EEG Biomarkers During Upper-Limb Action Observation Therapy for Stroke Rehabilitation: A Scoping Review.
EEG measures often changed during action observation and sometimes tracked upper-limb recovery after stroke. These signals are promising for guiding rehabilitation research, but they are not yet standardized clinical biomarkers.
Nguyen AT, Johnson MJ.
Annals of biomedical engineering · Publication date: 2026-09-29
Added to site: 2026-09-30
DOI: 10.1007/s10439-026-04404-2
Electronic publication date verified in Europe PMC and Crossref. This source date is separate from the site's addition date.
- Modalities
- EEG, BCI
- Clinical focus
- Stroke rehabilitation, Action observation, Motor biomarkers
- Population
- Stroke survivors participating in upper-limb action-observation paradigms or interventions
- Sample
- 22 included studies selected from 386 records
- Intervention / method
- Review of upper-limb action-observation studies combining EEG outcomes with motor assessments, including multi-week therapy, motor imagery and BCI-supported approaches
- Comparator
- No single pooled comparator; the included studies used heterogeneous control conditions and observational designs
Clinician summary
Mu and beta event-related desynchronization, beta connectivity and fast-to-slow spectral ratios repeatedly indexed cortical engagement. Multi-week intervention studies often reported neural changes alongside Fugl-Meyer, dexterity or functional gains, but the review did not pool effects.
How to interpret the findings
The full text reports heterogeneous tasks, EEG montages, preprocessing, stroke phases and lesion profiles; many studies were small, lacked rigorous controls or longer follow-up, and did not separate central mu suppression from posterior visual-attention alpha. Sensor-level effects were sometimes described with overly specific anatomical labels.
Equipment and disclosures
EEG methods varied across the 22 studies; the review included action-observation, motor-imagery, BCI and robot-related paradigms rather than a single device or acquisition system.
The article reports support from an American Heart Association Predoctoral Fellowship and the Vingroup Scholarship Program. The authors declared no conflict of interest.
Related evidence
Compare findings from the same clinical area, including mixed results.
- Combined repetitive transcranial magnetic stimulation and mirror therapy for upper limb rehabilitation in stroke survivors: A systematic review and meta-analysis. · Positive with limitations
- TMS-Derived Neurophysiological Measures of Corticospinal Excitability, Intracortical Excitability, and Interhemispheric Interactions Associated With Post-Stroke Motor Recovery: A Systematic Review. · Positive with limitations
Summary prepared with AI assistance. Source verification does not imply an independent replication or a clinician's endorsement. Read our review method.