BRAIN COMPUTER INTERFACE (BCI) ON ATTENTION: A SCOPING REVIEW

Technological innovations are now an integral part of healthcare. Brain-computer interface (BCI) is a novel technological intervention system that is useful in restoring function to people disabled by neurological disorders such as attention deficit hyperactivity disorder (ADHD), amyotrophic lateral sclerosis (ALS), cerebral palsy, stroke, or spinal cord injury. This paper surveys the literature concerning the effectiveness of BCI on attention in subjects under various conditions. The findings of this scoping review are that studies have been made on ADHD, ALS, ASD subjects, and subjects recovering from brain and spinal cord injuries. BCI based neurofeedback training is seen to be effective in improving attention in these subjects. Some studies have also been made on healthy subjects.BCI based neurofeedback training promises neurocognitive improvement and EEG changes in the elderly. Different cognitive assessments have been tried on healthy adults.   From this review, it is evident that hardly any research has been done on using BCI for enhancing attention in post-stroke subjects. So there arises the necessity for making a study on the effects of BCI based attention training in post-stroke subjects, as attention is the key for learning motor skills that get impaired following a stroke. Currently, many researches are underway to determine the effects of a BCI based training program for the enhancement of attention in post-stroke subjects

Predicting mental imagery based BCI performance from personality, cognitive profile and neurophysiological patterns

Mental-Imagery based Brain-Computer Interfaces (MI-BCIs) allow their users to send commands to a computer using their brain-activity alone (typically measured by ElectroEncephaloGraphy— EEG), which is processed while they perform specific mental tasks. While very promising, MI-BCIs remain barely used outside laboratories because of the difficulty encountered by users to control them. Indeed, although some users obtain good control performances after training, a substantial proportion remains unable to reliably control an MI-BCI. This huge variability in user-performance led the community to look for predictors of MI-BCI control ability. However, these predictors were only explored for motor-imagery based BCIs, and mostly for a single training session per subject. In this study, 18 participants were instructed to learn to control an EEG-based MI-BCI by performing 3 MI-tasks, 2 of which were non-motor tasks, across 6 training sessions, on 6 different days. Relationships between the participants’ BCI control performances and their personality, cognitive profile and neurophysiological markers were explored. While no relevant relationships with neurophysiological markers were found, strong correlations between MI-BCI performances and mental-rotation scores (reflecting spatial abilities) were revealed. Also, a predictive model of MI-BCI performance based on psychometric questionnaire scores was proposed. A leave-one-subject-out cross validation process revealed the stability and reliability of this model: it enabled to predict participants’ performance with a mean error of less than 3 points. This study determined how users’ profiles impact their MI-BCI control ability and thus clears the way for designing novel MI-BCI training protocols, adapted to the profile of each user

Paving the Way for Motor Imagery-Based Tele-Rehabilitation through a Fully Wearable BCI System

The present study introduces a brain–computer interface designed and prototyped to be wearable and usable in daily life. Eight dry electroencephalographic sensors were adopted to acquire the brain activity associated with motor imagery. Multimodal feedback in extended reality was exploited to improve the online detection of neurological phenomena. Twenty-seven healthy subjects used the proposed system in five sessions to investigate the effects of feedback on motor imagery. The sample was divided into two equal-sized groups: a “neurofeedback” group, which performed motor imagery while receiving feedback, and a “control” group, which performed motor imagery with no feedback. Questionnaires were administered to participants aiming to investigate the usability of the proposed system and an individual’s ability to imagine movements. The highest mean classification accuracy across the subjects of the control group was about 62% with 3% associated type A uncertainty, and it was 69% with 3% uncertainty for the neurofeedback group. Moreover, the results in some cases were significantly higher for the neurofeedback group. The perceived usability by all participants was high. Overall, the study aimed at highlighting the advantages and the pitfalls of using a wearable brain–computer interface with dry sensors. Notably, this technology can be adopted for safe and economically viable tele-rehabilitation

Using brain-computer interaction and multimodal virtual-reality for augmenting stroke neurorehabilitation

Every year millions of people suffer from stroke resulting to initial paralysis, slow motor recovery and chronic conditions that require continuous reha bilitation and therapy. The increasing socio-economical and psychological impact of stroke makes it necessary to find new approaches to minimize its sequels, as well as novel tools for effective, low cost and personalized reha bilitation. The integration of current ICT approaches and Virtual Reality (VR) training (based on exercise therapies) has shown significant improve ments. Moreover, recent studies have shown that through mental practice and neurofeedback the task performance is improved. To date, detailed in formation on which neurofeedback strategies lead to successful functional recovery is not available while very little is known about how to optimally utilize neurofeedback paradigms in stroke rehabilitation. Based on the cur rent limitations, the target of this project is to investigate and develop a novel upper-limb rehabilitation system with the use of novel ICT technolo gies including Brain-Computer Interfaces (BCI’s), and VR systems. Here, through a set of studies, we illustrate the design of the RehabNet frame work and its focus on integrative motor and cognitive therapy based on VR scenarios. Moreover, we broadened the inclusion criteria for low mobility pa tients, through the development of neurofeedback tools with the utilization of Brain-Computer Interfaces while investigating the effects of a brain-to-VR interaction.Todos os anos, milho˜es de pessoas sofrem de AVC, resultando em paral isia inicial, recupera¸ca˜o motora lenta e condic¸˜oes cr´onicas que requerem re abilita¸ca˜o e terapia cont´ınuas. O impacto socioecon´omico e psicol´ogico do AVC torna premente encontrar novas abordagens para minimizar as seque las decorrentes, bem como desenvolver ferramentas de reabilita¸ca˜o, efetivas, de baixo custo e personalizadas. A integra¸c˜ao das atuais abordagens das Tecnologias da Informa¸ca˜o e da Comunica¸ca˜o (TIC) e treino com Realidade Virtual (RV), com base em terapias por exerc´ıcios, tem mostrado melhorias significativas. Estudos recentes mostram, ainda, que a performance nas tare fas ´e melhorada atrav´es da pra´tica mental e do neurofeedback. At´e a` data, na˜o existem informac¸˜oes detalhadas sobre quais as estrat´egias de neurofeed back que levam a uma recupera¸ca˜o funcional bem-sucedida. De igual modo, pouco se sabe acerca de como utilizar, de forma otimizada, o paradigma de neurofeedback na recupera¸c˜ao de AVC. Face a tal, o objetivo deste projeto ´e investigar e desenvolver um novo sistema de reabilita¸ca˜o de membros supe riores, recorrendo ao uso de novas TIC, incluindo sistemas como a Interface C´erebro-Computador (ICC) e RV. Atrav´es de um conjunto de estudos, ilus tramos o design do framework RehabNet e o seu foco numa terapia motora e cognitiva, integrativa, baseada em cen´arios de RV. Adicionalmente, ampli amos os crit´erios de inclus˜ao para pacientes com baixa mobilidade, atrav´es do desenvolvimento de ferramentas de neurofeedback com a utilizac¸˜ao de ICC, ao mesmo que investigando os efeitos de uma interac¸˜ao c´erebro-para-RV

Active and Passive Brain-Computer Interfaces Integrated with Extended Reality for Applications in Health 4.0

This paper presents the integration of extended reality (XR) with brain-computer interfaces (BCI) to open up new possibilities in the health 4.0 framework. Such integrated systems are here investigated with respect to an active and a passive BCI paradigm. Regarding the active BCI, the XR part consists of providing visual and vibrotactile feedbacks to help the user during motor imagery tasks. Therefore, XR aims to enhance the neurofeedback by enhancing the user engagement. Meanwhile, in the passive BCI, user engagement monitoring allows the adaptivity of a XR-based rehabilitation game for children. Preliminary results suggest that the XR neurofeedback helps the BCI users to carry on motor imagery tasks with up to 84% classification accuracy, and that the level of emotional and cognitive engagement can be detected with an accuracy greater than 75%

Neurofeedback training with a motor imagery-based BCI: neurocognitive improvements and EEG changes in the elderly

Producción CientíficaNeurofeedback training (NFT) has shown to be promising and useful to rehabilitate cognitive functions. Recently, brain-computer interfaces (BCIs) were used to restore brain plasticity by inducing brain activity with a NFT. In our study, we hypothesized that a NFT with a motor imagery-based BCI (MI-BCI) could enhance cognitive functions related to aging effects. To assess the effectiveness of our MI-BCI application, 63 subjects (older than 60 years) were recruited. This novel application was used by 31 subjects (NFT group). Their Luria neuropsychological test scores were compared with the remaining 32 subjects, who did not perform NFT (control group). Electroencephalogram (EEG) changes measured by relative power (RP) endorsed cognitive potential findings under study: visuospatial, oral language, memory, intellectual and attention functions. Three frequency bands were selected to assess cognitive changes: 12, 18, and 21 Hz (bandwidth 3 Hz). Significant increases (p<0.01) in the RP of these frequency bands were found. Moreover, results from cognitive tests showed significant improvements (p<0.01) in four cognitive functions after performing five NFT sessions: visuospatial, oral language, memory, and intellectual. This established evidence in the association between NFT performed by a MI-BCI and enhanced cognitive performance. Therefore, it could be a novel approach to help elderly people.Ministerio de Economía y Competitividad (TEC2014-53196)Junta de Castilla y León (VA059U13

Thought-controlled games with brain-computer interfaces

Nowadays, EEG based BCI systems are starting to gain ground in games for health research. With reduced costs and promising an innovative and exciting new interaction paradigm, attracted developers and researchers to use them on video games for serious applications. However, with researchers focusing mostly on the signal processing part, the interaction aspect of the BCIs has been neglected. A gap between classification performance and online control quality for BCI based systems has been created by this research disparity, resulting in suboptimal interactions that lead to user fatigue and loss of motivation over time. Motor-Imagery (MI) based BCIs interaction paradigms can provide an alternative way to overcome motor-related disabilities, and is being deployed in the health environment to promote the functional and structural plasticity of the brain. A BCI system in a neurorehabilitation environment, should not only have a high classification performance, but should also provoke a high level of engagement and sense of control to the user, for it to be advantageous. It should also maximize the level of control on user’s actions, while not requiring them to be subject to long training periods on each specific BCI system. This thesis has two main contributions, the Adaptive Performance Engine, a system we developed that can provide up to 20% improvement to user specific performance, and NeuRow, an immersive Virtual Reality environment for motor neurorehabilitation that consists of a closed neurofeedback interaction loop based on MI and multimodal feedback while using a state-of-the-art Head Mounted Display.Hoje em dia, os sistemas BCI baseados em EEG estão a começar a ganhar terreno em jogos relacionados com a saúde. Com custos reduzidos e prometendo um novo e inovador paradigma de interação, atraiu programadores e investigadores para usá-los em vídeo jogos para aplicações sérias. No entanto, com os investigadores focados principalmente na parte do processamento de sinal, o aspeto de interação dos BCI foi negligenciado. Um fosso entre o desempenho da classificação e a qualidade do controle on-line para sistemas baseados em BCI foi criado por esta disparidade de pesquisa, resultando em interações subótimas que levam à fadiga do usuário e à perda de motivação ao longo do tempo. Os paradigmas de interação BCI baseados em imagética motora (IM) podem fornecer uma maneira alternativa de superar incapacidades motoras, e estão sendo implementados no sector da saúde para promover plasticidade cerebral funcional e estrutural. Um sistema BCI usado num ambiente de neuro-reabilitação, para que seja vantajoso, não só deve ter um alto desempenho de classificação, mas também deve promover um elevado nível de envolvimento e sensação de controlo ao utilizador. Também deve maximizar o nível de controlo nas ações do utilizador, sem exigir que sejam submetidos a longos períodos de treino em cada sistema BCI específico. Esta tese tem duas contribuições principais, o Adaptive Performance Engine, um sistema que desenvolvemos e que pode fornecer até 20% de melhoria para o desempenho específico do usuário, e NeuRow, um ambiente imersivo de Realidade Virtual para neuro-reabilitação motora, que consiste num circuito fechado de interação de neuro-feedback baseado em IM e feedback multimodal e usando um Head Mounted Display de última geração

Active Physical Practice Followed by Mental Practice Using BCI-Driven Hand Exoskeleton: A Pilot Trial for Clinical Effectiveness and Usability

Appropriately combining mental practice (MP) and physical practice (PP) in a post-stroke rehabilitation is critical for ensuring a substantially positive rehabilitation outcome. Here we present a rehabilitation protocol incorporating a separate active PP stage followed by MP stage, using a hand exoskeleton and brain-computer interface (BCI). The PP stage was mediated by a force sensor feedback based assist-as-needed control strategy, whereas the MP stage provided BCI based multimodal neurofeedback combining anthropomorphic visual feedback and proprioceptive feedback of the impaired hand extension attempt. A 6 week long clinical trial was conducted on 4 hemiparetic stroke patients (screened out of 16) with left hand disability. The primary outcome, motor functional recovery, was measured in terms of changes in Grip-Strength (GS) and Action Research Arm Test (ARAT) scores; whereas the secondary outcome, usability of the system, was measured in terms of changes in mood, fatigue and motivation on a visual-analog-scale (VAS). A positive rehabilitative outcome was found as the group mean changes from the baseline in the GS and ARAT were +6.38 kg and +5.66 accordingly. The VAS scale measurements also showed betterment in mood (-1.38), increased motivation (+2.10) and reduced fatigue (-0.98) as compared to the baseline. Thus the proposed neurorehabilitation protocol is found to be promising both in terms of clinical effectiveness and usability

Brain-Computer Interface for Clinical Purposes : Cognitive Assessment and Rehabilitation

Alongside the best-known applications of brain-computer interface (BCI) technology for restoring communication abilities and controlling external devices, we present the state of the art of BCI use for cognitive assessment and training purposes. We first describe some preliminary attempts to develop verbal-motor free BCI-based tests for evaluating specific or multiple cognitive domains in patients with Amyotrophic Lateral Sclerosis, disorders of consciousness, and other neurological diseases. Then we present the more heterogeneous and advanced field of BCI-based cognitive training, which has its roots in the context of neurofeedback therapy and addresses patients with neurological developmental disorders (autism spectrum disorder and attention-deficit/hyperactivity disorder), stroke patients, and elderly subjects. We discuss some advantages of BCI for both assessment and training purposes, the former concerning the possibility of longitudinally and reliably evaluating cognitive functions in patients with severe motor disabilities, the latter regarding the possibility of enhancing patients' motivation and engagement for improving neural plasticity. Finally, we discuss some present and future challenges in the BCI use for the described purposes