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Longevity of a Brain-Computer Interface for Amyotrophic Lateral Sclerosis.

Mariska J Vansteensel¹, Sacha Leinders¹, Mariana P Branco¹

¹From the Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands (M.J.V., S.L., M.P.B., Z.V.F., S.H.G., P.H.G., M.R., A.S., M.V., E.J.A., N.F.R.); the Department of Neurology, Johns Hopkins University School of Medicine, Baltimore (N.E.C.); and the Institute of Biomedical Engineering and the Department of Engineering Science, University of Oxford, Oxford, United Kingdom (T.D.).

The New England Journal of Medicine

|August 14, 2024

Summary

This summary is machine-generated.

This study tracked a brain-computer interface (BCI) for communication in amyotrophic lateral sclerosis (ALS) over 7 years. Ultimately, neurodegeneration caused BCI signal decline and ineffectiveness, despite initial success.

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Eye-Tracking Control to Assess Cognitive Functions in Patients with Amyotrophic Lateral Sclerosis

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Published on: October 13, 2016

Area of Science:

Neuroscience
Biomedical Engineering
Neurology

Background:

The long-term efficacy of brain-computer interfaces (BCIs) for communication in individuals with progressive neurodegenerative diseases remains under-explored.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that severely impacts motor control and communication abilities.

Purpose of the Study:

To evaluate the durability and long-term performance of an implanted BCI for communication in a patient with advanced ALS over a 7-year period.
To investigate the factors contributing to the eventual decline in BCI effectiveness in the context of progressive neurodegeneration.

Main Methods:

Longitudinal case study reporting on 7 years of independent at-home use of an implanted BCI for communication.
Monitoring of BCI usage frequency, patient's functional status (eye-gaze tracking), and neural signal amplitude.
Computed tomographic (CT) imaging to assess brain structure and neurodegeneration.

Main Results:

Initial increase in BCI usage frequency over the first 6 years, compensating for loss of eye-gaze control.
A subsequent progressive decrease in BCI use starting around year 6, leading to cessation due to unreliability.
No technical malfunctions identified; observed decline attributed to reduced neural signal amplitude and progressive cerebral atrophy linked to ALS.

Conclusions:

An implanted BCI can provide sustained communication for individuals with ALS for several years.
Progressive neurodegeneration, specifically reduced neural signal amplitude and brain atrophy, can ultimately limit BCI effectiveness.
Long-term BCI performance is influenced by the underlying disease progression, necessitating ongoing monitoring and potential adaptation strategies.