Effects of a Vibro-Tactile P300 Based Brain-Computer Interface on the Coma Recovery Scale-Revised in Patients With Disorders of Consciousness

Abstract

Persons diagnosed with disorders of consciousness (DOC) typically suffer from motor and cognitive disabilities. Recent research has shown that non-invasive brain-computer interface (BCI) technology could help assess these patients' cognitive functions and command following abilities. 20 DOC patients participated in the study and performed 10 vibro-tactile P300 BCI sessions over 10 days with 8-12 runs each day. Vibrotactile tactors were placed on the each patient's left and right wrists and one foot. Patients were instructed, via earbuds, to concentrate and silently count vibrotactile pulses on either their left or right wrist that presented a target stimulus and to ignore the others. Changes of the BCI classification accuracy were investigated over the 10 days. In addition, the Coma Recovery Scale-Revised (CRS-R) score was measured before and after the 10 vibro-tactile P300 sessions. In the first run, 10 patients had a classification accuracy above chance level (>12.5%). In the best run, every patient reached an accuracy ≥60%. The grand average accuracy in the first session for all patients was 40%. In the best session, the grand average accuracy was 88% and the median accuracy across all sessions was 21%. The CRS-R scores compared before and after 10 VT3 sessions for all 20 patients, are showing significant improvement (p = 0.024). Twelve of the twenty patients showed an improvement of 1 to 7 points in the CRS-R score after the VT3 BCI sessions (mean: 2.6). Six patients did not show a change of the CRS-R and two patients showed a decline in the score by 1 point. Every patient achieved at least 60% accuracy at least once, which indicates successful command following.

Progress in Brain Computer Interface: Challenges and Opportunities

“…Another possible application of bidirectional BCI framework is direct brain-to-brain communication (Grau et al, 2014 ; Rao et al, 2014 ). Moreover, some BCI applications require auxiliary modalities, e.g., proprioceptive feedback and functional electrical stimulation driven by brain signals as feedback for augmenting or regaining peripheral motor actions (Darvishi et al, 2017 ; Bhattacharyya et al, 2019 ; Bockbrader et al, 2019 ; Murovec et al, 2020 ).…”

Development of a brain-computer interface for patients in the critical care setting

“…Brain-computer interface (BCI) technology translates cerebral electrical activity, typically recorded by EEG, into computer commands bypassing other body functions [ 6 , 7 ]. Despite having used BCI systems efficiently for rehabilitation purposes [ 8 , 9 ], their introduction in the critical care context is limited [ 10 – 12 ]. Implementation of BCI systems in critical care settings has faced a number of technical and logistical challenges.…”

“…Auditory-based BCI tasks may be most promising, but are not without their own set of challenges. Auditory BCI studies with critically ill patients have often reported high variability and/or poor performance in a single session [ 12 ]. Multiple sessions pose challenges in a hectic ICU setting.…”

“…Multiple sessions pose challenges in a hectic ICU setting. Given this, currently studied BCI systems in the intensive care unit (ICU) focus on quick and reliable signaling (e.g., ‘yes’/‘no’ binary signals [ 11 ], steady-state visual evoked potential- (SSVEP-) based communication [ 10 ], or transient evoked potentials (P300 or N200) [ 12 ]) rather than spelling of words or sentences.…”

Effects of Skin Friction on Tactile P300 Brain‐Computer Interface Performance

“…Silvoni et al [ 29 ] investigated the tactile ERP and classification accuracy in a sample of ALS patients and found no significant differences in the accuracy between ALS patients and healthy participants, proving the feasibility of tactile BCI for patients with diseases. Most recently, Murovec et al [ 30 ] demonstrated the potential of communicating by a tactile BCI system for patients with disorders of consciousness.…”