How Mindfulness can help Patients in Neurorehabilitation

by S. Hussain Ather

Graphic design by Sherry An

Among its many benefits, mindfulness meditation has been shown to help people experience more control over their attention and emotions while becoming more self-aware as they enter states of relaxation. Recent research suggests that mindfulness meditation may help patients in neurorehabilitation, a set of treatments designed to help patients with impaired central and peripheral nervous systems to regain control over their bodies. In many applications, particularly for patients who may have suffered from stroke or spinal cord injury, they may require brain-computer interfaces (BCIs) to function. A patient using a BCI can use the signals measured from their brain to control computers and other devices such as neural-prostheses for communication, motion restoration to otherwise paralyzed limbs, and neural interfaces for general life improvement. 

BCI can be achieved through non-invasive means that involves electroencephalogram (EEG) recordings taken through the skull. This approach is safe and convenient compared to more risky invasive methods using a brain implant, but it may take longer to learn and users can vary in proficiency. Through recent research, meditation shows to be a promising way to improve non-invasive BCI performance and helps reduce the time for patients to learn how to effectively use their BCI. 

In a recent study, researchers found increased activity in the alpha-band region of the spectrum of neural activity, commonly involved with selective attention, for patients who spent time performing intentional mindfulness-based stress reduction (MBSR), a type of mind-body awareness training (MBAT), which corresponded with greater performance for BCI activities in which the patients had to rest.1 Described by MBSR’s founder Jon Kabat-Zinn, American Professor Emeritus of Medicine, as “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally,” the training involved a class that lasted two to three hours that met once a week along with a seven-and-a-half-hour silent retreat during the sixth week of the class. The participants were then asked to accurately measure breath counts—a metric commonly associated with greater mindfulness and meta-awareness alongside less mind-wandering. Using the BCI2000 software to encode EEG data into computer commands, participants were asked to move a cursor toward a target on a computer screen using their imagination alongside instructions to clear their mind. The participants who performed mindfulness exercises were able to modulate a set of EEG patterns of activity known as the “mu rhythm” with much greater ease than the control group. These are oscillatory patterns of EEG activity in the alpha band (between 8 to 12 Hz) recorded over sensorimotor rhythms (SMRs), primarily involved in real and imagined movements. These findings suggest that behavioral interventions such as MBAT could be done to help patients in neurorehabilitation to maximize the performance of BCI.

For patients with impaired nervous system in neurorehabilitation, researchers can study how the signals of interest from the brain correspond to various frequencies across a spectrum of data given by EEG. Should patients be able to exercise greater control over the frequencies emitted by their own brains, they could improve their functional performances when using BCI. In another study, 76 individuals were assigned randomly to either a meditation or control group. With only eight sessions of MBAT, the meditation group showed significantly greater abilities to control BCIs while becoming completely skillful at operating them in a short period of time compared to the control group. 

“Our findings suggest that, to practice sensorimotor rhythm BCIs—one BCI based on the imagination of actions—the link between one’s mind and their body is important,” said Bin He, Trustee Professor of Biomedical Engineering at Carnegie Mellon University, echoing the role of mindfulness to strengthen the connection between the mind and the body for relaxation and empowerment. Patients who need to imagine themselves moving a limb would benefit from these practices. 

While previous work has been done in MBSR intervention to tell patients to “rest better,” no differences had been found between the power of the alpha bands of the passive rest between groups after the intervention or throughout the training. In this study, the subjects at intentional (or volitional) rest could increase their alpha power while the scientists recorded electrophysiological responses. Choosing to rest during mindfulness caused this difference. Other work showing the effects of mindfulness meditation on improving BCI performance include the focused activation of the fronto-parietal region of the brain for motor imagery tasks.2 

“In our study, subjects are instructed to be ‘at rest’ without actively imagining limb movement,” said He, on the study of mindfulness meditation, “We then quantified such brain states using EEG spatial mapping and source imaging, and such electrophysiological responses and biomarkers helped us study the brain ‘at rest’.” 

In addition to health benefits, this research could be used in improving design and maintenance for BCIs. Understanding how areas of the brain change in response to activities such as mindfulness may allow neuroscientists and engineers to increase the effectiveness and efficiency of how BCIs interpret and understand brain signals themselves. BCI recalibration, in particular, can be time-consuming, and optimizing these methods may prove beneficial for their purpose. 

Though the study by He and colleagues was limited in that the research only focused on sustained attention, rather than all activities involved in BCI control, other increases in performance for patients with MBSR intervention were observed as well. For instance, the researchers noted how individuals could create motor imagery—images produced by activity from the motor cortex by imagining motor movements without moving one’s limbs or external stimuli. They found the patients could also regulate how well they could synchronize the rhythms of neural activity during motor imagery or rest tasks. 

Future work can be done in studying how MBAT affects alpha-band activity in neural communication for determining the more precise role of neural correlates in activities related to attention such as mind-wandering and releasing thoughts.


  1. Stieger JR, Engel S, Jiang H, et al. Mindfulness improves brain–computer interface performance by increasing control over neural activity in the alpha band. Cerebral Cortex. 2021 Jan;31(1):426-38.
  2. Tan LF, Dienes Z, Jansari A, Goh SY. Effect of mindfulness meditation on brain–computer interface performance. Consciousness and cognition. 2014 Jan 1;23:12-21.