Table 2.
Technical configurations and outcome attributes of included BCI interventions
| Study | BCI paradigm | Mental task | Feedback type and devices | Outcomes of original study (P/S) | Cognitive outcome measures |
|---|---|---|---|---|---|
| Fateeva, 2023 [27] | P300-BCI | Spelling task: Patients sequentially fixated on flashing letters to spell words (gradually increasing from 3 letters). Selected letters appeared in the input line with a 5-s transition interval. Protocol required a minimum of 3 words per session |
Visual: Target letter highlighting and real-time input display Devices: 8-channel EEG headset (monopolar, right earlobe reference) and LCD monitor matrix |
P: MoCA (total and domain scores) S: Number of correct letters per session |
MoCA |
| Wan, 2025 [28] | MI-BCI | Dual-task MI task: Simultaneous motor imagery of lower-limb pedaling and upper-limb interactive VR gameplay (e.g., steering and task completion) |
Visual + proprioceptive: Real-time attention index, game score, and immersive VR env. Devices: ZhenTec R1 lower-limb pedaling robot, ZhenTec NH1 EEG system (prefrontal α/β bands), VR controller, and monitor |
P: BBS S: TUGT, FMA-LE, SDMT |
SDMT |
| Zhao, 2022 [29] | SSMVEP-BCI | SSVEP-based visual fixation: Patients gazed at Newton’s rings oscillating at specific frequencies to trigger corresponding gait commands (e.g., locomotion, speed control). Training advanced through multiple difficulty levels (e.g., turning, obstacle avoidance) |
Visual + proprioceptive: Real-time on-screen avatar and synchronized robotic motion Devices: Lower-limb training robot, EEG acquisition system (g.USBamp, 10–20 system electrodes: O1, O2, Oz, PO3, PO4, POz), Newton’s ring stimulator |
P: LOTCA; FMA-LE S: FMA-B; FAC; MBI; Serum BDNF; MEP latency |
LOTCA |
| Lu, 2025 [30] | MI-BCI | Adaptive EEG modulation task: Patients actively focused attention or imagined lower-limb movements to achieve target control accuracy, with training difficulty dynamically adjusted based on real-time performance |
Visual + proprioceptive: Real-time accuracy scores and performance-based robotic speed adjustments Devices: L-B300 BCI system (EEG cap, amplifier, host PC with evaluation software) integrated with a lower-limb training device (adjustable speed: 5–45 r/min) |
P: FMA; MoCA; MBI S: Serum biomarkers; Middle cerebral artery flow velocity; Clinical efficacy rate |
MoCA |
| Yang, 2023 [31] | MI-BCI | Cued MI task: 2-s visual cue followed by 4-s focused hand-grasping imagery (without overt movement). Exceeding a pre-set brain engagement threshold dynamically triggered robotic hand assistance |
Visual + auditory + proprioceptive: VR environment tasks, auditory encouragement, and soft-robot-assisted hand grasping Devices: 32-channel saline-electrode EEG system (ZhenTec NT1; CPz reference, Fpz ground), soft robotic hand rehabilitation glove, and VR training platform |
P: FMA-UE; MoCA; MBI S: Brain engagement index |
MoCA |
| Gao, 2023 [32] | MI-BCI | Multi-limb MI task: Alternating upper-limb (swimming arm strokes) and lower-limb (bicycle pedaling) MI. Upon exceeding a pre-set MScore threshold, synchronized visual (virtual avatar) and kinesthetic (robot-driven limbs) feedback was dynamically triggered |
Visual + auditory + proprioceptive: Immersive VR avatar, voice prompts, and robot-driven limb movement Devices: L-B300 EEG system (8 channels: FP1/2, F3/4, C3/4, Fz, Cz; A1 reference, A2 bias), MOTOmed upper/lower limb training robot, and monitor |
P: MMSE; FMA-UE; FMA-LE; HAMD S: EQ-5D; 6MWD; MBI; MEP latency; MEP amplitude |
MMSE |
| Huang, 2024 [33] | MI-BCI | Dual-task MI task: Focused lower-limb pedaling imagery monitored via prefrontal EEG (Fp1). Exceeding a pre-set brain engagement threshold triggered robotic leg driving, while patients concurrently steered handlebars for upper-limb cognitive-motor tasks (e.g., target collection) in a virtual env |
Visual + auditory + proprioceptive: Gamified VR interface (avatar, route, score, real-time brain engagement), music/voice prompts, and robotic lower-limb pedaling Devices: ZhenTec NT1 32-channel saline-electrode EEG system, VR mountain-cycling platform, and a pedal-driven rehabilitation robot |
P: FMA-LE; MoCA; MMSE; SDMT S: DST; Brain engagement index |
MoCA; MMSE; SDMT; DST |
| Isakova, 2026 [34] | P300-BCI/MI-BCI |
P300 oddball task: Target stimuli discrimination within an interactive visual oddball paradigm (image matching, virtual typing, and question answering) MI task: The screen displays tasks to the patient at 10-s intervals: imagining opening the right or left hand, and the process of relaxing |
Visual/visual + proprioceptive: (1) P300 group: visual letter output/image manipulation; (2) MI group: exoskeleton-driven hand flexion/extension Devices: (1) P300 group: Neurochat BCI + BFB system; (2) MI group: Ekzokist-2 (Exohand-2) BCI + BFB system |
P: MoCA S: Tracking test-A; Schulte Grid Test; Kohs blocks; Luria “10 words” |
MoCA Tracking test-A; Schulte Grid Test; Kohs blocks; Luria “10 words” |
| Kotov, 2022 [35] | P300-BCI/MI-BCI |
P300 oddball task: Target stimuli discrimination within an interactive visual oddball paradigm (image matching, virtual typing, and question answering) MI task: The screen displays tasks to the patient at 10-s intervals: imagining opening the right or left hand, and the process of relaxing |
Visual/visual + proprioceptive: (1) P300 group: visual letter output/image manipulation; (2) MI group: exoskeleton-driven hand flexion/extension Devices: (1) P300 group: Neurochat BCI; (2) MI group: Ekzokist-2 (Exohand-2) BCI |
P: MoCA S: CDT; Luria “10 words” |
MoCA CDT Luria “10 words” |
| Liu, 2023 [36] | MI-BCI | Individualized MI task: Individualized upper-limb motor imagery tailored to patients’ functional status, including shoulder abduction, upper arm adduction, forearm flexion, wrist dorsiflexion, fist clenching, and wrist inversion |
Visual + auditory + proprioceptive: Animated motion cues, voice prompts, and FES-induced muscle contractions Devices: LSR-AII BCI system (14-channel EEG cap with 2 references per 10–20 system, amplifier, host PC) and a FES |
P: FMA-UE; ANT S: WMFT; Schulte Grid Test; SDMT |
ANT Schulte Grid Test SDMT |
| Chen, 2025 [37] | MI-BCI | MI task: Motor imagery of wrist dorsiflexion (extension) and flexion. Patients imagine performing wrist movements while visual feedback (virtual hand) and auditory cues are presented. Successful MI detection triggers FES to produce actual movement |
Visual + proprioceptive: Virtual hand proportionally driven by MI intensity, alongside FES-evoked muscle contraction Devices: NCERP Series D EEG amplifier (24-channel, 10–20 system), commercial FES stimulator |
P: FMA-UE; MBI; MoCA S: Neurophysiological biomarkers |
MoCA |
| Chung, 2015 [38] | MI-BCI | MI task: Focused attention on ankle dorsiflexion movement on a monitor screen |
Visual + proprioceptive: When attention index exceeded threshold, FES activated to produce ankle dorsiflexion Devices: Poly-G I EEG system and Microstim Ω FES |
P: Attention EEG; Activation EEG S: – |
Attention EEG |
P primary, S Secondary, LCD liquid crystal display, MoCA Montreal Cognitive Assessment, MI motor imagery, VR virtual reality, BBS Berg Balance Scale, TUGT timed up and go test, FMA-LE Fugl-Meyer Lower Extremity Assessment, SDMT Symbol Digit Modalities Test, SSMVEP steady-state motion visual evoked potential, LOTCA Loewenstein Occupational Therapy Cognitive Assessment, FMA-LE Fugl-Meyer Assessment for Lower Extremity, FMA-B Fugl-Meyer Assessment for Balance, FAC functional ambulation category, MBI Modified Barthel Index, BDNF brain-derived neurotrophic factor, MEP motor-evoked potential, FMA-UE Fugl-Meyer Assessment-Upper Extremities, MMSE Mini-Mental State Examination, HAMD Hamilton Depression Scale, EQ-5D EuroQol-5D visual analogue scale, 6MWD 6-min walking distance, DST Digit Span Test, BFB Biofeedback, CDT Clock Drawing Test, FES Functional Electrical Stimulator, ANT Attention Network Test, WMFT Wolf Motor Function Test