Coma Science Group, Cyclotron Research Centre, University and University Hospital of Liège, Liège, Belgium.
Clin Neurophysiol. 2013 Jan;124(1):101-6. doi: 10.1016/j.clinph.2012.04.030. Epub 2012 Aug 21.
To determine if brain-computer interfaces (BCIs) could serve as supportive tools for detecting consciousness in patients with disorders of consciousness by detecting response to command and communication.
We tested a 4-choice auditory oddball EEG-BCI paradigm on 16 healthy subjects and 18 patients in a vegetative state/unresponsive wakefulness syndrome, in a minimally conscious state (MCS), and in locked-in syndrome (LIS). Subjects were exposed to 4 training trials and 10 -12 questions.
Thirteen healthy subjects and one LIS patient were able to communicate using the BCI. Four of those did not present with a P3. One MCS patient showed command following with the BCI while no behavioral response could be detected at bedside. All other patients did not show any response to command and could not communicate with the BCI.
The present study provides evidence that EEG based BCI can detect command following in patients with altered states of consciousness and functional communication in patients with locked-in syndrome. However, BCI approaches have to be simplified to increase sensitivity.
For some patients without any clinical sign of consciousness, a BCI might bear the potential to employ a "yes-no" spelling device offering the hope of functional interactive communication.
通过检测对指令的反应和交流，确定脑-机接口（BCI）是否可以作为检测意识障碍患者意识的辅助工具。
我们在 16 名健康受试者和 18 名处于植物状态/无反应觉醒综合征、最小意识状态（MCS）和闭锁综合征（LIS）的患者中测试了一个 4 选择听觉Oddball EEG-BCI 范式。受试者接受了 4 次训练试验和 10-12 个问题。
13 名健康受试者和 1 名 LIS 患者能够使用 BCI 进行交流。其中 4 人没有出现 P3。1 名 MCS 患者在 BCI 中表现出对指令的跟随，而在床边没有检测到任何行为反应。其他所有患者均未对指令做出任何反应，无法使用 BCI 进行交流。
本研究提供了证据表明，基于脑电图的 BCI 可以检测意识障碍患者的指令跟随，并在闭锁综合征患者中进行功能性交流。然而，BCI 方法必须简化以提高敏感性。
对于一些没有任何临床意识迹象的患者，BCI 可能具有潜力使用“是/否”拼写设备，提供功能性互动交流的希望。
