Enhancing clinical communication assessments using an audiovisual BCI for patients with disorders of consciousness.

Abstract

OBJECTIVE:

The JFK coma recovery scale-revised (JFK CRS-R), a behavioral observation scale, is widely used in the clinical diagnosis/assessment of patients with disorders of consciousness (DOC). However, the JFK CRS-R is associated with a high rate of misdiagnosis (approximately 40%) because DOC patients cannot provide sufficient behavioral responses. A brain-computer interface (BCI) that detects command/intention-specific changes in electroencephalography (EEG) signals without the need for behavioral expression may provide an alternative method.

APPROACH:

In this paper, we proposed an audiovisual BCI communication system based on audiovisual 'yes' and 'no' stimuli to supplement the JFK CRS-R for assessing the communication ability of DOC patients. Specifically, patients were given situation-orientation questions as in the JFK CRS-R and instructed to select the answers using the BCI.

MAIN RESULTS:

Thirteen patients (eight vegetative state (VS) and five minimally conscious state (MCS)) participated in our experiments involving both the BCI- and JFK CRS-R-based assessments. One MCS patient who received a score of 1 in the JFK CRS-R achieved an accuracy of 86.5% in the BCI-based assessment. Seven patients (four VS and three MCS) obtained unresponsive results in the JFK CRS-R-based assessment but responsive results in the BCI-based assessment, and 4 of those later improved scores in the JFK CRS-R-based assessment. Five patients (four VS and one MCS) obtained usresponsive results in both assessments.

SIGNIFICANCE:

The experimental results indicated that the audiovisual BCI could provide more sensitive results than the JFK CRS-R and therefore supplement the JFK CRS-R.

• Authors: Fei Wang, Yanbin He, Jun Qu, Qiuyou Xie, Qing Lin, Xiaoxiao Ni, Yan Chen, Jiahui Pan, Steven Laureys, Ronghao Yu, Yuanqing Li
• Journal: Journal of neural engineering (J Neural Eng) Vol. 14 Issue 4 Pg. 046024 (08 2017) ISSN: 1741-2552 [Electronic] England
• PMID: 28393761 (Publication Type: Journal Article)

Topics

• Acoustic Stimulation (methods)
• Adolescent
• Adult
• Brain-Computer Interfaces (statistics & numerical data)
• Communication
• Consciousness Disorders (diagnosis, physiopathology, therapy)
• Female
• Humans
• Male
• Middle Aged
• Photic Stimulation (methods)
• Random Allocation
• Young Adult