Boosting brain-computer interfaces with functional electrical stimulation: potential applications in people with locked-in syndrome.
Evan Canny, Mariska J Vansteensel, Sandra M A van der Salm and 2 others
PMID 37980536WHAT IT FOUND
This review argues that combining brain-computer interfaces with electrical muscle stimulation could restore communication in locked-in syndrome.
It synthesizes evidence from stroke and spinal cord injury but reports no new patient outcomes. It is a theoretical proposal for future research.
Key findings
01The paper proposes combining brain-computer interfaces (BCI) with functional electrical stimulation (FES) to restore communication in locked-in syndrome, but does not report original data from patients with this condition.
02Existing evidence for BCI-FES systems comes primarily from individuals with stroke and spinal cord injury, where they have been used to restore motor function in limbs.
03Applying FES to facial muscles has been shown to induce movements like eyeblinks and smiles in people with facial nerve paralysis, suggesting potential for coded communication.
STILL TO COME
How it was doneWhat they found
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What it does not show
This is a theoretical review proposing a future direction for research. It does not present new clinical evidence, patient outcomes, or efficacy data for the proposed BCI-FES combination in locked-in syndrome. The evidence cited for FES effectiveness is largely from stroke, spinal cord injury, or facial nerve paralysis populations, not from individuals with locked-in syndrome, so generalization is speculative. The review acknowledges that muscle denervation in progressive conditions like ALS may make FES ineffective in later stages, a critical limitation for the target population.
Declared interests
The paper is supported by non-U.S. government funding. No specific commercial conflicts of interest that would bias the clinical recommendations are detailed in the provided text.
The easy way to misread this
Do not interpret this review as evidence that BCI-FES systems are currently available or proven to restore communication in patients with locked-in syndrome. The paper proposes this as a potential area for future research, synthesizing data from other neurological conditions like stroke and spinal cord injury.