Skip to main content
SpringerLink
Log in

Trends in BCI Research I: Brain-Computer Interfaces for Assessment of Patients with Locked-in Syndrome or Disorders of Consciousness

  • Chapter
  • First Online:
Brain-Computer Interface Research

Part of the book series: SpringerBriefs in Electrical and Computer Engineering ((BRIEFSELECTRIC))

Abstract

Patients diagnosed with complete locked in syndrome (CLIS) or a disorder of consciousness (DOC) have no reliable control of voluntary movements. Hence, assessing their cognitive functions and cognitive awareness can be challenging. The “gold standard” for such assessments relies on behavioral responses, and recent work using different neuroimaging methods has shown that behavioral diagnoses may underestimate patients’ capabilities. Thus, there is a pressing need for new methods that go beyond behavioral approaches and can help patients even if they are not able to produce any behavioral response. In one of the most prominent trends in brain-computer interface (BCI) research, many groups have been using BCI technology to provide a suite of approaches to assess cognition and consciousness using EEG-based tools. This paper presents results with P300, steady-state visual evoked potential (SSVEP) and motor imagery BCIs and other approaches with different target patients in several different real-world settings. Results confirm that EEG-based assessment can reveal details about patients’ remaining capabilities that can both change and extend diagnoses based on behavioral measures. The results can already be used in clinical practice to help physicians, patients, and families develop a more detailed and accurate assessments, and provide hope for further technical and methodological improvements through future research.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Guger C, Noirhomme Q, Naci L, Real R, Lugo Z, Veser S, Sorger B, Quitadamo L, Lesenfants D, Risetti M, Formisano R, Toppi J, Astolfi L, Emmerling T, Erlbeck H, Monti MM, Kotchoubey B, Bianchi L, Mattia D, Goebel R, Owen AM, Pellas F, Müller-Putz G, Kübler A (2014) Brain-computer interfaces for coma assessment and communication. In: Ganesh RN (ed) Emerging theory and practice in neuroprosthetics. IGIGLOBAL Press

    Google Scholar 

  2. Lesenfants D, Habbal D, Chatelle C, Schnakers C, Laureys S, Noirhomme Q Electromyographic decoding of response to command in disorders of consciousness, submitted A

    Google Scholar 

  3. Coyle D, Stow J, McCreadie K, Sciacca N, McElligott J, Carroll Á (2017) Motor imagery BCI with auditory feedback as a mechanism for assessment and communication in disorders of consciousness. In: Brain-Computer Interface Research. Springer International Publishing, pp 51–69

    Google Scholar 

  4. Laureys S, Pellas F, Van Eeckhout P, Ghorbel S, Schnakers C, Perrin F, Berre J, Feymonville ME, Pantke KH, Damas F, Lamy M, Moonen G, Goldman S (2005) The locked-in syndrome: What is it like to be conscious but paralyzed and voiceless? Prog Brain Res 150:495–511

    Article  Google Scholar 

  5. Ortner R, Lugo Z, Prückl R, Hintermüller C, Noirhomme Q, Guger C (2013) Performance of a tactile P300 speller for healthy people and severely disabled patients. In: Proceedings of the 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2013), Osaka, JP. 3–7 July 2013

    Google Scholar 

  6. Lugo ZR, Rodriguez J, Lechner A, Ortner R, Gantne IS, Laureys S, Guger C (2014) A vibrotactile p 300-based brain-computer interface for consciousness detection and communication. Clin EEG Neurosci 45:14–21

    Google Scholar 

  7. Guger C, Kapeller C, Ortner R, Kamada K (2015) Motor imagery with brain-computer interface neurotechnology. In: Garcia BM (ed) Motor imagery: emerging practices, role in physical therapy and clinical implications, pp 61–79

    Google Scholar 

  8. Guger C, Spataro R, Allison BZ, Heilinger A, Ortner R, Cho W, La Bella V (2017) Complete locked-in and locked-in patients: command following assessment and communication with vibro-tactile P300 and motor imagery brain-computer interface tools. Front Neurosci 11

    Google Scholar 

  9. Coyle D et al (2012) Enabling control in the minimally conscious state in a single session with a three channel BCI. In: 1st International Decoder Workshop, April, pp 1–4

    Google Scholar 

  10. Coyle D et al (2015) Sensorimotor modulation assessment and brain-computer interface training in disorders of consciousness. Arch Phys Med Rehabil 96(3):62–70

    Article  Google Scholar 

  11. Coyle D et al (2013) Visual and stereo audio sensorimotor rhythm feedback in the minimally conscious state. In: Proceedings of the Fifth International Brain-Computer Interface Meeting 2013, pp 38–39

    Google Scholar 

  12. Cruse D, Chennu S, Chatelle C, Bekinschtein TA, Fernández-Espejo D, Pickard JD, Owen AM (2011) Bedside detection of awareness in the vegetative state: a cohort study. Lancet 378(9809):2088–2094

    Google Scholar 

  13. Nuffield Council on Bioethics Report (2013) Novel neurotechnologies : intervening in the brain. http://nuffieldbioethics.org/wp-content/uploads/2013/06/Novel_neurotechnologies_report_PDF_web_0.pdf

  14. Aricò P, Aloise F, Schettini F, Salinari S, Mattia D, Cincotti F (2014) Influence of P300 latency jitter on event related potential-based brain-computer interface performance. J Neural Eng 11(3):035008

    Article  Google Scholar 

  15. Schettini F, Risetti M, Arico P, Formisano F, Babiloni F, Mattia D, Cincotti F (2015) P300 latency Jitter occurrence in patients with disorders of consciousness: toward a better design for brain computer interface applications. In: Engineering in Medicine and Biology Society (EMBC), 2015 37th Annual International Conference of the IEEE, 2015, pp 6178–6181

    Google Scholar 

  16. Olsson C-J, Nyberg L (2010) Motor imagery: If you can’t do it, you won’t think it. Scand J Med Sci Sports 20:711–715

    Article  Google Scholar 

  17. Bovend’Eerdt TJH, Dawes H, Sackley C, Wade DT (2012) Practical research-based guidance for motor imagery practice in neurorehabilitation. Disabil Rehabil 34(25):2192–2200

    Article  Google Scholar 

  18. Snyder AZ (1992) Steady-state vibration evoked potentials: description of technique and characterization of responses. Electroencephalogr Clin Neurophysiol Potentials Sect 84(3):257–268

    Article  Google Scholar 

  19. Severens M, Farquhar J, Duysens J, Desain P (2013) A multi-signature brain-computer interface: use of transient and steady-state responses. J Neural Eng 10(2):026005

    Article  Google Scholar 

  20. Choi I, Bond K, Krusienski D, Nam CS (2015) Comparison of stimulation patterns to elicit steady-state somatosensory evoked potentials (SSSEPs): implications for hybrid and SSSEP-based BCIs. In: IEEE International Conference on Systems, Man, and Cybernetics (SMC), 2015

    Google Scholar 

  21. Giacino JT, Kalmar K, Whyte J (2004) The JFK Coma Recovery Scale-Revised: Measurement characteristics and diagnostic utility. Arch Phys Med Rehabil 85(12):2020–2029

    Article  Google Scholar 

  22. Laureys S, Perrin F, Faymonville M-E, Schnakers C, Boly M (2004) Cerebral processing in the minimally conscious state. Neurology 63:916–918

    Article  Google Scholar 

  23. Jox RJ, Bernat JL, Laureys S, Racine E (2012) Disorders of consciousness: responding to requests for novel diagnostic and therapeutic interventions. Lancet Neurol 11(8):732–738

    Article  Google Scholar 

  24. Bruno MA, Bernheim JL, Ledoux D, Pellas F, Demertzi A, Laureys S (2011) A survey on self assessed well-being in a cohort of chronic locked-in syndrome patients: happy majority, miserable minority. BMJ Open 1(1):1–9

    Google Scholar 

  25. Bekinschtein TA, Coleman MR, Niklison J, Pickard JD, Manes FF (2008) Can electromyography objectively detect voluntary movement in disorders of consciousness? J Neurol Neurosurg Psychiatry 79(7):826–828

    Article  Google Scholar 

  26. Habbal D, Gosseries O, Noirhomme Q, Renaux J, Lesenfants D, Bekinschtein TA, Majerus S, Laureys S, Schnakers C (2014) Volitional electromyographic responses in disorders of consciousness. Brain Inj 28(9):1171–1179

    Article  Google Scholar 

  27. Stoll J, Chatelle C, Carter O, Koch C, Laureys S, Einhäuser W (2013) Pupil responses allow communication in locked-in syndrome patients. Curr Biol 23(15):R647–R648

    Article  Google Scholar 

  28. Ruf CA, DeMassari D, Wagner-Podmaniczky F, Matuz T, Birbaumer N (2013) Semantic conditioning of salivary pH for communication. Artif Intell Med 59(2):91–98

    Article  Google Scholar 

  29. Wilhelm B, Jordan M, Birbaumer N (2006) Communication in locked-in syndrome: effects of imagery on salivary pH. Neurology 67(3):534–535

    Article  Google Scholar 

  30. Charland-Verville V, Lesenfants D, Sela L, Noirhomme Q, Ziegler E, Chatelle C, Plotkin A, Sobel N, Laureys S (2014) Detection of response to command using voluntary control of breathing in disorders of consciousness. Front Hum Neurosci 8

    Google Scholar 

  31. Laureys S, Schiff ND (2012) Coma and consciousness: paradigms (re)framed by neuroimaging. NeuroImage 61:1681–1691

    Article  Google Scholar 

Download references

Acknowledgements

The work of g.tec was supported by the H2020 grant ComaWare and ComAlert (project number E! 9361 Com-Alert). Q. Noirhomme has received funding from the European Community’s Seventh Framework Program under grant agreement n° 602450 (IMAGEMEND). Research at OHSU was supported by NIH grant R01DC014294 and NIDILRR grant 90RE5017. Research at MGH was supported by NIH grant K23NS094538 and the American Academy of Neurology/American Brain Foundation. Research at NCSU was supported by NSF grant IIS1421948. Marzia De Lucia’s research at Lausanne University Hospital is supported by the “EUREKA-Eurostars” grant (project number E! 9361 Com-Alert). The work was partially supported by the Italian Ministry of Healthcare and the French Speaking Community Concerted Research Action (ARC-06/11-340). This paper reflects only the authors’ view and the funding sources are not liable for any use that may be made of the information contained therein.

Author information

Authors and Affiliations

  1. g.tec Guger Technologies OG, Herbersteinstrasse 60, 8020, Graz, Austria

    Christoph Guger & Brendan Z. Allison

  2. Faculty of Computing and Engineering, School of Computing and Intelligent Systems, Magee Campus, Ulster University, Northland Road, Derry, Northern Ireland, BT48 7JL, UK

    Damien Coyle

  3. Neuroelectrical Imaging and BCI Lab, Fondazione Santa Lucia, IRCCS, Via Ardeatina, 306, 00179, Rome, Italy

    Donatella Mattia

  4. Laboratoire de Recherche en Neuroimagerie (LREN), Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, chemin de Mont-Paisible 16, 1011, Lausanne, Switzerland

    Marzia De Lucia

  5. Department of Neurology, Massachusetts General Hospital, 175 Cambridge Street, Boston, MA, 02114, USA

    Leigh Hochberg & Brian L. Edlow

  6. Oregon Health & Science University, 707 SW Gaines St, #1290, Portland, OR, 97239, USA

    Betts Peters & Brandon Eddy

  7. Brain-Computer Interface (BCI) Lab, North Carolina State University, Raleigh, NC 27695, USA

    Chang S. Nam

  8. Coma Science Group, GIGA Research and Neurology Department, University Hospital of Liège, Liège, Belgium

    Quentin Noirhomme & Jitka Annen

Authors
  1. Christoph Guger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Damien Coyle
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Donatella Mattia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marzia De Lucia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Leigh Hochberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Brian L. Edlow
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Betts Peters
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Brandon Eddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Chang S. Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Quentin Noirhomme
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Brendan Z. Allison
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jitka Annen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christoph Guger .

Editor information

Editors and Affiliations

  1. g.tec Guger Technologies OG, Schiedlberg, Austria

    Christoph Guger

  2. g.tec Guger Technologies OG, Schiedlberg, Austria

    Brendan Allison

  3. Department of Neurobiology, Duke University, Durham, North Carolina, USA

    Mikhail Lebedev

Rights and permissions

Reprints and permissions

Copyright information

© 2017 The Author(s)

About this chapter

Cite this chapter

Guger, C. et al. (2017). Trends in BCI Research I: Brain-Computer Interfaces for Assessment of Patients with Locked-in Syndrome or Disorders of Consciousness. In: Guger, C., Allison, B., Lebedev, M. (eds) Brain-Computer Interface Research. SpringerBriefs in Electrical and Computer Engineering. Springer, Cham. https://doi.org/10.1007/978-3-319-64373-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64373-1_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64372-4

  • Online ISBN: 978-3-319-64373-1

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics

Search

Navigation