Artificial Intelligence (AI) powered P300 and SSVEP based Brain Computer Interfaces (BCI) used in Neurorehabilitation - a Systematic Review and Meta-Analysis
Kushal Prasad1, Aryan Gupta1, Vinay Chandramouli Bellur2, Ananya Prasad2, Allama Prabhu1, Advaith Rao2, Era Gupta1, Shradha Chervittara Karaveetil2, Anmol Rao2, Shruthi Raghunandan3
1Bangalore Medical College and Research Institute, 2M.S. Ramiah Medical College, 3Vydehi Institute of Medical Sciences and Research Centre
Objective:

This systematic review and meta-analysis aims to study the various Artificial Intelligence (AI) algorithms used as classifiers and their novel integration with state-of-the-art technologies like Brain Computer Interface (BCI). The primary objective is to statistically explore the AI’s accuracy and other performance metrics with BCI concerning neurorehabilitation in patients with stroke and other neurological complications. 

Background:

BCIs augment traditional rehabilitation methods with cutting-edge biomedical engineering. BCIs utilise electroencephalographic (EEG) signals in conjunction with AI as classifiers, providing real time feedback. BCI approaches like P300 and Steady State Visual Evoked Potential (SSVEP) paradigms have been widely explored for diverse applications like virtual reality and gaming. Other major applications include robotic prostheses, communication and rehabilitation in people suffering from motor disabilities like spinal cord lesions, ALS and locked-in syndrome, which needs to be further established. 

Design/Methods:

An extensive search was conducted in all the major medical databases for relevant articles concerning Visual Evoked Potential based BCI. The statistical analysis was performed in R-Studio. The pooled means of accuracy and Information Transmission Rate (ITR) were analysed using the Inverse variance method and the heterogeneity was assessed using the I^2 test. Subgroup analysis was also conducted.

Results:
The meta-analysis included 35 studies and 299 subjects that underwent visual stimulation assessment in BCI-enabled ecosystems. The statistical analysis of the algorithms indicated an accuracy rate of  88.0218 (84.5722; 91.4713, 95% CI, P > 0.01). The maximum accuracy was observed in the SSVEP-P300 hybrid LDA models (92.72), while the lowest was seen in the P300 and MI models (81.68). The pooled ITR was 27.48 bits/min (16.40;38.55, 95% CI, P > 0.01).
Conclusions:

Both SSVEP and P300 BCI systems were statistically appreciated. However, fundamental and technical differences—such as the experimental paradigm, cognitive and sensory demands, attention types (covert vs overt), and synchronous versus asynchronous operation—may impact their suitability for neurorehabilitation applications.



10.1212/WNL.0000000000212241
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.