# Brain-computer interface-functional electrical stimulation for stroke recovery

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA-IRVINE · 2020 · $752,061

## Abstract

Project Summary
There are over 7 million stroke survivors in the US alone, with approximately 795,000 new cases annually. Despite
the best available physiotherapy, 30-60% of stroke survivors remain affected by gait function impairments, with
foot drop often being the primary cause. Given that post-stroke gait impairments remain suboptimally addressed,
novel methods that can provide lasting neurological and functional improvements are necessary.
 Brain-computer interface (BCI) technology may be one such novel approach. BCI technology enables “direct
brain control” of external devices such as assistive devices and prostheses by translating brain electrophysiologi-
cal signals (e.g. EEG) into control signals. When BCI systems are integrated with functional electrical stimulation
(FES) systems, they can be used to deliver a novel physiotherapy to improve motor function after stroke. BCI-
FES systems are hypothesized to stimulate a Hebbian plasticity process (where “neurons that ﬁre together, wire
together”), and this approach may lead to functional recovery after stroke beyond that of conventional physiother-
apy. The applicant's preliminary research indicates that applying this technique to foot drop after stroke is safe
and may improve gait function via neural processes. Hence, this warrants further investigation to: 1. determine if
BCI-FES therapy can provide lasting gains in gait function in chronic stroke patients with foot drop; 2. determine
what factors inﬂuence BCI-FES therapy; and 3. explicitly elucidate the underlying neural repair mechanisms.
 First, a Phase II clinical trial in patients with foot drop due to chronic stroke will compare the effect of BCI-
FES dorsiﬂexion therapy to that of dose- and intensity-matched standard physiotherapy (Aim 1). Comparing
the improvement in gait velocity and other secondary outcome measures between the two groups will test the
hypothesis that BCI-FES therapy provides functional and neurological gains beyond those of conventional phys-
iotherapy. It will also determine which aspects of gait impairment are best addressed with BCI-FES therapy
versus conventional physiotherapy. The relationship between the subjects' baseline characteristics (gait velocity,
dorsiﬂexion function, motor evoked potentials, electroencephalogram features, sensation) and the outcomes will
determine what features inﬂuence responsiveness to BCI-FES dorsiﬂexion therapy (Aim 2). Finally, the underlying
mechanism driving the neurological improvements of BCI-FES will be elucidated using an explicit computational
neuroscience model of stroke recovery, informed by experimental neurophysiological measurements (Aim 3).
 Determining that BCI-FES therapy can provide improvements beyond that of conventional therapy may lead
to a new neural repair mechanism that can be effective in stroke patients. This mechanism can inform the design
of future physiotherapy techniques or improve current ones. Finally, BCI-FES therapy may ultimately become a
no...

## Key facts

- **NIH application ID:** 9897645
- **Project number:** 5R01HD095457-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA-IRVINE
- **Principal Investigator:** Steven C. Cramer
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $752,061
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9897645

## Citation

> US National Institutes of Health, RePORTER application 9897645, Brain-computer interface-functional electrical stimulation for stroke recovery (5R01HD095457-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9897645. Licensed CC0.

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