Brain-computer interfaces for consciousness assessment and communication in severely brain-injured patients

Abstract

Patients with disorders of consciousness (DOC) suffer from awareness deficits. Comorbidities such as motor disabilities or visual problems hamper clinical assessments, which can lead to misdiagnosis of the level of consciousness and render the patient unable to communicate. Objective measures of consciousness can reduce the risk of misdiagnosis and could enable patients to communicate by voluntarily modulating their brain activity. This chapter gives an overview of the literature regarding brain-computer interface (BCI) research in DOC patients. Different auditory, visual, and motor imagery paradigms are discussed, alongside their corresponding advantages and disadvantages. At this point, the use of BCIs for DOC patients in clinical applications is still preliminary. However, perspectives on the improvements in BCIs for DOC patients seem positive, and implementation during rehabilitation shows promise.

Keywords: Awareness; Command following; Communication; Disorders of consciousness; EEG; Locked-in syndrome; Minimally conscious state; P300; Unresponsive wakefulness syndrome.