title: Performance predictors of brain-computer interfaces in patients with amyotrophic lateral sclerosis.
abstract: OBJECTIVE
  Patients with amyotrophic lateral sclerosis (ALS) may benefit from brain-computer interfaces (BCI), but the utility of such devices likely will have to account for the functional, cognitive, and behavioral heterogeneity of this neurodegenerative disorder.
  
  
  METHODS
  In this study, a heterogeneous group of patients with ALS participated in a study on BCI based on the P300 event related potential and motor-imagery.
  
  
  RESULTS
  The presence of cognitive impairment in these patients significantly reduced the quality of the control signals required to use these communication systems, subsequently impairing performance, regardless of progression of physical symptoms. Loss in performance among the cognitively impaired was accompanied by a decrease in the signal-to-noise ratio of task-relevant EEG band power. There was also evidence that behavioral dysfunction negatively affects P300 speller performance. Finally, older participants achieved better performance on the P300 system than the motor-imagery system, indicating a preference of BCI paradigm with age.
  
  
  CONCLUSIONS
  These findings highlight the importance of considering the heterogeneity of disease when designing BCI augmentative and alternative communication devices for clinical applications.
authors.affiliation: Center for Neural Engineering, Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Geronimo
authors.forename: Z
authors.initials: Z
authors.lastname: Simmons
authors.forename: S J
authors.initials: SJ
authors.lastname: Schiff
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D062207:Brain-Computer Interfaces; D004569:Electroencephalography / Q000379:methods; D018913:Event-Related Potentials, P300 / Q000502:physiology; D005260:Female; D006801:Humans; D007092:Imagination / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation / Q000379:methods*; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology*; D011795:Surveys and Questionnaires