An adaptive closed-loop ECoG decoder for long-term and stable bimanual control of an exoskeleton by a tetraplegic

Invasive Brain Computer Interface for Motor Restoration in Spinal Cord Injury: A Systematic Review

STUDY DESIGN

Systematic review of the literature.

OBJECTIVES

In recent years, brain-computer interface (BCI) has emerged as a potential treatment for patients with spinal cord injury (SCI). This is the first systematic review of the literature on invasive closed-loop BCI technologies for the treatment of SCI in humans.

MATERIALS AND METHODS

A comprehensive search of PubMed MEDLINE, Web of Science, and Ovid EMBASE was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Of 8316 articles collected, 19 studies met all the inclusion criteria. Data from 21 patients were extracted from these studies. All patients sustained a cervical SCI and were treated using either a BCI with intracortical microelectrode arrays (n = 18, 85.7%) or electrocorticography (n = 3, 14.3%). To decode these neural signals, machine learning and statistical models were used: support vector machine in eight patients (38.1%), linear estimator in seven patients (33.3%), Hidden Markov Model in three patients (14.3%), and other in three patients (14.3%). As the outputs, ten patients (47.6%) underwent noninvasive functional electrical stimulation (FES) with a cuff; one (4.8%) had an invasive FES with percutaneous stimulation, and ten (47.6%) used an external device (neuroprosthesis or virtual avatar). Motor function was restored in all patients for each assigned task. Clinical outcome measures were heterogeneous across all studies.

CONCLUSIONS

Invasive techniques of BCI show promise for the treatment of SCI, but there is currently no technology that can restore complete functional autonomy in patients with SCI. The current techniques and outcomes of BCI vary greatly. Because invasive BCIs are still in the early stages of development, further clinical studies should be conducted to optimize the prognosis for patients with SCI.

Stable Decoding from a Speech BCI Enables Control for an Individual with ALS without Recalibration for 3 Months

Brain-computer interfaces (BCIs) can be used to control assistive devices by patients with neurological disorders like amyotrophic lateral sclerosis (ALS) that limit speech and movement. For assistive control, it is desirable for BCI systems to be accurate and reliable, preferably with minimal setup time. In this study, a participant with severe dysarthria due to ALS operates computer applications with six intuitive speech commands via a chronic electrocorticographic (ECoG) implant over the ventral sensorimotor cortex. Speech commands are accurately detected and decoded (median accuracy: 90.59%) throughout a 3-month study period without model retraining or recalibration. Use of the BCI does not require exogenous timing cues, enabling the participant to issue self-paced commands at will. These results demonstrate that a chronically implanted ECoG-based speech BCI can reliably control assistive devices over long time periods with only initial model training and calibration, supporting the feasibility of unassisted home use.

Walking naturally after spinal cord injury using a brain-spine interface

A spinal cord injury interrupts the communication between the brain and the region of the spinal cord that produces walking, leading to paralysis1,2. Here, we restored this communication with a digital bridge between the brain and spinal cord that enabled an individual with chronic tetraplegia to stand and walk naturally in community settings. This brain-spine interface (BSI) consists of fully implanted recording and stimulation systems that establish a direct link between cortical signals3 and the analogue modulation of epidural electrical stimulation targeting the spinal cord regions involved in the production of walking4-6. A highly reliable BSI is calibrated within a few minutes. This reliability has remained stable over one year, including during independent use at home. The participant reports that the BSI enables natural control over the movements of his legs to stand, walk, climb stairs and even traverse complex terrains. Moreover, neurorehabilitation supported by the BSI improved neurological recovery. The participant regained the ability to walk with crutches overground even when the BSI was switched off. This digital bridge establishes a framework to restore natural control of movement after paralysis.

Nine decades of electrocorticography: A comparison between epidural and subdural recordings

In recent years, electrocorticography (ECoG) has arisen as a neural signal recording tool in the development of clinically viable neural interfaces. ECoG electrodes are generally placed below the dura mater (subdural) but can also be placed on top of the dura (epidural). In deciding which of these modalities best suits long-term implants, complications and signal quality are important considerations. Conceptually, epidural placement may present a lower risk of complications as the dura is left intact but also a lower signal quality due to the dura acting as a signal attenuator. The extent to which complications and signal quality are affected by the dura, however, has been a matter of debate. To improve our understanding of the effects of the dura on complications and signal quality, we conducted a literature review. We inventorized the effect of the dura on signal quality, decodability and longevity of acute and chronic ECoG recordings in humans and non-human primates. Also, we compared the incidence and nature of serious complications in studies that employed epidural and subdural ECoG. Overall, we found that, even though epidural recordings exhibit attenuated signal amplitude over subdural recordings, particularly for high-density grids, the decodability of epidural recorded signals does not seem to be markedly affected. Additionally, we found that the nature of serious complications was comparable between epidural and subdural recordings. These results indicate that both epidural and subdural ECoG may be suited for long-term neural signal recordings, at least for current generations of clinical and high-density ECoG grids.

Impact of dataset size and long-term ECoG-based BCI usage on deep learning decoders performance

Introduction

In brain-computer interfaces (BCI) research, recording data is time-consuming and expensive, which limits access to big datasets. This may influence the BCI system performance as machine learning methods depend strongly on the training dataset size. Important questions arise: taking into account neuronal signal characteristics (e.g., non-stationarity), can we achieve higher decoding performance with more data to train decoders? What is the perspective for further improvement with time in the case of long-term BCI studies? In this study, we investigated the impact of long-term recordings on motor imagery decoding from two main perspectives: model requirements regarding dataset size and potential for patient adaptation.

Methods

We evaluated the multilinear model and two deep learning (DL) models on a long-term BCI & Tetraplegia (ClinicalTrials.gov identifier: NCT02550522) clinical trial dataset containing 43 sessions of ECoG recordings performed with a tetraplegic patient. In the experiment, a participant executed 3D virtual hand translation using motor imagery patterns. We designed multiple computational experiments in which training datasets were increased or translated to investigate the relationship between models' performance and different factors influencing recordings.

Results

Our results showed that DL decoders showed similar requirements regarding the dataset size compared to the multilinear model while demonstrating higher decoding performance. Moreover, high decoding performance was obtained with relatively small datasets recorded later in the experiment, suggesting motor imagery patterns improvement and patient adaptation during the long-term experiment. Finally, we proposed UMAP embeddings and local intrinsic dimensionality as a way to visualize the data and potentially evaluate data quality.

Discussion

DL-based decoding is a prospective approach in BCI which may be efficiently applied with real-life dataset size. Patient-decoder co-adaptation is an important factor to consider in long-term clinical BCI.

Online adaptive group-wise sparse Penalized Recursive Exponentially Weighted N-way Partial Least Square for epidural intracranial BCI

Introduction

Motor Brain-Computer Interfaces (BCIs) create new communication pathways between the brain and external effectors for patients with severe motor impairments. Control of complex effectors such as robotic arms or exoskeletons is generally based on the real-time decoding of high-resolution neural signals. However, high-dimensional and noisy brain signals pose challenges, such as limitations in the generalization ability of the decoding model and increased computational demands.

Methods

The use of sparse decoders may offer a way to address these challenges. A sparsity-promoting penalization is a common approach to obtaining a sparse solution. BCI features are naturally structured and grouped according to spatial (electrodes), frequency, and temporal dimensions. Applying group-wise sparsity, where the coefficients of a group are set to zero simultaneously, has the potential to decrease computational time and memory usage, as well as simplify data transfer. Additionally, online closed-loop decoder adaptation (CLDA) is known to be an efficient procedure for BCI decoder training, taking into account neuronal feedback. In this study, we propose a new algorithm for online closed-loop training of group-wise sparse multilinear decoders using L _p -Penalized Recursive Exponentially Weighted N-way Partial Least Square (PREW-NPLS). Three types of sparsity-promoting penalization were explored using L _p with p = 0., 0.5, and 1.

Results

The algorithms were tested offline in a pseudo-online manner for features grouped by spatial dimension. A comparison study was conducted using an epidural ECoG dataset recorded from a tetraplegic individual during long-term BCI experiments for controlling a virtual avatar (left/right-hand 3D translation). Novel algorithms showed comparable or better decoding performance than conventional REW-NPLS, which was achieved with sparse models. The proposed algorithms are compatible with real-time CLDA.

Discussion

The proposed algorithm demonstrated good performance while drastically reducing the computational load and the memory consumption. However, the current study is limited to offline computation on data recorded with a single patient, with penalization restricted to the spatial domain only.

Unsupervised adaptation of an ECoG based brain-computer interface using neural correlates of task performance

Brain-computer interfaces (BCIs) translate brain signals into commands to external effectors, and mainly target severely disabled users. The usability of BCIs may be improved by reducing their major constraints, such as the necessity for special training sessions to initially calibrate and later keep up to date the neural signal decoders. In this study, we show that it is possible to train and update BCI decoders during free use of motor BCIs. In addition to the neural signal decoder controlling effectors (control decoder), one more classifier is proposed to detect neural correlates of BCI motor task performances (MTP). MTP decoders reveal whether the actions performed by BCI effectors matched the user's intentions. The combined outputs of MTP and control decoders allow forming training datasets to update the control decoder online and in real time during free use of BCIs. The usability of the proposed auto-adaptive BCI (aaBCI) is demonstrated for two principle BCIs paradigms: with discrete outputs (4 classes BCI, virtual 4-limb exoskeleton), and with continuous outputs (cursor 2D control). The proof of concept was performed in an online simulation study using an ECoG dataset collected from a tetraplegic during a BCI clinical trial. The control decoder reached a multiclass area under the ROC curve of 0.7404 using aaBCI, compared to a chance level of 0.5173 and to 0.8187 for supervised training for the multiclass BCI, and a cosine similarity of 0.1211 using aaBCI, compared to a chance level of 0.0036 and to 0.2002 for supervised training for the continuous BCI.

Methodological Recommendations for Studies on the Daily Life Implementation of Implantable Communication-Brain-Computer Interfaces for Individuals With Locked-in Syndrome

Implantable brain-computer interfaces (BCIs) promise to be a viable means to restore communication in individuals with locked-in syndrome (LIS). In 2016, we presented the world-first fully implantable BCI system that uses subdural electrocorticography electrodes to record brain signals and a subcutaneous amplifier to transmit the signals to the outside world, and that enabled an individual with LIS to communicate via a tablet computer by selecting icons in spelling software. For future clinical implementation of implantable communication-BCIs, however, much work is still needed, for example, to validate these systems in daily life settings with more participants, and to improve the speed of communication. We believe the design and execution of future studies on these and other topics may benefit from the experience we have gained. Therefore, based on relevant literature and our own experiences, we here provide an overview of procedures, as well as recommendations, for recruitment, screening, inclusion, imaging, hospital admission, implantation, training, and support of participants with LIS, for studies on daily life implementation of implantable communication-BCIs. With this article, we not only aim to inform the BCI community about important topics of concern, but also hope to contribute to improved methodological standardization of implantable BCI research.

Decoding ECoG signal into 3D hand translation using deep learning

Objective.Motor brain-computer interfaces (BCIs) are a promising technology that may enable motor-impaired people to interact with their environment. BCIs would potentially compensate for arm and hand function loss, which is the top priority for individuals with tetraplegia. Designing real-time and accurate BCI is crucial to make such devices useful, safe, and easy to use by patients in a real-life environment. Electrocorticography (ECoG)-based BCIs emerge as a good compromise between invasiveness of the recording device and good spatial and temporal resolution of the recorded signal. However, most ECoG signal decoders used to predict continuous hand movements are linear models. These models have a limited representational capacity and may fail to capture the relationship between ECoG signal features and continuous hand movements. Deep learning (DL) models, which are state-of-the-art in many problems, could be a solution to better capture this relationship.Approach.In this study, we tested several DL-based architectures to predict imagined 3D continuous hand translation using time-frequency features extracted from ECoG signals. The dataset used in the analysis is a part of a long-term clinical trial (ClinicalTrials.gov identifier: NCT02550522) and was acquired during a closed-loop experiment with a tetraplegic subject. The proposed architectures include multilayer perceptron, convolutional neural networks (CNNs), and long short-term memory networks (LSTM). The accuracy of the DL-based and multilinear models was compared offline using cosine similarity.Main results.Our results show that CNN-based architectures outperform the current state-of-the-art multilinear model. The best architecture exploited the spatial correlation between neighboring electrodes with CNN and benefited from the sequential character of the desired hand trajectory by using LSTMs. Overall, DL increased the average cosine similarity, compared to the multilinear model, by up to 60%, from 0.189 to 0.302 and from 0.157 to 0.249 for the left and right hand, respectively.Significance.This study shows that DL-based models could increase the accuracy of BCI systems in the case of 3D hand translation prediction in a tetraplegic subject.