Hi all,

 

As well as the original paper there is a good analysis by NHS Choices here: http://www.nhs.uk/news/2017/02February/Pages/computer-helps-patients-with-severe-MND-communicate.aspx  

 

I think it is described as a different type of BCI because it uses “functional near-infrared spectroscopy” (picking up changes in reflected IR light based on changes in blood flow, based on changes in brain activity) – most other BCI I’ve seen/read is based on Electro Encephalography (picking up electrical signals from changes in brain activity) – either invasive or non-invasive. I don’t think fNIRS is new though.  I can see the attraction of fNIRS compared to these, but assume there must be trade offs too (e.g. in the ‘resolution’ of the number of ‘thoughts’ it can discriminate).  But I am no expert!

 

I do think this is great work and towards an amazingly important situation, but personally think it should have been more carefully reported.  A lot of the reporting of it (that I have seen) is not representative of the data in the paper  and really struggle with phrases like ‘reading thoughts’ with relation to BCI. e.g. the paper doesn’t discuss the ‘open’ questions that were widely reported in the media over here - I assume these were based on  a press release [2].   Like I say, it is amazing work though and it would be amazing to be able to have options for this group of people. Just my thoughts.

 

 

 

-------- Original Message --------
Subject: passing along new BCI article
From: Alisa Brownlee <xxxxxx@alsa-national.org>
Date: Wed, February 01, 2017 8:42 am
To: at listserv <xxxxxx@alsa.simplelists.com>

http://www.thedailybeast.com/articles/2017/01/31/computer-lets-fully-paralyzed-patients-speak-for-first-time.html

Computer Lets Fully Paralyzed Patients Speak for First Time

When a new brain-computer interface reached the thoughts of completely locked-in patients for the first time ever, it found them engaged and happy to be alive.

BOBBY AZARIAN

 

01.31.17 2:00 PM ET

Imagine what it would be like to be fully conscious and aware of your surroundings, but trapped inside a paralyzed body, not only unable to move, but unable to communicate in any way, for the rest of your life. Unable to express feelings, thoughts, intentions. Unable to express love or show appreciation for it.

In addition to the frustration and feelings of hopelessness this would create, you could also be faced with people assuming that you’re in a vegetative state, essentially already gone and not worth maintaining with sustenance and care. Even if they don’t make that assumption, it is likely that social interaction would dramatically slow down or stop completely if communicating is purely a one-way road.

This is not a hypothetical scenario. This is what life is like for those who suffer from what doctors and scientists call a “completely locked-in state.” These people, unlike those who are simply “locked-in,” are unable to make even small eye movements or subtle blinks. While the situation would seem utterly hopeless, using something called a brain-computer interface (BCI), scientists have—for the first time—enabled completely locked-in people to take part in two-way communication.  The study that achieved this breakthrough was published today in the journal PLOS Biology.  

In the study, scientists at the Wyss Center for Bio and Neuroengineering in Geneva, Switzerland, assessed four people with ALS (amyotrophic lateral sclerosis), also known as Lou Gehrig’s disease, a progressive motor neuron disease that attacks the part of the brain responsible for voluntary movement. These patients completed from 20 to 46 sessions over the course of several weeks, where they were asked both closed and open questions that required a “yes” or “no” nonverbal response, which was made possible by their noninvasive BCI.

A BCI is a direct communication pathway between a brain and a computer. Essentially, it is a device that is used to detect activity in the brain, and to translate that activity into a message. Since BCIs do not require any muscle control to function, they provide a potential path for restoring communication in those with total paralysis.

The first BCIs used invasive methods, whereby electrodes were implanted directly into brain tissue, which required surgery. With the development of non-invasive BCIs, they’ve become more practical and comfortable. Many non-invasive BCIs work by detecting changes in electrical activity in the brain through EEG (electroencephalography) recordings that use electrodes placed over the scalp, but unfortunately this method failed to work for completely locked-in people. For this reason, the researchers utilized a different type of BCI that detects blood flow changes in the brain—much like an fMRI machine—using a technology called functional near-infrared spectroscopy (fNIRS).

With this setup, locked-in patients were able to respond to questions with a “yes” or “no” by focusing their attention in a specific way, which caused two distinct patterns of blood oxygen level changes that could be detected and classified by the BCI.

The success of this communication method surprised even the authors of the paper, as it was thought that completely locked-in people lacked the sort of goal-directed thinking required to use any BCI.

What may seem more astonishing to people unfamiliar with research on locked-in states is that the study found that all four patients reported being generally content with life, despite their physical affliction. This conclusion is unmistakable, as the patients were routinely asked if they were happy over the course of many weeks. Although it is not perfect, researchers found that the method provided right answers to closed questions, such as “Is your husband’s name Joachim?” approximately 70 percent of the time.

Niels Birbaumer, the lead author of the paper, thinks that this development can be used to immediately and drastically improve the quality of life in completely locked-in people, who already have a strong will to live. “We were initially surprised at the positive responses when we questioned the four completely locked-in participants about their quality of life. All four had accepted artificial ventilation in order to sustain their life when breathing became impossible so, in a sense, they had already chosen to live. What we observed was, as long as they received satisfactory care at home, they found their quality of life acceptable. It is for this reason, if we could make this technique widely clinically available, it would have a huge impact on the day-to-day life of people with complete locked-in syndrome.”

This finding raises questions about how it is possible that someone who is permanently in a physical state that would feel torturous for any normal person could genuinely feel “happy.” Although it is speculation, perhaps over time total paralysis creates a state of relaxation similar to that experienced during meditation, a practice that requires complete stillness over prolonged periods. Indeed, the brain activity data gathered by the researchers, who also recorded electrical activity using EEG in addition to fNIRS, showed similarities to meditative states.

This new type of BCI has the potential to help not only those with ALS, but others in locked-in states as a result of stroke, spinal cord injury, or other neurodegenerative diseases. Additionally, it can be used to determine whether those who are thought to be in a vegetative state are actually cognitively and emotionally normal, and self-aware as the rest of us. In such cases, not only does opening a line of communication increase the quality of life for the locked-in sufferer, it can do the same for all their loved ones who have also been suffering due to their inability to interact with them.

 

 

Alisa Brownlee, ATP, CAPS

Assistive Technology Specialist/Consultant 

The ALS (Lou Gehrig’s Disease) Association National Office 

RESNA Certified Assistive Technology Professional

NAHB Certified Aging in Place Specialist in Home Modifications

Work: 215-631-1877

 

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