title: Hybrid P300-based brain-computer interface to improve usability for people with severe motor disability: electromyographic signals for error correction during a spelling task.
abstract: OBJECTIVE
  To evaluate the impact of a hybrid control on usability of a P300-based brain-computer interface (BCI) system that was designed to control an assistive technology software and was integrated with an electromyographic channel for error correction.
  
  
  METHODS
  Proof-of-principle study with a convenience sample.
  
  
  METHODS
  Neurologic rehabilitation hospital.
  
  
  METHODS
  Participants (N=11) in this pilot study included healthy (n=8) and severely motor impaired (n=3) persons. The 3 people with severe motor disability were identified as potential candidates to benefit from the proposed hybrid BCI system for communication and environmental interaction.
  
  
  METHODS
  To eventually investigate the improvement in usability, we compared 2 modalities of BCI system control: a P300-based and a hybrid P300 electromyographic-based mode of control.
  
  
  METHODS
  System usability was evaluated according to the following outcome measures within 3 domains: (1) effectiveness (overall system accuracy and P300-based BCI accuracy); (2) efficiency (throughput time and users' workload); and (3) satisfaction (users' satisfaction). We also considered the information transfer rate and time for selection.
  
  
  RESULTS
  Findings obtained in healthy participants were in favor of a higher usability of the hybrid control as compared with the nonhybrid. A similar trend was indicated by the observational results gathered from each of the 3 potential end-users.
  
  
  CONCLUSIONS
  The proposed hybrid BCI control modality could provide end-users with severe motor disability with an option to exploit some residual muscular activity, which could not be fully reliable for properly controlling an assistive technology device. The findings reported in this pilot study encourage the implementation of a clinical trial involving a large cohort of end-users.
authors.affiliation: Neuroelectrical Imaging and BCI Lab, Fondazione Santa Lucia, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy. Electronic address: a.riccio@hsantalucia.it.
authors.forename: Angela
authors.initials: A
authors.lastname: Riccio
authors.affiliation: Institute of Psychology, University of Würzburg, Würzburg, Germany.
authors.forename: Elisa Mira
authors.initials: EM
authors.lastname: Holz
authors.affiliation: Department of Computer, Control, and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Aricò
authors.affiliation: Department of Computer, Control, and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Leotta
authors.affiliation: Department of Computer, Control, and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Aloise
authors.affiliation: Ausilioteca, AIAS Bologna Onlus, Bologna, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Desideri
authors.affiliation: Ausilioteca, AIAS Bologna Onlus, Bologna, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Rimondini
authors.affiliation: Institute of Psychology, University of Würzburg, Würzburg, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Kübler
authors.affiliation: Neuroelectrical Imaging and BCI Lab, Fondazione Santa Lucia, Rome, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Mattia
authors.affiliation: Neuroelectrical Imaging and BCI Lab, Fondazione Santa Lucia, Rome, Italy; Department of Computer, Control, and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy.
authors.forename: Febo
authors.initials: F
authors.lastname: Cincotti
mesh_terms: D000328:Adult; D062207:Brain-Computer Interfaces; D006233:Persons with Disabilities / Q000534:rehabilitation*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000534:rehabilitation*; D017060:Patient Satisfaction; D010865:Pilot Projects; D012047:Rehabilitation Centers; D012656:Self-Help Devices; D014584:User-Computer Interface
keywords: ALS (amyotrophic lateral sclerosis); Assistive technology; Brain injuries; Brain-computer interfaces; Event-related potentials; P300; Rehabilitation