Functional recovery from chronic writer's cramp by brain-computer interface rehabilitation: A case report

Background: Dystonia is often currently treated with botulinum toxin injections to spastic muscles, or deep brain stimulation to the basal ganglia. In addition to these pharmacological or neurosurgical measures, a new noninvasive treatment concept, functional modulation using a brain-computer interface, was tested for feasibility. We recorded electroencephalograms (EEGs) over the bilateral sensorimotor cortex from a patient suffering from chronic writer's cramp. The patient was asked to suppress an exaggerated beta frequency component in the EEG during hand extension. Results: The patient completed biweekly one-hour training for 5 months without any adverse effects. Significant decrease of the beta frequency component during handwriting was confirmed, and was associated with clear functional improvement. Conclusion: The current pilot study suggests that a brain-computer Interface can give explicit feedback of ongoing cortical excitability to patients with dystonia and allow them to suppress exaggerated neural activity, resulting in functional recovery.