A systematic review of research on augmentative and alternative communication brain-computer interface systems for individuals with disabilities

Abstract

Augmentative and alternative communication brain-computer interface (AAC-BCI) systems are intended to offer communication access to people with severe speech and physical impairment (SSPI) without requiring volitional movement. As the field moves toward clinical implementation of AAC-BCI systems, research involving participants with SSPI is essential. Research has demonstrated variability in AAC-BCI system performance across users, and mixed results for comparisons of performance for users with and without disabilities. The aims of this systematic review were to (1) describe study, system, and participant characteristics reported in BCI research, (2) summarize the communication task performance of participants with disabilities using AAC-BCI systems, and (3) explore any differences in performance for participants with and without disabilities. Electronic databases were searched in May, 2018, and March, 2021, identifying 6065 records, of which 73 met inclusion criteria. Non-experimental study designs were common and sample sizes were typically small, with approximately half of studies involving five or fewer participants with disabilities. There was considerable variability in participant characteristics, and in how those characteristics were reported. Over 60% of studies reported an average selection accuracy ≤70% for participants with disabilities in at least one tested condition. However, some studies excluded participants who did not reach a specific system performance criterion, and others did not state whether any participants were excluded based on performance. Twenty-nine studies included participants both with and without disabilities, but few reported statistical analyses comparing performance between the two groups. Results suggest that AAC-BCI systems show promise for supporting communication for people with SSPI, but they remain ineffective for some individuals. The lack of standards in reporting outcome measures makes it difficult to synthesize data across studies. Further research is needed to demonstrate efficacy of AAC-BCI systems for people who experience SSPI of varying etiologies and severity levels, and these individuals should be included in system design and testing. Consensus in terminology and consistent participant, protocol, and performance description will facilitate the exploration of user and system characteristics that positively or negatively affect AAC-BCI use, and support innovations that will make this technology more useful to a broader group of people.Clinical trial registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018095345, PROSPERO: CRD42018095345.

Physiological Correlates of Hypnotizability: Hypnotic Behaviour and Prognostic Role in Medicine

“…The highs' better cerebrovascular reactivity may buffer transient alteration of blood flow and, theoretically, their stronger FE between imagery and perception/action [14], together with the higher excitability of the motor cortex [15,16], makes highs more prone than lows to take advantage from mental training after brain lesions of any origin [69]. The latter finding suggests that hypnotic assessment could predict the outcome of mental training and Brain Computer Interface interventions, which display large variability in the outcome and is ineffective in part of the general population [70]. Studies in progress are aimed at assessing whether training to mental imagery can increase FE in mediums/lows, thus extending the utilization of mental training to larger part of the population.…”

The Effect of Jittered Stimulus Onset Interval on Electrophysiological Markers of Attention in a Brain–Computer Interface Rapid Serial Visual Presentation Paradigm

“…Complementary to implantable systems, scalp-recorded EEGbased BCIs remain popular and accessible options for numerous applications [5]. Among their possible uses, EEG-based BCIs can assist with state monitoring [6,7] or augmentative and alternative communication (AAC-BCI) for individuals with disabilities [8,9]. One established AAC-BCI paradigm is rapid serial visual presentation (RSVP) [10][11][12][13], which presents a user with a rapid sequence of images (e.g., letters) and seeks to differentiate user intent to select one of the presented stimuli by capturing the so-called P300 response.…”

Identifying Thematics in a Brain‐Computer Interface Research

“…While BCI systems offer hope to many, there is a demographic who are BCI illiterate, with illiteracy rated ranging from 48.7–61.6%, and for these individuals, the promises made by researchers can lead to frustration and disillusionment [ 66 , 69 , 70 ]. Notwithstanding, BCI integration with such devices has occurred with a wide range of applications such as prosthetics and exoskeletons, robots, spelling and communication systems, cursors, joysticks, and wheelchairs [ 71 , 72 ].…”