Options for people with severe paralysis who have lost the ability to communicate orally are limited. We describe a method for communication in a patient with late-stage amyotrophic lateral sclerosis (ALS), involving a fully implanted brain-computer interface that consists of subdural electrodes placed over the motor cortex and a transmitter placed subcutaneously in the left side of the thorax. By attempting to move the hand on the side opposite the implanted electrodes, the patient accurately and independently controlled a computer typing program 28 weeks after electrode placement, at the equivalent of two letters per minute. The brain-computer interface offered autonomous communication that supplemented and at times supplanted the patient's eye-tracking device. (Funded by the Government of the Netherlands and the European Union; ClinicalTrials.gov number, NCT02224469 .).

This study presents first evidence that reliable EEG data can be recorded with a new cEEGrid electrode array, which consists of ten electrodes printed on flexible sheet and arranged in a c-shape to fit around the ear. Ten participants wore two cEEGrid systems for at least seven hours. Using a smartphone for stimulus delivery and signal acquisition, resting EEG and auditory oddball data were collected in the morning and in the afternoon six to seven hours apart. Analysis of resting EEG data confirmed well-known spectral differences between eyes open and eyes closed conditions. The ERP results confirmed the predicted condition effects with significantly larger P300 amplitudes for target compared to standard tones, and a high test-retest reliability of the P300 amplitude (r > = .74). Moreover, a linear classifier trained on data from the morning session revealed similar performance in classification accuracy for the morning and the afternoon sessions (both > 70%). These findings demonstrate the feasibility of concealed and comfortable brain activity acquisition over many hours.

Electroencephalography (EEG) is an important clinical tool and frequently used to study the brain-behavior relationship in humans noninvasively. Traditionally, EEG signals are recorded by positioning electrodes on the scalp and keeping them in place with glue, rubber bands, or elastic caps. This setup provides good coverage of the head, but is impractical for EEG acquisition in natural daily-life situations. Here, we propose the transparent EEG concept. Transparent EEG aims for motion tolerant, highly portable, unobtrusive, and near invisible data acquisition with minimum disturbance of a user's daily activities. In recent years several ear-centered EEG solutions that are compatible with the transparent EEG concept have been presented. We discuss work showing that miniature electrodes placed in and around the human ear are a feasible solution, as they are sensitive enough to pick up electrical signals stemming from various brain and non-brain sources. We also describe the cEEGrid flex-printed sensor array, which enables unobtrusive multi-channel EEG acquisition from around the ear. In a number of validation studies we found that the cEEGrid enables the recording of meaningful continuous EEG, event-related potentials and neural oscillations. Here, we explain the rationale underlying the cEEGrid ear-EEG solution, present possible use cases and identify open issues that need to be solved on the way toward transparent EEG.