Closed-loop rehabilitation

The general architecture of plasticity-driven rehabilitation BCIs: continuously sense a neural (and often behavioral) signal, decide in real time whether the desired state or intent is present, and deliver contingent feedback or stimulation that closes the sensorimotor loop, then repeat. Closing the loop is what distinguishes therapeutic pairing from open-loop stimulation — the feedback is delivered because of, and time-locked to, the patient's own volitional activity, which is exactly the contingency that Hebbian and reinforcement mechanisms require.

Honesty: 'closed-loop' is used loosely. A genuinely plasticity-relevant loop must close within the biological timing window and be contingent on the correct signal, not merely be automated. Poorly-chosen contingencies can reinforce compensation or noise, and the added complexity — real-time decoding, latency, calibration — is justified only when timing and contingency actually drive better outcomes than simpler paced practice.