Influence of age, cognitive function, attention, and mental state on the effectiveness of EEG-based brain-computer interface device use: a systematic review.
Xinyue Niu, Min Yuan, Dong Wang
PMID 41310746WHAT IT FOUND
Motor imagery BCIs are sensitive to age and cognitive decline, while visual-based systems like P300 and SSVEP remain stable across groups.
Fatigue and low attention significantly reduce control accuracy, requiring shorter sessions or adaptive feedback for effective rehabilitation.
Key findings
01Visual-based BCI paradigms (P300, SSVEP) show stable performance across age groups, whereas motor imagery (MI) systems are significantly more sensitive to cognitive maturity and aging.
02Mental fatigue and low attentional engagement directly reduce BCI classification accuracy and information transfer rates, though brief rest intervals can offset these declines.
03Higher cognitive function and mental rotation ability correlate with better motor imagery BCI performance, suggesting these users may adapt more effectively to MI-based training.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
High heterogeneity in study designs, participant demographics, and outcome metrics prevented meta-analysis. Most included studies had small sample sizes (often fewer than 15 to 80 participants). Many studies used healthy young adults rather than the clinical populations (e.g., elderly stroke patients) who would use BCI in practice. User-centered indicators like training time, subjective fatigue, and engagement were frequently omitted in the original studies. The review excluded invasive BCI systems, limiting generalizability to those technologies.
Declared interests
The study was funded by the Health Commission of Sichuan Province Medical Science and Technology Program and the Sichuan Medical Association Medical Youth Innovation Project. No specific conflicts of interest regarding commercial BCI entities were declared in the text.
The easy way to misread this
Do not assume that motor imagery BCIs are universally suitable for older adults or patients with cognitive impairment. The review found that MI performance is significantly sensitive to age and cognitive decline, whereas visual-based paradigms remain more stable. Using MI systems without assessing the patient's cognitive readiness may lead to frustration and poor rehabilitation outcomes.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →