Application of Brain–Computer Interface Technology in Vascular Cognitive Impairment: A Systematic Review

Background: Vascular cognitive impairment (VCI) is a common consequence of cerebrovascular diseases and significantly affects multiple cognitive domains. Brain–computer interface (BCI) technology has emerged as a promising tool for cognitive assessment and rehabilitation in patients with VCI. This systematic review examined the current applications of BCI technology for cognitive function in patients with VCI. Methods: In accordance with the PRISMA 2020 guidelines, we searched Medline, PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials. We included studies published between January 2000 and March 2026 that evaluate BCI for cognitive function in patients with VCI. Results: A total of 30 studies were included in the review. The participants comprised 696 stroke patients, 71 patients with early cerebral microangiopathy and 128 patients with VCI and no dementia. In patients with VCI, BCI interventions combined with other technologies (e.g., exoskeleton, virtual reality, functional electrical stimulation, acupuncture, or game-based cognitive training) appeared more effective for cognitive rehabilitation than BCI alone. Attention was the most consistently improved domain among the studies reviewed. Global cognitive function also improved in many studies, though not uniformly. Memory, executive function, and language outcomes varied depending on factors such as intervention protocols, training duration, and assessment tools. Conclusions: BCI is a promising tool for cognitive assessment and rehabilitation in patients with VCI. However, substantial heterogeneity across studies limits the conclusions. Future large-scale, well-designed randomized controlled trials with standardized outcome measures are needed to validate the efficacy of BCI technology and to explore its underlying mechanisms.