Towards Clinical Acceptability: Enhancing the P300-based Brain-Computer Interface

描述(由申请人提供)：当前使用P300拼写的脑机接口(BCI)系统可以为被锁定的患者提供有效的通信手段，如果患者愿意花费大量时间培训使用该系统并愿意接受相当慢的通信速率的话。这项研究的总体目标是通过增加系统的健壮性，增加患者实现的通信速率，并减少培训患者使用该系统所需的时间，将当前的P300 Speller脑机接口系统从研究实验室过渡到临床使用。在这项工作的R21阶段，将评估标准拼写和训练范式的三种变体实现这些目标的潜力：1)通过优化实验设计改进实时刺激选择，2)使用特征选择技术进行通道选择，以及3)通过对P300反应的顺序检测来改善沟通速度。在R21阶段结束时，这些方法有可能在一组正常受试者中大幅提高交流速度、改善稳健性和增加准确性。在这项工作的R33阶段，我们建议评估我们的R21发展对残疾人的影响。具体地说，我们将首先评估基线拼写系统和改进的拼写系统在临床环境中操作时对残疾对象的影响。利用在临床环境中从这些受试者身上学到的经验教训，我们将开始在家庭环境中测试基线和改进的系统。这一阶段性开发和概念验证工作的目标是将目前在研究环境中运行得相当好的P300拼写系统转变为可在家庭环境中使用的工具，该系统是为临床人群开发的。在成功完成R21/R33的工作后，一种可供ALS患者在家中使用的增强和替代通信(AAC)设备将得到验证，并具有强大和准确的性能，应该已经准备好开始商业化阶段。虽然目前存在基于P300拼写范例的研究和实验室系统，但它们还没有成功地过渡到临床或家庭。这一努力的目标是实现从研究平台到临床医生可开出的相关AAC设备的过渡。除了在临床上提供更强大的研究工具外，肌萎缩侧索硬化症患者还将能够在家里以强大和准确的方式进行交流。 公共卫生相关性：严重的发育性和获得性沟通障碍影响所有年龄段的个人，在英语国家，需要AAC支助的人的流行率估计在每1000人8至12人之间。虽然增强和辅助通信系统在临床上是可用的，但受到严重身体限制的个人，如肌萎缩侧索硬化症(ALS)或脑干中风，可能没有使用这些设备所需的身体能力。成功地克服了目前基于脑电信号处理的P300拼写系统的局限性，并将这些系统过渡到临床和家庭中，将使这些人能够获得不限制其词汇量的沟通辅助工具，并使他们能够保持联系、独立性和自我决定。

DESCRIPTION (provided by applicant): Current brain-computer interface (BCI) systems utilizing the P300 Speller can provide an effective means of communication for locked-in patients if the patients are willing to spend considerable time training to use the system and are willing to accept a fairly slow communication rate. The overarching goal of this research is to transition current P300 Speller BCI systems from research labs to clinical use by increasing system robustness, increasing the communication rate achieved by the patient, and reducing the time required to train the patient to use the system. In the R21 phase of this work, three variations on the standard speller and training paradigm will be evaluated for their potential to achieve these goals: 1) improved real-time stimulus selection via optimal experiment design, 2) channel selection using feature selection techniques, and 3) improved communication rates via the sequential detection of P300 responses. At the completion of the R21 phase, these approaches have the potential to substantively improve communication rates, improve robustness, and increase accuracy in a set of normal subjects. In the R33 phase of this effort, we propose to evaluate the impact of our R21 developments in subjects with disabilities. Specifically, we will begin by assessing the impact of the baseline and improved speller system on subjects with disabilities while operating the system in a clinical environment. Using lessons learned from these subjects in the clinical environment, we will begin testing the baseline and improved system in the home environment. The goal of this phased development and proof of concept effort is to transition the current P300 speller system which operates fairly well in a research environment into a tool that can be used in the home environment by the clinical population for which it was developed. At the successful completion of this R21/R33 effort, an Augmentative and Alternative Communication (AAC) device that can be used in the home by ALS patients with robust and accurate performance will have been demonstrated and should be ready to begin a commercialization phase. While research and laboratory systems exist currently that are based on the P300 speller paradigm, they have not been successfully transitioned to the clinic, or the home. The goal of this effort is to effect that transition from research platform to clinically relevant AAC device prescribable by a clinician. In addition to providing a more powerful research tool in the clinic, ALS subjects would be able to communicate in a robust and accurate fashion in the home. PUBLIC HEALTH RELEVANCE: Severe developmental and acquired communication disabilities affect individuals of all ages, and prevalence estimates of people requiring AAC support range from 8 to 12 persons per 1000 for English speaking countries. While augmentative and assistive communication systems are available clinically, individuals affected by severe physical limitations, such as those caused by amyotrophic lateral sclerosis (ALS) or brain stem stroke, may not have the physical ability required to use these devices. Successfully overcoming the limitations of current P300 Speller systems, which are based on processing EEG signals, and transitioning these systems into the clinic and home will allow these individuals access to a communication aid that does not limit their vocabulary and allows them to maintain connection, independence and self determination.