SSVEP BCI and Eye Tracking Use by Individuals With Late-Stage ALS and Visual Impairments.

Access to communication is critical for individuals with late-stage amyotrophic lateral sclerosis (ALS) and minimal volitional movement, but they sometimes present with concomitant visual or ocular motility impairments that affect their performance with eye tracking or visual brain-computer interface (BCI) systems. In this study, we explored the use of modified eye tracking and steady state visual evoked potential (SSVEP) BCI, in combination with the Shuffle Speller typing interface, for this population. Two participants with late-stage ALS, visual impairments, and minimal volitional movement completed a single-case experimental research design comparing copy-spelling performance with three different typing systems: (1) commercially available eye tracking communication software, (2) Shuffle Speller with modified eye tracking, and (3) Shuffle Speller with SSVEP BCI. Participant 1 was unable to type any correct characters with the commercial system, but achieved accuracies of up to 50% with Shuffle Speller eye tracking and 89% with Shuffle Speller BCI. Participant 2 also had higher maximum accuracies with Shuffle Speller, typing with up to 63% accuracy with eye tracking and 100% accuracy with BCI. However, participants' typing accuracy for both Shuffle Speller conditions was highly variable, particularly in the BCI condition. Both the Shuffle Speller interface and SSVEP BCI input show promise for improving typing performance for people with late-stage ALS. Further development of innovative BCI systems for this population is needed.

Ethical Considerations in Ending Exploratory Brain-Computer Interface Research Studies in Locked-in Syndrome.

Brain-computer interface (BCI) is a promising technology for restoring communication in individuals with locked-in syndrome (LIS). BCI technology offers a potential tool for individuals with impaired or absent means of effective communication to use brain activity to control an output device such as a computer keyboard. Exploratory studies of BCI devices for communication in people with LIS are underway. Research with individuals with LIS presents not only technological challenges, but ethical challenges as well. Whereas recent attention has been focused on ethical issues that arise at the initiation of studies, such as how to obtain valid consent, relatively little attention has been given to issues at the conclusion of studies. BCI research in LIS highlights one such challenge: How to decide when an exploratory BCI research study should end. In this article, we present the case of an individual with presumed LIS enrolled in an exploratory BCI study. We consider whether two common ethical frameworks for stopping randomized clinical trials-equipoise and nonexploitation-can be usefully applied to elucidating researcher obligations to end exploratory BCI research. We argue that neither framework is a good fit for exploratory BCI research. Instead, we apply recent work on clinician-researcher fiduciary obligations and in turn offer some preliminary recommendations for BCI researchers on how to end exploratory BCI studies.

Code-VEP vs. Eye Tracking: A Comparison Study.

Even with state-of-the-art techniques there are individuals whose paralysis prevents them from communicating with others. Brain⁻Computer-Interfaces (BCI) aim to utilize brain waves to construct a voice for those whose needs remain unmet. In this paper we compare the efficacy of a BCI input signal, code-VEP via Electroencephalography, against eye gaze tracking, among the most popular modalities used. These results, on healthy individuals without paralysis, suggest that while eye tracking works well for some, it does not work well or at all for others; the latter group includes individuals with corrected vision or those who squint their eyes unintentionally while focusing on a task. It is also evident that the performance of the interface is more sensitive to head/body movements when eye tracking is used as the input modality, compared to using c-VEP. Sensitivity to head/body movement could be better in eye tracking systems which are tracking the head or mounted on the face and are designed specifically as assistive devices. The sample interface developed for this assessment has the same reaction time when driven with c-VEP or with eye tracking; approximately 0.5⁻1 second is needed to make a selection among the four options simultaneously presented. Factors, such as system reaction time and robustness play a crucial role in participant preferences.

Pairwise, Ordinal Outlier Detection of Traumatic Brain Injuries.

Because mild Traumatic Brain Injuries (mTBI) are heterogeneous, classification methods perform outlier detection from a model of healthy tissue. Such a model is challenging to construct. Instead, we utilize region-specific pairwise (person-to-person) comparisons. Each person-region is characterized by a distribution of Fractional Anisotropy and comparisons are made via Median, Mean, Bhattacharya and Kullback-Liebler distances. Additionally, we examine an ordinal decision rule which compares a subject's nth most atypical region to a healthy control's. Ordinal comparison is motivated by mTBI's heterogeneity; each mTBI has some set of damaged tissue which is not necessarily spatially consistent. These improvements correctly distinguish Persistent Post-Concussive Symptoms in a small dataset but achieve only a .74 AUC in identifying mTBI subjects with milder symptoms. Finally, we perform subject-specific simulations which characterize which injuries are detected and which are missed.

Effects of simulated visual acuity and ocular motility impairments on SSVEP brain-computer interface performance: An experiment with Shuffle Speller.

Individuals with severe speech and physical impairments may have concomitant visual acuity impairments (VAI) or ocular motility impairments (OMI) impacting visual BCI use. We report on the use of the Shuffle Speller typing interface for an SSVEP BCI copy-spelling task under three conditions: simulated VAI, simulated OMI, and unimpaired vision. To mitigate the effect of visual impairments, we introduce a method that adaptively selects a user-specific trial length to maximize expected information transfer rate (ITR); expected ITR is shown to closely approximate the rate of correct letter selections. All participants could type under the unimpaired and simulated VAI conditions, with no significant differences in typing accuracy or speed. Most participants (31 of 37) could not type under the simulated OMI condition; some achieved high accuracy but with slower typing speeds. Reported workload and discomfort were low, and satisfaction high, under the unimpaired and simulated VAI conditions. Implications and future directions to examine effect of visual impairment on BCI use is discussed.

Recursive Bayesian Coding for BCIs.

Brain-Computer Interfaces (BCIs) seek to infer some task symbol, a task relevant instruction, from brain symbols, classifiable physiological states. For example, in a motor imagery robot control task a user would indicate their choice from a dictionary of task symbols (rotate arm left, grasp, etc.) by selecting from a smaller dictionary of brain symbols (imagined left or right hand movements). We examine how a BCI infers a task symbol using selections of brain symbols. We offer a recursive Bayesian decision framework which incorporates context prior distributions (e.g., language model priors in spelling applications), accounts for varying brain symbol accuracy and is robust to single brain symbol query errors. This framework is paired with Maximum Mutual Information (MMI) coding which maximizes a generalization of ITR. Both are applicable to any discrete task and brain phenomena (e.g., P300, SSVEP, MI). To demonstrate the efficacy of our approach we perform SSVEP "Shuffle" Speller experiments and compare our recursive coding scheme with traditional decision tree methods including Huffman coding. MMI coding leverages the asymmetry of the classifier's mistakes across a particular user's SSVEP responses; in doing so it offers a 33% increase in letter accuracy though it is 13% slower in our experiment.

Probabilistic Simulation Framework for EEG-Based BCI Design.

A simulation framework could decrease the burden of attending long and tiring experimental sessions on the potential users of brain computer interface (BCI) systems. Specifically during the initial design of a BCI, a simulation framework that could replicate the operational performance of the system would be a useful tool for designers to make design choices. In this manuscript, we develop a Monte Carlo based probabilistic simulation framework for electroencephalography (EEG) based BCI design. We employ one event related potential (ERP) based typing and one steady state evoked potential (SSVEP) based control interface as testbeds. We compare the results of simulations with real time experiments. Even though over and under estimation of the performance is possible, the statistical results over the Monte Carlo simulations show that the developed framework generally provides a good approximation of the real time system performance.