A multimodal brain-based feedback and communication system
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Updated: Aug 30, 2026

Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
Thilo Hinterberger1, Nicola Neumann, Mirko Pham
1Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Gartenstrasse 29, 72074, Tübingen, Germany. thilo.hinterberger@uni-tuebingen.de
Abstract:
The Thought Translation Device (TTD) is a brain-computer interface based on the self-regulation of slow cortical potentials (SCPs) and enables completely paralyzed patients to communicate using their brain potentials. Here, an extended version of the TTD is presented that has an auditory and a combined visual and auditory feedback modality added to the standard visual feedback. This feature is necessary for locked-in patients who are no longer able to focus their gaze. In order to test performance of physiological regulation with auditory feedback 54 healthy participants were randomly assigned to visual, auditory or combined visual-auditory feedback of slow cortical potentials. The training consisted of three sessions with 500 trials per session with random assignment of required cortical positivity or negativity in half of the trials. The data show that physiological regulation of SCPs can be learned with auditory and combined auditory and visual feedback although the performance of auditory feedback alone was significantly worse than with visual feedback alone.
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