A TECHNOLOGY ASSESSMENT OF BRAIN-COMPUTER INTERFACES. BRIDGING PRESENT AND FUTURE WITH A HUMAN-CENTERED PERSPECTIVE

Technology assessment is a systematic approach used to scientifically investigate the conditions and consequences of technology and technicization while determining its social evaluation. This research focuses on the evaluation of an emerging technology, Brain-Computer Interface (BCI), which enables direct communication between the brain and an external device. As an emerging technology, BCI is in its early stages of research, facing numerous challenges. To address the assessment of BCIs, a method-ology combining Constructive Technology Assessment (CTA) and Foresight within the umbrella con-cept of Future-oriented Technology Analysis (FTA), has been developed and applied. This thesis con-ducts a literature review and applies both structured, open-ended interviews and a survey seeking an-swers to these issues. It explores various social, ethical, legal, and philosophical issues to be addressed in the field of BCIs, both in the present as well as in the future. Understanding the key challenges, de-velopments, and potential future trajectories of this technology is essential to grasp how its applications can offer both opportunities and threats to society at large. The research addresses the concerns of both the Technology Assessment and Brain-Computer Interface communities, offering a comprehensive un-derstanding of how these social, ethical, legal, and philosophical issues may evolve over time. Perspec-tives from various key stakeholders in the BCI field, as well as neurotechnologies in the context of as-sistive technologies, are examined, providing valuable insights for further research in this area.A avaliação de tecnologia é uma abordagem sistemática usada para investigar cientificamente as condições e consequências da tecnologia e da tecnicização, ao mesmo tempo que determina sua avaliação social. Esta pesquisa concentra-se na avaliação de uma tecnologia emergente, a Interface Cérebro-Computador (BCI), que possibilita a comunicação direta entre o cérebro e um dispositivo externo. Como tecnologia emergente, a BCI está em seus estágios iniciais de pesquisa, enfrentando inúmeros desafios. Para abordar a avaliação das BCIs, foi desenvolvida e aplicada uma metodologia que combina a Avaliação Construtiva de Tecnologia (CTA) e a Prospectiva, dentro do conceito geral de Análise de Tecnologia Orientada para o Futuro (FTA). Esta tese realiza uma revisão de literatura e aplica tanto entrevistas estruturadas e abertas quanto um questionário na busca por respostas para estas questões. Ela explora várias questões sociais, éticas, legais e filosóficas a serem abordadas no campo das BCIs, tanto no presente como no futuro. Compreender os principais desafios, desenvolvimentos e possíveis trajetórias futuras dessa tecnologia é essencial para compreender como suas aplicações podem oferecer oportunidades e ameaças à sociedade em geral. A pesquisa aborda as preocupações das comunidades de Avaliação de Tecnologia e Interface Cérebro-Computador, oferecendo uma compreensão abrangente de como essas questões sociais, éticas, legais e filosóficas podem evoluir ao longo do tempo. Perspectivas de diversos atores-chave no campo de BCI, bem como neurotecnologias no contexto de tecnologias assistivas, são examinadas, fornecendo informações valiosas para pesquisas futuras nessa área

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device

Interaction Paradigms for Brain-Body Interfaces for Computer Users with Brain Injuries

In comparison to all types of injury, those to the brain are among the most likely to result in death or permanent disability. Some of these brain-injured people cannot communicate, recreate, or control their environment due to severe motor impairment. This group of individuals with severe head injury have received limited help from assistive technology. Brain-Computer Interfaces have opened up a spectrum of assistive technologies, which are particularly appropriate for people with traumatic brain injury, especially those who suffer from “locked-in” syndrome. The research challenge here is to develop novel interaction paradigms that suit brain-injured individuals, who could then use it for everyday communications. The developed interaction paradigms should require minimum training, reconfigurable and minimum effort to use. This thesis reports on the development of novel interaction paradigms for Brain-Body Interfaces to help brain-injured people to communicate better, recreate and control their environment using computers despite the severity of their brain injury. The investigation was carried out in three phases. Phase one was an exploratory study where a first novel interaction paradigm was developed and evaluated with able-bodied and disabled participants. Results obtained were fed into the next phase of the investigation. Phase two was carried out with able participants who acted as development group for the second novel interaction paradigm. This second novel interaction paradigm was evaluated with non-verbal participants with severe brain injury in phase three. An iterative design research methodology was chosen to develop the interaction paradigms. A non-invasive assistive technology device named Cyberlink™ was chosen as the Brain-Body Interface. This research improved previous work in this area by developing new interaction paradigms of personalised tiling and discrete acceleration in Brain- Body Interfaces. The research hypothesis of this study ‘that the performance of the Brain-Body Interface can be improved by the use of novel interaction paradigms’ was successfully demonstrated

Applications of Brain Computer Interface in Present Healthcare Setting

Brain-computer interface (BCI) is an innovative method of integrating technology for healthcare. Utilizing BCI technology allows for direct communication and/or control between the brain and an external device, thereby displacing conventional neuromuscular pathways. The primary goal of BCI in healthcare is to repair or reinstate useful function to people who have impairments caused by neuromuscular disorders (e.g., stroke, amyotrophic lateral sclerosis, spinal cord injury, or cerebral palsy). BCI brings with it technical and usability flaws in addition to its benefits. We present an overview of BCI in this chapter, followed by its applications in the medical sector in diagnosis, rehabilitation, and assistive technology. We also discuss BCI’s strengths and limitations, as well as its future direction

Analysis of consciousness for complete locked-in syndrome patients

This thesis presents methods for detecting consciousness in patients with complete locked-in syndrome (CLIS). CLIS patients are unable to speak and have lost all muscle movement. Externally, the internal brain activity of such patients cannot be easily perceived, but CLIS patients are considered to be still conscious and cognitively active. Detecting the current state of consciousness of CLIS patients is non-trivial, and it is difficult to ascertain whether CLIS patients are conscious or not. Thus, it is vital to develop alternative ways to re-establish communication with these patients during periods of awareness, and a possible platform is through brain–computer interface (BCI). Since consciousness is required to use BCI correctly, this study proposes a modus operandi to analyze not only in intracranial electrocorticography (ECoG) signals with greater signal-to-noise ratio (SNR) and higher signal amplitude, but also in non-invasive electroencephalography (EEG) signals. By applying three different time-domain analysis approaches sample entropy, permutation entropy, and Poincaré plot as feature extraction to prevent disease-related reductions of brainwave frequency bands in CLIS patients, and cross-validated to improve the probability of correctly detecting the conscious states of CLIS patients. Due to the lack a of 'ground truth' that could be used as teaching input to correct the outcomes, k-Means and DBSCAN these unsupervised learning methods were used to reveal the presence of different levels of consciousness for individual participation in the experiment first in locked-in state (LIS) patients with ALSFRS-R score of 0. The results of these different methods converge on the specific periods of consciousness of CLIS/LIS patients, coinciding with the period during which CLIS/LIS patients recorded communication with an experimenter. To determine methodological feasibility, the methods were also applied to patients with disorders of consciousness (DOC). The results indicate that the use of sample entropy might be helpful to detect awareness not only in CLIS/LIS patients but also in minimally conscious state (MCS)/unresponsive wakefulness syndrome (UWS) patients, and showed good resolution for both ECoG signals up to 24 hours a day and EEG signals focused on one or two hours at the time of the experiment. This thesis focus on consistent results across multiple channels to avoid compensatory effects of brain injury. Unlike most techniques designed to help clinicians diagnose and understand patients' long-term disease progression or distinguish between different disease types on the clinical scales of consciousness. The aim of this investigation is to develop a reliable brain-computer interface-based communication aid eventually to provide family members with a method for short-term communication with CLIS patients in daily life, and at the same time, this will keep patients' brains active to increase patients' willingness to live and improve their quality of life (QOL)

WAVE: Brain-computer interface connection and biofeedback monitor

Over the last couple of years I have had the unfortunate experience of helping a loved one through multiple hospital stays. Anyone who has ever been in a hospital knows it’s not the most pleasant experience one can have. These experiences have lead me to the question of, how do I create a space to optimize and inspire the body, mind, and emotional centers to heal and engage support and community? By using empathy I can create solutions for the most extreme patients and use those solutions for other patients and other situations. Through interviews with ICU patients, nurses and doctors, a reoccurring theme clearly developed; fear, isolation and lack of communication. When a person is experiencing these emotions an optimal healing environment is not possible. What if we could create a healing space that could monitor a person’s mood and general well being? By monitoring mood and having alternative way’s to communicate we would create an environment that could potentially have faster healing times, lower amounts of medication usage and a happier work environment. It’s time to bring humanity back to healthcare. Healthcare needs to concentrate on more then just the physical; it should include the mental and the emotional as well. We need all three to line up in order to heal. I have invented a Healing Space to help accomplish an optimum healing environment. The first device to come out of it is Wave, a brain computer interface designed to use EEG technology along with biofeedback. This device will change the relationship between, doctors, patients and nurses by giving them a way to communicate and to talk about mental states

Interaction paradigms for brain-body interfaces for computer users with brain injuries

In comparison to all types of injury, those to the brain are among the most likely to result in death or permanent disability. Some of these brain-injured people cannot communicate, recreate, or control their environment due to severe motor impairment. This group of individuals with severe head injury have received limited help from assistive technology. Brain-Computer Interfaces have opened up a spectrum of assistive technologies, which are particularly appropriate for people with traumatic brain injury, especially those who suffer from “locked-in” syndrome. The research challenge here is to develop novel interaction paradigms that suit brain-injured individuals, who could then use it for everyday communications. The developed interaction paradigms should require minimum training, reconfigurable and minimum effort to use. This thesis reports on the development of novel interaction paradigms for Brain-Body Interfaces to help brain-injured people to communicate better, recreate and control their environment using computers despite the severity of their brain injury. The investigation was carried out in three phases. Phase one was an exploratory study where a first novel interaction paradigm was developed and evaluated with able-bodied and disabled participants. Results obtained were fed into the next phase of the investigation. Phase two was carried out with able participants who acted as development group for the second novel interaction paradigm. This second novel interaction paradigm was evaluated with non-verbal participants with severe brain injury in phase three. An iterative design research methodology was chosen to develop the interaction paradigms. A non-invasive assistive technology device named Cyberlink™ was chosen as the Brain-Body Interface. This research improved previous work in this area by developing new interaction paradigms of personalised tiling and discrete acceleration in Brain- Body Interfaces. The research hypothesis of this study ‘that the performance of the Brain-Body Interface can be improved by the use of novel interaction paradigms’ was successfully demonstrated.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Robotic Platforms for Assistance to People with Disabilities

People with congenital and/or acquired disabilities constitute a great number of dependents today. Robotic platforms to help people with disabilities are being developed with the aim of providing both rehabilitation treatment and assistance to improve their quality of life. A high demand for robotic platforms that provide assistance during rehabilitation is expected because of the health status of the world due to the COVID-19 pandemic. The pandemic has resulted in countries facing major challenges to ensure the health and autonomy of their disabled population. Robotic platforms are necessary to ensure assistance and rehabilitation for disabled people in the current global situation. The capacity of robotic platforms in this area must be continuously improved to benefit the healthcare sector in terms of chronic disease prevention, assistance, and autonomy. For this reason, research about human–robot interaction in these robotic assistance environments must grow and advance because this topic demands sensitive and intelligent robotic platforms that are equipped with complex sensory systems, high handling functionalities, safe control strategies, and intelligent computer vision algorithms. This Special Issue has published eight papers covering recent advances in the field of robotic platforms to assist disabled people in daily or clinical environments. The papers address innovative solutions in this field, including affordable assistive robotics devices, new techniques in computer vision for intelligent and safe human–robot interaction, and advances in mobile manipulators for assistive tasks

Sensorimotor experience in virtual environments

The goal of rehabilitation is to reduce impairment and provide functional improvements resulting in quality participation in activities of life, Plasticity and motor learning principles provide inspiration for therapeutic interventions including movement repetition in a virtual reality environment, The objective of this research work was to investigate functional specific measurements (kinematic, behavioral) and neural correlates of motor experience of hand gesture activities in virtual environments stimulating sensory experience (VE) using a hand agent model. The fMRI compatible Virtual Environment Sign Language Instruction (VESLI) System was designed and developed to provide a number of rehabilitation and measurement features, to identify optimal learning conditions for individuals and to track changes in performance over time. Therapies and measurements incorporated into VESLI target and track specific impairments underlying dysfunction. The goal of improved measurement is to develop targeted interventions embedded in higher level tasks and to accurately track specific gains to understand the responses to treatment, and the impact the response may have upon higher level function such as participation in life. To further clarify the biological model of motor experiences and to understand the added value and role of virtual sensory stimulation and feedback which includes seeing one\u27s own hand movement, functional brain mapping was conducted with simultaneous kinematic analysis in healthy controls and in stroke subjects. It is believed that through the understanding of these neural activations, rehabilitation strategies advantaging the principles of plasticity and motor learning will become possible. The present research assessed successful practice conditions promoting gesture learning behavior in the individual. For the first time, functional imaging experiments mapped neural correlates of human interactions with complex virtual reality hands avatars moving synchronously with the subject\u27s own hands, Findings indicate that healthy control subjects learned intransitive gestures in virtual environments using the first and third person avatars, picture and text definitions, and while viewing visual feedback of their own hands, virtual hands avatars, and in the control condition, hidden hands. Moreover, exercise in a virtual environment with a first person avatar of hands recruited insular cortex activation over time, which might indicate that this activation has been associated with a sense of agency. Sensory augmentation in virtual environments modulated activations of important brain regions associated with action observation and action execution. Quality of the visual feedback was modulated and brain areas were identified where the amount of brain activation was positively or negatively correlated with the visual feedback, When subjects moved the right hand and saw unexpected response, the left virtual avatar hand moved, neural activation increased in the motor cortex ipsilateral to the moving hand This visual modulation might provide a helpful rehabilitation therapy for people with paralysis of the limb through visual augmentation of skills. A model was developed to study the effects of sensorimotor experience in virtual environments, and findings of the effect of sensorimotor experience in virtual environments upon brain activity and related behavioral measures. The research model represents a significant contribution to neuroscience research, and translational engineering practice, A model of neural activations correlated with kinematics and behavior can profoundly influence the delivery of rehabilitative services in the coming years by giving clinicians a framework for engaging patients in a sensorimotor environment that can optimally facilitate neural reorganization