Rehabilitation of Patients with Post-Stroke Cognitive Impairments Using a P300-Based Brain–Computer Interface: Results of a Randomized Controlled Trial

Objective. To study the effects of 10 days of cognitive training using brain–computer interface (BCI) technology based on the P300 wave on the recovery of cognitive functions in patients with stroke. Materials and methods. The study included 30 patients aged 22–82 years with ischemic stroke occurring less than three months previously and moderate cognitive impairment (<26 points on the Montreal Cognitive Assessment Scale, MoCA). All patients underwent neuropsychological testing, assessment of the presence of depression, and assessment of the activities of daily living. Patients were randomized into two groups: patients of group 1 received 10-day courses of cognitive rehabilitation in the form of daily exercises in a BCI environment based on the P300 wave, with a headset for recording the electroencephalogram (EEG). Patients of group 2 received a standard set of rehabilitation measures. Results. The study group experienced an increase in the mean score on the “Attention” domain of the MoCA scale as compared with the control group: from 2.3 ± 1.24 to 5.2 ± 1.16 points in the study group compared with a decrease from 5.9 ± 1.00 to 4.2 ± 0.94 points in the reference group (p < 0.05). Analysis of covariance with repeated measures taking into account the factors “Visit” and “Group” and the covariates “Depression” and “Training session number” revealed statistically significant effects for the MoCA domains “Naming” (p < 0.05), “Attention” (p < 0.05), and “Abstraction” (p < 0.05). By the end of 10-day cognitive BCI training courses, patients in group 1 displayed a statistically significant increase in the number of letters entered (from 20.8 ± 2.01 to 25.9 ± 1.7 characters (p = 0.02)) compared with an increase from 21.9 ± 1.9 to 23.1 ± 1.8 in group 2 (p = 0.06). Comparison of the number of words entered by patients after 10 days demonstrated a statistically significant between-group difference (p < 0.05). Conclusions. Rehabilitation of patients with post-stroke cognitive impairment using a BCI based on the P300 wave had significant positive effects on restoration of cognitive functions, primarily attention. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2024.