Closing the loop between brain and electrical stimulation: towards precision neuromodulation treatments.

One of the most critical challenges in using noninvasive brain stimulation (NIBS) techniques for the treatment of psychiatric and neurologic disorders is inter- and intra-individual variability in response to NIBS. Response variations in previous findings suggest that the one-size-fits-all approach does not seem the most appropriate option for enhancing stimulation outcomes. While there is a growing body of evidence for the feasibility and effectiveness of individualized NIBS approaches, the optimal way to achieve this is yet to be determined. Transcranial electrical stimulation (tES) is one of the NIBS techniques showing promising results in modulating treatment outcomes in several psychiatric and neurologic disorders, but it faces the same challenge for individual optimization. With new computational and methodological advances, tES can be integrated with real-time functional magnetic resonance imaging (rtfMRI) to establish closed-loop tES-fMRI for individually optimized neuromodulation. Closed-loop tES-fMRI systems aim to optimize stimulation parameters based on minimizing differences between the model of the current brain state and the desired value to maximize the expected clinical outcome. The methodological space to optimize closed-loop tES fMRI for clinical applications includes (1) stimulation vs. data acquisition timing, (2) fMRI context (task-based or resting-state), (3) inherent brain oscillations, (4) dose-response function, (5) brain target trait and state and (6) optimization algorithm. Closed-loop tES-fMRI technology has several advantages over non-individualized or open-loop systems to reshape the future of neuromodulation with objective optimization in a clinically relevant context such as drug cue reactivity for substance use disorder considering both inter and intra-individual variations. Using multi-level brain and behavior measures as input and desired outcomes to individualize stimulation parameters provides a framework for designing personalized tES protocols in precision psychiatry.

Planning ahead: Predictable switching recruits task-active and resting-state networks.

Switching is a difficult cognitive process characterised by costs in task performance; specifically, slowed responses and reduced accuracy. It is associated with the recruitment of a large coalition of task-positive regions including those referred to as the multiple demand cortex (MDC). The neural correlates of switching not only include the MDC, but occasionally the default mode network (DMN), a characteristically task-negative network. To unpick the role of the DMN during switching we collected fMRI data from 24 participants playing a switching paradigm that perturbed predictability (i.e., cognitive load) across three switch dimensions-sequential, perceptual, and spatial predictability. We computed the activity maps unique to switch vs. stay trials and all switch dimensions, then evaluated functional connectivity under these switch conditions by computing the pairwise mutual information functional connectivity (miFC) between regional timeseries. Switch trials exhibited an expected cost in reaction time while sequential predictability produced a significant benefit to task accuracy. Our results showed that switch trials recruited a broader activity map than stay trials, including regions of the DMN, the MDC, and task-positive networks such as visual, somatomotor, dorsal, salience/ventral attention networks. More sequentially predictable trials recruited increased activity in the somatomotor and salience/ventral attention networks. Notably, changes in sequential and perceptual predictability, but not spatial predictability, had significant effects on miFC. Increases in perceptual predictability related to decreased miFC between control, visual, somatomotor, and DMN regions, whereas increases in sequential predictability increased miFC between regions in the same networks, as well as regions within ventral attention/ salience, dorsal attention, limbic, and temporal parietal networks. These results provide novel clues as to how DMN may contribute to executive task performance. Specifically, the improved task performance, unique activity, and increased miFC associated with increased sequential predictability suggest that the DMN may coordinate more strongly with the MDC to generate a temporal schema of upcoming task events, which may attenuate switching costs.

TemplateFlow: FAIR-sharing of multi-scale, multi-species brain models.

Reference anatomies of the brain ('templates') and corresponding atlases are the foundation for reporting standardized neuroimaging results. Currently, there is no registry of templates and atlases; therefore, the redistribution of these resources occurs either bundled within existing software or in ad hoc ways such as downloads from institutional sites and general-purpose data repositories. We introduce TemplateFlow as a publicly available framework for human and non-human brain models. The framework combines an open database with software for access, management, and vetting, allowing scientists to share their resources under FAIR-findable, accessible, interoperable, and reusable-principles. TemplateFlow enables multifaceted insights into brains across species, and supports multiverse analyses testing whether results generalize across standard references, scales, and in the long term, species.

Handling EEG artifacts and searching individually optimal experimental parameter in real time: a system development and demonstration.

Objective.Neuroadaptive paradigms that systematically assess event-related potential (ERP) features across many different experimental parameters have the potential to improve the generalizability of ERP findings and may help to accelerate ERP-based biomarker discovery by identifying the exact experimental conditions for which ERPs differ most for a certain clinical population. Obtaining robust and reliable ERPs online is a prerequisite for ERP-based neuroadaptive research. One of the key steps involved is to correctly isolate electroencephalography artifacts in real time because they contribute a large amount of variance that, if not removed, will greatly distort the ERP obtained. Another key factor of concern is the computational cost of the online artifact handling method. This work aims to develop and validate a cost-efficient system to support ERP-based neuroadaptive research.Approach.We developed a simple online artifact handling method, single trial PCA-based artifact removal (SPA), based on variance distribution dichotomies to distinguish between artifacts and neural activity. We then applied this method in an ERP-based neuroadaptive paradigm in which Bayesian optimization was used to search individually optimal inter-stimulus-interval (ISI) that generates ERP with the highest signal-to-noise ratio.Main results.SPA was compared to other offline and online algorithms. The results showed that SPA exhibited good performance in both computational efficiency and preservation of ERP pattern. Based on SPA, the Bayesian optimization procedure was able to quickly find individually optimal ISI.Significance.The current work presents a simple yet highly cost-efficient method that has been validated in its ability to extract ERP, preserve ERP effects, and better support ERP-based neuroadaptive paradigm.

A Bayesian optimization approach for rapidly mapping residual network function in stroke.

Post-stroke cognitive and linguistic impairments are debilitating conditions, with limited therapeutic options. Domain-general brain networks play an important role in stroke recovery and characterizing their residual function with functional MRI has the potential to yield biomarkers capable of guiding patient-specific rehabilitation. However, this is challenging as such detailed characterization requires testing patients on multitudes of cognitive tasks in the scanner, rendering experimental sessions unfeasibly lengthy. Thus, the current status quo in clinical neuroimaging research involves testing patients on a very limited number of tasks, in the hope that it will reveal a useful neuroimaging biomarker for the whole cohort. Given the great heterogeneity among stroke patients and the volume of possible tasks this approach is unsustainable. Advancing task-based functional MRI biomarker discovery requires a paradigm shift in order to be able to swiftly characterize residual network activity in individual patients using a diverse range of cognitive tasks. Here, we overcome this problem by leveraging neuroadaptive Bayesian optimization, an approach combining real-time functional MRI with machine-learning, by intelligently searching across many tasks, this approach rapidly maps out patient-specific profiles of residual domain-general network function. We used this technique in a cross-sectional study with 11 left-hemispheric stroke patients with chronic aphasia (four female, age ± standard deviation: 59 ± 10.9 years) and 14 healthy, age-matched control subjects (eight female, age ± standard deviation: 55.6 ± 6.8 years). To assess intra-subject reliability of the functional profiles obtained, we conducted two independent runs per subject, for which the algorithm was entirely reinitialized. Our results demonstrate that this technique is both feasible and robust, yielding reliable patient-specific functional profiles. Moreover, we show that group-level results are not representative of patient-specific results. Whereas controls have highly similar profiles, patients show idiosyncratic profiles of network abnormalities that are associated with behavioural performance. In summary, our study highlights the importance of moving beyond traditional 'one-size-fits-all' approaches where patients are treated as one group and single tasks are used. Our approach can be extended to diverse brain networks and combined with brain stimulation or other therapeutics, thereby opening new avenues for precision medicine targeting a diverse range of neurological and psychiatric conditions.

Interpretable brain age prediction using linear latent variable models of functional connectivity.

Neuroimaging-driven prediction of brain age, defined as the predicted biological age of a subject using only brain imaging data, is an exciting avenue of research. In this work we seek to build models of brain age based on functional connectivity while prioritizing model interpretability and understanding. This way, the models serve to both provide accurate estimates of brain age as well as allow us to investigate changes in functional connectivity which occur during the ageing process. The methods proposed in this work consist of a two-step procedure: first, linear latent variable models, such as PCA and its extensions, are employed to learn reproducible functional connectivity networks present across a cohort of subjects. The activity within each network is subsequently employed as a feature in a linear regression model to predict brain age. The proposed framework is employed on the data from the CamCAN repository and the inferred brain age models are further demonstrated to generalize using data from two open-access repositories: the Human Connectome Project and the ATR Wide-Age-Range.

Efficiently searching through large tACS parameter spaces using closed-loop Bayesian optimization.

BACKGROUND: Selecting optimal stimulation parameters from numerous possibilities is a major obstacle for assessing the efficacy of non-invasive brain stimulation. OBJECTIVE: We demonstrate that Bayesian optimization can rapidly search through large parameter spaces and identify subject-level stimulation parameters in real-time. METHODS: To validate the method, Bayesian optimization was employed using participants' binary judgements about the intensity of phosphenes elicited through tACS. RESULTS: We demonstrate the efficiency of Bayesian optimization in identifying parameters that maximize phosphene intensity in a short timeframe (5 min for >190 possibilities). Our results replicate frequency-dependent effects across three montages and show phase-dependent effects of phosphene perception. Computational modelling explains that these phase effects result from constructive/destructive interference of the current reaching the retinas. Simulation analyses demonstrate the method's versatility for complex response functions, even when accounting for noisy observations. CONCLUSION: Alongside subjective ratings, this method can be used to optimize tACS parameters based on behavioral and neural measures and has the potential to be used for tailoring stimulation protocols to individuals.

Predicting Responses to Psychedelics: A Prospective Study.

Responses to psychedelics are notoriously difficult to predict, yet significant work is currently underway to assess their therapeutic potential and the level of interest in psychedelics among the general public appears to be increasing. We aimed to collect prospective data in order to improve our ability to predict acute- and longer-term responses to psychedelics. Individuals who planned to take a psychedelic through their own initiative participated in an online survey (www.psychedelicsurvey.com). Traits and variables relating to set, setting and the acute psychedelic experience were measured at five different time points before and after the experience. Principle component and regression methods were used to analyse the data. Sample sizes for the five time points were N = 654, N = 535, N = 379, N = 315, and N = 212 respectively. Psychological well-being was increased 2 weeks after a psychedelic experience and remained at this level after 4 weeks. Higher ratings of a "mystical-type experience" had a positive effect on the change in well-being after a psychedelic experience, whereas the other acute psychedelic experience measures, i.e., "challenging experience" and "visual effects", did not influence the change in well-being after the psychedelic experience. Having "clear intentions" for the experience was conducive to mystical-type experiences. Having a positive "set" as well as having the experience with intentions related to "recreation" were both found to decrease the likelihood of having a challenging experience. The baseline trait "absorption" and higher drug doses promoted all aspects of the acute experience, i.e., mystical-type and challenging experiences, as well as visual effects. When comparing the relative contribution of different types of variables in explaining the variance in the change in well-being, it seemed that baseline trait variables had the strongest effect on the change in well-being after a psychedelic experience. These results confirm the importance of extra-pharmacological factors in determining responses to a psychedelic. We view this study as an early step towards the development of empirical guidelines that can evolve and improve iteratively with the ultimate purpose of guiding crucial clinical decisions about whether, when, where and how to dose with a psychedelic, thus helping to mitigate risks while maximizing potential benefits in an evidence-based manner.

Dissociating frontoparietal brain networks with neuroadaptive Bayesian optimization.

Understanding the unique contributions of frontoparietal networks (FPN) in cognition is challenging because they overlap spatially and are co-activated by diverse tasks. Characterizing these networks therefore involves studying their activation across many different cognitive tasks, which previously was only possible with meta-analyses. Here, we use neuroadaptive Bayesian optimization, an approach combining real-time analysis of functional neuroimaging data with machine-learning, to discover cognitive tasks that segregate ventral and dorsal FPN activity. We identify and subsequently refine two cognitive tasks, Deductive Reasoning and Tower of London, which maximally dissociate the dorsal from ventral FPN. We subsequently investigate these two FPNs in the context of a wider range of FPNs and demonstrate the importance of studying the whole activity profile across tasks to uniquely differentiate any FPN. Our findings deviate from previous meta-analyses and hypothesized functional labels for these FPNs. Taken together the results form the starting point for a neurobiologically-derived cognitive taxonomy.

Bayesian Optimization for Neuroimaging Pre-processing in Brain Age Classification and Prediction.

Neuroimaging-based age prediction using machine learning is proposed as a biomarker of brain aging, relating to cognitive performance, health outcomes and progression of neurodegenerative disease. However, even leading age-prediction algorithms contain measurement error, motivating efforts to improve experimental pipelines. T1-weighted MRI is commonly used for age prediction, and the pre-processing of these scans involves normalization to a common template and resampling to a common voxel size, followed by spatial smoothing. Resampling parameters are often selected arbitrarily. Here, we sought to improve brain-age prediction accuracy by optimizing resampling parameters using Bayesian optimization. Using data on N = 2003 healthy individuals (aged 16-90 years) we trained support vector machines to (i) distinguish between young (<22 years) and old (>50 years) brains (classification) and (ii) predict chronological age (regression). We also evaluated generalisability of the age-regression model to an independent dataset (CamCAN, N = 648, aged 18-88 years). Bayesian optimization was used to identify optimal voxel size and smoothing kernel size for each task. This procedure adaptively samples the parameter space to evaluate accuracy across a range of possible parameters, using independent sub-samples to iteratively assess different parameter combinations to arrive at optimal values. When distinguishing between young and old brains a classification accuracy of 88.1% was achieved, (optimal voxel size = 11.5 mm3, smoothing kernel = 2.3 mm). For predicting chronological age, a mean absolute error (MAE) of 5.08 years was achieved, (optimal voxel size = 3.73 mm3, smoothing kernel = 3.68 mm). This was compared to performance using default values of 1.5 mm3 and 4mm respectively, resulting in MAE = 5.48 years, though this 7.3% improvement was not statistically significant. When assessing generalisability, best performance was achieved when applying the entire Bayesian optimization framework to the new dataset, out-performing the parameters optimized for the initial training dataset. Our study outlines the proof-of-principle that neuroimaging models for brain-age prediction can use Bayesian optimization to derive case-specific pre-processing parameters. Our results suggest that different pre-processing parameters are selected when optimization is conducted in specific contexts. This potentially motivates use of optimization techniques at many different points during the experimental process, which may improve statistical sensitivity and reduce opportunities for experimenter-led bias.

Active Acquisition for multimodal neuroimaging.

In many clinical and scientific situations the optimal neuroimaging sequence may not be known prior to scanning and may differ for each individual being scanned, depending on the exact nature and location of abnormalities. Despite this, the standard approach to data acquisition, in such situations, is to specify the sequence of neuroimaging scans prior to data acquisition and to apply the same scans to all individuals. In this paper, we propose and illustrate an alternative approach, in which data would be analysed as it is acquired and used to choose the future scanning sequence: Active Acquisition. We propose three Active Acquisition scenarios based around multiple MRI modalities. In Scenario 1, we propose a simple use of near-real time analysis to decide whether to acquire more or higher resolution data, or acquire data with a different field -of -view. In Scenario 2, we simulate how multimodal MR data could be actively acquired and combined with a decision tree to classify a known outcome variable (in the simple example here, age). In Scenario 3, we simulate using Bayesian optimisation to actively search across multiple MRI modalities to find those which are most abnormal. These simulations suggest that by actively acquiring data, the scanning sequence can be adapted to each individual. We also consider the many outstanding practical and technical challenges involving normative data acquisition, MR physics, statistical modelling and clinical relevance. Despite these, we argue that  Active Acquisition allows for potentially far more powerful, sensitive or rapid data acquisition, and may open up different perspectives on individual differences, clinical conditions, and biomarker discovery.

Decoding Time-Varying Functional Connectivity Networks via Linear Graph Embedding Methods.

An exciting avenue of neuroscientific research involves quantifying the time-varying properties of functional connectivity networks. As a result, many methods have been proposed to estimate the dynamic properties of such networks. However, one of the challenges associated with such methods involves the interpretation and visualization of high-dimensional, dynamic networks. In this work, we employ graph embedding algorithms to provide low-dimensional vector representations of networks, thus facilitating traditional objectives such as visualization, interpretation and classification. We focus on linear graph embedding methods based on principal component analysis and regularized linear discriminant analysis. The proposed graph embedding methods are validated through a series of simulations and applied to fMRI data from the Human Connectome Project.

Externally induced frontoparietal synchronization modulates network dynamics and enhances working memory performance.

Cognitive functions such as working memory (WM) are emergent properties of large-scale network interactions. Synchronisation of oscillatory activity might contribute to WM by enabling the coordination of long-range processes. However, causal evidence for the way oscillatory activity shapes network dynamics and behavior in humans is limited. Here we applied transcranial alternating current stimulation (tACS) to exogenously modulate oscillatory activity in a right frontoparietal network that supports WM. Externally induced synchronization improved performance when cognitive demands were high. Simultaneously collected fMRI data reveals tACS effects dependent on the relative phase of the stimulation and the internal cognitive processing state. Specifically, synchronous tACS during the verbal WM task increased parietal activity, which correlated with behavioral performance. Furthermore, functional connectivity results indicate that the relative phase of frontoparietal stimulation influences information flow within the WM network. Overall, our findings demonstrate a link between behavioral performance in a demanding WM task and large-scale brain synchronization.

Neuroadaptive Bayesian Optimization and Hypothesis Testing.

Cognitive neuroscientists are often interested in broad research questions, yet use overly narrow experimental designs by considering only a small subset of possible experimental conditions. This limits the generalizability and reproducibility of many research findings. Here, we propose an alternative approach that resolves these problems by taking advantage of recent developments in real-time data analysis and machine learning. Neuroadaptive Bayesian optimization is a powerful strategy to efficiently explore more experimental conditions than is currently possible with standard methodology. We argue that such an approach could broaden the hypotheses considered in cognitive science, improving the generalizability of findings. In addition, Bayesian optimization can be combined with preregistration to cover exploration, mitigating researcher bias more broadly and improving reproducibility.

Real-time estimation of dynamic functional connectivity networks.

Two novel and exciting avenues of neuroscientific research involve the study of task-driven dynamic reconfigurations of functional connectivity networks and the study of functional connectivity in real-time. While the former is a well-established field within neuroscience and has received considerable attention in recent years, the latter remains in its infancy. To date, the vast majority of real-time fMRI studies have focused on a single brain region at a time. This is due in part to the many challenges faced when estimating dynamic functional connectivity networks in real-time. In this work, we propose a novel methodology with which to accurately track changes in time-varying functional connectivity networks in real-time. The proposed method is shown to perform competitively when compared to state-of-the-art offline algorithms using both synthetic as well as real-time fMRI data. The proposed method is applied to motor task data from the Human Connectome Project as well as to data obtained from a visuospatial attention task. We demonstrate that the algorithm is able to accurately estimate task-related changes in network structure in real-time. Hum Brain Mapp 38:202-220, 2017. © 2016 Wiley Periodicals, Inc.

Novel Modeling of Task vs. Rest Brain State Predictability Using a Dynamic Time Warping Spectrum: Comparisons and Contrasts with Other Standard Measures of Brain Dynamics.

Dynamic time warping, or DTW, is a powerful and domain-general sequence alignment method for computing a similarity measure. Such dynamic programming-based techniques like DTW are now the backbone and driver of most bioinformatics methods and discoveries. In neuroscience it has had far less use, though this has begun to change. We wanted to explore new ways of applying DTW, not simply as a measure with which to cluster or compare similarity between features but in a conceptually different way. We have used DTW to provide a more interpretable spectral description of the data, compared to standard approaches such as the Fourier and related transforms. The DTW approach and standard discrete Fourier transform (DFT) are assessed against benchmark measures of neural dynamics. These include EEG microstates, EEG avalanches, and the sum squared error (SSE) from a multilayer perceptron (MLP) prediction of the EEG time series, and simultaneously acquired FMRI BOLD signal. We explored the relationships between these variables of interest in an EEG-FMRI dataset acquired during a standard cognitive task, which allowed us to explore how DTW differentially performs in different task settings. We found that despite strong correlations between DTW and DFT-spectra, DTW was a better predictor for almost every measure of brain dynamics. Using these DTW measures, we show that predictability is almost always higher in task than in rest states, which is consistent to other theoretical and empirical findings, providing additional evidence for the utility of the DTW approach.

LSD modulates music-induced imagery via changes in parahippocampal connectivity.

Psychedelic drugs such as lysergic acid diethylamide (LSD) were used extensively in psychiatry in the past and their therapeutic potential is beginning to be re-examined today. Psychedelic psychotherapy typically involves a patient lying with their eyes-closed during peak drug effects, while listening to music and being supervised by trained psychotherapists. In this context, music is considered to be a key element in the therapeutic model; working in synergy with the drug to evoke therapeutically meaningful thoughts, emotions and imagery. The underlying mechanisms involved in this process have, however, never been formally investigated. Here we studied the interaction between LSD and music-listening on eyes-closed imagery by means of a placebo-controlled, functional magnetic resonance imaging (fMRI) study. Twelve healthy volunteers received intravenously administered LSD (75µg) and, on a separate occasion, placebo, before being scanned under eyes-closed resting conditions with and without music-listening. The parahippocampal cortex (PHC) has previously been linked with (1) music-evoked emotion, (2) the action of psychedelics, and (3) mental imagery. Imaging analyses therefore focused on changes in the connectivity profile of this particular structure. Results revealed increased PHC-visual cortex (VC) functional connectivity and PHC to VC information flow in the interaction between music and LSD. This latter result correlated positively with ratings of enhanced eyes-closed visual imagery, including imagery of an autobiographical nature. These findings suggest a plausible mechanism by which LSD works in combination with music listening to enhance certain subjective experiences that may be useful in a therapeutic context.

The Automatic Neuroscientist: A framework for optimizing experimental design with closed-loop real-time fMRI.

Functional neuroimaging typically explores how a particular task activates a set of brain regions. Importantly though, the same neural system can be activated by inherently different tasks. To date, there is no approach available that systematically explores whether and how distinct tasks probe the same neural system. Here, we propose and validate an alternative framework, the Automatic Neuroscientist, which turns the standard fMRI approach on its head. We use real-time fMRI in combination with modern machine-learning techniques to automatically design the optimal experiment to evoke a desired target brain state. In this work, we present two proof-of-principle studies involving perceptual stimuli. In both studies optimization algorithms of varying complexity were employed; the first involved a stochastic approximation method while the second incorporated a more sophisticated Bayesian optimization technique. In the first study, we achieved convergence for the hypothesized optimum in 11 out of 14 runs in less than 10 min. Results of the second study showed how our closed-loop framework accurately and with high efficiency estimated the underlying relationship between stimuli and neural responses for each subject in one to two runs: with each run lasting 6.3 min. Moreover, we demonstrate that using only the first run produced a reliable solution at a group-level. Supporting simulation analyses provided evidence on the robustness of the Bayesian optimization approach for scenarios with low contrast-to-noise ratio. This framework is generalizable to numerous applications, ranging from optimizing stimuli in neuroimaging pilot studies to tailoring clinical rehabilitation therapy to patients and can be used with multiple imaging modalities in humans and animals.

Cascades and cognitive state: focused attention incurs subcritical dynamics.

The analysis of neuronal avalanches supports the hypothesis that the human cortex operates with critical neural dynamics. Here, we investigate the relationship between cascades of activity in electroencephalogram data, cognitive state, and reaction time in humans using a multimodal approach. We recruited 18 healthy volunteers for the acquisition of simultaneous electroencephalogram and functional magnetic resonance imaging during both rest and during a visuomotor cognitive task. We compared distributions of electroencephalogram-derived cascades to reference power laws for task and rest conditions. We then explored the large-scale spatial correspondence of these cascades in the simultaneously acquired functional magnetic resonance imaging data. Furthermore, we investigated whether individual variability in reaction times is associated with the amount of deviation from power law form. We found that while resting state cascades are associated with approximate power law form, the task state is associated with subcritical dynamics. Furthermore, we found that electroencephalogram cascades are related to blood oxygen level-dependent activation, predominantly in sensorimotor brain regions. Finally, we found that decreased reaction times during the task condition are associated with increased proximity to power law form of cascade distributions. These findings suggest that the resting state is associated with near-critical dynamics, in which a high dynamic range and a large repertoire of brain states may be advantageous. In contrast, a focused cognitive task induces subcritical dynamics, which is associated with a lower dynamic range, which in turn may reduce elements of interference affecting task performance.

Towards a holistic assessment of the user experience with hybrid BCIs.

OBJECTIVE: In recent years, brain-computer interfaces (BCIs) have become mature enough to immensely benefit from the expertise and tools established in the field of human-computer interaction (HCI). One of the core objectives in HCI research is the design of systems that provide a pleasurable user experience (UX). While the majority of BCI studies exclusively evaluate common efficiency measures such as classification accuracy and speed, single research groups have begun to look at further usability aspects such as ease of use, workload and learnability. However, these evaluation metrics only cover pragmatic aspects of UX while still not considering the hedonic quality of UX. In order to gain a holistic perspective on UX, hedonic quality aspects such as motivation and frustration were also taken into account for our evaluation of three BCI-driven interfaces, which were proposed to be used as a two-stage neuroprosthetic control within the EU project MUNDUS. APPROACH: At the first stage, one of six possible actions was selected and either confirmed or cancelled at the second stage. For the experiment, a solely event-related-potential-based interface (ERP-ERP) and two hybrid solutions were tested that were controlled by ERP and motor imagery (MI)--resulting in the two possible combinations: ERP selection/MI confirmation (ERP-MI) or MI selection/ERP confirmation (MI-ERP). Behavioural, subjective and encephalographic (EEG) data of 12 healthy subjects were collected during an online experiment with the three graphical user interfaces (GUIs). MAIN RESULTS: Results showed a significantly greater pragmatic quality (in terms of accuracy, efficiency, workload, use quality and learnability) for the ERP-ERP and ERP-MI GUIs in contrast to the MI-ERP GUI. Consequently, the MI-ERP GUI is least suited for use as a neuroprosthetic control. With respect to the comparison of the ERP-ERP and ERP-MI GUIs, no significant differences in pragmatic and hedonic quality of UX were found. Since throughout better results were obtained for the conventional approach and it was most preferred by the subjects, the ERP-ERP GUI seems more suitable for its deployment in actual end-users. Nevertheless, for individuals with stable MI patterns, the hybrid interface can be provided as an additional option of choice within the MUNDUS framework. SIGNIFICANCE: Although the paramount goal in BCI research still remains the improvement of classification accuracy and communication speed, it is of significance to note that it is equally important for end-users to keep up their motivation and prevent frustration. By including pragmatic as well as hedonic quality aspects, this study is the first effort to gain a holistic perspective of the UX while interacting with BCI-driven assistive technology aimed at actual end-users. The broad-scale methodology provided valuable insights into the underlying dynamics causing the users' experience to differ across the GUIs. The results will be used to refine a BCI-driven neuroprosthesis and test it with end-users.