Efficacy and safety of brain–computer interface for stroke rehabilitation: an overview of systematic review

Background: Stroke is a major global health challenge. In stroke rehabilitation, brain–computer interfaces (BCI) offer advantages over traditional training, including improved motor recovery and neuroplasticity. This study provides a first re-evaluation of systematic reviews and meta-analyses to further explore the safety and clinical efficacy of BCI in stroke rehabilitation. Methods: A standardized search was conducted in major databases up to October 2024. Literature quality was assessed using AMSTAR-2, PRISMA, publication year, study design, homogeneity, and publication bias. Data were visualized as radar plots for comprehensive evaluation. Results: Of 908 initially identified articles (after screening and eligibility assessment), 18 studies satisfied inclusion criteria. The re-evaluation showed that the quality of systematic reviews and meta-analyses on stroke BCI training is moderate, providing relatively good evidence. Conclusion: BCI-combined treatment can improve upper limb motor function and quality of daily life for stroke patients, especially in the subacute phase, with good safety. However, effects on speech function, lower limb motor function, and long-term outcomes require further evidence. Multicenter, long-term follow-up studies are needed. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024562114, CRD42023407720.