title: Detection of attempted movement from the EEG during neuromuscular block: proof of principle study in awake volunteers.
abstract: Brain-Computer Interfaces (BCIs) have the potential to detect intraoperative awareness during general anaesthesia. Traditionally, BCI research is aimed at establishing or improving communication and control for patients with permanent paralysis. Patients experiencing intraoperative awareness also lack the means to communicate after administration of a neuromuscular blocker, but may attempt to move. This study evaluates the principle of detecting attempted movements from the electroencephalogram (EEG) during local temporary neuromuscular blockade. EEG was obtained from four healthy volunteers making 3-second hand movements, both before and after local administration of rocuronium in one isolated forearm. Using offline classification analysis we investigated whether the attempted movements the participants made during paralysis could be distinguished from the periods when they did not move or attempt to move. Attempted movement trials were correctly identified in 81 (68-94)% (mean (95% CI)) and 84 (74-93)% of the cases using 30 and 9 EEG channels, respectively. Similar accuracies were obtained when training the classifier on the participants' actual movements. These results provide proof of the principle that a BCI can detect movement attempts during neuromuscular blockade. Based on this, in the future a BCI may serve as a communication channel between a patient under general anaesthesia and the anaesthesiologist.
authors.affiliation: 1] Radboud University Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands [2] Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Blokland
authors.affiliation: 1] Radboud University Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands [2] Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
authors.forename: Loukianos
authors.initials: L
authors.lastname: Spyrou
authors.affiliation: Radboud University Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: Lerou
authors.affiliation: Radboud University Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Jo
authors.initials: J
authors.lastname: Mourisse
authors.affiliation: Radboud University Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Jan Scheffer
authors.affiliation: Radboud University Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: van Geffen
authors.affiliation: Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
authors.forename: Jason
authors.initials: J
authors.lastname: Farquhar
authors.affiliation: 1] Radboud University Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands [2] Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands.
authors.forename: Jörgen
authors.initials: J
authors.lastname: Bruhn
mesh_terms: D000328:Adult; D001921:Brain / Q000187:drug effects* / Q000502:physiology*; D062207:Brain-Computer Interfaces; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement / Q000187:drug effects* / Q000502:physiology*; D019148:Neuromuscular Blockade / Q000379:methods; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage*; D010243:Paralysis / Q000503:physiopathology; D014584:User-Computer Interface; D014838:Volunteers; D014851:Wakefulness / Q000187:drug effects* / Q000502:physiology*; D055815:Young Adult
chemical_list: D009466:Neuromuscular Blocking Agents