Brain-computer interfaces (BCI) are used in stroke rehabilitation to translate brain signals into intended movements of the paralyzed limb. However, the efficacy and mechanisms of BCI-based therapies remain unclear. Here we show that BCI coupled to functional electrical stimulation (FES) elicits significant, clinically relevant, and lasting motor recovery in chronic stroke survivors more effectively than sham FES. Such recovery is associated to quantitative signatures of functional neuroplasticity. BCI patients exhibit a significant functional recovery after the intervention, which remains 6-12 months after the end of therapy. Electroencephalography analysis pinpoints significant differences in favor of the BCI group, mainly consisting in an increase in functional connectivity between motor areas in the affected hemisphere. This increase is significantly correlated with functional improvement. Results illustrate how a BCI-FES therapy can drive significant functional recovery and purposeful plasticity thanks to contingent activation of body natural efferent and afferent pathways.

中文翻译：

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脑卒中后，大脑激活的功能性电刺激引起手臂的持久运动。

脑机接口（BCI）用于中风康复，将脑信号转化为瘫痪肢体的预期运动。但是，基于BCI疗法的疗效和机制尚不清楚。在这里，我们显示，与假性FES相比，BCI结合功能性电刺激（FES）可以在慢性中风幸存者中引起明显的，临床相关的和持久的运动恢复。这种恢复与功能性神经可塑性的定量特征有关。BCI患者在干预后表现出明显的功能恢复，在治疗结束后仍保持6-12个月。脑电图分析指出了BCI组的显着差异，主要在于受影响的半球运动区域之间的功能连接性增加。这种增加与功能改善显着相关。结果说明了BCI-FES疗法由于身体自然传入和传出路径的持续激活而如何能够促进显着的功能恢复和有目的的可塑性。