Brain-computer interface in critical care and rehabilitation

Abstract

This comprehensive review explores the broad landscape of brain-computer interface (BCI) technology and its potential use in intensive care units (ICUs), particularly for patients with motor impairments such as quadriplegia or severe brain injury. By employing brain signals from various sensing techniques, BCIs offer enhanced communication and motor rehabilitation strategies for patients. This review underscores the concept and efficacy of noninvasive, electroencephalogram-based BCIs in facilitating both communicative interactions and motor function recovery. Additionally, it highlights the current research gap in intuitive "stop" mechanisms within motor rehabilitation protocols, emphasizing the need for advancements that prioritize patient safety and individualized responsiveness. Furthermore, it advocates for more focused research that considers the unique requirements of ICU environments to address the challenges arising from patient variability, fatigue, and limited applicability of current BCI systems outside of experimental settings.

Keywords: brain–computer interface; communication; intensive care unit; muscular weakness; neurorehabilitation.

Figure 1.

Illustration of a brain–computer interface (BCI) system. ECoG: electrocorticogram; EEG: electroencephalogram; fNIRS: functional near-infrared spectroscopy; MEG: magnetoencephalogram.

Figure 2.

The steady state visually evoked potential paradigm and typical frequency encoding from acquired electroencephalogram (EEG) signals. PSD: power spectral density.

Figure 3.

P300-based brain–computer interface [44]. (A) Oddball paradigm and P300 or P3 in the event-related potential family. (B) P300-based speller with the row-column paradigm.

Figure 4.

Closed-loop brain–computer interface (BCI) system for rehabilitation. SMR: sensorimotor rhythm; ERD: event-related desynchronization; ERS: event-related synchronization; EEG: electroencephalogram.