Long-Term Independent Brain-Computer Interface Home Use Improves Quality of Life of a Patient in the Locked-In State: A Case Study

Holz, Elisa Mira; Botrel, Loïc; Kaufmann, Tobias; Kübler, Andrea

doi:10.1016/j.apmr.2014.03.035

Cited by 143 publications

(108 citation statements)

References 28 publications

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“…2). Being not in control of a BCI can make its use frustrating (Holz et al, 2015). Frustration has been experienced as problematic in BCI use (Curran and Stokes, 2003) and further Kleih et al (2010Kleih et al ( , 2013 showed that learning an SMR-BCI task is facilitated by increased motivation.…”

Section: Introductionmentioning

confidence: 99%

The effect of multimodal and enriched feedback on SMR-BCI performance

Sollfrank

Ramsay

Perdikis

et al. 2016

Clinical Neurophysiology

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Section: Introductionmentioning

confidence: 99%

The effect of multimodal and enriched feedback on SMR-BCI performance

Sollfrank

Ramsay

Perdikis

et al. 2016

Clinical Neurophysiology

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“…[1]. We have few recent studies demonstrating the independent home use of BCI [2][3][4]. Although these were single case studies, they do show the potential feasibility of BCI for the target population and provide valuable information on the prerequisites for transferring BCI to patients' homes and for reliable operation.…”

mentioning

confidence: 93%

User-centred design in brain–computer interface research and development

Kübler

Müller-Putz

Mattia

2015

Annals of Physical and Rehabilitation Medicine

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In a recent article [1], Nijboer addressed an important topic for brain-computer interface (BCI) research and development: How can we develop a technology that will in the end be used by the target population? [1]. We have few recent studies demonstrating the independent home use of BCI [2][3][4]. Although these were single case studies, they do show the potential feasibility of BCI for the target population and provide valuable information on the prerequisites for transferring BCI to patients' homes and for reliable operation.Despite these exemplary success stories, indeed a wide gap exists between the amount of research conducted in laboratory settings with healthy subjects and translational research with targeted end-users, specifically in their home environment and without experts being present. Fig. 1 illustrates this gap: the overall number of BCI-related publications is high and has been almost exponentially increasing in the past 2 decades; however, those including or referring to patients are about 10-fold lower but are fortunately also increasing.As one measure to address the issue of technology transfer, the user-centred design (UCD) is recommended and requested to be adopted. In this iterative process, the developers and users communicate about the requirements of a product and its implementation, with the aim of the final product being used in the daily life of the target population. We agree that the UCD provides an excellent framework to foster BCI development together with the target users. Valuable work in this direction has been performed in recent years by the BCI community; for example, the first paper introducing the UCD in a BCI study with patient end-users was published in 2011 [5]. Kü bler and colleagues adapted the UCD to BCI with a sample of 19 patients with severe motor paralysis and the locked-in state (see Fig. 2) [6]. As requested by Nijboer, usability as defined by the ISO 9241-210 [7] was addressed with its components effectiveness, efficiency, and satisfaction. Effectiveness (i.e., how well the task can be mastered by the target group) was defined as accuracy. Accuracy indicates how often a correct selection occurred in relation to the total number of attempts. Efficiency (i.e., how much effort is needed to be effective) was operationalised as information transfer rate (ITR) and workload. ITR is an objective measure that captures how much information can be transferred per time unit and takes into account how many options for selection exist. Additionally, the utility metric was suggested, because if accuracy is < 50%, practically, no information can be conveyed if more than every other selection is wrong. Workload as a subjective measure can be assessed with the NASA Task Load Index [8]. Satisfaction was suggested to be measured by the Quebec User Evaluation of Satisfaction [9], which was adapted to BCI in that 4 BCI-relevant items were included: reliability, speed, learnability, and aesthetic design [5], all features considered important by Nijboer. Visual analogue scales were s...

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“…Patients wanted a system that could work outside of laboratory settings, providing capabilities beyond spelling. Most BCI research has been restricted to a laboratory setting, though home use by locked-in patients has been validated (Vaughan et al, 2006;Münßinger et al, 2010;Holz et al, 2015;McCane et al, 2015). Furthermore, while some BCI spellers have made a difference for patients, additional capabilities such as robot control could provide more help with activities of daily living (Zickler et al, 2009;Huggins et al, 2011;Blain et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Reaching and grasping a glass of water by locked-in ALS patients through a BCI-controlled humanoid robot

Spataro¹,

Sorbello²,

Tramonte³

et al. 2015

Journal of the Neurological Sciences

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Locked-in Amyotrophic Lateral Sclerosis (ALS) patients are fully dependent on caregivers for any daily need. At this stage, basic communication and environmental control may not be possible even with commonly used augmentative and alternative communication devices. Brain Computer Interface (BCI) technology allows users to modulate brain activity for communication and control of machines and devices, without requiring a motor control. In the last several years, numerous articles have described how persons with ALS could effectively use BCIs for different goals, usually spelling. In the present study, locked-in ALS patients used a BCI system to directly control the humanoid robot NAO (Aldebaran Robotics, France) with the aim of reaching and grasping a glass of water. Four ALS patients and four healthy controls were recruited and trained to operate this humanoid robot through a P300-based BCI. A few minutes training was sufficient to efficiently operate the system in different environments. Three out of the four ALS patients and all controls successfully performed the task with a high level of accuracy. These results suggest that BCI-operated robots can be used by locked-in ALS patients as an artificial alter-ego, the machine being able to move, speak and act in his/her place.

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Long-Term Independent Brain-Computer Interface Home Use Improves Quality of Life of a Patient in the Locked-In State: A Case Study

Cited by 143 publications

References 28 publications

The effect of multimodal and enriched feedback on SMR-BCI performance

The effect of multimodal and enriched feedback on SMR-BCI performance

User-centred design in brain–computer interface research and development

Reaching and grasping a glass of water by locked-in ALS patients through a BCI-controlled humanoid robot

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