Feasibility of an EEG-based brain-computer interface in the intensive care unit

Area of Science:

• Neuroscience
• Medical Technology
• Clinical Neurology

Background:

• Assessing consciousness in patients with acute brain injuries is challenging.
• Brain-computer interfaces (BCIs) offer a potential avenue for evaluating awareness.
• Commercially available BCIs require validation for intensive care unit (ICU) deployment.

Purpose of the Study:

• To evaluate the feasibility of a commercially available EEG-based BCI in the ICU setting.
• To assess the BCI's ability to detect consciousness in patients with acute disorders of consciousness (DoC) or locked-in syndrome (LIS).

Main Methods:

• Ten patients (9 DoC, 1 LIS) and 10 healthy subjects (HS) participated.
• The BCI employed oddball auditory evoked potentials, vibrotactile evoked potentials (VTP), and motor imagery (MoI).
• Assessment completion rates, time, sensitivity, and specificity were recorded.

Main Results:

• All patients completed the assessment, with 9 finishing in under an hour.
• The LIS patient experienced fatigue; HS and LIS patients showed more consistent BCI responses than DoC patients.
• No significant association was found between BCI responses and behavioral signs of consciousness in DoC patients.

Conclusions:

• The BCI system is deployable in the ICU and may aid in confirming consciousness in acute LIS.
• The BCI's unreliability in acute DoC necessitates further development.
• Improvements in accuracy and protocol duration are required for clinical implementation in DoC patients.