Archives of Physical Medicine and Rehabilitation
Original articleLong-Term Independent Brain-Computer Interface Home Use Improves Quality of Life of a Patient in the Locked-In State: A Case Study
Section snippets
Participant
The participant is a 73-year-old woman with ALS (spinal form) in the locked-in state with only residual eye movement. She is artificially ventilated and fed and is able to communicate with eye movements in the partner-scanning mode or with an eye tracker. She lives with her family and full-time caregivers. Painting had been her favorite hobby. Because she has had no application for creative expression, Brain Painting awoke her interest, and her family contacted the Brain Painting team of the
Event-related potentials
The P300 signal was more pronounced in calibration 2 and again increased in calibration 3 with initiation of the Einstein-face stimuli. ERPs from calibrations 1, 2, and 3 are depicted in figure 3.
Face valid measures of BCI use in daily life
The end user painted in about 200 sessions (at the date of data analysis). Mostly the end user opened 1 session per day (139 of 200). The mean total painting time was 81.86±52.15 minutes (range, .34–230.41) (fig 4A). The total painting time was positively correlated with session number (r=.60, P<.001).
Effectiveness
Discussion
In this study, Brain Painting was implemented at the home of 1 patient in the locked-in state because of ALS. Within 14 months the end user painted with the BCI several times per week resulting in 200 sessions. BCI sessions were evaluated in terms of effectiveness, efficiency, and satisfaction. Indicators of use in daily life and effect of the BCI-controlled Brain Painting on the patient's quality of life were assessed.
Conclusions
The current case study demonstrated that independent home use of a BCI-controlled painting application is possible and can be continued for >14 months. Provided that there is a perfect match between the user and technology and sufficient support by significant others, BCI-controlled applications can be used in daily life and contribute to quality of life. BCIs can support social inclusion and have come of age.
Suppliers
- a.
Gerwin Schalk, Ph.D. Center For Medical Sciences.
- b.
Python Software Foundation.
- c.
g.tec medical engineering GmbH.
- d.
The MathWorks GmbH.
Acknowledgments
We thank Christoph Guger, PhD, and g.tec for providing the BCI equipment.
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Presented to the National Institutes of Health, National Science Foundation, and other organizations (for a full list, see http://bcimeeting.org/2013/sponsors.html), June 3-7, 2013, Asilomar Conference Grounds, Pacific Grove, CA.
Supported by the European Information and Communication Technologies Program Project FP7-288566 (BackHome).
This article only reflects the authors' views, and funding agencies are not liable for any use that may be made of the information contained herein.
Disclosures: none.