Feasibility of an EEG-based brain-computer interface in the intensive care unit
Feasibility of an EEG-based brain-computer interface in the intensive care unit
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DOI：
10.1016/j.clinph.2018.04.747
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发表时间：
2018-08-01
影响因子：
4.7
通讯作者：
Edlow, Brian L.
中科院分区：
文献类型：
--
作者：
Chatelle, Camille;Spencer, Camille A.;Edlow, Brian L.
目的：我们测试了在重症监护室（ICU）部署基于EEG的脑机接口（BCI）检测急性意识障碍（DoC）或闭锁综合征（LIS）患者意识的可行性。方法：10例患者（9例DoC，1例LIS）和10例健康受试者（HS）入组。脑机接口采用oddball听觉诱发电位，振动触觉诱发电位（VTP）和运动想象（MoI）来评估意识。我们记录了评估完成率和评估所需的时间，并计算了每个范式检测意识行为体征的敏感性和特异性。结果：所有10例患者均完成了评估，其中9例需要不到1小时。LIS患者在疗程结束前报告疲劳。HS和LIS患者比DoC患者表现出更一致的BCI反应，但总体而言，BCI反应和意识的行为体征之间没有关联。结论：该系统在ICU中部署是可行的，可以在急性LIS中确认意识，但在急性DoC中不可靠。在这种商业上可获得的BCI准备好用于临床实施之前，用于检测意识的范例的准确性必须提高，并且协议的持续时间应该缩短在重症监护室的急性DoC患者中。(C)2018国际临床神经生理学联合会。Elsevier B.V.出版，保留所有权利。
Objective: We tested the feasibility of deploying a commercially available EEG-based brain-computer interface (BCI) in the intensive care unit (ICU) to detect consciousness in patients with acute disorders of consciousness (DoC) or locked-in syndrome (LIS).Methods: Ten patients (9 DoC, 1 LIS) and 10 healthy subjects (HS) were enrolled. The BCI utilized oddball auditory evoked potentials, vibrotactile evoked potentials (VTP) and motor imagery (MoI) to assess consciousness. We recorded the assessment completion rate and the time required for assessment, and we calculated the sensitivity and specificity of each paradigm for detecting behavioral signs of consciousness.Results: All 10 patients completed the assessment, 9 of whom required less than 1 h. The LIS patient reported fatigue before the end of the session. The HS and LIS patient showed more consistent BCI responses than DoC patients, but overall there was no association between BCI responses and behavioral signs of consciousness.Conclusions: The system is feasible to deploy in the ICU and may confirm consciousness in acute LIS, but it was unreliable in acute DoC.Significance: The accuracy of the paradigms for detecting consciousness must be improved and the duration of the protocol should be shortened before this commercially available BCI is ready for clinical implementation in the ICU in patients with acute DoC. (C) 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.