title: Automatic processing of self-regulation of slow cortical potentials: evidence from brain-computer communication in paralysed patients.
abstract: OBJECTIVE
  Direct brain-computer communication utilizes self-regulation of brain potentials to select letters, words or symbols from a computer menu. Selection of letters or words with brain potentials requires simultaneous processing of several tasks such as production of certain brain potentials at predefined time points simultaneously with processing of presented letter strings. This study addresses the question of whether the self-regulation of slow cortical potentials (SCP) automatizes with practice and can thus be considered as a skill comparable to motor or cognitive skills.
  
  
  METHODS
  Two nearly completely paralysed patients learned over several months to produce electrocortically negative and positive SCP by means of visual feedback. Improved performance and a reduction in performance variability were regarded as behavioural indicators for automaticity, while the topographic focalization of cortical activation was considered as a neurophysiological indicator for automaticity. Different indicators of automaticity were expected to covary along with practice.
  
  
  RESULTS
  In patient 1, performance measured as the percentage of correct SCP shifts increased simultaneously with the topographic focalization of cortical activation. His performance became more stable with practice. For this patient the criteria for automaticity were all met. In patient 2, performance also improved, but his cortical activity became topographically less focal. His performance was less stable than that of patient 1.
  
  
  CONCLUSIONS
  The present findings, albeit on only two subjects, provide preliminary evidence that SCP self-regulation may automatize with long-term practice and can therefore be considered a skill.
authors.affiliation: Institute of Medical Psychology and Behavioural Neurobiology, University of Tuebingen, Gartenstrasse 29, D-72074 Tuebingen, Germany. nicola.neumann@uni-tuebingen.de
authors.forename: N
authors.initials: N
authors.lastname: Neumann
authors.forename: T
authors.initials: T
authors.lastname: Hinterberger
authors.forename: J
authors.initials: J
authors.lastname: Kaiser
authors.forename: U
authors.initials: U
authors.lastname: Leins
authors.forename: N
authors.initials: N
authors.lastname: Birbaumer
authors.forename: A
authors.initials: A
authors.lastname: Kübler
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications; D001921:Brain / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000503:physiopathology*; D003142:Communication; D003143:Communication Devices for People with Disabilities; D003201:Computers; D004585:Electrooculography; D004594:Electrophysiology; D004867:Equipment Design; D006801:Humans; D008297:Male; D010243:Paralysis / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology*; D011930:Reaction Time; D012927:Social Control, Informal