Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
Wyss-Center for Bio- and Neuro-Engineering, Geneva, Switzerland.
Sci Rep. 2020 May 21;10(1):8452. doi: 10.1038/s41598-020-65333-1.
Patients in the transition from locked-in (i.e., a state of almost complete paralysis with voluntary eye movement control, eye blinks or twitches of face muscles, and preserved consciousness) to complete locked-in state (i.e., total paralysis including paralysis of eye-muscles and loss of gaze-fixation, combined with preserved consciousness) are left without any means of communication. An auditory communication system based on electrooculogram (EOG) was developed to enable such patients to communicate. Four amyotrophic lateral sclerosis patients in transition from locked-in state to completely locked-in state, with ALSFRS-R score of 0, unable to use eye trackers for communication, learned to use an auditory EOG-based communication system. The patients, with eye-movement amplitude between the range of ±200μV and ±40μV, were able to form complete sentences and communicate independently and freely, selecting letters from an auditory speller system. A follow-up of one year with one patient shows the feasibility of the proposed system in long-term use and the correlation between speller performance and eye-movement decay. The results of the auditory speller system have the potential to provide a means of communication to patient populations without gaze fixation ability and with low eye-movement amplitude range.
从闭锁状态（即几乎完全瘫痪，伴有自主眼球运动控制、眨眼或面部肌肉抽搐，以及意识保留）向完全闭锁状态（即眼球运动和凝视固定丧失，同时伴有意识保留的完全瘫痪）过渡的患者将无法进行任何交流。为了使这些患者能够进行交流，开发了一种基于眼电图（EOG）的听觉交流系统。四名从闭锁状态向完全闭锁状态过渡的肌萎缩性侧索硬化症患者，其 ALSFRS-R 评分为 0，无法使用眼动追踪器进行交流，他们学会了使用基于听觉 EOG 的交流系统。这些患者的眼球运动幅度在±200μV 和±40μV 之间，能够通过听觉拼写器系统独立、自由地形成完整的句子进行交流。对一名患者进行的为期一年的随访表明，该系统在长期使用中的可行性，以及拼写器性能与眼球运动衰减之间的相关性。听觉拼写器系统的结果有可能为没有凝视固定能力且眼球运动幅度较小的患者群体提供一种交流手段。
