1Xiangya School of Medicine, Central South University, Changsha 410013, Hunan, China;
2Department of Dentistry, Nanjing Medical University, Nanjing 211166, Jiangsu, China;
3Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau, China;
4Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China;
5Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
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Brain–computer interface (BCI) is a novel communication method between brain and machine. It enables signals from the human brain to influence or control external devices. Currently, much research interest is focused on the BCI-based neural rehabilitation of patients with motor and cognitive diseases. Over the decades, BCI has become an alternative treatment for motor and cognitive rehabilitation. Previous studies demonstrated the usefulness of BCI intervention in restoring motor function and recovery of the damaged brain. Electroencephalogram (EEG)-based BCI intervention could cast light on the mechanisms underlying neuroplasticity during upper limb recovery by providing feedback to the damaged brain. BCI could act as a useful tool to aid patients with daily communication and basic movement in severe motor loss cases like amyotrophic lateral sclerosis (ALS). Furthermore, recent findings have reported the therapeutic efficacy of BCI in people suffering from other diseases with different levels of motor impairment such as spastic cerebral palsy, neuropathic pain, etc. Besides motor functional recovery, BCI also plays its role in improving the behavior of patients with cognitive diseases like attention-deficit/hyperactivity disorder (ADHD). The BCI-based neurofeedback training is focused on either reducing the ratio of theta and beta rhythm, or enabling the patients to regulate their own slow cortical potentials, and both have made progress in increasing attention and alertness. With summary of several clinical studies with strong evidence, we present cutting edge results from the clinical application of BCI in motor and cognitive diseases, including stroke, spinal cord injury, ALS, and ADHD.

Key wordsbrain–computer interface (BCI)      neural rehabilitation      stroke      spinal cord injury (SCI)      amyotrophic lateral sclerosis (ALS)      attention-deficit/hyperactivity disorder (ADHD)     
Received: 09 October 2019      Published: 05 March 2020
Corresponding Authors: Yong Hu   
Cite this article:

Miaomiao Zhuang, Qingheng Wu, Feng Wan, Yong Hu. State-of-the-art non-invasive brain–computer interface for neural rehabilitation: A review. Journal of Neurorestoratology, 2020, 8: 12-25.

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Motor feedback in BCI-assisted rehabilitation. The basic parts of BCI-assisted rehabilitation include signal input and movement output of the BCI-system to help complete the intended action. In the process, the observation or passive movement could provide feedback to the initial movement intention to the brain which has been proved beneficial to the neurological rehabilitation and modification of the movement signal.
Neuronal feedback in neurorehabilitation. The process of movement provides visual, auditory, as well as proprioceptive feedback to the brain, serving as signals in modulation and adjustment of the next-step movement. The signals also close the sensorimotor loop, following the principle of neuroplasticity and enhancing the remaining neural pathways, thus promoting neurorehabilitation.
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