[en] Objective. The bedside detection of potential awareness in patients with disorders of consciousness (DOC) currently relies only on behavioral observations and tests; however, the misdiagnosis rates in this patient group are historically relatively high. In this study, we proposed a visual hybrid brain–computer interface (BCI) combining P300 and steady-state evoked potential (SSVEP) responses to detect awareness in severely brain injured patients. Approach. Four healthy subjects, seven DOC patients who were in a vegetative state (VS, n = 4) or minimally conscious state (MCS, n = 3), and one locked-in syndrome (LIS) patient attempted a command-following experiment. In each experimental trial, two photos were presented to each patient; one was the patientʼs own photo, and the other photo was unfamiliar. The patients were instructed to focus on their own or the unfamiliar photos. The BCI system determined which photo the patient focused on with both P300 and SSVEP detections. Main results. Four healthy subjects, one of the 4 VS, one of the 3 MCS, and the LIS patient were able to selectively attend to their own or the unfamiliar photos (classification accuracy, 66–100%). Two additional patients (one VS and one MCS) failed to attend the unfamiliar photo (50–52%) but achieved significant accuracies for their own photo (64–68%). All other patients failed to show any significant response to commands (46–55%). Significance. 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.
Research Center/Unit :
Giga-Neurosciences - ULiège
Disciplines :
Neurology
Author, co-author :
Pan, Jiahui
Xie, Qiuyou
He, Yanbin
Wang, Fei
Di, Haibo
Laureys, Steven ; Université de Liège > Centre de recherches du cyclotron
Yu, Ronghao
Li, Yuanqing
Language :
English
Title :
Detecting awareness in patients with disorders of consciousness using a hybrid brain–computer interface
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Allison B Z, Brunner C, Kaiser V, Müller-Putz G R, Neuper C and Pfurtscheller G 2010a Toward a hybrid brain-computer interface based on imagined movement and visual attention J. Neural Eng. 7 026007
Allison B, Luth T, Valbuena D, Teymourian A, Volosyak I and Graser A 2010b BCI demographics: How many (and what kinds of) people can use an SSVEP BCI? IEEE Trans. Neural Syst. Rehabil. Eng. 18 107-16
Andersen S K, Fuchs S and Müller M M 2011 Effects of feature-selective and spatial attention at different stages of visual processing J. Cogn. Neurosci. 23 238-46
Andrews K, Murphy L, Munday R and Littlewood C 1996 Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit Br. Med. J. 313 13-16
Bin G, Gao X, Yan Z, Hong B and Gao S 2009 An online multi-channel SSVEP-based brain-computer interface using a canonical correlation analysis method J. Neural Eng. 6 046002
Bindemann M, Burton A M, Hooge I T C, Jenkins R and de Haan E H F 2005 Faces retain attention Psychonomic Bull.Rev. 12 1048-53
Brunner P, Joshi S, Briskin S, Wolpaw J R, Bischof H and Schalk G 2010 Does the'P300speller depend on eye gaze? J. Neural Eng. 7 056013
Chatelle C, Chennu S, Noirhomme Q, Cruse D, Owen A M and Laureys S 2012 Brain-computer interfacing in disorders of consciousness Brain Injury 26 1510-22
Childs N L, Mercer W N and Childs H W 1993 Accuracy of diagnosis of persistent vegetative state Neurology 43 1465
Comerchero M D and Polich J 1999 P3a and P3b from typical auditory and visual stimuli Clin. Neurophysiol. 110 24-30
Coyle D H, Carroll A, Stow J, McCann A, Ally A and McElligott J 2012 Enabling control in the minimally conscious state in a single session with a three channel BCI The 1st Int. DECODER Workshop pp 25-8
Cruse D, Chennu S, Chatelle C, Bekinschtein T A, Fernández-Espejo D, Pickard J D, Laureys S and Owen A M 2012a Bedside detection of awareness in the vegetative state: a cohort study The Lancet 378 2088-94
Cruse D, Chennu S, Fernández-Espejo D, Payne W L, Young G B and Owen A M 2012b Detecting awareness in the vegetative state: electroencephalographic evidence for attempted movements to command PloS One 7 e49933
Di H B, Yu S M, Weng X C, Laureys S, Yu D, Li J Q, Qin P M, Zhu Y H, Zhang S Z and Chen Y Z 2007 Cerebral response to patients own name in the vegetative and minimally conscious states Neurology 68 895-9
Friman O, Volosyak I and Graser A 2007 Multiple channel detection of steady-state visual evoked potentials for brain-computer interfaces IEEE Trans. Biomed. Eng. 54 742-50
Giacino J T et al 2002 The minimally conscious state Definition and diagnostic criteria Neurology 58 349-53
Giacino J T, Kalmar K and Whyte J 2004 The JFK coma recovery scale-revised: measurement characteristics and diagnostic utility Arch. Phys. Med. Rehabil. 85 2020-9
Goldfine A M, Bardin J C, Noirhomme Q, Fins J J, Schiff N D and Victor J D 2013 Reanalysis of "Bedside detection of awareness in the vegetative state: a cohort study" Lancet 381 289
Goldfine A M, Victor J D, Conte M M, Bardin J C and Schiff N D 2012 Bedside detection of awareness in the vegetative state The Lancet 379 1701-2
Guger C, Daban S, Sellers E, Holzner C, Krausz G, Carabalona R, Gramatica F and Edlinger G 2009 How many people are able to control a P300-based brain-computer interface (BCI)? Neurosci. Lett. 462 94-98
Halder S, Rea M, Andreoni R, Nijboer F, Hammer E M, Kleih S C, Birbaumer N and Kübler A 2010 An auditory oddball brain-computer interface for binary choices Clin. Neurophysiol. 121 516-23
Jasper H H 1958 The ten twenty electrode system of the international federation Electroencephalogr. Clin. Neurophysiol. 10 371-5
Jennett B and Plum F 1972 Persistent vegetative state after brain damage: a syndrome in search of a name The Lancet 299 734-7
Kircher T T J, Senior C, Phillips M L, Benson P J, Bullmore E T, Brammer M, Simmons A, Williams S C R, Bartels M and David A S 2000 Towards a functional neuroanatomy of self processing: effects of faces and words Cogn. Brain Res. 10 133-44
Kircher T T J, Senior C, Phillips M L, Rabe-Hesketh S, Benson P J, Bullmore E T, Brammer M, Simmons A, Bartels M and David A S 2001 Recognizing ones own face Cognition 78 1-15
Kotchoubey B, Lang S, Mezger G, Schmalohr D, Schneck M, Semmler A, Bostanov V and Birbaumer N 2005 Information processing in severe disorders of consciousness: vegetative state and minimally conscious state Clin. Neurophysiol. 116 2441-53
Kübler A and Birbaumer N 2008 Brain-computer interfaces and communication in paralysis: extinction of goal directed thinking in completely paralysed patients? Clinical Neurophysiol. 119 2658-66
Kübler A, Furdea A, Halder S, Hammer E M, Nijboer F and Kotchoubey B 2009 A brain-computer interface controlled auditory event-related potential (P300) spelling system for locked-in patients Ann. New York Acad. Sci. 1157 90-100
Lan T, Erdogmus D, Adami A, Pavel M and Mathan S 2006 Salient EEG channel selection in brain-computer interfaces by mutual information maximization Engineering in Medicine and Biology Society (IEEE-EMBS 2005) 27th Annu. Int. Conf. IEEE 7064-7
Laureys S, Perrin F, Faymonville M-E, Schnakers C, Boly M, Bartsch V, Majerus S, Moonen G and Maquet P 2004 Cerebral processing in the minimally conscious state Neurology 63 916-8
Lavie N, Ro T and Russell C 2003 The role of perceptual load in processing distractor faces Psychol. Sci. 14 510-5
Lesenfants D, Partoune N, Soddu A, Lehembre R, Müller-Putz G, Laureys S and Noirhomme Q 2011 Design of a novel covert SSVEP-based BCI Proc. 5th Int. Brain-Computer Interface Conf. 2011 (Graz: University of Technology Publishing House) 1-4
Lewis D and Burke C J 1949 The use and misuse of the chi-square test Psychol. Bull. 46 433
Li Y, Pan J, Wang F and Yu Z 2013 A hybrid BCI system combining P300 and SSVEP and its application to wheelchair control IEEE Trans. Biomed. Eng. 60 3156-66
Liberati G and Birbaumer N 2012 Using brain-computer interfaces to overcome the extinction of goal-directed thinking in minimally conscious state patients Cogn. Process. 13 239-41
Linden D E J 2005 The P300: where in the brain is it produced and what does it tell us? The Neuroscientist 11 563-76
Long J, Li Y, Yu T and Gu Z 2012 Target selection with hybrid feature for BCI-based 2-D cursor control IEEE Trans. Biomed. Eng. 59 132-40
Lulé D et al 2012 Probing command following in patients with disorders of consciousness using a brain-computer interface Clin. Neurophysiol. 124 101-6
Monti M M, Vanhaudenhuyse A, Coleman M R, Boly M, Pickard J D, Tshibanda L, Owen A M and Laureys S 2010 Willful modulation of brain activity in disorders of consciousness New Engl. J. Med. 362 579-89
Muller M M, Picton T W, Valdes-Sosa P, Riera J, Teder-Salejarvi W A and Hillyard S A 1998 Effects of spatial selective attention on the steady-state visual evoked potential in the 20-28 Hz range Cogn. Brain Res. 6 249-62
Muller-Putz G R, Klobassa D S, Pokorny C, Pichler G, Erlbeck H, Real R G L, Kubler A, Risetti M and Mattia D 2012 The auditory p300-based SSBCI: A door to minimally conscious patients? Engineering in Medicine and Biology Society (EMBC), 2012 Annu. Int. Conf. of the IEEE 4672-5
Müller-Putz G R, Pokorny C, Klobassa D S and Horki P 2013 A single-switch BCI based on passive and imagined movements: toward restoring communication in minimally conscious patients Int. J. Neural Syst. 23 1250037
Naci L, Monti M M, Cruse D, Kübler A, Sorger B, Goebel R, Kotchoubey B and Owen A M 2012 Brain-computer interfaces for communication with nonresponsive patients Ann. Neurol. 72 312-23
Noirhomme Q, Lesenfants D, Lehembre R, Lugo Z, Chatelle C, Vanhaudenhuyse A and Laureys S 2013 Detecting consciousness with a brain-computer interface Converging Clinical and Engineering Research on Neurorehabilitation (Berlin: Springer) 1261-4
Owen A M, Coleman M R, Boly M, Davis M H, Laureys S and Pickard J D 2006 Detecting awareness in the vegetative state Science 313 1402
Owen A M, Menon D K, Johnsrude I S, Bor D, Scott S K, Manly T, Williams E J, Mummery C and Pickard J D 2002 Detecting residual cognitive function in persistent vegetative state Neurocase 8 394-403
Pastor M A, Artieda J, Arbizu J, Valencia M and Masdeu J C 2003 Human cerebral activation during steady-state visual-evoked responses J. Neurosci. 23 11621-7
Pastor M A, Valencia M, Artieda J, Alegre M and Masdeu J C 2007 Topography of cortical activation differs for fundamental and harmonic frequencies of the steady-state visual-evoked responses. An EEG and PET H215O study Cerebral Cortex 17 1899-905
Perrin F et al 2006 Brain response to ones own name in vegetative state, minimally conscious state, and locked-in syndrome Arch. Neurol. 63 562-9
Pfurtscheller G, Allison B Z, Brunner C, Bauernfeind G, Solis-Escalante T, Scherer R, Zander T O, Müller-Putz G, Neuper C and Birbaumer N 2010a The hybrid BCI Front. Neurosci. 4 1-11
Pfurtscheller G, Solis-Escalante T, Ortner R, Linortner P and Muller-Putz G R 2010b Self-paced operation of an SSVEP-based orthosis with and without an imagery-based "brain switch" a feasibility study towards a hybrid BCI IEEE Trans. Neural Syst. Rehabil. Eng. 18 409-14
Satorra A and Bentler P M 2001 A scaled difference chi-square test statistic for moment structure analysis Psychometrika 66 507-14
Schnakers C et al 2008 Voluntary brain processing in disorders of consciousness Neurology 71 1614-20
Schnakers C, Vanhaudenhuyse A, Giacino J, Ventura M, Boly M, Majerus S, Moonen G and Laureys S 2009 Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment BMC Neurol. 9 35
Sellers E W, Kubler A and Donchin E 2006 Brain-computer interface research at the University of South Florida Cognitive Psychophysiology Laboratory: the P300 speller IEEE Trans. Neural Syst. Rehabil. Eng. 14 221-4
Signorino M, D'Acunto S, Angeleri F and Pietropaoli P 1995 Eliciting P300 in comatose patients The Lancet 345 255-6
Silberstein R B et al 1995 Steady-state visually evoked potential topography during the Wisconsin card sorting test Electroencephalogr. Clin. Neurophysiol. 96 24-35
Treder M S, Schmidt N M and Blankertz B 2011 Gaze-independent brain-computer interfaces based on covert attention and feature attention J. Neural Eng. 8 066003
Wolpaw J R, Birbaumer N, McFarland D J, Pfurtscheller G and Vaughan T M 2002 Brain-computer interfaces for communication and control Clin. Neurophysiol. 113 767-91
Zhang D, Maye A, Gao X, Hong B, Engel A K and Gao S 2010 An independent brain-computer interface using covert non-spatial visual selective attention J. Neural Eng. 7 016010
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.