Neurological Progress

Brain–computer interfaces for communication with nonresponsive patients

  1. Lorina Naci PhD1,*,
  2. Martin M. Monti PhD2,
  3. Damian Cruse PhD1,
  4. Andrea Kübler PhD3,
  5. Bettina Sorger PhD4,
  6. Rainer Goebel PhD4,
  7. Boris Kotchoubey PhD5,
  8. Adrian M. Owen PhD1

Article first published online: 2 OCT 2012

DOI: 10.1002/ana.23656

Issue

Annals of Neurology

Annals of Neurology

Volume 72, Issue 3, pages 312–323, September 2012

Additional Information

How to Cite

Naci, L., Monti, M. M., Cruse, D., Kübler, A., Sorger, B., Goebel, R., Kotchoubey, B. and Owen, A. M. (2012), Brain–computer interfaces for communication with nonresponsive patients. Ann Neurol., 72: 312–323. doi: 10.1002/ana.23656

Author Information

  1. 1

    The Brain and Mind Institute, Department of Psychology, Western University, London, Ontario, Canada

  2. 2

    Department of Psychology, University of California at Los Angeles, Los Angeles, CA

  3. 3

    Department of Psychology I, University of Würzburg, Würzburg, Germany

  4. 4

    Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands

  5. 5

    Institute of Medical Psychology and Behavioral Neurobiology, Eberhard-Karls-University, Tübingen, Germany

*The Brain and Mind Institute, Department of Psychology, Western University, London, Ontario, N6A 5B7, Canada

Publication History

  1. Issue published online: 2 OCT 2012
  2. Article first published online: 2 OCT 2012
  3. Accepted manuscript online: 30 MAY 2012 04:21PM EST
  4. Manuscript Accepted: 21 MAY 2012
  5. Manuscript Revised: 25 APR 2012
  6. Manuscript Received: 21 FEB 2012

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Abstract

A substantial number of patients who survive severe brain injury progress to a nonresponsive state of wakeful unawareness, referred to as a vegetative state (VS). They appear to be awake, but show no signs of awareness of themselves, or of their environment in repeated clinical examinations. However, recent neuroimaging research demonstrates that some VS patients can respond to commands by willfully modulating their brain activity according to instruction. Brain–computer interfaces (BCIs) may allow such patients to circumvent the barriers imposed by their behavioral limitations and communicate with the outside world. However, although such devices would undoubtedly improve the quality of life for some patients and their families, developing BCI systems for behaviorally nonresponsive patients presents substantial technical and clinical challenges. Here we review the state of the art of BCI research across noninvasive neuroimaging technologies, and propose how such systems should be developed further to provide fully fledged communication systems for behaviorally nonresponsive populations. Ann Neurol 2012;72:312–323

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