title: Brain-computer interfaces in the completely locked-in state and chronic stroke.
abstract: Brain-computer interfaces (BCIs) use brain activity to control external devices, facilitating paralyzed patients to interact with the environment. In this chapter, we discuss the historical perspective of development of BCIs and the current advances of noninvasive BCIs for communication in patients with amyotrophic lateral sclerosis and for restoration of motor impairment after severe stroke. Distinct techniques have been explored to control a BCI in patient population especially electroencephalography (EEG) and more recently near-infrared spectroscopy (NIRS) because of their noninvasive nature and low cost. Previous studies demonstrated successful communication of patients with locked-in state (LIS) using EEG- and invasive electrocorticography-BCI and intracortical recordings when patients still showed residual eye control, but not with patients with complete LIS (ie, complete paralysis). Recently, a NIRS-BCI and classical conditioning procedure was introduced, allowing communication in patients in the complete locked-in state (CLIS). In severe chronic stroke without residual hand function first results indicate a possible superior motor rehabilitation to available treatment using BCI training. Here we present an overview of the available studies and recent results, which open new doors for communication, in the completely paralyzed and rehabilitation in severely affected stroke patients. We also reflect on and describe possible neuronal and learning mechanisms responsible for BCI control and perspective for future BMI research for communication in CLIS and stroke motor recovery.
authors: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany. Electronic address: uchau001@fiu.edu.
authors: U
authors: U
authors: Chaudhary
authors: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; Wyss-Center for Bio- and Neuro-Engineering, Geneva, Switzerland.
authors: N
authors: N
authors: Birbaumer
authors: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; TECNALIA, San Sebastian, Spain. Electronic address: ander.ramos@med.uni-tuebingen.de.
authors: A
authors: A
authors: Ramos-Murguialday
mesh_terms: D001921:Brain / Q000502:physiology*; D058256:Brain Waves / Q000502:physiology; D062207:Brain-Computer Interfaces; D002908:Chronic Disease; D003142:Communication; D003214:Conditioning, Classical / Q000502:physiology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D010243:Paralysis / Q000209:etiology* / Q000534:rehabilitation*; D019265:Spectroscopy, Near-Infrared; D020521:Stroke / Q000150:complications*; D014584:User-Computer Interface
keywords: Amyotrophic lateral sclerosis; Brain–computer interface; Classical conditioning; Communication; Complete locked-in state; Electroencephalography; Functional near-infrared spectroscopy; Locked-in state; Rehabilitation; Stroke