Brain-Computer Interface Priming for Cervical Transcutaneous Spinal Cord Stimulation Therapy: An Exploratory Case Study.

The study involved only one participant, so findings cannot be generalized to other people with spinal cord injury. The crossover design did not include a control group receiving only exercise training without stimulation, making it impossible to separate the effects of tSCS from the effects of intensive practice alone. Improvements in the second phase may have been a continuation of learning or recovery from the first phase rather than an added effect of the BCI priming. The right hand showed no detectable grip strength throughout the study, possibly due to the insensitivity of the dynamometer used, limiting the ability to assess unilateral strength changes accurately. The lack of change in independence measures suggests that the improvements seen in clinical tests did not translate to meaningful functional gains in daily life.

The authors declared no commercial or financial conflicts of interest. The work was supported by RCUK PhD scholarships, university mobility scholarships, and charitable funds.

Do not interpret the continued improvement in scores during the priming phase as evidence that BCI priming enhances recovery. The authors state these gains may have simply been a continuation of progress from the initial training phase, and independence in daily activities did not improve.