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Severe motor disability affects functional cortical integration in the context of brain–computer interface (BCI) use

The purpose of this study was to investigate cortical interaction between brain regions in people with and without severe motor disability during brain–computer interface (BCI) operation through coherence analysis. Eighteen subjects, including six patients with cerebral palsy (CP) and three patients with amyotrophic lateral sclerosis (ALS), participated. The results showed (1) the existence of BCI performance difference caused by severe motor disability; (2) different coherence patterns between participants with and without severe motor disability during BCI operation and (3) effects of motor disability on cortical connections varying in the brain regions for the different frequency bands, indicating reduced cortical differentiation and specialisation. Participants with severe neuromuscular impairments, as compared with the able-bodied group, recruited more cortical regions to compensate for the difficulties caused by their motor disability, reflecting a less efficient operating strategy for the BCI task. This study demonstrated that coherence analysis can be applied to examine the ways cortical networks cooperate with each other during BCI tasks. Practitioner Summary: Few studies have investigated the electrophysiological underpinnings of differences in BCI performance. This study contributes by assessing neuronal synchrony among brain regions. Our findings revealed that severe motor disability causes more cortical areas to be recruited to perform the BCI task, indicating reduced cortical differentiation and specialisation.