Brain-Computer Interface and Functional Electrical Stimulation for Neurorehabilitation of Hand in Sub-acute Tetraplegic Patients - Functional and Neurological Outcomes

The aim of this paper is to compare neurological and functional outcomes between two groups of subacute hospitalised patients with incomplete tetraplegia receiving two experimental therapies. Seven patients received 20 sessions of Brain Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) while five patients received 20 sessions of passive FES. The treatment assessment measures were EEG during movement attempt, Somatosensory evoked potential (SSEP) of the ulnar and median nerve and the range of movement of both wrists. Patients in both groups initially had intense cortical activity during a movement attempt, which was wide-spread, not restricted to the sensory-motor cortex. Following the treatment, cortical activity restored towards the activity in able-bodied people in BCI-FES group only. SSEP also returned in 3 patients in BCI-FES group while in FES group no changes were noticed. The range of movement improved in both groups and results are inconclusive due to the small number of participants. This study confirms the feasibility of prolonged BCI-FES therapy in a hospital setting. The results indicate better neurological recovery in BCI-FES group. Larger and longer studies are required to assess the potential advantage of BCI-FES on functional recovery.

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