IEEE Trans Neural Syst Rehabil Eng. 2019 Mar;27(3):507-513. doi: 10.1109/TNSRE.2019.2896092. Epub 2019 Jan 31.
The coma recovery scale-revised (CRS-R) behavioral scale is commonly used for the clinical evaluation of patients with disorders of consciousness (DOC). However, since DOC patients generally cannot supply stable and efficient behavioral responses to external stimulation, evaluation results based on behavioral scales are not sufficiently accurate. In this paper, we proposed a novel brain-computer interface (BCI) based on 3D stereo audiovisual stimuli to supplement object recognition evaluation in the CRS-R. During the experiment, subjects needed to follow the instructions and to focus on the target object on the screen, whereas EEG data were recorded and analyzed in real time to determine the object of focus, and the detection result was output as feedback. Thirteen DOC patients participated in the object recognition assessments using the 3D audiovisual BCI and CRS-R. None of the patients showed object recognition function in the CRS-R assessment before the BCI experiment. However, six of these DOC patients achieved accuracies that were significantly higher than the chance level in the BCI-based assessment, indicating the successful detection of object recognition function in these six patients using our 3D audiovisual BCI system. These results suggest that the BCI method may provide a more sensitive object recognition evaluation compared with CRS-R and may be used to assist clinical CRS-R for DOC patients.
昏迷恢复量表修订版（CRS-R）行为量表常用于意识障碍（DOC）患者的临床评估。然而，由于 DOC 患者通常无法对外部刺激提供稳定和有效的行为反应，因此基于行为量表的评估结果不够准确。在本文中，我们提出了一种基于 3D 立体视听刺激的新型脑机接口（BCI），以补充 CRS-R 中的目标识别评估。在实验中，被试需要根据指令集中注意力于屏幕上的目标物体，同时实时记录和分析 EEG 数据以确定关注的对象，并将检测结果作为反馈输出。13 名 DOC 患者参与了使用 3D 视听 BCI 和 CRS-R 的目标识别评估。在 BCI 实验之前，没有患者在 CRS-R 评估中表现出目标识别功能。然而，这 13 名患者中有 6 名在基于 BCI 的评估中达到了显著高于机会水平的准确率，表明我们的 3D 视听 BCI 系统成功检测到了这 6 名患者的目标识别功能。这些结果表明，BCI 方法可能比 CRS-R 提供更敏感的目标识别评估，并可用于辅助临床 CRS-R 对 DOC 患者进行评估。
