BAsIC - Brain-computer-interface practical Application in the Intensive Care unit: a pilot study

越来越多的患者在危重护理中幸存下来，但对许多人来说，这种经历在一定程度上是心理上的折磨 因为它们失去了对环境的所有控制权。神经损伤的患者尤其容易患上 这一重大的自主性丧失影响了他们的长期恢复。脑机接口(BCI)技术 将与患者思想相关的生理变化转化为可操作的输出。这项技术是 在重症监护环境之外迅速发展并得到很好的支持。这个项目的目标是确定 有意识和无意识出现的ICU患者是否能够传达他们的基本需求，如 如疼痛、饥饿和口渴，给使用BCI技术的医疗保健提供者。我们将在床边应用脑机接口 ICU中的系统使用机器学习算法来分析常规EEG的变化以响应 通过耳机向患者提出标准化问题。BCI系统将提供即时闭合- 向患者提供关于其表现的循环反馈(听觉和/或视觉)。为了实现我们的目标，我们首先要测试 如果有意识的ICU患者能够使用BCI向卫生保健提供者表达基本需求，如疼痛 技术患者将触发BCI系统，然后针对特定问题表达他们的需求 (例如，“你疼吗？”)。其次，我们将确定患者是否可以进行基本的交流 认知运动分离(即，看起来昏迷，但使用脑电运动遵循指令的患者 意象范式)。我们将测试这些患者是否能够使用脑-机接口系统来回答简单的问题 (即，“激活警报”)。最后，我们将使用脑机接口技术评估患者的体验 研究以及在患者、家庭和健康的未来临床试验中使用脑机接口技术的接受度 参与这项研究的护理提供者。这项提案的长期目标是准备一项大型临床试验以进行测试 脑机接口辅助沟通在脑损伤ICU患者中的益处。

Patients increasingly survive critical care, but for many the experience is psychologically tormenting in part because they lose all control over their environment. Patients with neurological injury in particular suffer from this major loss of autonomy which impacts their long term recovery. Brain-computer interface (BCI) technology transforms physiological changes associated with patient thoughts into actionable outputs. The technology is rapidly advancing and well established outside of the critical care setting. The goal of this project is to determine whether conscious and unconscious appearing ICU patients are able to communicate their basic needs, such as pain, hunger, and thirst, to health care providers using the BCI technology. We will apply a bedside BCI system in the ICU using a machine-learning algorithm that analyzes changes in routine EEG in response to standardized questions presented to the patient by headphones. The BCI system will provide immediate closed- loop feedback (auditory and/or visual) to patients about their performance. To achieve our goals, we will first test if conscious ICU patients are able to express basic needs, such as pain, to health care providers using the BCI technology. Patients will trigger the BCI system to then express their needs in response to specific questions (e.g., “Do you have pain?”). Secondly, we will determine whether basic communication is possible for patients with cognitive motor dissociation (i.e., patients who appear unconscious, but follow commands using EEG motor imagery paradigms). We will test if these patients are able to use the BCI system to respond to simple questions (i.e., “Activate the alarm”). Finally, we will assess the patient's experience using BCI technology as part of this study, as well as acceptance of using BCI technology in future clinical trials from patients, families, and health care providers involved in the study. The long-term goal of this proposal is to prepare a large clinical trial to test the benefits of BCI-assisted communication in brain-injured ICU patients.