No abstract

Amyotrophic lateral sclerosis (ALS) can result in the locked-in state (LIS), characterized by paralysis, and eventual respiratory failure, compensated by artificial ventilation, 1 or the completely LIS (CLIS), with additional total paralysis of eye muscles. Brain–computer interfaces (BCIs) have been used to allow paralyzed people to regain basic communication, 2 although current EEG-based BCIs have not succeeded with CLIS patients. 3 We present Class IV case evidence to establish that communication in the CLIS is possible with a metabolic BCI based on near-infrared spectroscopy (NIRS).