Cognitive motor dissociation; Coma; Communication; Electroencephalography; Functional magnetic resonance imaging; Head injury; Neural repair; Critical Care and Intensive Care Medicine; Neurology (clinical)
Abstract :
[en] [en] BACKGROUND: We developed a gap analysis that examines the role of brain-computer interfaces (BCI) in patients with disorders of consciousness (DoC), focusing on their assessment, establishment of communication, and engagement with their environment.
METHODS: The Curing Coma Campaign convened a Coma Science work group that included 16 clinicians and neuroscientists with expertise in DoC. The work group met online biweekly and performed a gap analysis of the primary question.
RESULTS: We outline a roadmap for assessing BCI readiness in patients with DoC and for advancing the use of BCI devices in patients with DoC. Additionally, we discuss preliminary studies that inform development of BCI solutions for communication and assessment of readiness for use of BCIs in DoC study participants. Special emphasis is placed on the challenges posed by the complex pathophysiologies caused by heterogeneous brain injuries and their impact on neuronal signaling. The differences between one-way and two-way communication are specifically considered. Possible implanted and noninvasive BCI solutions for acute and chronic DoC in adult and pediatric populations are also addressed.
CONCLUSIONS: We identify clinical and technical gaps hindering the use of BCI in patients with DoC in each of these contexts and provide a roadmap for research aimed at improving communication for adults and children with DoC, spanning the clinical spectrum from intensive care unit to chronic care.
Disciplines :
Neurosciences & behavior
Author, co-author :
Schiff, Nicholas D ; Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA. nds2001@med.cornell.edu
Diringer, Michael; Departments of Neurology and Neurosurgery, Washington University in St. Louis, St. Louis, MO, USA
Diserens, Karin; Neurology and Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Edlow, Brian L; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Gosseries, Olivia ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Hill, N Jeremy; National Center for Adaptive Neurotechnologies, Stratton VA Medical Center, Albany, NY, USA ; Electrical & Computer Engineering Department, State University of New York at Albany, Albany, NY, USA
Hochberg, Leigh R; Veterans Affairs Rehabilitation Research & Development Center for Neurorestoration and Neurotechnology, Rehabilitation Research & Development Service, Providence VA Medical Center, Providence, RI, USA ; School of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA ; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Ismail, Fatima Y; Department of Pediatrics, United Arab Emirates University, Al Ain, United Arab Emirates ; Department of Neurology, Adjunct Johns Hopkins University School of Medicine, Baltimore, MD, USA
Meyer, Ivo A; Neurology and Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland ; Centre for Advanced Research in Sleep Medicine and Integrated Trauma Centre, Integrated University Health and Social Services Centre (CIUSSS) du Nord-de-L'Île-de-Montréal, Montreal, QC, Canada
Mikell, Charles B; Department of Neurosurgery, Stony Brook University Hospital, Stony Brook, NY, USA
Mofakham, Sima; Department of Neurosurgery, Stony Brook University Hospital, Stony Brook, NY, USA ; Department of Electrical and Computer Engineering, Stony Brook University, Stony Brook, NY, USA
Molteni, Erika; School of Biomedical Engineering and Imaging Sciences, and Centre for Medical Engineering, King's College London, London, UK
Polizzotto, Leonard; Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
Shah, Sudhin A; Department of Radiology, Weill Cornell Medical College, New York, NY, USA
Stevens, Robert D; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
Thengone, Daniel; Brown University, Providence, RI, USA
and the Curing Coma Campaign and its Contributing Members
The authors acknowledge the following sources: the NIH Director’s Office (DP2HD101400) and Chen Institute MGH Research Scholar Award (B.L.E.), F.R.S-FNRS (OG), IAM’s contribution to this paper was made during his tenure as a research assistant in Montreal, Canada, funded by the Gianni Biaggi de Blasys Foundation, Lausanne, Switzerland, NJH acknowledges support from NIH (NIBIB) P41EB018783 and from the Stratton VA Medical Center.
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