Wearable Technologies for Electrodermal and Cardiac Activity Measurements: A Comparison between Fitbit Sense, Empatica E4 and Shimmer GSR3.

The capability of measuring specific neurophysiological and autonomic parameters plays a crucial role in the objective evaluation of a human's mental and emotional states. These human aspects are commonly known in the scientific literature to be involved in a wide range of processes, such as stress and arousal. These aspects represent a relevant factor especially in real and operational environments. Neurophysiological autonomic parameters, such as Electrodermal Activity (EDA) and Photoplethysmographic data (PPG), have been usually investigated through research-graded devices, therefore resulting in a high degree of invasiveness, which could negatively interfere with the monitored user's activity. For such a reason, in the last decade, recent consumer-grade wearable devices, usually designed for fitness-tracking purposes, are receiving increasing attention from the scientific community, and are characterized by a higher comfort, ease of use and, therefore, by a higher compatibility with daily-life environments. The present preliminary study was aimed at assessing the reliability of a consumer wearable device, i.e., the Fitbit Sense, with respect to a research-graded wearable, i.e., the Empatica E4 wristband, and a laboratory device, i.e., the Shimmer GSR3+. EDA and PPG data were collected among 12 participants while they performed multiple resting conditions. The results demonstrated that the EDA- and PPG-derived features computed through the wearable and research devices were positively and significantly correlated, while the reliability of the consumer device was significantly lower.

A Neuroergonomic Approach Fostered by Wearable EEG for the Multimodal Assessment of Drivers Trainees.

When assessing trainees' progresses during a driving training program, instructors can only rely on the evaluation of a trainee's explicit behavior and their performance, without having any insight about the training effects at a cognitive level. However, being able to drive does not imply knowing how to drive safely in a complex scenario such as the road traffic. Indeed, the latter point involves mental aspects, such as the ability to manage and allocate one's mental effort appropriately, which are difficult to assess objectively. In this scenario, this study investigates the validity of deploying an electroencephalographic neurometric of mental effort, obtained through a wearable electroencephalographic device, to improve the assessment of the trainee. The study engaged 22 young people, without or with limited driving experience. They were asked to drive along five different but similar urban routes, while their brain activity was recorded through electroencephalography. Moreover, driving performance, subjective and reaction times measures were collected for a multimodal analysis. In terms of subjective and performance measures, no driving improvement could be detected either through the driver's subjective measures or through their driving performance. On the other side, through the electroencephalographic neurometric of mental effort, it was possible to catch their improvement in terms of mental performance, with a decrease in experienced mental demand after three repetitions of the driving training tasks. These results were confirmed by the analysis of reaction times, that significantly improved from the third repetition as well. Therefore, being able to measure when a task is less mentally demanding, and so more automatic, allows to deduce the degree of users training, becoming capable of handling additional tasks and reacting to unexpected events.

An EEG-Based Transfer Learning Method for Cross-Subject Fatigue Mental State Prediction.

Fatigued driving is one of the main causes of traffic accidents. The electroencephalogram (EEG)-based mental state analysis method is an effective and objective way of detecting fatigue. However, as EEG shows significant differences across subjects, effectively "transfering" the EEG analysis model of the existing subjects to the EEG signals of other subjects is still a challenge. Domain-Adversarial Neural Network (DANN) has excellent performance in transfer learning, especially in the fields of document analysis and image recognition, but has not been applied directly in EEG-based cross-subject fatigue detection. In this paper, we present a DANN-based model, Generative-DANN (GDANN), which combines Generative Adversarial Networks (GAN) to enhance the ability by addressing the issue of different distribution of EEG across subjects. The comparative results show that in the analysis of cross-subject tasks, GDANN has a higher average accuracy of 91.63% in fatigue detection across subjects than those of traditional classification models, which is expected to have much broader application prospects in practical brain-computer interaction (BCI).

The Sample Size Matters: To What Extent the Participant Reduction Affects the Outcomes of a Neuroscientific Research. A Case-Study in Neuromarketing Field.

The sample size is a crucial concern in scientific research and even more in behavioural neurosciences, where besides the best practice it is not always possible to reach large experimental samples. In this study we investigated how the outcomes of research change in response to sample size reduction. Three indices computed during a task involving the observations of four videos were considered in the analysis, two related to the brain electroencephalographic (EEG) activity and one to autonomic physiological measures, i.e., heart rate and skin conductance. The modifications of these indices were investigated considering five subgroups of sample size (32, 28, 24, 20, 16), each subgroup consisting of 630 different combinations made by bootstrapping n (n = sample size) out of 36 subjects, with respect to the total population (i.e., 36 subjects). The correlation analysis, the mean squared error (MSE), and the standard deviation (STD) of the indexes were studied at the participant reduction and three factors of influence were considered in the analysis: the type of index, the task, and its duration (time length). The findings showed a significant decrease of the correlation associated to the participant reduction as well as a significant increase of MSE and STD (p < 0.05). A threshold of subjects for which the outcomes remained significant and comparable was pointed out. The effects were to some extents sensitive to all the investigated variables, but the main effect was due to the task length. Therefore, the minimum threshold of subjects for which the outcomes were comparable increased at the reduction of the spot duration.

A Video-Based Technique for Heart Rate and Eye Blinks Rate Estimation: A Potential Solution for Telemonitoring and Remote Healthcare.

Current telemedicine and remote healthcare applications foresee different interactions between the doctor and the patient relying on the use of commercial and medical wearable sensors and internet-based video conferencing platforms. Nevertheless, the existing applications necessarily require a contact between the patient and sensors for an objective evaluation of the patient's state. The proposed study explored an innovative video-based solution for monitoring neurophysiological parameters of potential patients and assessing their mental state. In particular, we investigated the possibility to estimate the heart rate (HR) and eye blinks rate (EBR) of participants while performing laboratory tasks by mean of facial-video analysis. The objectives of the study were focused on: (i) assessing the effectiveness of the proposed technique in estimating the HR and EBR by comparing them with laboratory sensor-based measures and (ii) assessing the capability of the video-based technique in discriminating between the participant's resting state (Nominal condition) and their active state (Non-nominal condition). The results demonstrated that the HR and EBR estimated through the facial-video technique or the laboratory equipment did not statistically differ (p > 0.1), and that these neurophysiological parameters allowed to discriminate between the Nominal and Non-nominal states (p < 0.02).

Wearable Technologies for Mental Workload, Stress, and Emotional State Assessment during Working-Like Tasks: A Comparison with Laboratory Technologies.

The capability of monitoring user's performance represents a crucial aspect to improve safety and efficiency of several human-related activities. Human errors are indeed among the major causes of work-related accidents. Assessing human factors (HFs) could prevent these accidents through specific neurophysiological signals' evaluation but laboratory sensors require highly-specialized operators and imply a certain grade of invasiveness which could negatively interfere with the worker's activity. On the contrary, consumer wearables are characterized by their ease of use and their comfortability, other than being cheaper compared to laboratory technologies. Therefore, wearable sensors could represent an ideal substitute for laboratory technologies for a real-time assessment of human performances in ecological settings. The present study aimed at assessing the reliability and capability of consumer wearable devices (i.e., Empatica E4 and Muse 2) in discriminating specific mental states compared to laboratory equipment. The electrooculographic (EOG), electrodermal activity (EDA) and photoplethysmographic (PPG) signals were acquired from a group of 17 volunteers who took part to the experimental protocol in which different working scenarios were simulated to induce different levels of mental workload, stress, and emotional state. The results demonstrated that the parameters computed by the consumer wearable and laboratory sensors were positively and significantly correlated and exhibited the same evidences in terms of mental states discrimination.

Correlation and Similarity between Cerebral and Non-Cerebral Electrical Activity for User's States Assessment.

Human tissues own conductive properties, and the electrical activity produced by human organs can propagate throughout the body due to neuro transmitters and electrolytes. Therefore, it might be reasonable to hypothesize correlations and similarities between electrical activities among different parts of the body. Since no works have been found in this direction, the proposed study aimed at overcoming this lack of evidence and seeking analogies between the brain activity and the electrical activity of non-cerebral locations, such as the neck and wrists, to determine if i) cerebral parameters can be estimated from non-cerebral sites, and if ii) non-cerebral sensors can replace cerebral sensors for the evaluation of the users under specific experimental conditions, such as eyes open or closed. In fact, the use of cerebral sensors requires high-qualified personnel, and reliable recording systems, which are still expensive. Therefore, the possibility to use cheaper and easy-to-use equipment to estimate cerebral parameters will allow making some brain-based applications less invasive and expensive, and easier to employ. The results demonstrated the occurrence of significant correlations and analogies between cerebral and non-cerebral electrical activity. Furthermore, the same discrimination and classification accuracy were found in using the cerebral or non-cerebral sites for the user's status assessment.

The Dry Revolution: Evaluation of Three Different EEG Dry Electrode Types in Terms of Signal Spectral Features, Mental States Classification and Usability.

One century after the first recording of human electroencephalographic (EEG) signals, EEG has become one of the most used neuroimaging techniques. The medical devices industry is now able to produce small and reliable EEG systems, enabling a wide variety of applications also with no-clinical aims, providing a powerful tool to neuroscientific research. However, these systems still suffer from a critical limitation, consisting in the use of wet electrodes, that are uncomfortable and require expertise to install and time from the user. In this context, dozens of different concepts of EEG dry electrodes have been recently developed, and there is the common opinion that they are reaching traditional wet electrodes quality standards. However, although many papers have tried to validate them in terms of signal quality and usability, a comprehensive comparison of different dry electrode types from multiple points of view is still missing. The present work proposes a comparison of three different dry electrode types, selected among the main solutions at present, against wet electrodes, taking into account several aspects, both in terms of signal quality and usability. In particular, the three types consisted in gold-coated single pin, multiple pins and solid-gel electrodes. The results confirmed the great standards achieved by dry electrode industry, since it was possible to obtain results comparable to wet electrodes in terms of signals spectra and mental states classification, but at the same time drastically reducing the time of montage and enhancing the comfort. In particular, multiple-pins and solid-gel electrodes overcome gold-coated single-pin-based ones in terms of comfort.

Quantitative Assessment of the Training Improvement in a Motor-Cognitive Task by Using EEG, ECG and EOG Signals.

Generally, the training evaluation methods consist in experts supervision and qualitative check of the operator's skills improvement by asking them to perform specific tasks and by verifying the final performance. The aim of this work is to find out if it is possible to obtain quantitative information about the degree of the learning process throughout the training period by analyzing neuro-physiological signals, such as the electroencephalogram, the electrocardiogram and the electrooculogram. In fact, it is well known that such signals correlate with a variety of cognitive processes, e.g. attention, information processing, and working memory. A group of 10 subjects have been asked to train daily with the NASA multi-attribute-task-battery. During such training period the neuro-physiological, behavioral and subjective data have been collected. In particular, the neuro-physiological signals have been recorded on the first (T1), on the third (T3) and on the last training day (T5), while the behavioral and subjective data have been collected every day. Finally, all these data have been compared for a complete overview of the learning process and its relations with the neuro-physiological parameters. It has been shown how the integration of brain activity, in the theta and alpha frequency bands, with the autonomic parameters of heart rate and eyeblink rate could be used as metric for the evaluation of the learning progress, as well as the final training level reached by the subjects, in terms of request of cognitive resources.

Hybrid P300-based brain-computer interface to improve usability for people with severe motor disability: electromyographic signals for error correction during a spelling task.

OBJECTIVE: To evaluate the impact of a hybrid control on usability of a P300-based brain-computer interface (BCI) system that was designed to control an assistive technology software and was integrated with an electromyographic channel for error correction. DESIGN: Proof-of-principle study with a convenience sample. SETTING: Neurologic rehabilitation hospital. PARTICIPANTS: Participants (N=11) in this pilot study included healthy (n=8) and severely motor impaired (n=3) persons. The 3 people with severe motor disability were identified as potential candidates to benefit from the proposed hybrid BCI system for communication and environmental interaction. INTERVENTIONS: To eventually investigate the improvement in usability, we compared 2 modalities of BCI system control: a P300-based and a hybrid P300 electromyographic-based mode of control. MAIN OUTCOME MEASURES: System usability was evaluated according to the following outcome measures within 3 domains: (1) effectiveness (overall system accuracy and P300-based BCI accuracy); (2) efficiency (throughput time and users' workload); and (3) satisfaction (users' satisfaction). We also considered the information transfer rate and time for selection. RESULTS: Findings obtained in healthy participants were in favor of a higher usability of the hybrid control as compared with the nonhybrid. A similar trend was indicated by the observational results gathered from each of the 3 potential end-users. CONCLUSIONS: The proposed hybrid BCI control modality could provide end-users with severe motor disability with an option to exploit some residual muscular activity, which could not be fully reliable for properly controlling an assistive technology device. The findings reported in this pilot study encourage the implementation of a clinical trial involving a large cohort of end-users.

A Novel EEG-Based Assessment of Distraction in Simulated Driving under Different Road and Traffic Conditions.

The drivers' distraction plays a crucial role in road safety as it is one of the main impacting causes of road accidents. The phenomenon of distraction encompasses both psychological and environmental factors and, therefore, addressing the complex interplay contributing to human distraction in automotive is crucial for developing technologies and interventions for improving road safety. In scientific literature, different works were proposed for the distraction characterization in automotive, but there is still the lack of a univocal measure to assess the degree of distraction, nor a gold-standard tool that allows to "detect" eventual events, road traffic, and additional driving tasks that might contribute to the drivers' distraction. Therefore, the present study aimed at developing an EEG-based "Distraction index" obtained by the combination of the driver's mental workload and attention neurometrics and investigating and validating its reliability by analyzing together subjective and behavioral measures. A total of 25 licensed drivers were involved in this study, where they had to drive in two different scenarios, i.e., City and Highway, while different secondary tasks were alternatively proposed in addition to the main one to modulate the driver's attentional demand. The statistical analysis demonstrated the reliability of the proposed EEG-based distraction index in identifying the drivers' distraction when driving along different roads and traffic conditions (all p < 0.001). More importantly, the proposed index was demonstrated to be reliable in identifying which are the most impacting additional driving tasks on the drivers' distraction (all p < 0.01).

Two are better than one: Differences in cortical EEG patterns during auditory and visual verbal working memory processing between Unilateral and Bilateral Cochlear Implanted children.

Despite the proven effectiveness of cochlear implant (CI) in the hearing restoration of deaf or hard-of-hearing (DHH) children, to date, extreme variability in verbal working memory (VWM) abilities is observed in both unilateral and bilateral CI user children (CIs). Although clinical experience has long observed deficits in this fundamental executive function in CIs, the cause to date is still unknown. Here, we have set out to investigate differences in brain functioning regarding the impact of monaural and binaural listening in CIs compared with normal hearing (NH) peers during a three-level difficulty n-back task undertaken in two sensory modalities (auditory and visual). The objective of this pioneering study was to identify electroencephalographic (EEG) marker pattern differences in visual and auditory VWM performances in CIs compared to NH peers and possible differences between unilateral cochlear implant (UCI) and bilateral cochlear implant (BCI) users. The main results revealed differences in theta and gamma EEG bands. Compared with hearing controls and BCIs, UCIs showed hypoactivation of theta in the frontal area during the most complex condition of the auditory task and a correlation of the same activation with VWM performance. Hypoactivation in theta was also observed, again for UCIs, in the left hemisphere when compared to BCIs and in the gamma band in UCIs compared to both BCIs and NHs. For the latter two, a correlation was found between left hemispheric gamma oscillation and performance in the audio task. These findings, discussed in the light of recent research, suggest that unilateral CI is deficient in supporting auditory VWM in DHH. At the same time, bilateral CI would allow the DHH child to approach the VWM benchmark for NH children. The present study suggests the possible effectiveness of EEG in supporting, through a targeted approach, the diagnosis and rehabilitation of VWM in DHH children.

Reducing flight upset risk and startle response: A study of the wake vortex alert with licensed commercial pilots.

The study aimed at investigating the impact of an innovative Wake Vortex Alert (WVA) avionics on pilots' operation and mental states, intending to improve aviation safety by mitigating the risks associated with wake vortex encounters (WVEs). Wake vortices, generated by jet aircraft, pose a significant hazard to trailing or crossing aircrafts. Despite existing separation rules, incidents involving WVEs continue to occur, especially affecting smaller aircrafts like business jets, resulting in aircraft upsets and occasional cabin injuries. To address these challenges, the study focused on developing and validating an alert system that can be presented to air traffic controllers, enabling them to warn flight crews. This empowers the flight crews to either avoid the wake vortex or secure the cabin to prevent injuries. The research employed a multidimensional approach including an analysis of human performance and human factors (HF) issues to determine the potential impact of the alert on pilots' roles, tasks, and mental states. It also utilizes Human Assurance Levels (HALs) to evaluate the necessary human factors support based on the safety criticality of the new system. Realistic flight simulations were conducted to collect data of pilots' behavioural, subjective and neurophysiological responses during WVEs. The data allowed for an objective evaluation of the WVA impact on pilots' operation, behaviour and mental states (mental workload, stress levels and arousal). In particular, the results highlighted the effectiveness of the alert system in facilitating pilots' preparation, awareness and crew resource management (CRM). The results also highlighted the importance of avionics able to enhance aviation safety and reducing risks associated with wake vortex encounters. In particular, we demonstrated how providing timely information and improving situational awareness, the WVA will minimize the occurrence of WVEs and contribute to safer aviation operations.

What Is behind In-Stream Advertising on YouTube? A Remote Neuromarketing Study employing Eye-Tracking and Facial Coding techniques.

Not all elements displayed in a YouTube in-stream video ad are attributable to the ad itself. Some of those are automatically introduced by the platform, such as the countdown timer and the time progress bar. In recent years, some authors started exploring the effects associated with the presence of such non-ad items, providing valuable findings. However, objective evaluation of viewers' visual attention is lacking in this context as well as emotional investigation. In addition, previous research showed how the manipulation of seemingly negligible details can yield dramatically different outcomes in the context of in-stream advertising. To extend knowledge, the authors explored the effects of the non-ad items' presence by employing eye-tracking and facial coding techniques in combination with self-reports in a between-subjects experimental design focusing on the YouTube 15-s, mid-roll, non-skippable in-stream ad format. Results showed that the ad format currently employed by YouTube performs worse than its equivalent without the non-ad items on all the investigated measures and than its equivalent in which the non-ad items' presence was experimentally reduced on facial coding disgust, self-reported disgust, ad irritation, and ad attitude. Managerial insights and challenges concerning the future of in-stream advertising and neuromarketing are highlighted.

Neurophysiological Evaluation of Students' Experience during Remote and Face-to-Face Lessons: A Case Study at Driving School.

Nowadays, fostered by technological progress and contextual circumstances such as the economic crisis and pandemic restrictions, remote education is experiencing growing deployment. However, this growth has generated widespread doubts about the actual effectiveness of remote/online learning compared to face-to-face education. The present study was aimed at comparing face-to-face and remote education through a multimodal neurophysiological approach. It involved forty students at a driving school, in a real classroom, experiencing both modalities. Wearable devices to measure brain, ocular, heart and sweating activities were employed in order to analyse the students' neurophysiological signals to obtain insights into the cognitive dimension. In particular, four parameters were considered: the Eye Blink Rate, the Heart Rate and its Variability and the Skin Conductance Level. In addition, the students filled out a questionnaire at the end to obtain an explicit measure of their learning performance. Data analysis showed higher cognitive activity, in terms of attention and mental engagement, in the in-presence setting compared to the remote modality. On the other hand, students in the remote class felt more stressed, particularly during the first part of the lesson. The analysis of questionnaires demonstrated worse performance for the remote group, thus suggesting a common "disengaging" behaviour when attending remote courses, thus undermining their effectiveness. In conclusion, neuroscientific tools could help to obtain insights into mental concerns, often "blind", such as decreasing attention and increasing stress, as well as their dynamics during the lesson itself, thus allowing the definition of proper countermeasures to emerging issues when introducing new practices into daily life.

Neurophysiological mental fatigue assessment for developing user-centered Artificial Intelligence as a solution for autonomous driving.

The human factor plays a key role in the automotive field since most accidents are due to drivers' unsafe and risky behaviors. The industry is now pursuing two main solutions to deal with this concern: in the short term, there is the development of systems monitoring drivers' psychophysical states, such as inattention and fatigue, and in the medium-long term, there is the development of fully autonomous driving. This second solution is promoted by recent technological progress in terms of Artificial Intelligence and sensing systems aimed at making vehicles more and more accurately aware of their "surroundings." However, even with an autonomous vehicle, the driver should be able to take control of the vehicle when needed, especially during the current transition from the lower (SAE < 3) to the highest level (SAE = 5) of autonomous driving. In this scenario, the vehicle has to be aware not only of its "surroundings" but also of the driver's psychophysical state, i.e., a user-centered Artificial Intelligence. The neurophysiological approach is one the most effective in detecting improper mental states. This is particularly true if considering that the more automatic the driving will be, the less available the vehicular data related to the driver's driving style. The present study aimed at employing a holistic approach, considering simultaneously several neurophysiological parameters, in particular, electroencephalographic, electrooculographic, photopletismographic, and electrodermal activity data to assess the driver's mental fatigue in real time and to detect the onset of fatigue increasing. This would ideally work as an information/trigger channel for the vehicle AI. In all, 26 professional drivers were engaged in a 45-min-lasting realistic driving task in simulated conditions, during which the previously listed biosignals were recorded. Behavioral (reaction times) and subjective measures were also collected to validate the experimental design and to support the neurophysiological results discussion. Results showed that the most sensitive and timely parameters were those related to brain activity. To a lesser extent, those related to ocular parameters were also sensitive to the onset of mental fatigue, but with a delayed effect. The other investigated parameters did not significantly change during the experimental session.

Neurophysiological Assessment of An Innovative Maritime Safety System in Terms of Ship Operators' Mental Workload, Stress, and Attention in the Full Mission Bridge Simulator.

The current industrial environment relies heavily on maritime transportation. Despite the continuous technological advances for the development of innovative safety software and hardware systems, there is a consistent gap in the scientific literature regarding the objective evaluation of the performance of maritime operators. The human factor is profoundly affected by changes in human performance or psychological state. The difficulty lies in the fact that the technology, tools, and protocols for investigating human performance are not fully mature or suitable for experimental investigation. The present research aims to integrate these two concepts by (i) objectively characterizing the psychological state of mariners, i.e., mental workload, stress, and attention, through their electroencephalographic (EEG) signal analysis, and (ii) validating an innovative safety framework countermeasure, defined as Human Risk-Informed Design (HURID), through the aforementioned neurophysiological approach. The proposed study involved 26 mariners within a high-fidelity bridge simulator while encountering collision risk in congested waters with and without the HURID. Subjective, behavioral, and neurophysiological data, i.e., EEG, were collected throughout the experimental activities. The results showed that the participants experienced a statistically significant higher mental workload and stress while performing the maritime activities without the HURID, while their attention level was statistically lower compared to the condition in which they performed the experiments with the HURID (all p < 0.05). Therefore, the presented study confirmed the effectiveness of the HURID during maritime operations in critical scenarios and led the way to extend the neurophysiological evaluation of the HFs of maritime operators during the performance of critical and/or standard shipboard tasks.

A covert attention P300-based brain-computer interface: Geospell.

The Farwell and Donchin P300 speller interface is one of the most widely used brain-computer interface (BCI) paradigms for writing text. Recent studies have shown that the recognition accuracy of the P300 speller decreases significantly when eye movement is impaired. This report introduces the GeoSpell interface (Geometric Speller), which implements a stimulation framework for a P300-based BCI that has been optimised for operation in covert visual attention. We compared the Geospell with the P300 speller interface under overt attention conditions with regard to effectiveness, efficiency and user satisfaction. Ten healthy subjects participated in the study. The performance of the GeoSpell interface in covert attention was comparable with that of the P300 speller in overt attention. As expected, the effectiveness of the spelling decreased with the new interface in covert attention. The NASA task load index (TLX) for workload assessment did not differ significantly between the two modalities. PRACTITIONER SUMMARY: This study introduces and evaluates a gaze-independent, P300-based brain-computer interface, the efficacy and user satisfaction of which were comparable with those off the classical P300 speller. Despite a decrease in effectiveness due to the use of covert attention, the performance of the GeoSpell far exceeded the threshold of accuracy with regard to effective spelling.

EEG-Based Index for Timely Detecting User's Drowsiness Occurrence in Automotive Applications.

Human errors are widely considered among the major causes of road accidents. Furthermore, it is estimated that more than 90% of vehicle crashes causing fatal and permanent injuries are directly related to mental tiredness, fatigue, and drowsiness of the drivers. In particular, driving drowsiness is recognized as a crucial aspect in the context of road safety, since drowsy drivers can suddenly lose control of the car. Moreover, the driving drowsiness episodes mostly appear suddenly without any prior behavioral evidence. The present study aimed at characterizing the onset of drowsiness in car drivers by means of a multimodal neurophysiological approach to develop a synthetic electroencephalographic (EEG)-based index, able to detect drowsy events. The study involved 19 participants in a simulated scenario structured in a sequence of driving tasks under different situations and traffic conditions. The experimental conditions were designed to induce prominent mental drowsiness in the final part. The EEG-based index, so-called "MDrow index", was developed and validated to detect the driving drowsiness of the participants. The MDrow index was derived from the Global Field Power calculated in the Alpha EEG frequency band over the parietal brain sites. The results demonstrated the reliability of the proposed MDrow index in detecting the driving drowsiness experienced by the participants, resulting also more sensitive and timely sensible with respect to more conventional autonomic parameters, such as the EyeBlinks Rate and the Heart Rate Variability, and to subjective measurements (self-reports).

EEG-based Brain-Computer Interfaces for people with Disorders of Consciousness: Features and applications. A systematic review.

Background: Disorders of Consciousness (DoC) are clinical conditions following a severe acquired brain injury (ABI) characterized by absent or reduced awareness, known as coma, Vegetative State (VS)/Unresponsive Wakefulness Syndrome (VS/UWS), and Minimally Conscious State (MCS). Misdiagnosis rate between VS/UWS and MCS is attested around 40% due to the clinical and behavioral fluctuations of the patients during bedside consciousness assessments. Given the large body of evidence that some patients with DoC possess "covert" awareness, revealed by neuroimaging and neurophysiological techniques, they are candidates for intervention with brain-computer interfaces (BCIs). Objectives: The aims of the present work are (i) to describe the characteristics of BCI systems based on electroencephalography (EEG) performed on DoC patients, in terms of control signals adopted to control the system, characteristics of the paradigm implemented, classification algorithms and applications (ii) to evaluate the performance of DoC patients with BCI. Methods: The search was conducted on Pubmed, Web of Science, Scopus and Google Scholar. The PRISMA guidelines were followed in order to collect papers published in english, testing a BCI and including at least one DoC patient. Results: Among the 527 papers identified with the first run of the search, 27 papers were included in the systematic review. Characteristics of the sample of participants, behavioral assessment, control signals employed to control the BCI, the classification algorithms, the characteristics of the paradigm, the applications and performance of BCI were the data extracted from the study. Control signals employed to operate the BCI were: P300 (N = 19), P300 and Steady-State Visual Evoked Potentials (SSVEP; hybrid system, N = 4), sensorimotor rhythms (SMRs; N = 5) and brain rhythms elicited by an emotional task (N = 1), while assessment, communication, prognosis, and rehabilitation were the possible applications of BCI in DoC patients. Conclusion: Despite the BCI is a promising tool in the management of DoC patients, supporting diagnosis and prognosis evaluation, results are still preliminary, and no definitive conclusions may be drawn; even though neurophysiological methods, such as BCI, are more sensitive to covert cognition, it is suggested to adopt a multimodal approach and a repeated assessment strategy.