SSVEP BCI and Eye Tracking Use by Individuals With Late-Stage ALS and Visual Impairments

Emergence from Disorders of Consciousness: Optimizing Self-Agency Through Communication

Language and communication deficits are intrinsic to disorders of consciousness. This article will provide an overview of language and communication deficits that can significantly confound the accuracy of diagnostic assessment in these patients. Authors will also discuss interventions to promote early communication using assistive technology and augmentative communication rehabilitation strategies. Finally, this article will discuss the importance of family education as well as ethical considerations connected to the recovery of communication and adaptive strategies to support patient autonomy and enhance self-agency.

Brain-computer interface in critical care and rehabilitation

This comprehensive review explores the broad landscape of brain-computer interface (BCI) technology and its potential use in intensive care units (ICUs), particularly for patients with motor impairments such as quadriplegia or severe brain injury. By employing brain signals from various sensing techniques, BCIs offer enhanced communication and motor rehabilitation strategies for patients. This review underscores the concept and efficacy of noninvasive, electroencephalogram-based BCIs in facilitating both communicative interactions and motor function recovery. Additionally, it highlights the current research gap in intuitive "stop" mechanisms within motor rehabilitation protocols, emphasizing the need for advancements that prioritize patient safety and individualized responsiveness. Furthermore, it advocates for more focused research that considers the unique requirements of ICU environments to address the challenges arising from patient variability, fatigue, and limited applicability of current BCI systems outside of experimental settings.

MI-based BCI with accurate real-time three-class classification processing and light control application

The use of brain-computer interfaces (BCIs) to control intelligent devices is a current and future research direction. However, the challenges of low accuracy of real-time recognition and the need for multiple electroencephalographic channels are yet to be overcome. While a number of research teams have proposed many ways to improve offline classification accuracy, the potential problems in real-time experiments are often overlooked. In this study, we proposed a label-based channel diversion preprocessing to solve the problem of low real-time classification accuracy. The Tikhonov regularised common spatial-pattern algorithm (TRCSP) and one vs rest support vector machine (OVR-SVM) were used for feature extraction and pattern classification. High accuracy was achieved in real-time three-class classification using only three channels (average real-time accuracy of 87.46%, with a maximum of 90.33%). In addition, the stability and reliability of the system were verified through lighting control experiments in a real environment. Using the autonomy of MI and real-time feedback of light brightness, we have built a fully autonomous interactive system. The improvement in the real-time classification accuracy in this study is of great significance to the industrialisation of BCI.

Multi-modal access method (eye-tracking + switch-scanning) for individuals with severe motor impairment: A preliminary investigation

Individuals with severe motor impairments often require alternative means to access computers and communication technology. A range of alternative access devices exist; however, most rely on use of a single access modality. While this approach works for some individuals, it can be limiting for others. This study explored the use of a multi-modal prototype (eye-tracking + switch-scanning) on typing performance with a range of individuals with motor impairments. The multi-modal prototype was compared to eye-tracking alone for this study. Results indicated that the multi-modal prototype had significantly slower typing rate but significantly lower total errors compared to eye-tracking alone. Analysis of individual data revealed four subgroups of clinical relevance including individuals that 1) benefit from multi-modal, 2) benefit from eye-tracking, 3) demonstrate learning and 4) demonstrate fluctuating performance.

Demands Associated With an Augmentative and Alternative Communication System in Relation to Alternative Forms of Access for Individuals With Motor Impairments

PURPOSE

Successful adoption and use of aided augmentative and alternative communication (AAC) must address how to promote fluid, efficient, and organized execution of the motor behavior needed to access the AAC system. A substantial number of people who use AAC have significant motor impairments and require "alternative" access options, such as eye gaze or switch use. Such individuals may be particularly vulnerable to interference from a poorly designed system. However, the inherent demands of alternative access methods have received little direct study. The goal of this tutorial is to offer a clinically and theoretically guided framework for considerations concerning AAC access, with the hope of spurring further discussion and empirical research.

METHOD

A framework that draws upon dynamic systems theory was used to illustrate the interactions between the various elements of importance to AAC access. Information and research from the fields of motor learning, developmental dynamic systems theory, AAC, and assistive technology was integrated into this tutorial to examine their applications for alternative AAC access methods.

RESULTS

The framework illustrated that AAC access involves a complex coordination between individual skills, the demands of the communication environment, the activity being undertaken, and the supports and demands inherent in the AAC system itself.

CONCLUSIONS

Awareness of the many demands that alternative forms of access place on the person who uses them can guide clinicians during assessment and intervention decision making regarding access options for individuals with significant motor impairments. Specific directions for future research are considered.

Multi-Task Learning-Based Deep Neural Network for Steady-State Visual Evoked Potential-Based Brain-Computer Interfaces

Amyotrophic lateral sclerosis (ALS) causes people to have difficulty communicating with others or devices. In this paper, multi-task learning with denoising and classification tasks is used to develop a robust steady-state visual evoked potential-based brain-computer interface (SSVEP-based BCI), which can help people communicate with others. To ease the operation of the input interface, a single channel-based SSVEP-based BCI is selected. To increase the practicality of SSVEP-based BCI, multi-task learning is adopted to develop the neural network-based intelligent system, which can suppress the noise components and obtain a high level of accuracy of classification. Thus, denoising and classification tasks are selected in multi-task learning. The experimental results show that the proposed multi-task learning can effectively integrate the advantages of denoising and discriminative characteristics and outperform other approaches. Therefore, multi-task learning with denoising and classification tasks is very suitable for developing an SSVEP-based BCI for practical applications. In the future, an augmentative and alternative communication interface can be implemented and examined for helping people with ALS communicate with others in their daily lives.

A systematic review of research on augmentative and alternative communication brain-computer interface systems for individuals with disabilities

Augmentative and alternative communication brain-computer interface (AAC-BCI) systems are intended to offer communication access to people with severe speech and physical impairment (SSPI) without requiring volitional movement. As the field moves toward clinical implementation of AAC-BCI systems, research involving participants with SSPI is essential. Research has demonstrated variability in AAC-BCI system performance across users, and mixed results for comparisons of performance for users with and without disabilities. The aims of this systematic review were to (1) describe study, system, and participant characteristics reported in BCI research, (2) summarize the communication task performance of participants with disabilities using AAC-BCI systems, and (3) explore any differences in performance for participants with and without disabilities. Electronic databases were searched in May, 2018, and March, 2021, identifying 6065 records, of which 73 met inclusion criteria. Non-experimental study designs were common and sample sizes were typically small, with approximately half of studies involving five or fewer participants with disabilities. There was considerable variability in participant characteristics, and in how those characteristics were reported. Over 60% of studies reported an average selection accuracy ≤70% for participants with disabilities in at least one tested condition. However, some studies excluded participants who did not reach a specific system performance criterion, and others did not state whether any participants were excluded based on performance. Twenty-nine studies included participants both with and without disabilities, but few reported statistical analyses comparing performance between the two groups. Results suggest that AAC-BCI systems show promise for supporting communication for people with SSPI, but they remain ineffective for some individuals. The lack of standards in reporting outcome measures makes it difficult to synthesize data across studies. Further research is needed to demonstrate efficacy of AAC-BCI systems for people who experience SSPI of varying etiologies and severity levels, and these individuals should be included in system design and testing. Consensus in terminology and consistent participant, protocol, and performance description will facilitate the exploration of user and system characteristics that positively or negatively affect AAC-BCI use, and support innovations that will make this technology more useful to a broader group of people.

Clinical trial registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018095345, PROSPERO: CRD42018095345.

Development of a Sensing Platform Based on Hands-Free Interfaces for Controlling Electronic Devices

Hands-free interfaces are essential to people with limited mobility for interacting with biomedical or electronic devices. However, there are not enough sensing platforms that quickly tailor the interface to these users with disabilities. Thus, this article proposes to create a sensing platform that could be used by patients with mobility impairments to manipulate electronic devices, thereby their independence will be increased. Hence, a new sensing scheme is developed by using three hands-free signals as inputs: voice commands, head movements, and eye gestures. These signals are obtained by using non-invasive sensors: a microphone for the speech commands, an accelerometer to detect inertial head movements, and an infrared oculography to register eye gestures. These signals are processed and received as the user's commands by an output unit, which provides several communication ports for sending control signals to other devices. The interaction methods are intuitive and could extend boundaries for people with disabilities to manipulate local or remote digital systems. As a study case, two volunteers with severe disabilities used the sensing platform to steer a power wheelchair. Participants performed 15 common skills for wheelchair users and their capacities were evaluated according to a standard test. By using the head control they obtained 93.3 and 86.6%, respectively for volunteers A and B; meanwhile, by using the voice control they obtained 63.3 and 66.6%, respectively. These results show that the end-users achieved high performance by developing most of the skills by using the head movements interface. On the contrary, the users were not able to develop most of the skills by using voice control. These results showed valuable information for tailoring the sensing platform according to the end-user needs.

Brain-computer interfaces based on code-modulated visual evoked potentials (c-VEP): a literature review

Objective.Code-modulated visual evoked potentials (c-VEP) have been consolidated in recent years as robust control signals capable of providing non-invasive brain-computer interfaces (BCIs) for reliable, high-speed communication. Their usefulness for communication and control purposes has been reflected in an exponential increase of related articles in the last decade. The aim of this review is to provide a comprehensive overview of the literature to gain understanding of the existing research on c-VEP-based BCIs, since its inception (1984) until today (2021), as well as to identify promising future research lines.Approach.The literature review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. After assessing the eligibility of journal manuscripts, conferences, book chapters and non-indexed documents, a total of 70 studies were included. A comprehensive analysis of the main characteristics and design choices of c-VEP-based BCIs was discussed, including stimulation paradigms, signal processing, modeling responses, applications, etc.Main results.The literature review showed that state-of-the-art c-VEP-based BCIs are able to provide an accurate control of the system with a large number of commands, high selection speeds and even without calibration. In general, a lack of validation in real setups was observed, especially regarding the validation with disabled populations. Future work should be focused toward developing self-paced c-VEP-based portable BCIs applied in real-world environments that could exploit the unique benefits of c-VEP paradigms. Some aspects such as asynchrony, unsupervised training, or code optimization still require further research and development.Significance.Despite the growing popularity of c-VEP-based BCIs, to the best of our knowledge, this is the first literature review on the topic. In addition to providing a joint discussion of the advances in the field, some future lines of research are suggested to contribute to the development of reliable plug-and-play c-VEP-based BCIs.

Summary of over Fifty Years with Brain-Computer Interfaces-A Review

Over the last few decades, the Brain-Computer Interfaces have been gradually making their way to the epicenter of scientific interest. Many scientists from all around the world have contributed to the state of the art in this scientific domain by developing numerous tools and methods for brain signal acquisition and processing. Such a spectacular progress would not be achievable without accompanying technological development to equip the researchers with the proper devices providing what is absolutely necessary for any kind of discovery as the core of every analysis: the data reflecting the brain activity. The common effort has resulted in pushing the whole domain to the point where the communication between a human being and the external world through BCI interfaces is no longer science fiction but nowadays reality. In this work we present the most relevant aspects of the BCIs and all the milestones that have been made over nearly 50-year history of this research domain. We mention people who were pioneers in this area as well as we highlight all the technological and methodological advances that have transformed something available and understandable by a very few into something that has a potential to be a breathtaking change for so many. Aiming to fully understand how the human brain works is a very ambitious goal and it will surely take time to succeed. However, even that fraction of what has already been determined is sufficient e.g., to allow impaired people to regain control on their lives and significantly improve its quality. The more is discovered in this domain, the more benefit for all of us this can potentially bring.