Augmentative and Alternative Communication Training Using Eye Blink Switch for Locked-in Syndrome Patient

Abstract

Locked-in Syndrome is a severe pontine stroke causing quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement in a conscious patient. We present a case of a Locked-in Syndrome patient who received communication training with augmentative and alternative communication equipment by using eye blinks. After 3 weeks of training, the patient was able to make an attempt to interact with other people, and associate a new word by Korean alphabet selection. Augmentative and alternative communication equipment which uses eye blinks might be considered to be beneficial in improving the communication skills of locked-in syndrome patients.

A concept-environment for computer-based augmentative and alternative communication founded on a systematic review

“…Paper Category (Bermúdez et al, 2010), (Cabrera et al, 2008), (Chin et al, 2010), (Deepa et al, 2010), (Okasaka and Hoshino, 2012), (Schalk et al, 2008), (Sorger et al, 2009), (Sun et al, 2010, (Thomas et al, 2008), (Thompson et al, 2013), (Ortner et al, 2011), (Al-Abdullatif et al, 2013), , , (Ming et al, 2009) BCI (Hanson et al, 2010) Speech generator device (Keegan et al, 2009) EOG (Joubert et al, 2011) Exploratory study (Ann and Theng, 2011b) Facial expression (Park et al, 2012), (Cipresso et al, 2011) Eyetracking (AlJa 'am et al, 2008), (Ann and Theng, 2011b), (Friginal et al, 2013), , (Sorna et al, 2009), (Hsieh et al, 2009) Software modeling , , , (Silva and Pereira, 2011), (Tsai, 2013) Communication board (Belani, 2012), (Arnott and Alm, 2013), (Deepa et al, 2010), (Hill, 2010), (McCoy et al, 2013), (Mak and Wolpaw, 2009), Conceptual review (Alwell and Cobb, 2009), (Finke et al, 2008) Systematic review , (Prabhu and Prasad, 2011), Alternative virtual keyboard…”

“…These movements can be tracked by using image processing (Park et al, 2012) or even by measuring the activity of the eye muscles (Keegan et al, 2009). BCI is recommended only for people with full LIS.…”

“…Specially, Computing has great potential to contribute to advancing AT through integrating information processing and communication tools in a multimedia context. Park et al (2012) concluded that, due to the increasing popularization of computers and the internet expansion, many studies have been carried out to assist the communication of people with aphasia and tetraplegia. Augmentative and Alternative Communication (AAC) is an important field of AT that comprises the methods and technologies designed to assist or replace the oral communication of people with limited speech (Wilkinson and Hennig, 2007).…”

“…For instance, the eye movements can be acquired by video cameras (Park et al, 2012) or by recording signals from the eye muscles (Electrooculography -EOG) . The most used technique to acquire brain activity is the Electroencephalography (EEG) (Cabrera et al, 2008).…”

“…The input device is used to capture any type of voluntary intent of the patient. The eye movements were used as inputs in Park et al (2012) and Cipresso et al (2011), while Blain et al (2008), Schalk et al (2008), Usakli et al (2009) andAl-Abdullatif et al (2013) used patient's brain activity to provide communication resources.…”