title: Clinical application of an EEG-based brain-computer interface: a case study in a patient with severe motor impairment.
abstract: OBJECTIVE
  This case study describes how a completely paralyzed patient, diagnosed with severe cerebral palsy, was trained over a period of several months to use an electroencephalography (EEG)-based brain-computer interface (BCI) for verbal communication.
  
  
  METHODS
  EEG feedback training was performed in the patient's home (clinic), supervised from a distant laboratory with the help of a 'telemonitoring system'. Online feedback computation was based on single-trial analysis and classification of specific band power features of the spontaneous EEG. Task-related changes in brain oscillations over the course of training steps was investigated by quantifying time-frequency maps of event-related (de-)synchronization (ERD/ERS).
  
  
  RESULTS
  The patient learned to 'produce' two distinct EEG patterns, beta band ERD during movement imagery vs. no ERD during relaxing, and to use this for BCI-controlled spelling. Significant learning progress was found as a function of training session, resulting in an average accuracy level of 70% (correct responses) for letter selection. 'Copy spelling' was performed with a rate of approximately one letter per min.
  
  
  CONCLUSIONS
  The proposed BCI training procedure, based on electroencephalogram (EEG) biofeedback and concomitant adaptation of feature extraction and classification, may improve actual levels of communication ability in locked-in patients. 'Telemonitoring-assisted' BCI training facilitates clinical application in a larger number of patients.
authors.affiliation: Department of Medical Informatics, Ludwig-Boltzmann Institute for Medical Informatics and Neuroinformatics, University of Technology Graz, Graz Austria. neuper@tugraz.at
authors.forename: C
authors.initials: C
authors.lastname: Neuper
authors.forename: G R
authors.initials: GR
authors.lastname: Müller
authors.forename: A
authors.initials: A
authors.lastname: Kübler
authors.forename: N
authors.initials: N
authors.lastname: Birbaumer
authors.forename: G
authors.initials: G
authors.lastname: Pfurtscheller
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology; D002547:Cerebral Palsy / Q000534:rehabilitation*; D003143:Communication Devices for People with Disabilities; D003144:Communication Barriers; D004569:Electroencephalography / Q000379:methods*; D006801:Humans; D008297:Male; D009044:Motor Cortex / Q000502:physiology; D010243:Paralysis / Q000534:rehabilitation; D012720:Severity of Illness Index; D013003:Somatosensory Cortex / Q000502:physiology; D014584:User-Computer Interface