Utility of the P300 Brain-Computer Interface for Patients in Acute Care Environme

描述（由申请人提供）：麻痹性损伤和疾病，如颈脊髓损伤、脑干中风、神经肌肉衰竭（如重症肌无力、格林-巴利综合征）或多重创伤，可使患者清醒并住院，但无法充分沟通数天、数周或更长时间。虽然有些病人可能会用眨眼或其他简单的方法来表达“是”或“否”，但这种缓慢而费力的方法往往会导致沮丧和沟通不足，而在这段时间里，回答和提出有关医疗保健的问题的能力是最关键的。基于在ALS患者的受控家庭环境中使用脑机接口（bci）的令人鼓舞的初步数据，这项拟议的转化研究将探索是否可以为刚刚入住重症监护室或急性医院环境的患者开发类似的技术。将为24名不能说话的住院患者提供只需要EEG电极帽、放大器和笔记本电脑/患者监护仪的P300-BCI。使用P300-BCI，患者只需注意显示器上出现的所需字母，就可以尝试“键入”字母表中的字母。我们的第一个目标是确定识别与注意指示字母（“复制拼写”）相关的脑电图特征（“P300波”）的分类器算法。这将需要研究初始“复制-拼写”任务的效率，以及离线EEG分析以优化复制-拼写性能。我们的第二个目标是确定急性护理环境中的患者是否可以使用P300-BCI进行沟通，并进一步优化用户界面，以便在急性瘫痪患者与其医护人员和家人之间提供快速、准确的沟通。能够使用P300-BCI进行通信的患者将获得一个BCI系统，供其住院期间使用。为了实现NIDCD治疗沟通障碍和改善为沟通障碍患者提供服务的使命，这项多机构、多学科、转化性研究将支持两个主要研究小组之间的合作：纽约州奥尔巴尼Wadsworth中心的基础科学和脑机接口开发团队，马萨诸塞州总医院和哈佛医学院布里格姆妇女医院神经内科的临床研究和神经危重症护理团队。医院里的瘫痪病人有时无法说话或交流，尽管他们完全清醒。这项研究旨在测试和开发一种“脑机接口”系统，该系统可以通过看着电脑屏幕上闪烁的字母来恢复打字的能力。

DESCRIPTION (provided by applicant): Paralyzing injuries and illnesses such as cervical spinal cord injury, brainstem stroke, neuromuscular failure (e.g., myasthenia gravis, Guillain-Barre Syndrome), or multi-trauma can leave patients awake and hospitalized, yet unable to communicate adequately for days, weeks, or longer. While some patients may use eye blinks or other simple means to communicate 'yes' or 'no', this slow and laborious method often results in frustration and inadequate communication during a period when the ability to answer and ask questions regarding one's medical care is most critical. Based upon encouraging preliminary data from use of brain-computer interfaces (BCIs) in the controlled home environment of people with ALS, this proposed translational research will explore whether a similar technology can be developed for patients just admitted to the intensive care unit or acute hospital setting. A P300-BCI that requires only an EEG electrode cap, amplifier, and a laptop/patient monitor will be provided to 24 hospitalized patients who are unable to speak. Using the P300-BCI, patients will try to "type" letters of the alphabet simply by attending to desired letters as they appear on the monitor. Our first aim is to determine the classifier algorithm that recognizes EEG signatures (the "P300 wave") associated with attention to instructed letters ("copy-spelling"). This will require studying the efficiency of the initial "copy-spelling" task, as well as offline EEG analyses to optimize copy-spelling performance. Our second aim is to determine whether patients in acute care settings can use the P300-BCI to communicate, and to optimize further the user interface to provide rapid, accurate communication between the acutely paralyzed patient and his/her healthcare staff and family. Patients able to use the P300-BCI to communicate will be provided with a BCI system for use during their hospitalization. Toward the NIDCD's mission of treating communication disorders and improving delivery of services to people with communication disorders, this multi-institutional, multi-disciplinary, translational study will support the collaboration between two premier research groups: the basic science and BCI development team at the Wadsworth Center in Albany, NY, and the clinical research and neurocritical care teams in the Departments of Neurology at Massachusetts General Hospital and Brigham and Women's Hospital at Harvard Medical School, Boston, MA. Paralyzed patients in the hospital are sometimes unable to talk or communicate, despite being fully awake. This research aims to test and develop a "brain-computer interface" system that could restore the ability to type words, just by looking at letters as they flash on a computer screen.