Therapeutic Applications of BCI Technologies

Anti-artifacts techniques for neural recording front-ends in closed-loop brain-machine interface ICs

In recent years, thanks to the development of integrated circuits, clinical medicine has witnessed significant advancements, enabling more efficient and intelligent treatment approaches. Particularly in the field of neuromedical, the utilization of brain-machine interfaces (BMI) has revolutionized the treatment of neurological diseases such as amyotrophic lateral sclerosis, cerebral palsy, stroke, or spinal cord injury. The BMI acquires neural signals via recording circuits and analyze them to regulate neural stimulator circuits for effective neurological treatment. However, traditional BMI designs, which are often isolated, have given way to closed-loop brain-machine interfaces (CL-BMI) as a contemporary development trend. CL-BMI offers increased integration and accelerated response speed, marking a significant leap forward in neuromedicine. Nonetheless, this advancement comes with its challenges, notably the stimulation artifacts (SA) problem inherent to the structural characteristics of CL-BMI, which poses significant challenges on the neural recording front-ends (NRFE) site. This paper aims to provide a comprehensive overview of technologies addressing artifacts in the NRFE site within CL-BMI. Topics covered will include: (1) understanding and assessing artifacts; (2) exploring the impact of artifacts on traditional neural recording front-ends; (3) reviewing recent technological advancements aimed at addressing artifact-related issues; (4) summarizing and classifying the aforementioned technologies, along with an analysis of future trends.

Beta bursts question the ruling power for brain-computer interfaces

Objective: Current efforts to build reliable brain-computer interfaces (BCI) span multiple axes from hardware, to software, to more sophisticated experimental protocols, and personalized approaches. However, despite these abundant efforts, there is still room for significant improvement. We argue that a rather overlooked direction lies in linking BCI protocols with recent advances in fundamental neuroscience.Approach: In light of these advances, and particularly the characterization of the burst-like nature of beta frequency band activity and the diversity of beta bursts, we revisit the role of beta activity in 'left vs. right hand' motor imagery (MI) tasks. Current decoding approaches for such tasks take advantage of the fact that MI generates time-locked changes in induced power in the sensorimotor cortex and rely on band-passed power changes in single or multiple channels. Although little is known about the dynamics of beta burst activity during MI, we hypothesized that beta bursts should be modulated in a way analogous to their activity during performance of real upper limb movements.Main results and Significance: We show that classification features based on patterns of beta burst modulations yield decoding results that are equivalent to or better than typically used beta power across multiple open electroencephalography datasets, thus providing insights into the specificity of these bio-markers.

Event-Related Potential-Based Brain-Computer Interface Using the Thai Vowels' and Numerals' Auditory Stimulus Pattern

Herein, we developed an auditory stimulus pattern for an event-related potential (ERP)-based brain-computer interface (BCI) system to improve control and communication in quadriplegia with visual impairment. Auditory stimulus paradigms for multicommand electroencephalogram (EEG)-based BCIs and audio stimulus patterns were examined. With the proposed auditory stimulation, using the selected Thai vowel, similar to the English vowel, and Thai numeral sounds, as simple target recognition, we explored the ERPs' response and classification efficiency from the suggested EEG channels. We also investigated the use of single and multi-loudspeakers for auditory stimuli. Four commands were created using the proposed paradigm. The experimental paradigm was designed to observe ERP responses and verify the proposed auditory stimulus pattern. The conventional classification method produced four commands using the proposed auditory stimulus pattern. The results established that the proposed auditory stimulation with 20 to 30 trials of stream stimuli could produce a prominent ERP response from Pz channels. The vowel stimuli could achieve higher accuracy than the proposed numeral stimuli for two auditory stimuli intervals (100 and 250 ms). Additionally, multi-loudspeaker patterns through vowel and numeral sound stimulation provided an accuracy greater than 85% of the average accuracy. Thus, the proposed auditory stimulation patterns can be implemented as a real-time BCI system to aid in the daily activities of quadratic patients with visual and tactile impairments. In future, practical use of the auditory ERP-based BCI system will be demonstrated and verified in an actual scenario.

Steady-State Visual Evoked Potential-Based Brain–Computer Interface Using a Novel Visual Stimulus with Quick Response (QR) Code Pattern

Steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI) systems suffer from low SSVEP response intensity and visual fatigue, resulting in lower accuracy when operating the system for continuous commands, such as an electric wheelchair control. This study proposes two SSVEP improvements to create a practical BCI for communication and control in disabled people. The first is flicker pattern modification for increasing SSVEP response through mixing (1) fundamental and first harmonic frequencies, and (2) two fundamental frequencies for an additional number of commands. The second method utilizes a quick response (QR) code for visual stimulus patterns to increase the SSVEP response and reduce visual fatigue. Eight different stimulus patterns from three flickering frequencies (7, 13, and 17 Hz) were presented to twelve participants for the test and score levels of visual fatigue. Two popular SSVEP methods, i.e., power spectral density (PSD) with Welch periodogram and canonical correlation analysis (CCA) with overlapping sliding window, are used to detect SSVEP intensity and response, compared to the checkerboard pattern. The results suggest that the QR code patterns can yield higher accuracy than checkerboard patterns for both PSD and CCA methods. Moreover, a QR code pattern with low frequency can reduce visual fatigue; however, visual fatigue can be easily affected by high flickering frequency. The findings can be used in the future to implement a real-time, SSVEP-based BCI for verifying user and system performance in actual environments.

An Impending Paradigm Shift in Motor Imagery Based Brain-Computer Interfaces

The development of reliable assistive devices for patients that suffer from motor impairments following central nervous system lesions remains a major challenge in the field of non-invasive Brain-Computer Interfaces (BCIs). These approaches are predominated by electroencephalography and rely on advanced signal processing and machine learning methods to extract neural correlates of motor activity. However, despite tremendous and still ongoing efforts, their value as effective clinical tools remains limited. We advocate that a rather overlooked research avenue lies in efforts to question neurophysiological markers traditionally targeted in non-invasive motor BCIs. We propose an alternative approach grounded by recent fundamental advances in non-invasive neurophysiology, specifically subject-specific feature extraction of sensorimotor bursts of activity recorded via (possibly magnetoencephalography-optimized) electroencephalography. This path holds promise in overcoming a significant proportion of existing limitations, and could foster the wider adoption of online BCIs in rehabilitation protocols.

Technology-Based Neurorehabilitation in Parkinson’s Disease—A Narrative Review

This narrative review provides a brief overview of the current literature on technology-based interventions for the neurorehabilitation of persons with Parkinson’s disease (PD). The role of brain–computer interfaces, exergaming/virtual-reality-based exercises, robot-assisted therapies and wearables is discussed. It is expected that technology-based neurorehabilitation will gain importance in the management of PD patients, although it is often not clear yet whether this approach is superior to conventional therapies. High-intensity technology-based neurorehabilitation may hold promise with respect to neuroprotective or neurorestorative actions in PD. Overall, more research is required in order to obtain more data on the feasibility, efficacy and safety of technology-based neurorehabilitation in persons with PD.

Weighted neurofeedback facilitates greater self-regulation of functional connectivity between the primary motor area and cerebellum

Objective.Brain-computer interface (BCI) is a tool that can be used to train brain self-regulation and influence specific activity patterns, including functional connectivity, through neurofeedback. The functional connectivity of the primary motor area (M1) and cerebellum play a critical role in motor recovery after a brain injury, such as stroke. The objective of this study was to determine the feasibility of achieving control of the functional connectivity between M1 and the cerebellum in healthy subjects. Additionally, we aimed to compare the brain self-regulation of two different feedback modalities and their effects on motor performance.Approach.Nine subjects were trained with a real-time functional magnetic resonance imaging BCI system. Two groups were conformed: equal feedback group (EFG), which received neurofeedback that weighted the contribution of both regions of interest (ROIs) equally, and weighted feedback group (WFG) that weighted each ROI differentially (30% cerebellum; 70% M1). The magnitude of the brain activity induced by self-regulation was evaluated with the blood-oxygen-level-dependent (BOLD) percent change (BPC). Functional connectivity was assessed using temporal correlations between the BOLD signal of both ROIs. A finger-tapping task was included to evaluate the effect of brain self-regulation on motor performance.Main results.A comparison between the feedback modalities showed that WFG achieved significantly higher BPC in M1 than EFG. The functional connectivity between ROIs during up-regulation in WFG was significantly higher than EFG. In general, both groups showed better tapping speed in the third session compared to the first. For WFG, there were significant correlations between functional connectivity and tapping speed.Significance.The results show that it is possible to train healthy individuals to control M1-cerebellum functional connectivity with rtfMRI-BCI. Besides, it is also possible to use a weighted feedback approach to facilitate a higher activity of one region over another.

Review of Riemannian Distances and Divergences, Applied to SSVEP-based BCI

The firstgeneration of brain-computer interfaces (BCI) classifies multi-channel electroencephalographic (EEG) signals, enhanced by optimized spatial filters.The second generation directly classifies covariance matrices estimated on EEG signals, based on straightforward algorithms such as the minimum-distance-to-Riemannian-mean (MDRM). Classification results vary greatly depending on the chosen Riemannian distance or divergence, whose definitions and reference implementations are spread across a wide mathematical literature. This paper reviews all the Riemannian distances and divergences to process covariance matrices, with an implementation compatible with BCI constraints. The impact of using different metrics is assessed on a steady-state visually evoked potentials (SSVEP) dataset, evaluating centers of classes and classification accuracy. Riemannian approaches embed crucial properties to process EEG data. The Riemannian centers of classes outperform Euclidean ones both in offline and online setups. Some Riemannian distances and divergences have better performances in terms of classification accuracy, while others have appealing computational efficiency.

Effect of power feature covariance shift on BCI spatial-filtering techniques: A comparative study

BACKGROUND AND OBJECTIVE

The input data distributions of EEG-based BCI systems can change during intra-session transitions due to nonstationarity caused by features covariate shifts, thus compromising BCI performance. We aimed to identify the most robust spatial filtering approach, among most used methods, testing them on calibration dataset, and test dataset recorded 30 min afterwards. In addition, we also investigated if their performance improved after application of Stationary Subspace Analysis (SSA).

METHODS

We have recorded, in 17 healthy subjects, the calibration set at the beginning of the upper limb motor imagery BCI experiment and testing set separately 30 min afterwards. Both the calibration and test data were pre-processed and the BCI models were produced by using several spatial filtering approaches on the calibration set. Those models were subsequently evaluated on a test set. The differences between the accuracy estimated by cross-validation on the calibration dataset and the accuracy on the test dataset were investigated. The same procedure was performed with, and without SSA pre-processing step.

RESULTS

A significant reduction in accuracy on the test dataset was observed for CSP, SPoC and SpecRCSP approaches. For SLap and SpecCSP only a slight decreasing trend was observed, while FBCSP and FBCSPT largely maintained moderately high median accuracy >70%. In the case of application of SSA pre-processing, the differences between accuracy observed on calibration and test dataset were reduced. In addition, accuracy values both on calibration and test set were slightly higher in case of SSA pre-processing and also in this case FBCSP and FBCSPT presented slightly better performance compared to other methods.

CONCLUSION

The intrinsic signal nonstationarity characteristics, caused by covariance shifts of power features, reduced the accuracy of BCI model, therefore, suggesting that this evaluation framework should be considered for testing and simulating real life performance. FBCSP and FBSCPT approaches showed to be more robust to feature covariance shift. SSA can improve the models performance and reduce accuracy decline from calibration to test set.

A randomized controlled trial (RCT) to explore the effect of audio-visual entrainment among psychological disorders

BACKGROUND AND AIM

Although many mental disorders have relevant proud in neurobiological dysfunctions, most intervention approaches neglect neurophysiological features or use pharmacological intervention alone. Non-invasive Brain-Computer Interfaces (BCIs), providing natural ways of modulating mood states, can be promoted as an alternative intervention to cope with neurobiological dysfunction.

METHODS

A BCI prototype was proposed to feedback a person's affective state such that a closed-loop interaction between the participant's brain responses and the musical stimuli is established. It feedbacks in real-time flickering lights matching with the individual's brain rhythms undergo to auditory stimuli. A RCT was carried out on 15 individuals of both genders (mean age = 49.27 years) with anxiety and depressive spectrum disorders randomly assigned to 2 groups (experimental vs. active control).

RESULTS

Outcome measures revealed either a significant decrease in Hamilton Rating Scale for Depression (HAM-D) scores and gains in cognitive functions only for participants who undergone to the experimental treatment. Variability in HAM-D scores seems explained by the changes in beta 1, beta 2 and delta bands. Conversely, the rise in cognitive function scores appear associated with theta variations.

CONCLUSIONS

Future work needs to validate the relationship proposed here between music and brain responses. Findings of the present study provided support to a range of research examining BCI brain modulation and contributes to the understanding of this technique as instruments to alternative therapies We believe that Neuro-Upper can be used as an effective new tool for investigating affective responses, and emotion regulation (www.actabiomedica.it).

SimBSI: An open-source Simulink library for developing closed-loop brain signal interfaces in animals and humans

OBJECTIVE

A promising application of BCI technology is in the development of personalized therapies that can target neural circuits linked to mental or physical disabilities. Typical BCIs, however, offer limited value due to simplistic designs and poor understanding of the conditions being treated. Building BCIs on more solid grounds may require the characterization of the brain dynamics supporting cognition and behavior at multiple scales, from single-cell and local field potential (LFP) recordings in animals to non-invasive electroencephalography (EEG) in humans. Despite recent efforts, a unifying software framework to support closed-loop studies in both animals and humans is still lacking. The objective of this paper is to develop such a unifying neurotechnological software framework.

APPROACH

Here we develop the Simulink for Brain Signal Interfaces library (SimBSI). Simulink is a mature graphical programming environment within MATLAB that has gained traction for processing electrophysiological data. SimBSI adds to this ecosystem: 1) advanced human EEG source imaging, 2) cross-species multimodal data acquisition based on the Lab Streaming Layer library, and 3) a graphical experimental design platform.

MAIN RESULTS

We use several examples to demonstrate the capabilities of the library, ranging from simple signal processing, to online EEG source imaging, cognitive task design, and closed-loop neuromodulation. We further demonstrate the simplicity of developing a sophisticated experimental environment for rodents within this environment.

SIGNIFICANCE

With the SimBSI library we hope to aid BCI practitioners of dissimilar backgrounds in the development of, much needed, single and cross-species closed-loop neuroscientific experiments. These experiments may provide the necessary mechanistic data for BCIs to become effective therapeutic tools.

Bacomics: a comprehensive cross area originating in the studies of various brain-apparatus conversations

The brain is the most important organ of the human body, and the conversations between the brain and an apparatus can not only reveal a normally functioning or a dysfunctional brain but also can modulate the brain. Here, the apparatus may be a nonbiological instrument, such as a computer, and the consequent brain-computer interface is now a very popular research area with various applications. The apparatus may also be a biological organ or system, such as the gut and muscle, and their efficient conversations with the brain are vital for a healthy life. Are there any common bases that bind these different scenarios? Here, we propose a new comprehensive cross area: Bacomics, which comes from brain-apparatus conversations (BAC) + omics. We take Bacomics to cover at least three situations: (1) The brain is normal, but the conversation channel is disabled, as in amyotrophic lateral sclerosis. The task is to reconstruct or open up new channels to reactivate the brain function. (2) The brain is in disorder, such as in Parkinson's disease, and the work is to utilize existing or open up new channels to intervene, repair and modulate the brain by medications or stimulation. (3) Both the brain and channels are in order, and the goal is to enhance coordinated development between the brain and apparatus. In this paper, we elaborate the connotation of BAC into three aspects according to the information flow: the issue of output to the outside (BAC-1), the issue of input to the brain (BAC-2) and the issue of unity of brain and apparatus (BAC-3). More importantly, there are no less than five principles that may be taken as the cornerstones of Bacomics, such as feedforward and feedback control, brain plasticity, harmony, the unity of opposites and systems principles. Clearly, Bacomics integrates these seemingly disparate domains, but more importantly, opens a much wider door for the research and development of the brain, and the principles further provide the general framework in which to realize or optimize these various conversations.

What is it like to use a BCI? - insights from an interview study with brain-computer interface users

Background

The neurotechnology behind brain-computer interfaces (BCIs) raises various ethical questions. The ethical literature has pinpointed several issues concerning safety, autonomy, responsibility and accountability, psychosocial identity, consent, privacy and data security. This study aims to assess BCI users’ experiences, self-observations and attitudes in their own right and looks for social and ethical implications.

Methods

We conducted nine semi-structured interviews with BCI users, who used the technology for medical reasons. The transcribed interviews were analyzed according to the Grounded Theory coding method.

Results

BCI users perceive themselves as active operators of a technology that offers them social participation and impacts their self-definition. Each of these aspects bears its own opportunities and risks. BCIs can contribute to retaining or regaining human capabilities. At the same time, BCI use contains elements that challenge common experiences, for example when the technology is in conflict with the affective side of BCI users. The potential benefits of BCIs are regarded as outweighing the risks in that BCI use is considered to promote valuable qualities and capabilities. BCI users appreciate the opportunity to regain lost capabilities as well as to gain new ones.

Conclusions

BCI users appreciate the technology for various reasons. The technology is highly appreciated in cases where it is beneficial in terms of agency, participation and self-definitions. Rather than questioning human nature, the technology can retain and restore characteristics and abilities which enrich our lives.

State-of-the-art non-invasive brain–computer interface for neural rehabilitation: A review

Brain–computer interface (BCI) is a novel communication method between brain and machine. It enables signals from the human brain to influence or control external devices. Currently, much research interest is focused on the BCI-based neural rehabilitation of patients with motor and cognitive diseases. Over the decades, BCI has become an alternative treatment for motor and cognitive rehabilitation. Previous studies demonstrated the usefulness of BCI intervention in restoring motor function and recovery of the damaged brain. Electroencephalogram (EEG)-based BCI intervention could cast light on the mechanisms underlying neuroplasticity during upper limb recovery by providing feedback to the damaged brain. BCI could act as a useful tool to aid patients with daily communication and basic movement in severe motor loss cases like amyotrophic lateral sclerosis (ALS). Furthermore, recent findings have reported the therapeutic efficacy of BCI in people suffering from other diseases with different levels of motor impairment such as spastic cerebral palsy, neuropathic pain, etc. Besides motor functional recovery, BCI also plays its role in improving the behavior of patients with cognitive diseases like attention-deficit/hyperactivity disorder (ADHD). The BCI-based neurofeedback training is focused on either reducing the ratio of theta and beta rhythm, or enabling the patients to regulate their own slow cortical potentials, and both have made progress in increasing attention and alertness. With summary of several clinical studies with strong evidence, we present cutting edge results from the clinical application of BCI in motor and cognitive diseases, including stroke, spinal cord injury, ALS, and ADHD.

Using brain-computer interfaces: a scoping review of studies employing social research methods

Background

The rapid expansion of research on Brain-Computer Interfaces (BCIs) is not only due to the promising solutions offered for persons with physical impairments. There is also a heightened need for understanding BCIs due to the challenges regarding ethics presented by new technology, especially in its impact on the relationship between man and machine. Here we endeavor to present a scoping review of current studies in the field to gain insight into the complexity of BCI use. By examining studies related to BCIs that employ social research methods, we seek to demonstrate the multitude of approaches and concerns from various angles in considering the social and human impact of BCI technology.

Methods

For this scoping review of research on BCIs’ social and ethical implications, we systematically analyzed six databases, encompassing the fields of medicine, psychology, and the social sciences, in order to identify empirical studies on BCIs. The search yielded 73 publications that employ quantitative, qualitative, or mixed methods.

Results

Of the 73 publications, 71 studies address the user perspective. Some studies extend to consideration of other BCI stakeholders such as medical technology experts, caregivers, or health care professionals. The majority of the studies employ quantitative methods. Recurring themes across the studies examined were general user opinion towards BCI, central technical or social issues reported, requests/demands made by users of the technology, the potential/future of BCIs, and ethical aspects of BCIs.

Conclusions

Our findings indicate that while technical aspects of BCIs such as usability or feasibility are being studied extensively, comparatively little in-depth research has been done on the self-image and self-experience of the BCI user. In general there is also a lack of focus or examination of the caregiver’s perspective.

Electronic supplementary material

The online version of this article (10.1186/s12910-019-0354-1) contains supplementary material, which is available to authorized users.

WaveCSP: a robust motor imagery classifier for consumer EEG devices

There is an increasing demand for reliable motor imagery (MI) classification algorithms for applications in consumer level brain-computer interfacing (BCI). For the practical use, such algorithms must be robust to both device limitations and subject variability, which make MI classification a challenging task. This study proposes methods to study the effect of limitations including a limited number of electrodes, limited spatial distribution of electrodes, lower signal quality, subject variabilities and BCI literacy, on the performance of MI classification. To mitigate these limitations, we propose a machine learning approach, WaveCSP that uses 24 features extracted from EEG signals using wavelet transform and common spatial pattern (CSP) filtering techniques. The algorithm shows better performance in terms of subject variability compared to existing work. The application of WaveCSP to Physionet MI database shows more than 50% of the 109 subjects achieving accuracy higher than 64%. The data obtained from a commercial EEG headset using the same experimental protocol result in up to four out of five subjects who had prior BCI experience (out of a total of 25 subjects) performing with accuracy higher than 64%.

EEG-Based Brain-Computer Interfaces

Brain-Computer Interfaces (BCIs) are real-time computer-based systems that translate brain signals into useful commands. To date most applications have been demonstrations of proof-of-principle; widespread use by people who could benefit from this technology requires further development. Improvements in current EEG recording technology are needed. Better sensors would be easier to apply, more confortable for the user, and produce higher quality and more stable signals. Although considerable effort has been devoted to evaluating classifiers using public datasets, more attention to real-time signal processing issues and to optimizing the mutually adaptive interaction between the brain and the BCI are essential for improving BCI performance. Further development of applications is also needed, particularly applications of BCI technology to rehabilitation. The design of rehabilitation applications hinges on the nature of BCI control and how it might be used to induce and guide beneficial plasticity in the brain.