This section will include items in lay language that describe the Center, the scope, prospects, and limitations of adaptive neurotechnologies, and specific Center technologies of particular interest to the public. It should also serve to stimulate valuable collaborations and service relationships with engineers, scientists, and clinicians whose primary expertise lies in areas other than those involved in neurotechnology. As an example, we include here information about the Wadsworth BCI Home System.
The Wadsworth BCI Home System
Progress in medical science now enables people with severe paralysis to live for many years. Many of these individuals have great difficulty in communicating. Some may even be entirely "locked in" to their bodies: their minds are functioning, but they cannot move a single muscle to communicate in any way. The capacity for simple communication could greatly improve the quality of their lives. The Center for Adaptive Neurotechnologies has addressed this problem by developing a new generation of brain-based communication devices (brain-computer interfaces or BCIs) that can provide communication and control functions to people who have lost muscle control. By recording brain waves from the scalp and then decoding them, this system allows people to move a computer cursor up/down and left/right, to spell words, and to perform other simple control functions.
What is the purpose of brain-computer interface technology? The goal of BCI technology is to give severely paralyzed people another way to communicate, a way that does not depend on muscle control. Researchers at the Center for Adaptive Neurotechnologies and their collaborators have developed a BCI that can be used by people with severe disabilities in their homes and they are validating it in long-term home use by these individuals. This project is at the forefront of research and development aimed at improving BCIs so that they can be made widely available for independent use.
How does a BCI work? Many people with disabilities use computers to communicate and to control their environments. However, conventional methods for using computers, like typing on a keyboard or moving a computer mouse, require muscle control and thus may not be useful for people who have little or no muscle control. In contrast, a BCI allows people to use electrical signals from the brain, rather than muscles, to select letters for word-processing and email, to select icons on a computer screen, or to operate devices controlling television settings or room temperature. Studies have shown that even people who have lost muscle control due to disease or injury can use their brain activity to communicate their intent to a BCI that then translates it into device control.
Are all BCI systems the same? BCI technology is based on measurements of the brain’s natural electrical signals. These can be recorded from the scalp, from the surface of the brain, or from within the brain. The Wadsworth BCI system uses scalp-recorded signals that are recorded using standard clinical EEG (electroencephalographic, or brain wave) methods. Thus, unlike some other types of BCI systems, the Wadsworth EEG-based BCI does not require surgery.
Is Wadsworth’s portable BCI system available for in-home use? Currently, the Wadsworth BCI system is available for in-home use only by people participating in the research studies conducted by the Center for Adaptive Neurotechnologies in conjunction with Helen Hayes Rehabilitation Hospital. These studies are funded by the New York State Department of Health, by the National Institutes of Health, and by several private foundations.
Who is eligible to participate in these BCI studies? People who are:
- severely disabled by any of a variety of neuromuscular disorders such as amyotrophic lateral sclerosis (ALS, Lou Gehrig’s Disease), cerebral palsy, muscular dystrophy, multiple sclerosis, brainstem stroke, and high-level spinal cord injury;
- too disabled to use conventional assistive communication technology such as systems that use muscle activity or eye movements;
- in stable physical condition, with stable physical and social environments, and with caregiver(s) who have basic computer skills;
- able to see and to understand instructions;
- able to use the BCI system as determined in a screening evaluation;
- in a geographical location and an environment that allows the Center personnel to provide ongoing technical support.
How many people have been provided with the Wadsworth BCI system? To date, about 30 severely disabled people have used the system in their homes for periods ranging from several months to five years. One used the system in running his Federally-funded medical research laboratory for three years.
What are the training and technical requirements for in-home use? If an initial screening process suggests that a person could possibly benefit from the Wadsworth BCI Home System, Center personnel make an initial home visit to do an in-home evaluation. This includes an in-home EEG recording and a trial with the BCI system to help determine if the person will be able to use it. If the results are positive, a second home visit is made for further testing and confirmation. In third and fourth visits, the person’s caregivers are trained to place the electrode cap and start the BCI software. If these visits are successful, the system may then be placed in the person’s home. Subsequently, continuing technical support is provided by Center personnel and/or Helen Hayes Hospital personnel via telephone, the Internet, and, if needed, home visits. Visits may be required by problems such as a noisy electrical environment, changes in health status, or equipment malfunctions. Thus, at the present time, the person’s geographical location is an important factor in determining whether use of the Wadsworth BCI system is practical.
How much does the system cost? While the hardware components cost about $5000, the Wadsworth BCI home system is not yet available outside the confines of our research studies due to the need for ongoing technical support. Efforts are underway to reduce this need and thereby enable much wider dissemination of the Wadsworth system.
Can anyone purchase a system and be trained? No, home use of the Wadsworth BCI system is currently confined to a research protocol. Individuals who are interested in and believe they may qualify for the BCI studies, should contact the Clinical Programs Development office at the Center (518-473-3631; email- firstname.lastname@example.org).
What is needed for the Wadsworth BCI system to become widely available? Continued research and development is needed to:
- further simplify the BCI's use and operation and reduce the need for ongoing technical support;
- further develop useful and easy-to-use applications;
- gain FDA approval for widespread dissemination of the system beyond the research setting.
What other resources are available for disabled individuals who may not have access to BCI technology at this time? Many severely disabled people who have difficulty with communication and control can benefit from standard, widely available assistive communication technology. Rehabilitation engineers, speech pathologists, occupational therapists, and rehabilitation therapists are professionals who can provide access to these technologies and assistance in their use. Physiatrists, departments of physical medicine and rehabilitation in local hospitals, rehabilitation centers, nursing homes, and local and national organizations such as the ALS (amyotrophic lateral sclerosis) and MD (muscular dystrophy) associations can provide information about how to access these resources. There are also several national and international groups that maintain helpful websites, including RESNA (Rehabilitation Engineering and Assistive Technology Society of North America) and ISAAC (International Society for Augmentive & Alternative Communication). For New York State and the Tri-State area, the Center for Rehabilitation Technology at Helen Hayes Hospital provides a comprehensive service for people needing assistive communication and control technology. At present, most people with disabilities that impair communication and control should first explore the wide spectrum of conventional assistive devices before seriously considering BCI technology.
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