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The ReHand-BCI trial: a randomized controlled trial of a brain-computer interface for upper extremity stroke neurorehabilitation

J. Cantillo-Negrete, M. E. Rodríguez-García, P. Carrillo-Mora, Ó. Arias-Carrión, Emmanuel Ortega-Robles, M. Galicia-Alvarado, R. Valdés-Cristerna, Ana G. Ramirez-Nava et al.

Frontiers in Neuroscience, 2025

18 citations

Abstract

Background Brain-computer interfaces (BCI) are a promising complementary therapy for stroke rehabilitation due to the close-loop feedback that can be provided with these systems, but more evidence is needed regarding their clinical and neuroplasticity effects. Methods A randomized controlled trial was performed using the ReHand-BCI system that provides feedback with a robotic hand orthosis. The experimental group (EG) used the ReHand-BCI, while sham-BCI was given to the control group (CG). Both groups performed 30 therapy sessions, with primary outcomes being the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE) and the Action Research Arm Test (ARAT). Secondary outcomes were hemispheric dominance, measured with electroencephalography and functional magnetic resonance imaging, white matter integrity via diffusion tensor imaging, and corticospinal tract integrity and excitability, measured with transcranial magnetic stimulation. Results At post-treatment, patients in both groups had significantly different FMA-UE scores (EG: baseline = 24.5[20, 36], post-treatment 28[23, 43], CG: baseline = 26[16, 37.5], post-treatment = 34[17.3, 46.5]), while only the EG had significantly different ARAT scores at post-treatment (EG: baseline = 8.5[5, 26], post-treatment = 20[7, 36], CG: baseline = 3[1.8, 30.5], post-treatment = 15[2.5, 40.8]). In addition, across the intervention, the EG showed trends of more pronounced ipsilesional cortical activity and higher ipsilesional…

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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.

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