A Study on the Efficacy of an Online Neurofeedback Game Using Consumer-Grade EEG on Enhancing Attention Skills in Stroke and Mild Cognitive Impairment Patients

The burden of cognitive impairment is increasing worldwide and the rehabilitation of patients with such disorders is a major concern. Neurofeedback training (NFT) is emerging as a promising non-pharmacological intervention for enhancing cognition in healthy and cognitive-deficit patients. In this paper, we examine the efficacy of a real-time neurofeedback game using a four-channel consumer-grade Electroencephalography (EEG) system on enhancing overt and covert attention skills in Stroke and Mild cognitive impairment (MCI) patients. The game works based on navigating a car on a computer screen using the player's attention level computed from EEG signals streamed in real-time. The proposed NFT is conducted across 18 patients (10 Stroke and 8 MCI). The attention score significantly improved from the first session to the final session by 1.25-12.55% in the stroke group and 1.84-44.14% in the MCI group. The experimental results demonstrate that the proposed neurofeedback game using consumer-grade EEG is an effective tool for enhancing overt and covert attention skills in patients with cognitive impairment. To our knowledge, this is the first EEG-Brain Computer Interface study for improving overt and covert attention on the cross-sectional stroke-MCI patients.