%0 Journal Article %J Clin Neurophysiol %D 2011 %T Transition from the locked in to the completely locked-in state: a physiological analysis. %A Murguialday, A Ramos %A Jeremy Jeremy Hill %A Bensch, M %A Martens, S M M %A S Halder %A Nijboer, F %A Schoelkopf, Bernhard %A Niels Birbaumer %A Gharabaghi, A %K Adult %K Amyotrophic Lateral Sclerosis %K Area Under Curve %K Brain %K Communication Aids for Disabled %K Disease Progression %K Electroencephalography %K Electromyography %K Humans %K Male %K Signal Processing, Computer-Assisted %K User-Computer Interface %X

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.

%B Clin Neurophysiol %V 122 %P 925-33 %8 06/2011 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/20888292 %N 5 %R 10.1016/j.clinph.2010.08.019 %0 Journal Article %J Epilepsy Behav %D 2008 %T Voluntary brain regulation and communication with electrocorticogram signals. %A Hinterberger, T. %A Widman, Guido %A Lal, T.N %A Jeremy Jeremy Hill %A Tangermann, Michael %A Rosenstiel, W. %A Schölkopf, B %A Elger, Christian %A Niels Birbaumer %K Adult %K Biofeedback, Psychology %K Cerebral Cortex %K Communication Aids for Disabled %K Dominance, Cerebral %K Electroencephalography %K Epilepsies, Partial %K Female %K Humans %K Imagination %K Male %K Middle Aged %K Motor Activity %K Motor Cortex %K Signal Processing, Computer-Assisted %K Software %K Somatosensory Cortex %K Theta Rhythm %K User-Computer Interface %K Writing %X

Brain-computer interfaces (BCIs) can be used for communication in writing without muscular activity or for learning to control seizures by voluntary regulation of brain signals such as the electroencephalogram (EEG). Three of five patients with epilepsy were able to spell their names with electrocorticogram (ECoG) signals derived from motor-related areas within only one or two training sessions. Imagery of finger or tongue movements was classified with support-vector classification of autoregressive coefficients derived from the ECoG signals. After training of the classifier, binary classification responses were used to select letters from a computer-generated menu. Offline analysis showed increased theta activity in the unsuccessful patients, whereas the successful patients exhibited dominant sensorimotor rhythms that they could control. The high spatial resolution and increased signal-to-noise ratio in ECoG signals, combined with short training periods, may offer an alternative for communication in complete paralysis, locked-in syndrome, and motor restoration.

%B Epilepsy Behav %V 13 %P 300-6 %8 08/2008 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/18495541 %N 2 %R 10.1016/j.yebeh.2008.03.014 %0 Journal Article %J Neuroimage %D 2007 %T An MEG-based brain-computer interface (BCI). %A Mellinger, Jürgen %A Gerwin Schalk %A Christoph Braun %A Preissl, Hubert %A Rosenstiel, W. %A Niels Birbaumer %A Kübler, A. %K Adult %K Algorithms %K Artifacts %K Brain %K Electroencephalography %K Electromagnetic Fields %K Electromyography %K Feedback %K Female %K Foot %K Hand %K Head Movements %K Humans %K Magnetic Resonance Imaging %K Magnetoencephalography %K Male %K Movement %K Principal Component Analysis %K Signal Processing, Computer-Assisted %K User-Computer Interface %X

Brain-computer interfaces (BCIs) allow for communicating intentions by mere brain activity, not involving muscles. Thus, BCIs may offer patients who have lost all voluntary muscle control the only possible way to communicate. Many recent studies have demonstrated that BCIs based on electroencephalography(EEG) can allow healthy and severely paralyzed individuals to communicate. While this approach is safe and inexpensive, communication is slow. Magnetoencephalography (MEG) provides signals with higher spatiotemporal resolution than EEG and could thus be used to explore whether these improved signal properties translate into increased BCI communication speed. In this study, we investigated the utility of an MEG-based BCI that uses voluntary amplitude modulation of sensorimotor mu and beta rhythms. To increase the signal-to-noise ratio, we present a simple spatial filtering method that takes the geometric properties of signal propagation in MEG into account, and we present methods that can process artifacts specifically encountered in an MEG-based BCI. Exemplarily, six participants were successfully trained to communicate binary decisions by imagery of limb movements using a feedback paradigm. Participants achieved significant mu rhythm self control within 32 min of feedback training. For a subgroup of three participants, we localized the origin of the amplitude modulated signal to the motor cortex. Our results suggest that an MEG-based BCI is feasible and efficient in terms of user training.

%B Neuroimage %V 36 %P 581-93 %8 07/2007 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/17475511 %N 3 %R 10.1016/j.neuroimage.2007.03.019 %0 Journal Article %J IEEE Trans Neural Syst Rehabil Eng %D 2006 %T Classifying EEG and ECoG signals without subject training for fast BCI implementation: comparison of nonparalyzed and completely paralyzed subjects. %A Jeremy Jeremy Hill %A Lal, T.N %A Schröder, Michael %A Hinterberger, T. %A Wilhelm, Barbara %A Nijboer, F %A Mochty, Ursula %A Widman, Guido %A Elger, Christian %A Schölkopf, B %A Kübler, A. %A Niels Birbaumer %K Algorithms %K Artificial Intelligence %K Cluster Analysis %K Computer User Training %K Electroencephalography %K Evoked Potentials %K Female %K Humans %K Imagination %K Male %K Middle Aged %K Paralysis %K Pattern Recognition, Automated %K User-Computer Interface %X

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.

%B IEEE Trans Neural Syst Rehabil Eng %V 14 %P 183-6 %8 06/2006 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/16792289 %N 2 %R 10.1109/TNSRE.2006.875548 %0 Journal Article %J Neurology %D 2005 %T Patients with ALS can use sensorimotor rhythms to operate a brain-computer interface. %A Kübler, A. %A Nijboer, F %A Mellinger, Jürgen %A Theresa M Vaughan %A Pawelzik, H %A Gerwin Schalk %A Dennis J. McFarland %A Niels Birbaumer %A Jonathan Wolpaw %K Aged %K Amyotrophic Lateral Sclerosis %K Electroencephalography %K Evoked Potentials, Motor %K Evoked Potentials, Somatosensory %K Female %K Humans %K Imagination %K Male %K Middle Aged %K Motor Cortex %K Movement %K Paralysis %K Photic Stimulation %K Prostheses and Implants %K Somatosensory Cortex %K Treatment Outcome %K User-Computer Interface %X

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.

%B Neurology %V 64 %P 1775-7 %8 05/2005 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/15911809 %N 10 %R 10.1212/01.WNL.0000158616.43002.6D