Brain-Computer Interfaces for Communication in Patients with Disorders of Consciousness: A Gap Analysis and Scientific Roadmap.

Cognitive motor dissociation Coma Communication Electroencephalography Functional magnetic resonance imaging Head injury Neural repair

Journal

Neurocritical care
ISSN: 1556-0961
Titre abrégé: Neurocrit Care
Pays: United States
ID NLM: 101156086

Informations de publication

Date de publication:
29 Jan 2024
Historique:
received: 11 12 2023
accepted: 14 12 2023
medline: 30 1 2024
pubmed: 30 1 2024
entrez: 29 1 2024
Statut: aheadofprint

Résumé

We developed a gap analysis that examines the role of brain-computer interfaces (BCI) in patients with disorders of consciousness (DoC), focusing on their assessment, establishment of communication, and engagement with their environment. The Curing Coma Campaign convened a Coma Science work group that included 16 clinicians and neuroscientists with expertise in DoC. The work group met online biweekly and performed a gap analysis of the primary question. We outline a roadmap for assessing BCI readiness in patients with DoC and for advancing the use of BCI devices in patients with DoC. Additionally, we discuss preliminary studies that inform development of BCI solutions for communication and assessment of readiness for use of BCIs in DoC study participants. Special emphasis is placed on the challenges posed by the complex pathophysiologies caused by heterogeneous brain injuries and their impact on neuronal signaling. The differences between one-way and two-way communication are specifically considered. Possible implanted and noninvasive BCI solutions for acute and chronic DoC in adult and pediatric populations are also addressed. We identify clinical and technical gaps hindering the use of BCI in patients with DoC in each of these contexts and provide a roadmap for research aimed at improving communication for adults and children with DoC, spanning the clinical spectrum from intensive care unit to chronic care.

Sections du résumé

BACKGROUND BACKGROUND
We developed a gap analysis that examines the role of brain-computer interfaces (BCI) in patients with disorders of consciousness (DoC), focusing on their assessment, establishment of communication, and engagement with their environment.
METHODS METHODS
The Curing Coma Campaign convened a Coma Science work group that included 16 clinicians and neuroscientists with expertise in DoC. The work group met online biweekly and performed a gap analysis of the primary question.
RESULTS RESULTS
We outline a roadmap for assessing BCI readiness in patients with DoC and for advancing the use of BCI devices in patients with DoC. Additionally, we discuss preliminary studies that inform development of BCI solutions for communication and assessment of readiness for use of BCIs in DoC study participants. Special emphasis is placed on the challenges posed by the complex pathophysiologies caused by heterogeneous brain injuries and their impact on neuronal signaling. The differences between one-way and two-way communication are specifically considered. Possible implanted and noninvasive BCI solutions for acute and chronic DoC in adult and pediatric populations are also addressed.
CONCLUSIONS CONCLUSIONS
We identify clinical and technical gaps hindering the use of BCI in patients with DoC in each of these contexts and provide a roadmap for research aimed at improving communication for adults and children with DoC, spanning the clinical spectrum from intensive care unit to chronic care.

Identifiants

DOI: 10.1007/s12028-023-01924-w PMID: 38286946
pubmed: 38286946
doi: 10.1007/s12028-023-01924-w
pii: 10.1007/s12028-023-01924-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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Auteurs

Nicholas D Schiff (ND)

Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA. nds2001@med.cornell.edu.
ORCID: 0000-0003-0008-426X

Michael Diringer (M)

Departments of Neurology and Neurosurgery, Washington University in St. Louis, St. Louis, MO, USA.

Karin Diserens (K)

Neurology and Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Brian L Edlow (BL)

Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

Olivia Gosseries (O)

Coma Science Group, GIGA-Consciousness, Centre du Cerveau, University Hospital of Liège, University of Liège & Centre du Cerveau, Liège, Belgium.

N Jeremy Hill (NJ)

National Center for Adaptive Neurotechnologies, Stratton VA Medical Center, Albany, NY, USA.
Electrical & Computer Engineering Department, State University of New York at Albany, Albany, NY, USA.

Leigh R Hochberg (LR)

Veterans Affairs Rehabilitation Research & Development Center for Neurorestoration and Neurotechnology, Rehabilitation Research & Development Service, Providence VA Medical Center, Providence, RI, USA.
School of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA.
Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Fatima Y Ismail (FY)

Department of Pediatrics, United Arab Emirates University, Al Ain, United Arab Emirates.
Department of Neurology, Adjunct Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Ivo A Meyer (IA)

Neurology and Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Centre for Advanced Research in Sleep Medicine and Integrated Trauma Centre, Integrated University Health and Social Services Centre (CIUSSS) du Nord-de-L'Île-de-Montréal, Montreal, QC, Canada.

Charles B Mikell (CB)

Department of Neurosurgery, Stony Brook University Hospital, Stony Brook, NY, USA.

Sima Mofakham (S)

Department of Neurosurgery, Stony Brook University Hospital, Stony Brook, NY, USA.
Department of Electrical and Computer Engineering, Stony Brook University, Stony Brook, NY, USA.

Erika Molteni (E)

School of Biomedical Engineering and Imaging Sciences, and Centre for Medical Engineering, King's College London, London, UK.

Leonard Polizzotto (L)

Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA.

Sudhin A Shah (SA)

Department of Radiology, Weill Cornell Medical College, New York, NY, USA.

Robert D Stevens (RD)

Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Daniel Thengone (D)

Brown University, Providence, RI, USA.

Classifications MeSH