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Action observation (AO) therapy holds promise for priming residual motor pathways even when voluntary movement is minimal. This scoping review aimed to identify EEG-derived indicators of cortical engagement during upper-limb AO therapy after stroke, examine how these neural metrics relate to motor outcomes, and summarize methodological variability across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA-ScR guidelines, six databases were searched, yielding 386 records. Twenty-two studies met inclusion criteria by combining upper-limb AO paradigms with EEG outcomes and motor assessments. Data were extracted on AO task characteristics, EEG acquisition and processing, biomarker definitions, and associations with behavioral measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across paradigms, sensorimotor event-related desynchronization (ERD) in the mu (8\u201313 Hz) and beta (13\u201330 Hz) bands consistently indexed activation of action observation network. Multi-week AO therapy interventions produced sustained increases in mu\/beta ERD, beta-band connectivity, and fast-to-slow spectral power ratios. These neural changes frequently correlated with improvements in Fugl-Meyer Assessment scores, dexterity tests, and functional performance. Furthermore, AO-driven brain\u2013computer interface paradigms and combined AO and motor imagery elicited robust cortical and functional gains, underscoring the potential of EEG-guided, closed-loop AO therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EEG provides reproducible, temporally precise biomarkers of AO-induced cortical engagement and motor recovery in stroke rehabilitation. Nonetheless, heterogeneity in AO protocol and stimulus design hampers cross-study comparability. Future work should standardize protocols and determine reliable biomarkers for real-time AO personalized neurorehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10439-026-04404-2","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:43:54Z","timestamp":1790689434000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["EEG Biomarkers During Upper-Limb Action Observation Therapy for Stroke Rehabilitation: A Scoping Review"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9794-597X","authenticated-orcid":false,"given":"Anh T.","family":"Nguyen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"5","key":"4404_CR1","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/S1474-4422(19)30034-1","volume":"18","author":"CO Johnson","year":"2019","unstructured":"Johnson, C. 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