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Brain-computer interfaces and communication in paralysis: extinction of goal directed thinking in completely paralysed patients?
Open accessAbstract
Objective To investigate the relationship between physical impairment and brain-computer interface (BCI) performance.Method We present a meta-analysis of 29 patients with amyotrophic lateral sclerosis and six patients with other severe neurological diseases in different stages of physical impairment who were trained with a BCI. In most cases voluntary regulation of slow cortical potentials has been used as input signal for BCI-control. More recently sensorimotor rhythms and the P300 event-related brain potential were recorded.Results A strong correlation has been found between physical impairment and BCI performance, indicating that performance worsens as impairment increases. Seven patients were in the complete locked-in state (CLIS) with no communication possible. After removal of these patients from the analysis, the relationship between physical impairment and BCI performance disappeared. The lack of a relation between physical impairment and BCI performance was confirmed when adding BCI data of patients from other BCI research groups.Conclusions Basic communication (yes/no) was not restored in any of the CLIS patients with a BCI. Whether locked-in patients can transfer learned brain control to the CLIS remains an open empirical question.Significance Voluntary brain regulation for communication is possible in all stages of paralysis except the CLIS.
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“Firstly, works where users acquired BCI control (able-bodied [3,25] and end-users [40,41,51,62,63]) do not report any learning metric over time.”
From The Cybathlon BCI race: Successful longitudinal mutual learning with two tetraplegic users (2018) · cites this paper as [62]
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Metadata
- Authors
- Kübler, A., & Birbaumer, N.
- Affiliations
- University of Tübingen (DE)
- National Institutes of Health (US)
- Corresponding author
- Kübler, A.
- Venue
- Clinical Neurophysiology
- Publisher
- Elsevier BV
- Published
- 2008-11
- Volume
- 119
- Issue
- 11
- Pages
- 2658-2666
- ISSN
- 1388-2457 (ISSN-L)
- PMC
- PMC2644824
- OpenAlex
- W1972606226
- Cited by
- 441
- References
- 50
- Citations by year
- 2026: 10 · 2025: 20 · 2024: 14 · 2023: 14 · 2022: 13 · 2021: 18 · 2020: 26 · 2019: 20 · 2018: 26 · 2017: 22 · 2016: 35 · 2015: 33 · 2014: 35 · 2013: 43 · 2012: 39
- FWCI
- 12.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Neurophysiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- National Institute of Neurological Disorders and Stroke
- National Institute of Biomedical Imaging and Bioengineering (EB 00856, R01EB000856)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD030146, HD30146)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › EEG and Brain-Computer Interfaces
- Physical Sciences › Computer Science › Human-Computer Interaction › Gaze Tracking and Assistive Technology
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- brain-computer interface, paralysis, amyotrophic lateral sclerosis, locked-in state, physical impairment, communication, slow cortical potentials, sensorimotor rhythm, P300
- MeSH terms
- Adult, Aged, Brain Diseases, Communication Devices for People with Disabilities, Computer Systems, Electroencephalography, Female, Goals, Humans, Male, Middle Aged, Paralysis, Periodicity, Thinking, User-Computer Interface, Meta-Analysis as Topic, Event-Related Potentials, P300
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