Background: Brain–computer interface (BCI) is a procedure involving brain activity in which neural status is provided to the participants for self-regulation. The current review aims to evaluate the effect sizes of clinical studies investigating the use of BCI-based rehabilitation interventions in restoring upper extremity function and effective methods to detect brain activity for motor recovery. Methods: A computerized search of MEDLINE, CENTRAL, Web of Science, and PEDro was performed to identify relevant articles. We selected clinical trials that used BCI-based training for post-stroke patients and provided motor assessment scores before and after the intervention. The pooled standardized mean differences of BCI-based training were calculated using the random-effects model. Results: We initially identified 655 potentially relevant articles; finally, 16 articles fulfilled the inclusion criteria, involving 382 participants. A significant effect of neurofeedback intervention for the paretic upper limb was observed (standardized mean difference = .48, [.16-.80], P = .006). However, the effect estimates were moderately heterogeneous among the studies ( I² = 45%, P = .03). Subgroup analysis of the method of measurement of brain activity indicated the effectiveness of the algorithm focusing on sensorimotor rhythm. Conclusion: This meta-analysis suggested that BCI-based training was superior to conventional interventions for motor recovery of the upper limbs in patients with stroke. However, the results are not conclusive because of a high risk of bias and a large degree of heterogeneity due to the differences in the BCI interventions and the participants; therefore, further studies involving larger cohorts are required to confirm these results.

There is evidence that social relationships may modify cognitive decline in older people. We examined the prospective association between social support and cognitive function among community-dwelling older people. Japanese adults recruited at health checkups in suburban towns were surveyed at baseline and one-year follow-up. Cognitive function was assessed using the Montreal Cognitive Assessment, Japanese version (MoCA-J). Social support from coresiding family, non-coresiding family, and neighbors/friends was assessed using self-administered questionnaires. Multivariable linear regression analysis was conducted to examine the effects of social support on MoCA-J scores at follow-up. Data were analyzed from 121 older people (mean age (standard deviation): 73.86 (4.95) years). There was a positive association between social support exchanges with neighbors and friends and MoCA-J scores at follow-up after covariate adjustment (unstandardized β = 1.23, p = 0.006). Social support exchanges with coresiding family and non-coresiding family and relatives were not associated with MoCA-J scores at follow-up (coresiding family: Unstandardized β = 0.28, p = 0.813, non-coresiding family and relatives: Unstandardized β = 0.51, p = 0.238). The provision of emotional support to neighbors and friends had the largest effect on MoCA-J scores. Our findings suggest that social support exchanges with neighbors and friends are protective against cognitive decline.

Beta-band (15-30 ​Hz) corticomuscular and intermuscular coherences are important markers of the corticospinal interaction. The purpose of this study was to investigate whether amount of visual feedback during an isometric pinch grip contraction would influence these coherences in young and elderly adults. Thirty-three healthy young and elderly subjects performed pinch grip force-matching task with right thumb and index finger, while scalp electroencephalogram (EEG) and electromyogram (EMG) from the first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles were recorded. The amount of visual feedback was altered by manipulation of visual gain (low and high). Beta-band corticomuscular coherence was computed between EEG over the sensorimotor cortex and EMG from the FDI muscle and between EEG and EMG from the APB muscle (EEG-FDI and EEG-APB coherences). Also, beta-band intermuscular coherence was computed between EMG signals from the FDI and APB muscles (EMG-EMG coherence). Task performance was quantified as standard deviation (SD) of force and mean force error (MFE). EEG-FDI coherence was larger at high than low visual gain in the elderly but not in the young subjects, whereas there was no effect of age or visual gain on EEG-APB coherence. EMG-EMG coherence was smaller at high than low visual gain in the young and elderly subjects. The MFE was smaller at high than low visual gain in the young and elderly subjects, but the SD of force was smaller at high than low visual gain only in the young subjects. These results suggest that the effect of aging on beta-band coherence depends on the amount of visual feedback and further that visual feedback modulates beta-band corticomuscular and intermuscular coherences differently.

The voluntary step execution task is a popular measure for identifying fall risks among elderly individuals in the community setting because most falls have been reported to occur during movement. However, the neurophysiological functions during this movement are not entirely understood. Here, we used electromyography (EMG) to explore the relationship between EMG-EMG coherence, which reflects common oscillatory drive to motoneurons, and motor performance associated with stepping tasks: simple reaction time (SRT) and choice reaction time (CRT) tasks. Ten healthy elderly adults participated in the study. Participants took a single step forward in response to a visual imperative stimulus. EMG-EMG coherence was analyzed for 1000 ms before the presentation of the stimulus (stationary standing position) from proximal and distal tibialis anterior (TA) and soleus (SOL) muscles. The main result showed that all paired EMG-EMG coherences in the alpha and beta frequency bands were greater in the SRT than the CRT task. This finding suggests that the common oscillatory drive to the motoneurons during the SRT task occurred prior to taking a step, whereas the lower value of corticospinal activity during the CRT task prior to taking a step may indicate an involvement of inhibitory activity, which is consistent with observations from our previous study (Watanabe et al., 2016). Furthermore, the beta band coherence in intramuscular TA tended to positively correlate with the number of performance errors that are associated with fall risks in the CRT task, suggesting that a reduction in the inhibitory activity may result in a decrease of stepping performance. These findings could advance the understanding of the neurophysiological features of postural adjustments in elderly individuals.