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

Nicholas D. Schiff; Michael Diringer; Karin Diserens; Brian L. Edlow; Olivia Gosseries; N. Jeremy Hill; Leigh R. Hochberg; Fatima Y. Ismail; Ivo A. Meyer; Charles B. Mikell; Sima Mofakham; Erika Molteni; Leonard Polizzotto; Sudhin A. Shah; Robert D. Stevens; Daniel Thengone

doi:10.1007/s12028-023-01924-w

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

Nicholas D. Schiff^*, Michael Diringer, Karin Diserens, Brian L. Edlow, Olivia Gosseries, N. Jeremy Hill, Leigh R. Hochberg, Fatima Y. Ismail, Ivo A. Meyer, Charles B. Mikell, Sima Mofakham, Erika Molteni, Leonard Polizzotto, Sudhin A. Shah, Robert D. Stevens, Daniel Thengone

^*Corresponding author for this work

Biomedical Engineering Department

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

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: 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: 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: 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.

Original language	English
Pages (from-to)	129-145
Number of pages	17
Journal	NEUROCRITICAL CARE
Volume	41
Issue number	1
Early online date	29 Jan 2024
DOIs	https://doi.org/10.1007/s12028-023-01924-w
Publication status	Published - Aug 2024

Keywords

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

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10.1007/s12028-023-01924-w

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Schiff, N. D., Diringer, M., Diserens, K., Edlow, B. L., Gosseries, O., Hill, N. J., Hochberg, L. R., Ismail, F. Y., Meyer, I. A., Mikell, C. B., Mofakham, S., Molteni, E., Polizzotto, L., Shah, S. A., Stevens, R. D., & Thengone, D. (2024). Brain–Computer Interfaces for Communication in Patients with Disorders of Consciousness: A Gap Analysis and Scientific Roadmap. NEUROCRITICAL CARE, 41(1), 129-145. https://doi.org/10.1007/s12028-023-01924-w

@article{9cc4ce81d14a4bebb10034794c513f44,

title = "Brain–Computer Interfaces for Communication in Patients with Disorders of Consciousness: A Gap Analysis and Scientific Roadmap",

abstract = "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: 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: 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: 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.",

keywords = "Cognitive motor dissociation, Coma, Communication, Electroencephalography, Functional magnetic resonance imaging, Head injury, Neural repair",

author = "Schiff, {Nicholas D.} and Michael Diringer and Karin Diserens and Edlow, {Brian L.} and Olivia Gosseries and Hill, {N. Jeremy} and Hochberg, {Leigh R.} and Ismail, {Fatima Y.} and Meyer, {Ivo A.} and Mikell, {Charles B.} and Sima Mofakham and Erika Molteni and Leonard Polizzotto and Shah, {Sudhin A.} and Stevens, {Robert D.} and Daniel Thengone",

note = "Funding Information: The authors acknowledge the following sources: the NIH Director{\textquoteright}s Office (DP2HD101400) and Chen Institute MGH Research Scholar Award (B.L.E.), F.R.S-FNRS (OG), IAM{\textquoteright}s contribution to this paper was made during his tenure as a research assistant in Montreal, Canada, funded by the Gianni Biaggi de Blasys Foundation, Lausanne, Switzerland, NJH acknowledges support from NIH (NIBIB) P41EB018783 and from the Stratton VA Medical Center. Publisher Copyright: {\textcopyright} 2024, Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society. Publisher Copyright: {\textcopyright} Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2024.",

year = "2024",

month = aug,

doi = "10.1007/s12028-023-01924-w",

language = "English",

volume = "41",

pages = "129--145",

journal = "NEUROCRITICAL CARE",

issn = "1541-6933",

publisher = "Humana Press",

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Schiff, ND, Diringer, M, Diserens, K, Edlow, BL, Gosseries, O, Hill, NJ, Hochberg, LR, Ismail, FY, Meyer, IA, Mikell, CB, Mofakham, S, Molteni, E, Polizzotto, L, Shah, SA, Stevens, RD & Thengone, D 2024, 'Brain–Computer Interfaces for Communication in Patients with Disorders of Consciousness: A Gap Analysis and Scientific Roadmap', NEUROCRITICAL CARE, vol. 41, no. 1, pp. 129-145. https://doi.org/10.1007/s12028-023-01924-w

TY - JOUR

T1 - Brain–Computer Interfaces for Communication in Patients with Disorders of Consciousness

T2 - A Gap Analysis and Scientific Roadmap

AU - Schiff, Nicholas D.

AU - Diringer, Michael

AU - Diserens, Karin

AU - Edlow, Brian L.

AU - Gosseries, Olivia

AU - Hill, N. Jeremy

AU - Hochberg, Leigh R.

AU - Ismail, Fatima Y.

AU - Meyer, Ivo A.

AU - Mikell, Charles B.

AU - Mofakham, Sima

AU - Molteni, Erika

AU - Polizzotto, Leonard

AU - Shah, Sudhin A.

AU - Stevens, Robert D.

AU - Thengone, Daniel

N1 - Funding Information: The authors acknowledge the following sources: the NIH Director’s Office (DP2HD101400) and Chen Institute MGH Research Scholar Award (B.L.E.), F.R.S-FNRS (OG), IAM’s contribution to this paper was made during his tenure as a research assistant in Montreal, Canada, funded by the Gianni Biaggi de Blasys Foundation, Lausanne, Switzerland, NJH acknowledges support from NIH (NIBIB) P41EB018783 and from the Stratton VA Medical Center. Publisher Copyright: © 2024, Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society. Publisher Copyright: © Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2024.

PY - 2024/8

Y1 - 2024/8

N2 - 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: 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: 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: 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.

AB - 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: 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: 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: 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.

KW - Cognitive motor dissociation

KW - Coma

KW - Communication

KW - Electroencephalography

KW - Functional magnetic resonance imaging

KW - Head injury

KW - Neural repair

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U2 - 10.1007/s12028-023-01924-w

DO - 10.1007/s12028-023-01924-w

M3 - Article

AN - SCOPUS:85183345482

SN - 1541-6933

VL - 41

SP - 129

EP - 145

JO - NEUROCRITICAL CARE

JF - NEUROCRITICAL CARE

IS - 1

ER -

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

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Keywords

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