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Josefina Gutiérrez-Martínez, Jorge A. Mercado-Gutiérrez, Blanca E. Carvajal-Gámez | Frontiers in Human Neuroscience | (2021)
Abstract
Brain-Computer Interface (BCI) is a technology that uses electroencephalographic (EEG) signals to control external devices, such as Functional Electrical Stimulation (FES). Visual BCI paradigms based on P300 and Steady State Visually Evoked potentials (SSVEP) have shown high potential for clinical purposes. Numerous studies have been published on P300- and SSVEP-based non-invasive BCIs, but many of them present two shortcomings: (1) they are not aimed for motor rehabilitation applications, and (2) they do not report in detail the artificial intelligence (AI) methods used for classification, or their performance metrics. To address this gap, in this paper the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology was applied to prepare a systematic literature review (SLR). Papers older than 10 years, repeated or not related to a motor rehabilitation application, were excluded. Of all the studies, 51.02% referred to theoretical analysis of classification algorithms. Of the remaining, 28.48% were for spelling, 12.73% for diverse applications (control of wheelchair or home appliances), and only 7.77% were focused on motor rehabilitation. After the inclusion and exclusion criteria were applied and quality screening was performed, 34 articles were selected. Of them, 26.47% used the P300 and 55.8% the SSVEP signal. Five applications categories were established: Rehabilitation Systems (17.64%), Virtual Reality environments (23.52%), FES (17.64%), Orthosis (29.41%), and Prosthesis (11.76%). Of all the works, only four performed tests with patients. The most reported machine learning (ML) algorithms used for classification were linear discriminant analysis (LDA) (48.64%) and support vector machine (16.21%), while only one study used a deep learning algorithm: a Convolutional Neural Network (CNN). The reported accuracy ranged from 38.02 to 100%, and the Information Transfer Rate from 1.55 to 49.25 bits per minute. While LDA is still the most used AI algorithm, CNN has shown promising results, but due to their high technical implementation requirements, many researchers do not justify its implementation as worthwile. To achieve quick and accurate online BCIs for motor rehabilitation applications, future works on SSVEP-, P300-based and hybrid BCIs should focus on optimizing the visual stimulation module and the training stage of ML and DL algorithms.
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Sample Definition And Size
The systematic literature review (SLR) focused on non‑invasive visual evoked potential (P300, SSVEP, or hybrid) based brain‑computer interface (BCI) systems applied to motor rehabilitation. From an initial pool of 3,691 records identified across multiple databases, 1,388 articles published after 2011 were screened; 1,269 were excluded for not involving actual applications, 392 were for spelling, and 175 for other control tasks, leaving 107 focused on motor rehabilitation. After quality screening, 34 articles were selected for detailed analysis.
Study Type
Systematic literature review following PRISMA methodology, covering studies up to June 2021, with inclusion/exclusion criteria applied across identification, screening, and inclusion phases.
Conflicts Of Interest
No conflicts of interest are declared in the paper.
Results Summary
Of the 34 included studies, 26.47% (9) used P300, 55.8% (19) used SSVEP, and 17.64% (6) used hybrid modalities. Applications were categorized as FES (17.64%), VR (23.52%), Orthosis (29.41%), Prosthesis/Exoskeleton (11.76%), and Robotic Rehabilitation Systems (17.64%). Only four studies involved patient testing. The most common classifiers were LDA (48.64%) and SVM (16.21%); only one study used a CNN (deep learning). Reported accuracies ranged from 38.02% to 100%, and information transfer rates (ITR) ranged from 1.55 to 49.25 bits per minute. LDA was the most used algorithm; CNN showed promise but was limited by technical complexity.
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Created: Apr 5, 2026