TY - JOUR T1 - Transition from the locked in to the completely locked-in state: a physiological analysis. JF - Clin Neurophysiol Y1 - 2011 A1 - Murguialday, A Ramos A1 - Jeremy Jeremy Hill A1 - Bensch, M A1 - Martens, S M M A1 - S Halder A1 - Nijboer, F A1 - Schoelkopf, Bernhard A1 - Niels Birbaumer A1 - Gharabaghi, A KW - Adult KW - Amyotrophic Lateral Sclerosis KW - Area Under Curve KW - Brain KW - Communication Aids for Disabled KW - Disease Progression KW - Electroencephalography KW - Electromyography KW - Humans KW - Male KW - Signal Processing, Computer-Assisted KW - User-Computer Interface AB -

OBJECTIVE: 

To clarify the physiological and behavioral boundaries between locked-in (LIS) and the completely locked-in state (CLIS) (no voluntary eye movements, no communication possible) through electrophysiological data and to secure brain-computer-interface (BCI) communication.

METHODS: 

Electromyography from facial muscles, external anal sphincter (EAS), electrooculography and electrocorticographic data during different psychophysiological tests were acquired to define electrophysiological differences in an amyotrophic lateral sclerosis (ALS) patient with an intracranially implanted grid of 112 electrodes for nine months while the patient passed from the LIS to the CLIS.

RESULTS: 

At the very end of the LIS there was no facial muscle activity, nor external anal sphincter but eye control. Eye movements were slow and lasted for short periods only. During CLIS event related brainpotentials (ERP) to passive limb movements and auditory stimuli were recorded, vibrotactile stimulation of different body parts resulted in no ERP response.

CONCLUSIONS: 

The results presented contradict the commonly accepted assumption that the EAS is the last remaining muscle under voluntary control and demonstrate complete loss of eye movements in CLIS. The eye muscle was shown to be the last muscle group under voluntary control. The findings suggest ALS as a multisystem disorder, even affecting afferent sensory pathways.

SIGNIFICANCE: 

Auditory and proprioceptive brain-computer-interface (BCI) systems are the only remaining communication channels in CLIS.

VL - 122 UR - http://www.ncbi.nlm.nih.gov/pubmed/20888292 IS - 5 ER - TY - JOUR T1 - A note on ethical aspects of BCI. JF - Neural Netw Y1 - 2009 A1 - Haselager, Pim A1 - Vlek, Rutger A1 - Jeremy Jeremy Hill A1 - Nijboer, F KW - Bioethics KW - Brain KW - Communication KW - Communications Media KW - Cooperative Behavior KW - Humans KW - Informed Consent KW - Professional-Patient Relations KW - Quadriplegia KW - User-Computer Interface AB -

This paper focuses on ethical aspects of BCI, as a research and a clinical tool, that are challenging for practitioners currently working in the field. Specifically, the difficulties involved in acquiring informed consent from locked-in patients are investigated, in combination with an analysis of the shared moral responsibility in BCI teams, and the complications encountered in establishing effective communication with media.

VL - 22 UR - http://www.ncbi.nlm.nih.gov/pubmed/19616405 IS - 9 ER - TY - CHAP T1 - Brain Computer Interfaces for Communication in Paralysis: a Clinical-Experimental Approach. Y1 - 2007 A1 - Hinterberger, T. A1 - Nijboer, F A1 - Kübler, A. A1 - Matuz, T. A1 - Adrian Furdea A1 - Mochty, Ursula A1 - Jordan, M. A1 - Lal, T.N A1 - Jeremy Jeremy Hill A1 - Mellinger, Jürgen A1 - Bensch, M A1 - Tangermann, Michael A1 - Widmann, G. A1 - Elger, Christian A1 - Rosenstiel, W. A1 - Schölkopf, B A1 - Niels Birbaumer KW - brain-computer interfaces KW - EEG KW - experiment KW - Medical sciences Medicine KW - paralyzed patients KW - slow cortical potentials KW - Thought-Translation Device AB -

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 “Thought-Translation Device (TTD)” 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' 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, µ-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 µ-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.

PB - Virtual Library of Psychology at Saarland University and State Library, GERMANY, PsyDok [http://psydok.sulb.uni-saarland.de/phpoai/oai2.php] (Germany) SN - 9780262256049 UR - http://psydok.sulb.uni-saarland.de/volltexte/2008/2154/ ER - TY - JOUR T1 - Classifying EEG and ECoG signals without subject training for fast BCI implementation: comparison of nonparalyzed and completely paralyzed subjects. JF - IEEE Trans Neural Syst Rehabil Eng Y1 - 2006 A1 - Jeremy Jeremy Hill A1 - Lal, T.N A1 - Schröder, Michael A1 - Hinterberger, T. A1 - Wilhelm, Barbara A1 - Nijboer, F A1 - Mochty, Ursula A1 - Widman, Guido A1 - Elger, Christian A1 - Schölkopf, B A1 - Kübler, A. A1 - Niels Birbaumer KW - Algorithms KW - Artificial Intelligence KW - Cluster Analysis KW - Computer User Training KW - Electroencephalography KW - Evoked Potentials KW - Female KW - Humans KW - Imagination KW - Male KW - Middle Aged KW - Paralysis KW - Pattern Recognition, Automated KW - User-Computer Interface AB -

We summarize results from a series of related studies that aim to develop a motor-imagery-based brain-computer interface using a single recording session of electroencephalogram (EEG) or electrocorticogram (ECoG) signals for each subject. We apply the same experimental and analytical methods to 11 nonparalysed subjects (eight EEG, three ECoG), and to five paralyzed subjects (four EEG, one ECoG) who had been unable to communicate for some time. While it was relatively easy to obtain classifiable signals quickly from most of the nonparalyzed subjects, it proved impossible to classify the signals obtained from the paralyzed patients by the same methods. This highlights the fact that though certain BCI paradigms may work well with healthy subjects, this does not necessarily indicate success with the target user group. We outline possible reasons for this failure to transfer.

VL - 14 UR - http://www.ncbi.nlm.nih.gov/pubmed/16792289 IS - 2 ER - TY - JOUR T1 - Patients with ALS can use sensorimotor rhythms to operate a brain-computer interface. JF - Neurology Y1 - 2005 A1 - Kübler, A. A1 - Nijboer, F A1 - Mellinger, Jürgen A1 - Theresa M Vaughan A1 - Pawelzik, H A1 - Gerwin Schalk A1 - Dennis J. McFarland A1 - Niels Birbaumer A1 - Jonathan Wolpaw KW - Aged KW - Amyotrophic Lateral Sclerosis KW - Electroencephalography KW - Evoked Potentials, Motor KW - Evoked Potentials, Somatosensory KW - Female KW - Humans KW - Imagination KW - Male KW - Middle Aged KW - Motor Cortex KW - Movement KW - Paralysis KW - Photic Stimulation KW - Prostheses and Implants KW - Somatosensory Cortex KW - Treatment Outcome KW - User-Computer Interface AB -

People with severe motor disabilities can maintain an acceptable quality of life if they can communicate. Brain-computer interfaces (BCIs), which do not depend on muscle control, can provide communication. Four people severely disabled by ALS learned to operate a BCI with EEG rhythms recorded over sensorimotor cortex. These results suggest that a sensorimotor rhythm-based BCI could help maintain quality of life for people with ALS.

VL - 64 UR - http://www.ncbi.nlm.nih.gov/pubmed/15911809 IS - 10 ER - TY - JOUR T1 - P300 for communication: Evidence from patients with amyotrophic lateral sclerosis (ALS). JF - Biomedizinische Technik Y1 - 2004 A1 - Mellinger, Jürgen A1 - Nijboer, F A1 - Pawelzik, H A1 - Gerwin Schalk A1 - Dennis J. McFarland A1 - Theresa M Vaughan A1 - Jonathan Wolpaw A1 - Niels Birbaumer A1 - Kuebler, A. ER -