Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy.
Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy; Laboratory of Neuropsychology, IRCCS San Camillo Hospital, via Alberoni 70, 30126 Lido-Venice, Italy.
Clin Neurophysiol. 2015 Jun;126(6):1255-1263. doi: 10.1016/j.clinph.2014.09.017. Epub 2014 Oct 2.
Despite recent groundbreaking findings on the genetic causes of amyotrophic lateral sclerosis (ALS), and improvements on neuroimaging techniques for ALS diagnosis have been reported, the main clinical intervention in ALS remains palliative care. Brain-computer interfaces (BCIs) have been proposed as a channel of communication and control for ALS patients. The present metanalysis was performed to test the evidence of BCI effectiveness in ALS, and to investigate whether the promising aims emerged from the first studies have been reached.
Studies on ALS patients tested with BCIs, until June 2013, were searched in PubMed and PsychInfo. The random-effect approach was used to compute the pooled effectiveness of BCI in ALS. A meta-regression was performed to test whether there was a BCI performance improvement as a function of time. Finally, BCI effectiveness for complete paralyzed ALS patients was tested. Twenty-seven studies were eligible for metanalysis.
The pooled classification accuracy (C.A.) of ALS patients with BCI was about 70%, but this estimation was affected by significant heterogeneity and inconsistency. C.A. did not significantly increase as a function of time. C.A. of completely paralyzed ALS patients with BCI did not differ from that obtained by chance.
After 15 years of studies, it is as yet not possible to reliably establish the effectiveness of BCIs.
Methodological issues among the retrieved studies should be addressed and new well-powered studies should be conducted to confirm BCI effectiveness for ALS patients.
尽管最近在肌萎缩侧索硬化症（ALS）的遗传病因方面取得了突破性的发现，并报道了用于 ALS 诊断的神经影像学技术的改进，但 ALS 的主要临床干预措施仍然是姑息治疗。脑机接口（BCI）已被提议作为 ALS 患者的一种交流和控制渠道。本荟萃分析旨在检验 BCI 在 ALS 中的有效性证据，并探讨最初研究中出现的有希望的目标是否已经实现。
在 2013 年 6 月之前，在 PubMed 和 PsychInfo 中搜索了使用 BCI 测试的 ALS 患者的研究。采用随机效应方法计算 BCI 在 ALS 中的综合有效性。进行了元回归分析，以检验 BCI 性能是否随着时间的推移而提高。最后，测试了完全瘫痪的 ALS 患者的 BCI 有效性。有 27 项研究符合荟萃分析的条件。
具有 BCI 的 ALS 患者的综合分类准确率（C.A.）约为 70%，但该估计受到显著的异质性和不一致性的影响。C.A. 并未随着时间的推移而显著增加。具有 BCI 的完全瘫痪的 ALS 患者的 C.A.与随机获得的 C.A.没有区别。
经过 15 年的研究，仍然不可能可靠地确定 BCI 的有效性。
应解决检索到的研究中的方法学问题，并进行新的有力研究，以确认 BCI 对 ALS 患者的有效性。
