Driving a BCI Wheelchair: A Patient Case Study

Our brain-actuated wheelchair uses shared control to couple the user input with the contextual information about the surroundings in order to perform natural manoeuvres both safely and efficiently. In this study, we investigate the feasibility of using our brain–controlled wheelchair with patients in a rehabilitation clinic. Both user and system performance metrics are analysed. We find that the driving performance of a motor-disabled patient at the clinic is comparable with the performance of four healthy subjects. All five participants were able to complete the driving task successfully

Transferring BCI skills to successful application controls

The goal of our research is to enable various end-users to control applications by using a brain-computer interface (BCI). Since applications–like telepresence robots, wheelchairs or text entry systems–are quite demanding a good level of BCI control is needed. However, little is known on how much training is needed to achieve such a level. A second open issue is, if this can be done at rehabilitation clinics or user-centers, without BCI experts present? In this work we wanted to train BCI-naïve end-users within 10 days to successfully control such applications and present results of 23 severely motor-disabled participants

Motor Recovery After Stroke by Means of BCI-Guided Functional Electrical Stimulation

Brain-Computer Interfaces (BCIs) provide a mean to access the damaged motor network of the brain after stroke, and could be used to drive and promote beneficial plasticity. Among the available therapeutic approaches, Functional Electrical Stimulation (FES) is often applied during rehabilitation to directly engage muscles of the affected side of the body, especially when the residual functionality is weak or absent. In this paper, we describe a BCI system for stroke rehabilitation that decodes the attempt to execute a sustained hand extension movement from non-invasive human EEG and activates FES of affected arm muscles, accordingly. The system allows the physical therapist to monitor current brain activity through an EEG-guided visualization. Preliminary results on 4 chronic stroke patients show consistency in the EEG features selected for further training. Three of the patients completed the testing, and they all show recovery of target muscle function. Our results support the idea that BCI can be used to promote beneficial plasticity even during chronic phase, and justify further testing on a larger population

Psychosocial and Ethical Aspects in Non-Invasive EEG-Based BCI Research — A Survey Among BCI Users and BCI Professionals

In this paper, the results of a pilot interview study with 19 subjects participating in an EEG-based non-invasive brain–computer interface (BCI) research study on stroke rehabilitation and assistive technology and of a survey among 17 BCI professionals are presented and discussed in the light of ethical, legal, and social issues in research with human subjects. Most of the users were content with study participation and felt well informed. Negative aspects reported include the long and cumbersome preparation procedure, discomfort with the cap and the wet electrodes, problems concerning BCI control, and strains during the training sessions. In addition, some users reflected on issues concerning system security. When asked for morally problematic issues in this field of non-invasive BCI research, the BCI professionals stressed the need for correct information transfer, the obligation to avoid unrealistic expectations in study participants, the selection of study participants, benefits and strains of participation, BCI illiteracy, the possibility of detrimental brain modifications induced by BCI use, and problems that may arise at the end of the trials. Furthermore, privacy issues were raised. Based on the results obtained, psychosocial and ethical aspects of EEG-based non-invasive BCI research are discussed and possible implications for future research addressed

"Psychosocial and Ethical Aspects in Non-Invasive EEG-Based BCI Research—A Survey Among BCI Users and BCI Professionals"

In this paper, the results of a pilot interview study with 19 subjects participating in an EEG-based non-invasive brain–computer interface (BCI) research study on stroke rehabilitation and assistive technology and of a survey among 17 BCI professionals are presented and discussed in the light of ethical, legal, and social issues in research with human subjects. Most of the users were content with study participation and felt well informed. Negative aspects reported include the long and cumbersome preparation procedure, discomfort with the cap and the wet electrodes, problems concerning BCI control, and strains during the training sessions. In addition, some users reflected on issues concerning system security. When asked for morally problematic issues in this field of non-invasive BCI research, the BCI professionals stressed the need for correct information transfer, the obligation to avoid unrealistic expectations in study participants, the selection of study participants, benefits and strains of participation, BCI illiteracy, the possibility of detrimental brain modifications induced by BCI use, and problems that may arise at the end of the trials. Furthermore, privacy issues were raised. Based on the results obtained, psychosocial and ethical aspects of EEG-based non-invasive BCI research are discussed and possible implications for future research addressed

Conception de dispositifs de rééducation motrice et d’assistance à la marche associant orthèse et électromyostimulation transcutanée rétrocontrôlée (Cyberthèse).

En rééducation motrice il est essentiel de travailler un mouvement ou un ensemble de mouvements de manière précise et aussi physiologique que possible. Pour la rééducation de la marche, cette exigence est à l’origine de méthodes d’entraînement sur tapis roulant. La mise en oeuvre de cette technique demande aux thérapeutes beaucoup de temps et d'énergie. Le contrôle du mouvement des membres inférieurs par les thérapeutes est d’autant plus difficile que l’atteinte motrice est importante. Une robotisation du déplacement des membres inférieurs permet une meilleure reproduction de la cinématique physiologique. Mais celle-ci ne peut rendre le mouvement actif au delà de la capacité motrice résiduelle du sujet. De plus, la dynamique de marche sur un tapis roulant reste différente de celle de la déambulation sur sol fixe. Il en est de même des informations proprioceptives reçues par le système nerveux central pendant un tel entraînement. De ce fait, les schémas moteurs entraînés avec cette méthode ne sont pas identiques à ceux de la marche normale à rééduquer

Atrogin-1, MuRF1, and FoXo, as well as phosphorylated GSK-3β and 4E-BP1 are reduced in skeletal muscle of chronic spinal cord-injured patients

Chronic complete spinal cord injury (SCI) is associated with severe skeletal muscle atrophy as well several atrophy and physical-inactivity-related comorbidity factors such as diabetes, obesity, lipid disorders, and cardiovascular diseases. Intracellular mechanisms associated with chronic complete SCI-related muscle atrophy are not well understood, and thus their characterization may assist with developing strategies to reduce the risk of comorbidity factors. Therefore, the aim of this study was to determine whether there was an increase in catabolic signaling targets, such as atrogin-1, muscle ring finger-1 (MuRF1), forkhead transcription factor (FoXO), and myostatin, and decreases in anabolic signaling targets, such as insulin-like growth factor (IGF), v-akt murine thymoma viral oncogene (Akt), glycogen synthase kinase-β (GSK-3β), mammalian target of rapamycin (mTOR), eukaryotic initiation factor 4E binding protein 1 (4E-BP1), and p70s6kinase in chronic complete SCI patients. In SCI patients, when compared with controls, there was a significant reduction in mRNA levels of atrogin-1 (59%; P < 0.05), MuRF1 (55%; P < 0.05), and myostatin (46%; P < 0.01), and in protein levels of FoXO1 (72%; P < 0.05), FoXO3a (60%; P < 0.05), and atrogin-1 (36%; P < 0.05). Decreases in the protein levels of IGF-1 (48%; P < 0.001) and phosphorylated GSK-3β (54%; P < 0.05), 4E-BP1 (48%; P < 0.05), and p70s6kinase (60%; P = 0.1) were also observed, the latter three in an Akt-and mTOR-independent manner. Reductions in atrogin-1, MuRF1, FoXO, and myostatin suggest the existence of an internal mechanism aimed at reducing further loss of muscle proteins during chronic SCI. The downregulation of signaling proteins that regulate anabolism, such as IGF, GSK-3β, and 4E-BP1, would reduce the ability to increase protein synthesis rates. © 2009 Wiley Periodicals, Inc

Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury

Objective: To investigate changes in body ownership and chronic neuropathic pain in patients with spinal cord injury (SCI) using multisensory own body illusions and virtual reality (VR). Methods: Twenty patients with SCI with paraplegia and 20 healthy control participants (HC) participated in 2 factorial, randomized, repeated-measures design studies. In the virtual leg illusion (VLI), we applied asynchronous or synchronous visuotactile stimulation to the participant's back (either immediately above the lesion level or at the shoulder) and to the virtual legs as seen on a VR head-mounted display. We tested the effect of the VLI on the sense of leg ownership (questionnaires) and on perceived neuropathic pain (visual analogue scale pain ratings). We compared illusory leg ownership with illusory global body ownership (induced in the full body illusion [FBI]), by applying asynchronous or synchronous visuotactile stimulation to the participant's back and the back of a virtual body as seen on a head-mounted display. Results: Our data show that patients with SCI are less sensitive to multisensory stimulations inducing illusory leg ownership (as compared to HC) and that leg ownership decreased with time since SCI. In contrast, we found no differences between groups in global body ownership as tested in the FBI. VLI and FBI were both associated with mild analgesia that was only during the VLI specific for synchronous visuotactile stimulation and the lower back position. Conclusions: The present findings show that VR exposure using multisensory stimulation differently affected leg vs body ownership, and is associated with mild analgesia with potential for SCI neurorehabilitation protocols

BCI telepresence: A six patient evaluation

In this paper we present the results of six motor-disabled patients manoeuvring a telepresence robot via a BCI. Remarkably, although five of the patients had never visited the location where the telepresence robot was operating, they achieved similar performances to a group of four healthy users who were familiar with the environment. In particular, the experimental results confirm the benefits of using shared control for brain-controlled telepresence robots. Shared control empowered all subjects (including the less experienced motor-disabled BCI subjects) to complete a complex BCI task in a comparable time and with a similar number of commands to those required for a manual condition