04388nas a2200385 4500008004100000022001400041245009500055210006900150260001200219300001100231490000800242520325500250653001003505653003403515653002103549653001003570653003603580653002403616653002703640653002103667653001103688653000903699653004103708653002803749100002603777700002503803700001403828700001903842700001403861700001503875700002503890700002103915700001803936856004803954 2011 eng d a1872-895200aTransition from the locked in to the completely locked-in state: a physiological analysis.0 aTransition from the locked in to the completely lockedin state a c06/2011 a925-330 v1223 a

OBJECTIVE: 

To clarify the physiological and behavioral boundaries between locked-in (LIS) and the completely locked-in state (CLIS) (no voluntary eye movements, no communication possible) through electrophysiological data and to secure brain-computer-interface (BCI) communication.

METHODS: 

Electromyography from facial muscles, external anal sphincter (EAS), electrooculography and electrocorticographic data during different psychophysiological tests were acquired to define electrophysiological differences in an amyotrophic lateral sclerosis (ALS) patient with an intracranially implanted grid of 112 electrodes for nine months while the patient passed from the LIS to the CLIS.

RESULTS: 

At the very end of the LIS there was no facial muscle activity, nor external anal sphincter but eye control. Eye movements were slow and lasted for short periods only. During CLIS event related brainpotentials (ERP) to passive limb movements and auditory stimuli were recorded, vibrotactile stimulation of different body parts resulted in no ERP response.

CONCLUSIONS: 

The results presented contradict the commonly accepted assumption that the EAS is the last remaining muscle under voluntary control and demonstrate complete loss of eye movements in CLIS. The eye muscle was shown to be the last muscle group under voluntary control. The findings suggest ALS as a multisystem disorder, even affecting afferent sensory pathways.

SIGNIFICANCE: 

Auditory and proprioceptive brain-computer-interface (BCI) systems are the only remaining communication channels in CLIS.

10aAdult10aAmyotrophic Lateral Sclerosis10aArea Under Curve10aBrain10aCommunication Aids for Disabled10aDisease Progression10aElectroencephalography10aElectromyography10aHumans10aMale10aSignal Processing, Computer-Assisted10aUser-Computer Interface1 aMurguialday, Ramos, A1 aHill, Jeremy, Jeremy1 aBensch, M1 aMartens, S M M1 aHalder, S1 aNijboer, F1 aSchoelkopf, Bernhard1 aBirbaumer, Niels1 aGharabaghi, A uhttp://www.ncbi.nlm.nih.gov/pubmed/2088829203358nas a2200397 4500008004100000020001800041245009600059210006900155260015500224520204800379653003002427653000802457653001502465653003002480653002302510653002902533653003102562100002002593700001502613700001502628700001302643700001902656700001902675700001402694700001302708700002502721700002302746700001402769700002402783700001502807700002102822700001802843700001802861700002102879856006002900 2007 eng d a978026225604900aBrain Computer Interfaces for Communication in Paralysis: a Clinical-Experimental Approach.0 aBrain Computer Interfaces for Communication in Paralysis a Clini bVirtual Library of Psychology at Saarland University and State Library, GERMANY, PsyDok [http://psydok.sulb.uni-saarland.de/phpoai/oai2.php] (Germany)3 a

An overview of different approaches to brain-computer interfaces (BCIs) developed in our laboratory is given. An important clinical application of BCIs is to enable communication or environmental control in severely paralyzed patients. The BCI “Thought-Translation Device (TTD)” allows verbal communication through the voluntary self-regulation of brain signals (e.g., slow cortical potentials (SCPs)), which is achieved by operant feedback training. Humans' ability to self-regulate their SCPs is used to move a cursor toward a target that contains a selectable letter set. Two different approaches were followed to developWeb browsers that could be controlled with binary brain responses. Implementing more powerful classification methods including different signal parameters such as oscillatory features improved our BCI considerably. It was also tested on signals with implanted electrodes. Most BCIs provide the user with a visual feedback interface. Visually impaired patients require an auditory feedback mode. A procedure using auditory (sonified) feedback of multiple EEG parameters was evaluated. Properties of the auditory systems are reported and the results of two experiments with auditory feedback are presented. Clinical data of eight ALS patients demonstrated that all patients were able to acquire efficient brain control of one of the three available BCI systems (SCP, µ-rhythm, and P300), most of them used the SCP-BCI. A controlled comparison of the three systems in a group of ALS patients, however, showed that P300-BCI and the µ-BCI are faster and more easily acquired than SCP-BCI, at least in patients with some rudimentary motor control left. Six patients who started BCI training after entering the completely locked-in state did not achieve reliable communication skills with any BCI system. One completely locked-in patient was able t o communicate shortly with a ph-meter, but lost control afterward.

10abrain-computer interfaces10aEEG10aexperiment10aMedical sciences Medicine10aparalyzed patients10aslow cortical potentials10aThought-Translation Device1 aHinterberger, T1 aNijboer, F1 aKübler, A1 aMatuz, T1 aFurdea, Adrian1 aMochty, Ursula1 aJordan, M1 aLal, T N1 aHill, Jeremy, Jeremy1 aMellinger, Jürgen1 aBensch, M1 aTangermann, Michael1 aWidmann, G1 aElger, Christian1 aRosenstiel, W1 aSchölkopf, B1 aBirbaumer, Niels uhttp://psydok.sulb.uni-saarland.de/volltexte/2008/2154/