Brain-Computer Interfaces for Communication: Preferences of Individuals With Locked-in Syndrome.
Mariana P Branco, Elmar G M Pels, Ruben H Sars and 4 others
PMID 33530868WHAT IT FOUND
People with locked-in syndrome want communication brain-computer interfaces that allow direct conversation and writing, controlled by imagining movement or speech.
They prefer to learn about these aids when they first lose the ability to speak or move, rather than earlier in their disease.
Key findings
01Participants ranked direct personal communication and private conversation/writing as the most important applications for a brain-computer interface, significantly preferring these over artistic expression.
02When choosing a mental strategy to control the interface, participants strongly preferred attempted speech and body movements over counting backward or visual/auditory signal methods.
03Both those with progressive neuromuscular disease and those with sudden onset conditions preferred to receive information about assistive technology when they reached the locked-in state, coinciding with the loss of speech or movement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study included only 28 participants, which limits the generalizability of the findings to the broader locked-in syndrome population. A majority of participants (86%) had prior exposure to brain-computer interface concepts, which may have influenced their preferences or understanding of the technology. Caregivers and family members were present during interviews, which could have biased the participants' answers even though they were asked not to respond on behalf of the patient. The study did not assess participants' cognitive status formally, so it is unknown if comorbid cognitive issues affected their ability to imagine certain mental strategies. The questionnaire asked about an ideal, perfectly functioning system, so preferences may differ when faced with the actual speed, accuracy, and frustration of current technology.
Declared interests
The authors declared no conflicts of interest. The research was funded by the European Research Council, the Dutch Technology Foundation STW, and the National Institutes of Health.
The easy way to misread this
Do not assume these preferences translate to successful clinical implementation. Participants rated an idealized, perfectly accurate system; current brain-computer interfaces are often slower and less reliable than the eye-tracking or switch systems many participants already use, which may explain why most felt current BCIs offered limited benefit.