TeleBCI: remote user training, monitoring, and communication with an evoked-potential brain-computer interface

Brain-computer interfaces (BCIs) are a movement-independent form of augmentative and alternative communication (AAC) for individuals with amyotrophic lateral sclerosis (ALS). The rare utilization of such devices in the homes of patients stems from a number of factors, one of which is the complexity of providing training and support for users. This paper describes the teleBCI interface used to train the patient and facilitator in the operation of a virtual keyboard using an evoked potential BCI. Fifteen patients with motor neuron disease and their communication partners were included in the study, participating from their homes while receiving remote support from the research team. Patient/caregiver teams completed 8 sessions each of P300 BCI training virtually with the researcher. As they participated in subsequent training sessions, participant teams required less help to complete physical, computer, and BCI-specific tasks associated with device use. A subset of users experienced improved performance over sessions, progressing to utilize the full functionality of the speller and communicate with a nurse partner over a telemedicine interface. Perceptions of device utility varied with accuracy of the BCI system. In the management of ALS, the integration of telemedicine provides new opportunities for care delivery, including how BCI-AAC are deployed and used.