From the Department of Neurology (J.R.W., D.S.H.), Albany Stratton Veterans Affairs Medical Center; Wadsworth Center (J.R.W., T.M.V., S.M.H., L.M.M., C.S.C., S.W., D.J.M., E.W.S.), National Center for Adaptive Neurotechnologies, New York State Department of Health, Albany; Durham Veterans Affairs Medical Center (R.S.B.) and Department of Neurology (R.S.B.), Duke University School of Medicine, NC; Veterans Affairs Cooperative Studies Program Coordinating Center (D.J.R., H.S., T.P.), Hines VA Medical Center, IL; Veterans Affairs Cooperative Studies Program Clinical Research Pharmacy Coordinating Center (R.J.R.) and University of New Mexico College of Pharmacy; Department of Neurology (P.G.B.), Louis Stokes Cleveland Veterans Affairs Medical Center, OH; Providence Veterans Affairs Medical Center (A.C.L.) and Department of Neurology, Brown University, RI; Veterans Affairs Connecticut Healthcare System (H.S.P.) and Department of Neurology, Yale School of Medicine, New Haven, CT; Department of Communication Science and Disorders (K.J.H.), University of Pittsburgh, PA; Cooperative Studies Program Central Office (D.G.H.), Department of Veterans Affairs Office of Research & Development, Washington, DC; and Louis Stokes Cleveland Veterans Affairs Medical Center (R.L.R.) and Department of Neurology, Case Western Reserve University School of Medicine, OH.
Neurology. 2018 Jul 17;91(3):e258-e267. doi: 10.1212/WNL.0000000000005812. Epub 2018 Jun 27.
To assess the reliability and usefulness of an EEG-based brain-computer interface (BCI) for patients with advanced amyotrophic lateral sclerosis (ALS) who used it independently at home for up to 18 months.
Of 42 patients consented, 39 (93%) met the study criteria, and 37 (88%) were assessed for use of the Wadsworth BCI. Nine (21%) could not use the BCI. Of the other 28, 27 (men, age 28-79 years) (64%) had the BCI placed in their homes, and they and their caregivers were trained to use it. Use data were collected by Internet. Periodic visits evaluated BCI benefit and burden and quality of life.
Over subsequent months, 12 (29% of the original 42) left the study because of death or rapid disease progression and 6 (14%) left because of decreased interest. Fourteen (33%) completed training and used the BCI independently, mainly for communication. Technical problems were rare. Patient and caregiver ratings indicated that BCI benefit exceeded burden. Quality of life remained stable. Of those not lost to the disease, half completed the study; all but 1 patient kept the BCI for further use.
The Wadsworth BCI home system can function reliably and usefully when operated by patients in their homes. BCIs that support communication are at present most suitable for people who are severely disabled but are otherwise in stable health. Improvements in BCI convenience and performance, including some now underway, should increase the number of people who find them useful and the extent to which they are used.
评估一种基于脑电图的脑机接口（BCI）的可靠性和实用性，该接口供晚期肌萎缩侧索硬化症（ALS）患者在家中独立使用，最长使用时间为 18 个月。
在同意参与的 42 名患者中，有 39 名（93%）符合研究标准，有 37 名（88%）接受了 Wadsworth BCI 的评估。其中 9 名（21%）无法使用 BCI。在其余 28 名患者中，有 27 名（男性，年龄 28-79 岁）（64%）将 BCI 置于家中，对他们及其护理人员进行了使用培训。使用数据通过互联网收集。定期访视评估 BCI 的获益和负担以及生活质量。
随后的几个月中，由于死亡或疾病快速进展，12 名（原始 42 名患者中的 29%）退出了研究，6 名（14%）因兴趣减退而退出。14 名（33%）完成了培训并独立使用 BCI，主要用于交流。技术问题很少见。患者和护理人员的评分表明 BCI 的获益大于负担。生活质量保持稳定。在未因病而失访的患者中，有一半完成了研究；除 1 名患者外，所有人都保留了 BCI 以备进一步使用。
当患者在家中操作时，Wadsworth BCI 家庭系统可以可靠且有效地运行。目前，支持交流的 BCI 最适合那些严重残疾但健康状况稳定的人。BCI 便利性和性能的改进（包括目前正在进行的改进）应该会增加认为它们有用的人数，以及使用它们的程度。
