Detecting awareness in patients with disorders of consciousness using a hybrid brain–computer interface

Pan, Jiahui; Xie, Qiuyou; He, Yanbin; Wang, Fei; Di, Haibo; Laureys, Steven; Yu, Rong; Li, Yuanqing

doi:10.1088/1741-2560/11/5/056007

Cited by 88 publications

(79 citation statements)

References 58 publications

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“…And the experimental result indicated that our approach had the higher classification accuracy and ITR. Recently, several SSVEP-based hybrid BCIs had been developed for increasing classification accuracies Wang et al, 2014;Pan et al, 2014). Our algorithm could be considered as a reliable method for improving the efficiency of these hybrid BCIs.…”

Section: Parametersmentioning

confidence: 99%

Sequence detection analysis based on canonical correlation for steady-state visual evoked potential brain computer interfaces

Cao

et al. 2015

Journal of Neuroscience Methods

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Section: Parametersmentioning

confidence: 99%

Sequence detection analysis based on canonical correlation for steady-state visual evoked potential brain computer interfaces

Cao

et al. 2015

Journal of Neuroscience Methods

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“…Multi-disciplinary studies including functional neuroimaging and electrophysiological recording, namely PET, fMRI and BCI, have also been performed in our laboratory (66,67). In addition, our group has established cooperation among research institutes and non-governmental organizations to promote the welfare of DOC patients, with an ultimate goal of establishing the first DOC society in China.…”

Section: Resultsmentioning

confidence: 99%

Chronic disorders of consciousness

Xie

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Over the last 20 years, studies have provided greater insight into disorders of consciousness (DOC), also known as altered state of consciousness. Increased brain residual functions have been identified in patients with DOC due to the successful application of novel next-generation imaging technologies. Many unconscious patients have now been confirmed to retain considerable cognitive functions. It is hoped that greater insight regarding the psychological state of patients may be achieved through the use of functional magnetic resonance imaging and brain-computer interfaces. However, issues surrounding the research and treatment of DOC remain problematic. These include differing opinions on the definition of consciousness, difficulties in diagnosis, assessment, prognosis and/or treatment, and newly emerging ethical, legal and social issues. To overcome these, appropriate care must be offered to patients with DOC by clinicians and families, as DOC patients may now be considered to live in more than just a vegetative state. The present article reviews the controversy surrounding the definition of consciousness and the reliability of novel technologies, prognostic prediction, communication with DOC patients and treatment methods. The ethical and social issues surrounding the treatment of DOC and future perspectives are also considered.

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“…Previous studies mainly focused on using BCI to detect the awareness of DOC patients [13][14][15]. These studies determined whether patients were aware by verifying whether the patients followed commands.…”

Section: Discussionmentioning

confidence: 99%

“…Several BCI systems have recently been applied in awareness detection for patients with DOC [13][14][15][16]. Cruse et al accessed 16 VS patients by having them complete a motor imagery (MI) task in which they were instructed to imagine movements of their right hand and toes in response to commands [13].…”

Section: Introductionmentioning

confidence: 99%

“…Three of the patients could repeatedly and reliably generate appropriate EEG responses to two distinct commands. Pan et al reported a visual hybrid BCI that combined P300 and SSVEP to detect awareness in four VS, three MCS and one LIS patients [14]. They successfully demonstrated command following in three patients (one VS, one MCS and one LIS).…”

Section: Introductionmentioning

confidence: 99%

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Enhancing clinical communication assessments using an audiovisual BCI for patients with disorders of consciousness

Wang

et al. 2017

J. Neural Eng.

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Objective. The JFK coma recovery scale-revised (JFK CRS-R), a behavioral observation scale, is widely used in the clinical diagnosis/assessment of patients with disorders of consciousness (DOC). However, the JFK CRS-R is associated with a high rate of misdiagnosis (approximately 40%) because DOC patients cannot provide sufficient behavioral responses. A brain–computer interface (BCI) that detects command/intention-specific changes in electroencephalography (EEG) signals without the need for behavioral expression may provide an alternative method. Approach. In this paper, we proposed an audiovisual BCI communication system based on audiovisual ‘yes’ and ‘no’ stimuli to supplement the JFK CRS-R for assessing the communication ability of DOC patients. Specifically, patients were given situation-orientation questions as in the JFK CRS-R and instructed to select the answers using the BCI. Main results. Thirteen patients (eight vegetative state (VS) and five minimally conscious state (MCS)) participated in our experiments involving both the BCI- and JFK CRS-R-based assessments. One MCS patient who received a score of 1 in the JFK CRS-R achieved an accuracy of 86.5% in the BCI-based assessment. Seven patients (four VS and three MCS) obtained unresponsive results in the JFK CRS-R-based assessment but responsive results in the BCI-based assessment, and 4 of those later improved scores in the JFK CRS-R-based assessment. Five patients (four VS and one MCS) obtained usresponsive results in both assessments. Significance. The experimental results indicated that the audiovisual BCI could provide more sensitive results than the JFK CRS-R and therefore supplement the JFK CRS-R.

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Detecting awareness in patients with disorders of consciousness using a hybrid brain–computer interface

Abstract: Through the hybrid BCI system, command following was detected in four healthy subjects, two of 7 DOC patients, and one LIS patient. We suggest that the hybrid BCI system could be used as a supportive bedside tool to detect awareness in patients with DOC.

Cited by 88 publications

References 58 publications

Sequence detection analysis based on canonical correlation for steady-state visual evoked potential brain computer interfaces

Sequence detection analysis based on canonical correlation for steady-state visual evoked potential brain computer interfaces

Chronic disorders of consciousness

Enhancing clinical communication assessments using an audiovisual BCI for patients with disorders of consciousness

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