Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALS
Patients with locked-in syndrome (LIS) are typically unable to move or communicate and can be misdiagnosed as patients with disorders of consciousness (DOC). Behavioral assessment scales are limited in their ability to detect signs of consciousness in this population. Recent research has shown that...
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2018-07-01
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doaj-bd81400df2c84b428aa3e16c1b8287522020-11-25T02:34:04ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2018-07-011210.3389/fnins.2018.00514385452Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALSAlexander Heilinger0Rupert Ortner1Vincenzo La Bella2Zulay R. Lugo3Zulay R. Lugo4Zulay R. Lugo5Camille Chatelle6Steven Laureys7Rossella Spataro8Rossella Spataro9Christoph Guger10Christoph Guger11g.tec medical engineering GmbH, Schiedlberg, Austriag.tec medical engineering Spain SL, Barcelona, SpainALS Clinical Research Center, BioNeC, University of Palermo, Palermo, ItalyGIGA Consciousness, Coma Science Group, University of Liège, Liège, BelgiumFrench Association of Locked-in Syndrome (ALIS), Paris, FranceResearch Department, Hospital Universitari Institut Pere Mata, Reus, SpainGIGA Consciousness, Coma Science Group, University of Liège, Liège, BelgiumGIGA Consciousness, Coma Science Group, University of Liège, Liège, BelgiumALS Clinical Research Center, BioNeC, University of Palermo, Palermo, ItalyCentro Neurolesi Bonino Pulejo (IRCCS), Palermo, Italyg.tec medical engineering GmbH, Schiedlberg, AustriaGuger Technologies OG, Graz, AustriaPatients with locked-in syndrome (LIS) are typically unable to move or communicate and can be misdiagnosed as patients with disorders of consciousness (DOC). Behavioral assessment scales are limited in their ability to detect signs of consciousness in this population. Recent research has shown that brain-computer interface (BCI) technology could supplement behavioral scales and allows to establish communication with these severely disabled patients. In this study, we compared the vibro-tactile P300 based BCI performance in two groups of patients with LIS of different etiologies: stroke (n = 6) and amyotrophic lateral sclerosis (ALS) (n = 9). Two vibro-tactile paradigms were administered to the patients to assess conscious function and command following. The first paradigm is called vibrotactile evoked potentials (EPs) with two tactors (VT2), where two stimulators were placed on the patient’s left and right wrist, respectively. The patients were asked to count the rare stimuli presented to one wrist to elicit a P300 complex to target stimuli only. In the second paradigm, namely vibrotactile EPs with three tactors (VT3), two stimulators were placed on the wrists as done in VT2, and one additional stimulator was placed on his/her back. The task was to count the rare stimuli presented to one wrist, to elicit the event-related potentials (ERPs). The VT3 paradigm could also be used for communication. For this purpose, the patient had to count the stimuli presented to the left hand to answer “yes” and to count the stimuli presented to the right hand to answer “no.” All patients except one performed above chance level in at least one run in the VT2 paradigm. In the VT3 paradigm, all 6 stroke patients and 8/9 ALS patients showed at least one run above chance. Overall, patients achieved higher accuracies in VT2 than VT3. LIS patients due to ALS exhibited higher accuracies that LIS patients due to stroke, in both the VT2 and VT3 paradigms. These initial data suggest that controlling this type of BCI requires specific cognitive abilities that may be impaired in certain sub-groups of severely motor-impaired patients. Future studies on a larger cohort of patients are needed to better identify and understand the underlying cortical mechanisms of these differences.https://www.frontiersin.org/article/10.3389/fnins.2018.00514/fulllocked-in syndromeBCI performancestrokeALStactile stimulationP300 event-related potential |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alexander Heilinger Rupert Ortner Vincenzo La Bella Zulay R. Lugo Zulay R. Lugo Zulay R. Lugo Camille Chatelle Steven Laureys Rossella Spataro Rossella Spataro Christoph Guger Christoph Guger |
spellingShingle |
Alexander Heilinger Rupert Ortner Vincenzo La Bella Zulay R. Lugo Zulay R. Lugo Zulay R. Lugo Camille Chatelle Steven Laureys Rossella Spataro Rossella Spataro Christoph Guger Christoph Guger Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALS Frontiers in Neuroscience locked-in syndrome BCI performance stroke ALS tactile stimulation P300 event-related potential |
author_facet |
Alexander Heilinger Rupert Ortner Vincenzo La Bella Zulay R. Lugo Zulay R. Lugo Zulay R. Lugo Camille Chatelle Steven Laureys Rossella Spataro Rossella Spataro Christoph Guger Christoph Guger |
author_sort |
Alexander Heilinger |
title |
Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALS |
title_short |
Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALS |
title_full |
Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALS |
title_fullStr |
Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALS |
title_full_unstemmed |
Performance Differences Using a Vibro-Tactile P300 BCI in LIS-Patients Diagnosed With Stroke and ALS |
title_sort |
performance differences using a vibro-tactile p300 bci in lis-patients diagnosed with stroke and als |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neuroscience |
issn |
1662-453X |
publishDate |
2018-07-01 |
description |
Patients with locked-in syndrome (LIS) are typically unable to move or communicate and can be misdiagnosed as patients with disorders of consciousness (DOC). Behavioral assessment scales are limited in their ability to detect signs of consciousness in this population. Recent research has shown that brain-computer interface (BCI) technology could supplement behavioral scales and allows to establish communication with these severely disabled patients. In this study, we compared the vibro-tactile P300 based BCI performance in two groups of patients with LIS of different etiologies: stroke (n = 6) and amyotrophic lateral sclerosis (ALS) (n = 9). Two vibro-tactile paradigms were administered to the patients to assess conscious function and command following. The first paradigm is called vibrotactile evoked potentials (EPs) with two tactors (VT2), where two stimulators were placed on the patient’s left and right wrist, respectively. The patients were asked to count the rare stimuli presented to one wrist to elicit a P300 complex to target stimuli only. In the second paradigm, namely vibrotactile EPs with three tactors (VT3), two stimulators were placed on the wrists as done in VT2, and one additional stimulator was placed on his/her back. The task was to count the rare stimuli presented to one wrist, to elicit the event-related potentials (ERPs). The VT3 paradigm could also be used for communication. For this purpose, the patient had to count the stimuli presented to the left hand to answer “yes” and to count the stimuli presented to the right hand to answer “no.” All patients except one performed above chance level in at least one run in the VT2 paradigm. In the VT3 paradigm, all 6 stroke patients and 8/9 ALS patients showed at least one run above chance. Overall, patients achieved higher accuracies in VT2 than VT3. LIS patients due to ALS exhibited higher accuracies that LIS patients due to stroke, in both the VT2 and VT3 paradigms. These initial data suggest that controlling this type of BCI requires specific cognitive abilities that may be impaired in certain sub-groups of severely motor-impaired patients. Future studies on a larger cohort of patients are needed to better identify and understand the underlying cortical mechanisms of these differences. |
topic |
locked-in syndrome BCI performance stroke ALS tactile stimulation P300 event-related potential |
url |
https://www.frontiersin.org/article/10.3389/fnins.2018.00514/full |
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