Brain Computer Interface ALS: Helping Locked In Patients Communicate
A brain computer interface ALS breakthrough could revolutionize the lives of people living with completely locked in syndrome, according to a study published in PLOS Biology. Counter to expectations, participants in the study reported being “happy” despite their condition.
In the trial, people with completely locked in syndrome — who were incapable of even moving their eyes to communicate — were able to respond “yes” or “no” via thought to spoken questions. A non invasive brain computer interface detected their responses by measuring changes in blood oxygen levels in the brain.
What Is Locked In Syndrome?
People with preserved awareness and cognition but complete paralysis except for up and down eye movements and blinking are classified as having locked in syndrome. If all eye movements are lost, the condition is referred to as complete locked in syndrome.
The results of this brain computer interface ALS study overturn previous theories that people with completely locked in syndrome lack the goal directed thinking necessary to use a brain computer interface and are therefore incapable of communication.
How Did the Brain Computer Interface ALS Study Work?
Extensive investigations were carried out in four people with ALS — amyotrophic lateral sclerosis — a progressive motor neuron disease that leads to complete destruction of the part of the nervous system responsible for movement.
The researchers asked personal questions with known answers and open questions requiring “yes” or “no” responses including “Your husband’s name is Joachim?” and “Are you happy?” They found the questions elicited correct responses seven times out of ten.
The brain computer interface ALS technique used near infrared spectroscopy combined with electroencephalography to measure blood oxygenation and electrical activity in the brain. While other brain computer interfaces have previously enabled some paralyzed patients to communicate, near infrared spectroscopy is so far the only successful approach to restore communication to people with complete locked in syndrome.
What Did Researchers Find?
Professor Niels Birbaumer, neuroscientist at the Wyss Center for Bio and Neuroengineering in Geneva and senior author of the paper, said the results overturned his own theory that people with completely locked in syndrome are not capable of communication. All four people tested were able to answer personal questions using thought alone.
The question “Are you happy?” resulted in a consistent “Yes” response from all four participants, repeated over weeks of questioning.
Professor Birbaumer noted that all four had accepted artificial ventilation to sustain their life when breathing became impossible — in a sense, they had already chosen to live. As long as they received satisfactory care at home, they found their quality of life acceptable. Making this brain computer interface ALS technique widely clinically available could have a profound impact on the day to day lives of people with completely locked in syndrome.
In one notable case, a family requested that researchers ask one participant whether he would agree for his daughter to marry her boyfriend Mario. The answer was “No” nine times out of ten.
What Are the Future Applications?
Professor John Donoghue, Director of the Wyss Center, stated that restoring communication for completely locked in people is a crucial first step in the challenge to regain movement. The Wyss Center plans to build on these brain computer interface ALS results to develop clinically useful technology available to people with paralysis resulting from ALS, stroke, or spinal cord injury. The technology also has broader applications for treating and monitoring people with a wide range of neurological disorders.
According to the Wyss Center for Bio and Neuroengineering, developing brain computer interfaces for communication and movement restoration remains one of the most promising frontiers in neurotechnology research.
For those interested in how clinical research studies like this one are structured and conducted, our introduction to clinical trials provides a comprehensive overview of how medical breakthroughs move from research to real world application.
Source: PLOS Biology | Published: February 2, 2017