Closed-Loop SCS-BCI for Post-Stroke Hemiplegia

In the researchers' words

This study evaluates a new closed-loop rehabilitation system for stroke survivors with arm weakness. The system combines a brain-computer interface (BCI, a special cap that reads brain signals), spinal cord stimulation (a temporary implanted electrode that sends gentle electrical pulses to the spine), and a robotic hand exoskeleton. When the participant imagines moving their affected hand, the system detects this intention from brain signals and immediately triggers the spinal stimulation and robotic assistance to help complete the movement. The goal is to test whether this "brain-spine-hand" closed-loop approach is safe and can improve upper limb function after stroke. About 30 stroke patients with chronic arm weakness will be enrolled. Participants will first undergo brain signal testing to confirm they can produce detectable movement intentions. Eligible participants will then have a temporary spinal cord stimulator electrode placed under the skin near the spine. Over the next 4 weeks, they will receive daily training sessions (about 90 minutes, 5 days per week) using the closed-loop system. After 4 weeks, the electrode will be removed, and participants will continue standard rehabilitation. Hand and arm function will be assessed before, during, and after the intervention.