Brain-Machine Interfaces in the Completely Locked-In and Stroke
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1
University Tübingen, Institute of Medical Psychology and Behavioral Neurobiology, Germany
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2
Ospitale san Camillo, IRCCS, Italy
It’s an old dream of humankind to communicate and interact with the environment using the power of thoughts only. Recent advances in sensor technology and computational capacities suggest that this dream might become true in near future. Results from three applications of BMIs are described and their scientific, clinical and societal impact evaluated:
1. BMIs for brain-communication in the locked-in patients
BMIs using EEG, implanted Electrocorticogram (ECoG) were used extensively for brain communication in patients with severe paralysis, mainly amyotrophic lateral sclerosis (ALS). Up to the locked-in (LI) stage different types of EEG-ECoG-BMIs were used successfully to select letters or answers with brain oscillations (mainly sensorimotor rhythm, SMR) or cognitive event-related potentials from a computer menue. However, attempts to use BMI in the completely locked-in-syndrome (CLIS) were largely unsuccessful despite intensive research efforts. The first successful attempts in a group of 6 CLIS patients using near-infrared-spectroscopy (NIRS)-EEG-BMI systems (Gallegos-Ayala et al. 2014) will be described.
2. BMIs as a rehabilitation modality for severe chronic stroke
A controlled outcome study of severe chronic stroke patients without residual hand mobility and without any available treatment modality left was recently published by this group (Ramos et al. 2013) using a non-invasive extensive BMI-training with a neuroprosthetic device driven by sensorimotor brain oscillations (SMR) provides the first evidence of the clinical usefulness of BMI in this patient group. Reasons for this successful behavioral change and productive brain reorganization are presented and the necessity of future invasive BMI based on direct recordings from motor neurons comparable to those of Hochberg et al. (2006, 2012) presented here by J. Donoghue in severe chronic stroke is emphasized.
3. BMI-metabolic fMRI-neurofeedback in neuropsychiatric disorders
Neurofeedback of EEG oscillations was used as a behavioral training-approach with considerable success in attentional disorders and epilepsy. Recently real-time-functional magnetic resonance (rt-fMRI) neurofeedback was developed by the Tuebingen group and tested in several neuropsychiatric disorders such as psychopathy, addiction, schizophrenia, obsessive-compulsive disorder and obesity (see Birbaumer et al 2013 for a review). Rt-fMRI-neurofeedback allows self-regulation of circumscribed well-defined cortical and subcortical brain systems and their connectivity. Some recent results in addiction are reported and the problem of brain-behavior associations related to BMI-training discussed.
It’s an old dream of humankind to communicate and interact with the environment using the power of thoughts only. Recent advances in sensor technology and computational capacities suggest that this dream might become true in near future. Results from three applications of BMIs are described and their scientific, clinical and societal impact evaluated:
1. BMIs for brain-communication in the locked-in patients
BMIs using EEG, implanted Electrocorticogram (ECoG) were used extensively for brain communication in patients with severe paralysis, mainly amyotrophic lateral sclerosis (ALS). Up to the locked-in (LI) stage different types of EEG-ECoG-BMIs were used successfully to select letters or answers with brain oscillations (mainly sensorimotor rhythm, SMR) or cognitive event-related potentials from a computer menue. However, attempts to use BMI in the completely locked-in-syndrome (CLIS) were largely unsuccessful despite intensive research efforts. The first successful attempts in a group of 6 CLIS patients using near-infrared-spectroscopy (NIRS)-EEG-BMI systems (Gallegos-Ayala et al 2014) will be described.
2. BMIs as a rehabilitation modality for severe chronic stroke
A controlled outcome study of severe chronic stroke patients without residual hand mobility and without any available treatment modality left was recently published by this group (Ramos et al 2013) using a non-invasive extensive BMI-training with a neuroprosthetic device driven by sensorimotor brain oscillations (SMR) provides the first evidence of the clinical usefulness of BMI in this patient group. Reasons for this successful behavioral change and productive brain reorganization are presented and the necessity of future invasive BMI based on direct recordings from motor neurons comparable to those of Hochberg et al (2006, 2012) presented here by J. Donoghue in severe chronic stroke is emphasized.
3. BMI-metabolic fMRI-neurofeedback in neuropsychiatric disorders
Neurofeedback of EEG oscillations was used as a behavioral training-approach with considerable success in attentional disorders and epilepsy. Recently real-time-functional magnetic resonance (rt-fMRI) neurofeedback was developed by the Tuebingen group and tested in several neuropsychiatric disorders such as psychopathy, addiction, schizophrenia, obsessive-compulsive disorder and obesity (see Birbaumer et al 2013 for a review). Rt-fMRI-neurofeedback allows self-regulation of circumscribed well-defined cortical and subcortical brain systems and their connectivity. Some recent results in addiction are reported and the problem of brain-behavior associations related to BMI-training discussed.
It’s an old dream of humankind to communicate and interact with the environment using the power of thoughts only. Recent advances in sensor technology and computational capacities suggest that this dream might become true in near future. Results from three applications of BMIs are described and their scientific, clinical and societal impact evaluated:
1. BMIs for brain-communication in the locked-in patients
BMIs using EEG, implanted Electrocorticogram (ECoG) were used extensively for brain communication in patients with severe paralysis, mainly amyotrophic lateral sclerosis (ALS). Up to the locked-in (LI) stage different types of EEG-ECoG-BMIs were used successfully to select letters or answers with brain oscillations (mainly sensorimotor rhythm, SMR) or cognitive event-related potentials from a computer menue. However, attempts to use BMI in the completely locked-in-syndrome (CLIS) were largely unsuccessful despite intensive research efforts. The first successful attempts in a group of 6 CLIS patients using near-infrared-spectroscopy (NIRS)-EEG-BMI systems (Gallegos-Ayala et al 2014) will be described.
2. BMIs as a rehabilitation modality for severe chronic stroke
A controlled outcome study of severe chronic stroke patients without residual hand mobility and without any available treatment modality left was recently published by this group (Ramos et al 2013) using a non-invasive extensive BMI-training with a neuroprosthetic device driven by sensorimotor brain oscillations (SMR) provides the first evidence of the clinical usefulness of BMI in this patient group. Reasons for this successful behavioral change and productive brain reorganization are presented and the necessity of future invasive BMI based on direct recordings from motor neurons comparable to those of Hochberg et al (2006, 2012) presented here by J. Donoghue in severe chronic stroke is emphasized.
3. BMI-metabolic fMRI-neurofeedback in neuropsychiatric disorders
Neurofeedback of EEG oscillations was used as a behavioral training-approach with considerable success in attentional disorders and epilepsy. Recently real-time-functional magnetic resonance (rt-fMRI) neurofeedback was developed by the Tuebingen group and tested in several neuropsychiatric disorders such as psychopathy, addiction, schizophrenia, obsessive-compulsive disorder and obesity (see Birbaumer et al 2013 for a review). Rt-fMRI-neurofeedback allows self-regulation of circumscribed well-defined cortical and subcortical brain systems and their connectivity. Some recent results in addiction are reported and the problem of brain-behavior associations related to BMI-training discussed.
Acknowledgements
Supported by Deutsche Forschungsgemeinschaft DFG (Koselleck BI 195/69-1), German Federal Ministry of Education and Research (BMBF, grant numbers 01GQ0831, 16SV5838K, 01GI0925), VW, Baden-Württemberg Stiftung, EU-FP7 and HORIZON 2020 (WAY, BRAINTRAIN, ERC to Rosenstiel & Birbaumer), CIN, FORTUNE (Faculty of Medicine, Univ. of Tuebingen) and Eva und Horst Köhler Stiftung.
Conference:
2015 International Workshop on Clinical Brain-Machine Interfaces (CBMI2015), Tokyo, Japan, 13 Mar - 15 Mar, 2015.
Presentation Type:
Oral presentation / lecture
Topic:
Clinical Brain-Machine Interfaces
Citation:
Birbaumer
N
(2015). Brain-Machine Interfaces in the Completely Locked-In and Stroke.
Conference Abstract:
2015 International Workshop on Clinical Brain-Machine Interfaces (CBMI2015).
doi: 10.3389/conf.fnhum.2015.218.00019
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Received:
23 Apr 2015;
Published Online:
29 Apr 2015.
*
Correspondence:
PhD. Niels Birbaumer, University Tübingen, Institute of Medical Psychology and Behavioral Neurobiology, Tübingen, Ba-Wü, 72076, Germany, niels.birbaumer@uni-tuebingen.de