Introduction: Perinatal stroke (PS) causes hemiparetic cerebral palsy and lifelong disability.

Brain computer interfaces (BCI) are an emerging rehabilitation tool including coupling to functional electrical stimulation (FES) where adult stroke trials suggest efficacy. Whether children with large brain lesions and cerebral palsy can control BCI is unknown. We explored the ability of children with PS to use a simple BCI and hypothesized that performance would be comparable to typically developing children.

Methods: Prospective, case-controlled study. Inclusion criteria were: (1) MRI-confirmed perinatal stroke, (2) hemiparetic cerebral palsy, (3) age 6-18 years old, and (4) informed consent/assent. Typically developing controls of comparable age and gender were recruited. Participants trained for 10 minutes using a commercially available, electroencephalogram (EEG) based device (EPOC Emotiv). All performed 4 trials to complete two tasks (driving a remote-controlled car and moving a computer cursor) using two different strategies (motor imagery and goal-oriented) in random order. Primary outcome was Cohen’s Kappa with a value >0.40 suggesting BCI competency.

Results: Nineteen participants (42% female, mean age 13+/-3 years) were compared to 23 controls (27% female, mean age 13+/-3.6). No difference in overall BCI performance was observed between PS (0.43+/-0.06) and controls (0.46+/-0.05, p=0.23). Performance was lower for children with arterial stroke (M=.34 SE=.035) compared to venous strokes and controls (p=0.074). No difference was observed for specific task or strategy. Procedures were well tolerated.

Discussion: Children with PS can quickly learn tasks using simple EEG-based BCI.

Non-invasive BCI carries substantial potential for the rehabilitation of children disabled by cerebral palsy.