@article {4450, title = {Towards clinical application of implantable brain-computer interfaces for people with late-stage ALS: medical and ethical considerations.}, journal = {J Neurol}, volume = {270}, year = {2023}, month = {03/2023}, pages = {1323-1336}, abstract = {

Individuals with amyotrophic lateral sclerosis (ALS) frequently develop speech and communication problems in the course of their disease. Currently available augmentative and alternative communication technologies do not present a solution for many people with advanced ALS, because these devices depend on residual and reliable motor activity. Brain-computer interfaces (BCIs) use neural signals for computer control and may allow people with late-stage ALS to communicate even when conventional technology falls short. Recent years have witnessed fast progression in the development and validation of implanted BCIs, which place neural signal recording electrodes in or on the cortex. Eventual widespread clinical application of implanted BCIs as an assistive communication technology for people with ALS will have significant consequences for their daily life, as well as for the clinical management of the disease,~among others because of the potential interaction between the BCI and other procedures people with ALS undergo, such as tracheostomy. This article aims to facilitate responsible real-world implementation of implanted BCIs. We review the state of the art of research on implanted BCIs for communication, as well as the medical and ethical implications of the clinical application of this technology. We conclude that the contribution of all BCI stakeholders, including clinicians of the various ALS-related disciplines, will be needed to develop procedures for, and shape the process of, the responsible clinical application of implanted BCIs.

}, keywords = {Amyotrophic Lateral Sclerosis, brain-computer interfaces, Electroencephalography, Humans, Self-Help Devices, Speech}, issn = {1432-1459}, doi = {10.1007/s00415-022-11464-6}, author = {Vansteensel, Mariska J and Klein, Eran and van Thiel, Ghislaine and Gaytant, Michael and Simmons, Zachary and Wolpaw, Jonathan R and Vaughan, Theresa M} } @article {4495, title = {Brain-computer interface-based assessment of color vision.}, journal = {J Neural Eng}, volume = {18}, year = {2021}, month = {2021 Nov 26}, abstract = {

Present methods for assessing color vision require the person{\textquoteright}s active participation. Here we describe a brain-computer interface-based method for assessing color vision that does not require the person{\textquoteright}s participation.This method uses steady-state visual evoked potentials to identify metamers-two light sources that have different spectral distributions but appear to the person to be the same color.We demonstrate that: minimization of the visual evoked potential elicited by two flickering light sources identifies the metamer; this approach can distinguish people with color-vision deficits from those with normal color vision; and this metamer-identification process can be automated.This new method has numerous potential clinical, scientific, and industrial applications.

}, keywords = {brain-computer interfaces, Color Vision, Electroencephalography, Evoked Potentials, Visual, Humans, Light, Photic Stimulation, Research Design}, issn = {1741-2552}, doi = {10.1088/1741-2552/ac3264}, author = {Norton, James J S and DiRisio, Grace F and Carp, Jonathan S and Norton, Amanda E and Kochan, Nicholas S and Wolpaw, Jonathan R} } @article {4362, title = {A Voting-Enhanced Dynamic-Window-Length Classifier for SSVEP-Based BCIs.}, journal = {IEEE Trans Neural Syst Rehabil Eng}, volume = {29}, year = {2021}, month = {2021}, pages = {1766-1773}, abstract = {

We present a dynamic window-length classifier for steady-state visual evoked potential (SSVEP)-based brain-computer interfaces (BCIs) that does not require the user to choose a feature extraction method or channel set. Instead, the classifier uses multiple feature extraction methods and channel selections to infer the SSVEP and relies on majority voting to pick the most likely target. The classifier extends the window length dynamically if no target obtains the majority of votes. Compared with existing solutions, our classifier: (i) does not assume that any single feature extraction method will consistently outperform the others; (ii) adapts the channel selection to individual users or tasks; (iii) uses dynamic window lengths; (iv) is unsupervised (i.e., does not need training). Collectively, these characteristics make the classifier easy-to-use, especially for caregivers and others with limited technical expertise. We evaluated the performance of our classifier on a publicly available benchmark dataset from 35 healthy participants. We compared the information transfer rate (ITR) of this new classifier to those of the minimum energy combination (MEC), maximum synchronization index (MSI), and filter bank canonical correlation analysis (FBCCA). The new classifier increases average ITR to 123.5 bits-per-minute (bpm), 47.5, 51.2, and 19.5 bpm greater than the MEC, MSI, and FBCCA classifiers, respectively.

}, keywords = {Algorithms, brain-computer interfaces, Electroencephalography, Evoked Potentials, Visual, Humans, Photic Stimulation}, issn = {1558-0210}, doi = {10.1109/TNSRE.2021.3106876}, author = {Habibzadeh, Hadi and Norton, James J S and Vaughan, Theresa M and Soyata, Tolga and Zois, Daphney-Stavroula} } @article {4367, title = {Enhancing Communication for People in Late-Stage ALS Using an fNIRS-Based BCI System.}, journal = {IEEE Trans Neural Syst Rehabil Eng}, volume = {28}, year = {2020}, month = {05/2020}, pages = {1198-1207}, abstract = {

OBJECTIVE: Brain-computer interface (BCI) based communication remains a challenge for people with later-stage amyotrophic lateral sclerosis (ALS) who lose all voluntary muscle control. Although recent studies have demonstrated the feasibility of functional near-infrared spectroscopy (fNIRS) to successfully control BCIs primarily for healthy cohorts, these systems are yet inefficient for people with severe motor disabilities like ALS. In this study, we developed a new fNIRS-based BCI system in concert with a single-trial Visuo-Mental (VM) paradigm to investigate the feasibility of enhanced communication for ALS patients, particularly those in the later stages of the disease.

METHODS: In the first part of the study, we recorded data from six ALS patients using our proposed protocol (fNIRS-VM) and compared the results with the conventional electroencephalography (EEG)-based multi-trial P3Speller (P3S). In the second part, we recorded longitudinal data from one patient in the late locked-in state (LIS) who had fully lost eye-gaze control. Using statistical parametric mapping (SPM) and correlation analysis, the optimal channels and hemodynamic features were selected and used in linear discriminant analysis (LDA).

RESULTS: Over all the subjects, we obtained an average accuracy of 81.3\%{\textpm}5.7\% within comparatively short times (< 4 sec) in the fNIRS-VM protocol relative to an average accuracy of 74.0\%{\textpm}8.9\% in the P3S, though not competitive in patients with no substantial visual problems. Our longitudinal analysis showed substantially superior accuracy using the proposed fNIRS-VM protocol (73.2\%{\textpm}2.0\%) over the P3S (61.8\%{\textpm}1.5\%).

SIGNIFICANCE: Our findings indicate the potential efficacy of our proposed system for communication and control for late-stage ALS patients.

}, keywords = {Amyotrophic Lateral Sclerosis, brain-computer interfaces, Communication, Electroencephalography, Humans, Spectroscopy, Near-Infrared}, issn = {1558-0210}, doi = {10.1109/TNSRE.2020.2980772}, author = {Borgheai, Seyyed Bahram and McLinden, John and Zisk, Alyssa Hillary and Hosni, Sarah Ismail and Deligani, Roohollah Jafari and Abtahi, Mohammadreza and Mankodiya, Kunal and Shahriari, Yalda} } @article {4095, title = {Differential roles of high gamma and local motor potentials for movement preparation and execution}, journal = {Brain-Computer Interfaces}, volume = {3}, year = {2016}, month = {May}, pages = {88-102}, abstract = {Determining a person{\textquoteright}s intent, such as the planned direction of their movement, directly from their cortical activity could support important applications such as brain-computer interfaces (BCIs). Continuing development of improved BCI systems requires a better understanding of how the brain prepares for and executes movements. To contribute to this understanding, we recorded surface cortical potentials (electrocorticographic signals; ECoG) in 11 human subjects performing a delayed center-out task to establish the differential role of high gamma activity (HGA) and the local motor potential (LMP) as a function of time and anatomical area during movement preparation and execution. High gamma modulations mostly confirm previous findings of sensorimotor cortex involvement, whereas modulations in LMPs are observed in prefrontal cortices. These modulations include directional information during movement planning as well as execution. Our results suggest that sampling signals from these widely distributed cortical areas improves decoding accuracy.}, keywords = {BCI, brain-computer interfaces, ECoG, Electrocorticography, sensorimotor systems}, doi = {https://doi.org/10.1080/2326263X.2016.1179087}, author = {Gunduz, Aysegul and Peter Brunner and Sharma, Mohit and Leuthardt, Eric C. and Ritaccio, Anthony L. and Pesaran, Bijan and Schalk, Gerwin} } @article {3415, title = {Toward independent home use of brain-computer interfaces: a decision algorithm for selection of potential end-users.}, journal = {Arch Phys Med Rehabil}, volume = {96}, year = {2015}, month = {03/2015}, pages = {S27-32}, abstract = {

Noninvasive brain-computer interfaces (BCIs) use scalp-recorded electrical activity from the brain to control an application. Over the past 20 years, research demonstrating that BCIs can provide communication and control to individuals with severe motor impairment has increased almost exponentially. Although considerable effort has been dedicated to offline analysis for improving signal detection and translation, far less effort has been made to conduct online studies with target populations. Thus, there remains a great need for both long-term and translational BCI studies that include individuals with disabilities in their own homes. Completing these studies is the only sure means to answer questions about BCI utility and reliability. Here we suggest an algorithm for candidate selection for electroencephalographic (EEG)-based BCI home studies. This algorithm takes into account BCI end-users and their environment and should assist in study design and substantially improve subject retention rates, thereby improving the overall efficacy of BCI home studies. It is the result of a workshop at the Fifth International BCI Meeting that allowed us to leverage the expertise of multiple research laboratories and people from multiple backgrounds in BCI research.

}, keywords = {Algorithms, brain-computer interfaces, Cognition, Disabled Persons, Electroencephalography, Environment, Humans, Patient Selection, Physical Therapy Modalities}, issn = {1532-821X}, doi = {10.1016/j.apmr.2014.03.036}, url = {http://www.ncbi.nlm.nih.gov/pubmed/25721544}, author = {K{\"u}bler, Andrea and Holz, Elisa Mira and Sellers, Eric W and Theresa M Vaughan} } @article {3395, title = {Adaptive spatio-temporal filtering for movement related potentials in EEG-based brain-computer interfaces.}, journal = {IEEE Trans Neural Syst Rehabil Eng}, volume = {22}, year = {2014}, month = {07/2014}, pages = {847-57}, abstract = {Movement related potentials (MRPs) are used as features in many brain-computer interfaces (BCIs) based on electroencephalogram (EEG). MRP feature extraction is challenging since EEG is noisy and varies between subjects. Previous studies used spatial and spatio-temporal filtering methods to deal with these problems. However, they did not optimize temporal information or may have been susceptible to overfitting when training data are limited and the feature space is of high dimension. Furthermore, most of these studies manually select data windows and low-pass frequencies. We propose an adaptive spatio-temporal (AST) filtering method to model MRPs more accurately in lower dimensional space. AST automatically optimizes all parameters by employing a Gaussian kernel to construct a low-pass time-frequency filter and a linear ridge regression (LRR) algorithm to compute a spatial filter. Optimal parameters are simultaneously sought by minimizing leave-one-out cross-validation error through gradient descent. Using four BCI datasets from 12 individuals, we compare the performances of AST filter to two popular methods: the discriminant spatial pattern filter and regularized spatio-temporal filter. The results demonstrate that our AST filter can make more accurate predictions and is computationally feasible.}, keywords = {Algorithms, Artificial Intelligence, brain-computer interfaces, Data Interpretation, Statistical, Electroencephalography, Evoked Potentials, Motor, Humans, Imagination, Motor Cortex, Movement, Pattern Recognition, Automated, Reproducibility of Results, Sensitivity and Specificity, Signal Processing, Computer-Assisted, Spatio-Temporal Analysis}, issn = {1558-0210}, doi = {10.1109/TNSRE.2014.2315717}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24723632}, author = {Lu, Jun and Xie, Kan and Dennis J. McFarland} } @article {3370, title = {Brain-computer interface (BCI) evaluation in people with amyotrophic lateral sclerosis.}, journal = {Amyotroph Lateral Scler Frontotemporal Degener}, volume = {15}, year = {2014}, month = {06/2014}, pages = {207-15}, abstract = {Brain-computer interfaces (BCIs) might restore communication to people severely disabled by amyotrophic lateral sclerosis (ALS) or other disorders. We sought to: 1) define a protocol for determining whether a person with ALS can use a visual P300-based BCI; 2) determine what proportion of this population can use the BCI; and 3) identify factors affecting BCI performance. Twenty-five individuals with ALS completed an evaluation protocol using a standard 6 {\texttimes} 6 matrix and parameters selected by stepwise linear discrimination. With an 8-channel EEG montage, the subjects fell into two groups in BCI accuracy (chance accuracy 3\%). Seventeen averaged 92 ({\textpm} 3)\% (range 71-100\%), which is adequate for communication (G70 group). Eight averaged 12 ({\textpm} 6)\% (range 0-36\%), inadequate for communication (L40 subject group). Performance did not correlate with disability: 11/17 (65\%) of G70 subjects were severely disabled (i.e. ALSFRS-R < 5). All L40 subjects had visual impairments (e.g. nystagmus, diplopia, ptosis). P300 was larger and more anterior in G70 subjects. A 16-channel montage did not significantly improve accuracy. In conclusion, most people severely disabled by ALS could use a visual P300-based BCI for communication. In those who could not, visual impairment was the principal obstacle. For these individuals, auditory P300-based BCIs might be effective.}, keywords = {Adult, Aged, Amyotrophic Lateral Sclerosis, Biofeedback, Psychology, brain-computer interfaces, Communication Disorders, Electroencephalography, Event-Related Potentials, P300, Female, Humans, Male, Middle Aged, Online Systems, Photic Stimulation, Psychomotor Performance, Reaction Time}, issn = {2167-9223}, doi = {10.3109/21678421.2013.865750}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24555843}, author = {McCane, Lynn M and Sellers, Eric W and Dennis J. McFarland and Mak, Joseph N and Carmack, C Steve and Zeitlin, Debra and Jonathan Wolpaw and Theresa M Vaughan} } @article {3386, title = {A practical, intuitive brain-computer interface for communicating {\textquoteright}yes{\textquoteright} or {\textquoteright}no{\textquoteright} by listening.}, journal = {J Neural Eng}, volume = {11}, year = {2014}, month = {06/2014}, pages = {035003}, abstract = {OBJECTIVE: Previous work has shown that it is possible to build an EEG-based binary brain-computer interface system (BCI) driven purely by shifts of attention to auditory stimuli. However, previous studies used abrupt, abstract stimuli that are often perceived as harsh and unpleasant, and whose lack of inherent meaning may make the interface unintuitive and difficult for beginners. We aimed to establish whether we could transition to a system based on more natural, intuitive stimuli (spoken words {\textquoteright}yes{\textquoteright} and {\textquoteright}no{\textquoteright}) without loss of performance, and whether the system could be used by people in the locked-in state. APPROACH: We performed a counterbalanced, interleaved within-subject comparison between an auditory streaming BCI that used beep stimuli, and one that used word stimuli. Fourteen healthy volunteers performed two sessions each, on separate days. We also collected preliminary data from two subjects with advanced amyotrophic lateral sclerosis (ALS), who used the word-based system to answer a set of simple yes-no questions. MAIN RESULTS: The N1, N2 and P3 event-related potentials elicited by words varied more between subjects than those elicited by beeps. However, the difference between responses to attended and unattended stimuli was more consistent with words than beeps. Healthy subjects{\textquoteright} performance with word stimuli (mean 77\% {\textpm} 3.3 s.e.) was slightly but not significantly better than their performance with beep stimuli (mean 73\% {\textpm} 2.8 s.e.). The two subjects with ALS used the word-based BCI to answer questions with a level of accuracy similar to that of the healthy subjects. SIGNIFICANCE: Since performance using word stimuli was at least as good as performance using beeps, we recommend that auditory streaming BCI systems be built with word stimuli to make the system more pleasant and intuitive. Our preliminary data show that word-based streaming BCI is a promising tool for communication by people who are locked in.}, keywords = {Adult, Aged, Algorithms, Auditory Perception, brain-computer interfaces, Communication Aids for Disabled, Electroencephalography, Equipment Design, Equipment Failure Analysis, Female, Humans, Male, Man-Machine Systems, Middle Aged, Quadriplegia, Treatment Outcome, User-Computer Interface}, issn = {1741-2552}, doi = {10.1088/1741-2560/11/3/035003}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24838278}, author = {Jeremy Jeremy Hill and Ricci, Erin and Haider, Sameah and McCane, Lynn M and Susan M Heckman and Jonathan Wolpaw and Theresa M Vaughan} } @inbook {2865, title = {BCIs That Use Electrocorticographic Activity.}, booktitle = {Brain-Computer Interfaces: Principles and Practice}, year = {2012}, publisher = {Oxford University Press}, organization = {Oxford University Press}, abstract = {This chapter discusses the potential of electrocorticography (ECoG) as a clinically useful brain-computer interface signal modality. ECoG has greater amplitude, higher topographical resolution, and a much broader frequency range than scalp-recorded electroencephalography and is less susceptible to artifacts. With current and foreseeable recording methodologies, ECoG is likely to have greater long-term stability than intracortically recorded signals. Furthermore, it can more readily be recorded from larger cortical areas, and it requires much lower digitization rates, thus greatly reducing the power requirements of wholly implanted systems.}, keywords = {brain signals, brain-computer interfaces, ECoG, intracortically recorded signals}, issn = {ISBN: 978-0195388855}, doi = {10.1093/acprof:oso/9780195388855.003.0015}, url = {http://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780195388855.001.0001/acprof-9780195388855-chapter-015}, author = {Jonathan Wolpaw and E. Winter-Wolpaw and Gerwin Schalk} } @article {2922, title = {Electrocorticographic (ECoG) Correlates of Human Arm Movements.}, journal = {Exp Brain Res}, volume = {223}, year = {2012}, month = {11/2012}, pages = {1-10}, abstract = {Invasive and non-invasive brain-computer interface (BCI) studies have long focused on the motor cortex for kinematic control of artificial devices. Most of these studies have used single-neuron recordings or electroencephalography (EEG). Electrocorticography (ECoG) is a relatively new recording modality in BCI research that has primarily been built on successes in EEG recordings. We built on prior experiments related to single-neuron recording and quantitatively compare the extent to which different brain regions reflect kinematic tuning parameters of hand speed, direction, and velocity in both a reaching and tracing task in humans. Hand and arm movement experiments using ECoG have shown positive results before, but the tasks were not designed to tease out which kinematics are encoded. In non-human primates, the relationships among these kinematics have been more carefully documented, and we sought to begin elucidating that relationship in humans using ECoG. The largest modulation in ECoG activity for direction, speed, and velocity representation was found in the primary motor cortex. We also found consistent cosine tuning across both tasks, to hand direction and velocity in the high gamma band (70-160~Hz). Thus, the results of this study clarify the neural substrates involved in encoding aspects of motor preparation and execution and confirm the important role of the motor cortex in BCI applications.}, keywords = {arm tuning, brain-computer interfaces, cosine tuning, Electrocorticography, Motor Cortex, subdural electroencephalography}, issn = {1432-1106}, doi = {10.1007/s00221-012-3226-1}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23001369}, author = {Nicholas R Anderson and Blakely, Timothy and Gerwin Schalk and Leuthardt, E C and Moran, Daniel W} } @inbook {2139, title = {Brain Computer Interfaces for Communication in Paralysis: a Clinical-Experimental Approach.}, year = {2007}, publisher = {Virtual Library of Psychology at Saarland University and State Library, GERMANY, PsyDok [http://psydok.sulb.uni-saarland.de/phpoai/oai2.php] (Germany)}, organization = {Virtual Library of Psychology at Saarland University and State Library, GERMANY, PsyDok [http://psydok.sulb.uni-saarland.de/phpoai/oai2.php] (Germany)}, abstract = {

An overview of different approaches to brain-computer interfaces (BCIs) developed in our laboratory is given. An important clinical application of BCIs is to enable communication or environmental control in severely paralyzed patients. The BCI {\textquotedblleft}Thought-Translation Device (TTD){\textquotedblright} allows verbal communication through the voluntary self-regulation of brain signals (e.g., slow cortical potentials (SCPs)), which is achieved by operant feedback training. Humans{\textquoteright} ability to self-regulate their SCPs is used to move a cursor toward a target that contains a selectable letter set. Two different approaches were followed to developWeb browsers that could be controlled with binary brain responses. Implementing more powerful classification methods including different signal parameters such as oscillatory features improved our BCI considerably. It was also tested on signals with implanted electrodes. Most BCIs provide the user with a visual feedback interface. Visually impaired patients require an auditory feedback mode. A procedure using auditory (sonified) feedback of multiple EEG parameters was evaluated. Properties of the auditory systems are reported and the results of two experiments with auditory feedback are presented. Clinical data of eight ALS patients demonstrated that all patients were able to acquire efficient brain control of one of the three available BCI systems (SCP, {\textmu}-rhythm, and P300), most of them used the SCP-BCI. A controlled comparison of the three systems in a group of ALS patients, however, showed that P300-BCI and the {\textmu}-BCI are faster and more easily acquired than SCP-BCI, at least in patients with some rudimentary motor control left. Six patients who started BCI training after entering the completely locked-in state did not achieve reliable communication skills with any BCI system. One completely locked-in patient was able t o communicate shortly with a ph-meter, but lost control afterward.

}, keywords = {brain-computer interfaces, EEG, experiment, Medical sciences Medicine, paralyzed patients, slow cortical potentials, Thought-Translation Device}, isbn = {9780262256049}, url = {http://psydok.sulb.uni-saarland.de/volltexte/2008/2154/}, author = {Hinterberger, T. and Nijboer, F and K{\"u}bler, A. and Matuz, T. and Adrian Furdea and Mochty, Ursula and Jordan, M. and Lal, T.N and Jeremy Jeremy Hill and Mellinger, J{\"u}rgen and Bensch, M and Tangermann, Michael and Widmann, G. and Elger, Christian and Rosenstiel, W. and Sch{\"o}lkopf, B and Niels Birbaumer} } @article {3219, title = {Brain-computer interfaces (BCIs) for communication and control: a mini-review.}, journal = {Supplements to Clinical neurophysiology}, volume = {57}, year = {2004}, month = {02/2004}, pages = {607{\textendash}613}, keywords = {augmentative communication and control, brain-computer interfaces, neuro-muscular disorders}, issn = {1567-424X}, doi = {10.1145/1296843.1296845}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16106662}, author = {Jonathan Wolpaw} }