title: Face stimuli effectively prevent brain-computer interface inefficiency in patients with neurodegenerative disease.
abstract: OBJECTIVE
  Recently, we proposed a new stimulation paradigm for brain computer interfaces (BCI) based on event-related potentials (ERP), i.e. flashing characters with superimposed pictures of well-known faces. This new face flashing (FF) paradigm significantly outperformed the commonly used character flashing (CF) approach, i.e. simply highlighting characters.
  
  
  METHODS
  In the current study we assessed the impact of face stimuli on BCI inefficiency in patients with neurodegenerative disease, i.e. on their inability to communicate by means of a BCI. Healthy participants (N = 16) and those with neurodegenerative disease (N = 9) performed spelling tasks using CF and FF paradigms.
  
  
  RESULTS
  Online performance with FF was significantly increased as compared to CF in both, healthy and impaired users. Importantly, two patients who were classified "highly inefficient" with the classic CF stimulation were able to spell with high accuracy using FF. Our results particularly emphasize great benefit of the FF paradigm for those users displaying low signal-to-noise ratio of the recorded ERPs in the classic stimulation approach.
  
  
  CONCLUSIONS
  In conclusion, we confirm previously reported results now systematically validated in an online setting and display specifically beneficial effects of FF for motor-impaired users.
  
  
  CONCLUSIONS
  The FF paradigm thus constitutes a big step forward against the BCI inefficiency phenomenon.
authors.affiliation: Institute of Psychology, University of Würzburg, Marcusstr. 9-11, 97070 Würzburg, Germany. tobias.kaufmann@uni-wuerzburg.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Kaufmann
authors.forename: Stefan M
authors.initials: SM
authors.lastname: Schulz
authors.forename: Anja
authors.initials: A
authors.lastname: Köblitz
authors.forename: Gregor
authors.initials: G
authors.lastname: Renner
authors.forename: Carsten
authors.initials: C
authors.lastname: Wessig
authors.forename: Andrea
authors.initials: A
authors.lastname: Kübler
mesh_terms: D000328:Adult; D001921:Brain / Q000502:physiology; D062207:Brain-Computer Interfaces / Q000523:psychology; D003143:Communication Devices for People with Disabilities; D018913:Event-Related Potentials, P300 / Q000502:physiology*; D005145:Face / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D010775:Photic Stimulation / Q000379:methods; D013647:Task Performance and Analysis; D014584:User-Computer Interface; D014796:Visual Perception / Q000502:physiology; D055815:Young Adult