Brain-computer interfaces for people with amyotrophic lateral sclerosis

A brain-computer interface (BCI) records and extracts features from brain signals, and translates these features into commands that can replace, restore, enhance, supplement, or improve natural CNS outputs. As demonstrated in the other chapters of this book, the focus of the work of the last three decades of BCI research has been the replacement, restoration, or improvement of diminished or lost function in people with CNS disease or injury including those with amyotrophic lateral sclerosis (ALS). Due in part to the desire to conduct controlled studies, and, in part, to the complexity of BCI technology, most of this work has been carried out in laboratories with healthy controls or with limited numbers of potential consumers with a variety of diagnoses under supervised conditions. The intention of this chapter is to describe the growing body of BCI research that has included people with amyotrophic lateral sclerosis (ALS). People in the late stages of ALS can lose all voluntary control, including the ability to communicate; and while recent research has provided new insights into underlying mechanisms, ALS remains a disease with no cure. As a result, people with ALS and their families, caregivers, and advocates have an active interest in both the current and potential capabilities of BCI technology. The focus of BCI research for people with ALS is on communication, and this topic is well covered elsewhere in this volume. This chapter focuses on the efforts dedicated to make BCI technology useful to people with ALS in their daily lives with a discussion of how researchers, clinicians, and patients must become partners in that process.