Sensorimotor Modulation Assessment and Brain-Computer Interface Training in Disorders of Consciousness

Damien Coyle, Jacqueline Stow, Karl McCreadie, Jacinta McElligott, Áine Carroll

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)

Abstract

Objectives
To assess awareness in subjects who are in a minimally conscious state by using an electroencephalogram-based brain-computer interface (BCI), and to determine whether these patients may learn to modulate sensorimotor rhythms with visual feedback, stereo auditory feedback, or both.
Design
Initial assessment included imagined hand movement or toe wiggling to activate sensorimotor areas and modulate brain rhythms in 90 trials (4 subjects). Within-subject and within-group analyses were performed to evaluate significant activations. A within-subject analysis was performed involving multiple BCI technology training sessions to improve the capacity of the user to modulate sensorimotor rhythms through visual and auditory feedback.
Setting
Hospital, homes of subjects, and a primary care facility.
Participants
Subjects (N=4; 3 men, 1 woman) who were in a minimally conscious state (age range, 27–53y; 1–12y after brain injury).
Interventions
Not applicable.
Main Outcome Measures
Awareness detection was determined from sensorimotor patterns that differed for each motor imagery task. BCI performance was determined from the mean classification accuracy of brain patterns by using a BCI signal processing framework and assessment of performance in multiple sessions.
Results
All subjects demonstrated significant and appropriate brain activation during the initial assessment, and real-time feedback was provided to improve arousal. Consistent activation was observed in multiple sessions.
Conclusions
The electroencephalogram-based assessment showed that patients in a minimally conscious state may have the capacity to operate a simple BCI-based communication system, even without any detectable volitional control of movement.
Original languageEnglish
Pages (from-to)S62-S70
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume96
Issue number3
Early online date23 Feb 2015
DOIs
Publication statusPublished (in print/issue) - 31 Mar 2015

Keywords

  • Brain injuries
  • Rehabilitation
  • Communication
  • Electroencephalography
  • Minimally conscious state

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