Phenomenology of the Locked-In Syndrome: an Overview and Some Suggestions

Vidal, Fernando

doi:10.1007/s12152-018-9388-1

Cited by 13 publications

(6 citation statements)

References 159 publications

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“…The health of one's muscles and nerves can be assessed with the use of a test called electromyography. The results of this test might assist medical experts in ruling out the possibility of just muscle and nerve injury 20 . Pontine myelinolysis can be found with blood tests, like a full metabolic panel.…”

Section: Researchmentioning

confidence: 99%

Neuroscience of consciousness in the locked‐in syndrome: Prognostic and diagnostic review

Maciejewicz

2022

Ibrain

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The neurological illness known as a locked-in syndrome is brought on by damage to the brainstem, usually as a consequence of a stroke. It is characterized by total paralysis with intact consciousness and cognitive capacity. The subjective experiences of people with locked-in syndrome are poorly understood. Presently, there is no systematic evaluation developed to describe them. The most compelling resources come from individuals' own words; however, only a small fraction of these accounts have been explored.When it comes to bioethics, locked-in syndrome protocols are almost completely absent. Investigations on how people with this condition feel about their sense of continuity are of importance. Utilizing the locked-in syndrome to pose questions on embodied cognition and levels of consciousness could serve as a lens through which to examine problems in the phenomenology of neuroparalysis and communication. Care and quality of patients' lives might be improved by an effort to understand this condition better, and ontological questions like "what makes a person a person?," "what makes a person appear in continuity?," and "what are the dynamics of embodiment and intersubjectivity?" might be better explored through that lens. This article aims to explore some biomedical factors that contribute to locked-in syndrome and offers some prognostic and diagnostic recommendations for this rare condition.

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Section: Researchmentioning

confidence: 99%

Neuroscience of consciousness in the locked‐in syndrome: Prognostic and diagnostic review

Maciejewicz

2022

Ibrain

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“…Communication is a critical feature in the experience of personhood, as it is so important for agency and for relations with others. As Vidal points out, “[t]he agony of incommunicability and the pain of not being able to touch their loved ones is a recurrent theme in [locked in state] testimonies” ( Vidal, 2020 ). In this section, we focus on self-determination and choice, where the ability to communicate allows a person to make and express fundamental personal decisions that others are legally obligated to respect and allows one to obtain assistance from others to meet needs and wishes.…”

Section: Three Dimensions Of Communication Through Detection Of Imagi...mentioning

confidence: 99%

“…Inclusive communication channels are needed to realize the right to democratic participation through voting. Legal struggles over the use of AAC by people claiming their right to vote illustrate the challenges faced by people with communication disabilities ( Domínguez Rubio and Lezaun, 2012 ; Vidal, 2020 ).…”

Section: Three Dimensions Of Communication Through Detection Of Imagi...mentioning

confidence: 99%

Brain Computer Interfaces and Communication Disabilities: Ethical, Legal, and Social Aspects of Decoding Speech From the Brain

Chandler

Loos

Boehnke

et al. 2022

Front. Hum. Neurosci.

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A brain-computer interface technology that can decode the neural signals associated with attempted but unarticulated speech could offer a future efficient means of communication for people with severe motor impairments. Recent demonstrations have validated this approach. Here we assume that it will be possible in future to decode imagined (i.e., attempted but unarticulated) speech in people with severe motor impairments, and we consider the characteristics that could maximize the social utility of a BCI for communication. As a social interaction, communication involves the needs and goals of both speaker and listener, particularly in contexts that have significant potential consequences. We explore three high-consequence legal situations in which neurally-decoded speech could have implications: Testimony, where decoded speech is used as evidence; Consent and Capacity, where it may be used as a means of agency and participation such as consent to medical treatment; and Harm, where such communications may be networked or may cause harm to others. We then illustrate how design choices might impact the social and legal acceptability of these technologies.

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“…In its most severe form, quadriplegic CP, individuals lack muscular control in all limbs, the head, neck and trunk [ 2 , 3 ]. Children with quadriplegic CP are often cognitively capable but have extremely limited ability to move or speak, a condition analogous to “locked-in syndrome” [ 4 ]. Intellectual disability is thought to occur in approximately 50% of children with CP, with higher rates for those with spastic quadriplegic CP [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Fatigue in children using motor imagery and P300 brain-computer interfaces

Keough,

Irvine,

Kelly

et al. 2024

J NeuroEngineering Rehabil

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Background Brain-computer interface (BCI) technology offers children with quadriplegic cerebral palsy unique opportunities for communication, environmental exploration, learning, and game play. Research in adults demonstrates a negative impact of fatigue on BCI enjoyment, while effects on BCI performance are variable. To date, there have been no pediatric studies of BCI fatigue. The purpose of this study was to assess the effects of two different BCI paradigms, motor imagery and visual P300, on the development of self-reported fatigue and an electroencephalography (EEG) biomarker of fatigue in typically developing children. Methods Thirty-seven typically-developing school-aged children were recruited to a prospective, crossover study. Participants attended three sessions: (A) motor imagery-BCI, (B) visual P300-BCI, and (C) video viewing (control). The motor imagery task involved an imagined left- or right-hand squeeze. The P300 task involved attending to one square on a 3 × 3 grid during a random single flash sequence. Each paradigm had respective calibration periods and a similar visual counting game. Primary outcomes were self-reported fatigue and the power of the EEG alpha band both collected during resting-state periods pre- and post-task. Self-reported fatigue was measured using a 10-point visual analog scale. EEG alpha band power was calculated as the integrated power spectral density from 8 to 12 Hz of the EEG spectrum. Results Thirty-two children completed the protocol (age range 7–16, 63% female). Self-reported fatigue and EEG alpha band power increased across all sessions (F(1,155) = 33.9, p < 0.001; F = 5.0(1,149), p = 0.027 respectively). No differences in fatigue development were observed between session types. There was no correlation between self-reported fatigue and EEG alpha band power change. BCI performance varied between participants and paradigms as expected but was not associated with self-reported fatigue or EEG alpha band power. Conclusion Short periods (30-mintues) of BCI use can increase self-reported fatigue and EEG alpha band power to a similar degree in children performing motor imagery and P300 BCI paradigms. Performance was not associated with our measures of fatigue; the impact of fatigue on useability and enjoyment is unclear. Our results reflect the variability of fatigue and the BCI experience more broadly in children and warrant further investigation.

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Phenomenology of the Locked-In Syndrome: an Overview and Some Suggestions

Cited by 13 publications

References 159 publications

Neuroscience of consciousness in the locked‐in syndrome: Prognostic and diagnostic review

Neuroscience of consciousness in the locked‐in syndrome: Prognostic and diagnostic review

Brain Computer Interfaces and Communication Disabilities: Ethical, Legal, and Social Aspects of Decoding Speech From the Brain

Fatigue in children using motor imagery and P300 brain-computer interfaces

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