Biomedical subjects

Nicola Neumann

Publications and source records attributed to Nicola Neumann.

11 recordsLinked to original sources

PubMed2006

Neural internet: Web surfing with brain potentials for the completely paralyzed.

Neural Internet is a new technological advancement in brain-computer interface research, which enables locked-in patients to operate a Web browser directly with their brain potentials. Neural Internet was successfully tested with a locked-in patient diagnosed with amyotrophic lateral sclerosis rendering him the first paralyzed person to surf the Internet solely by regulating his electrical brain activity. The functioning of Neural Internet and its clinical implications for motor-impaired patients are highlighted.

Amyotrophic Lateral Sclerosis↗

PubMed2005

Emotional responding in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a fatal disease, leaving the patient in a partially or completely deafferented state. In an explorative study, we investigated responses to visual socio-emotional stimuli in ALS patients. Pictures from the International Affective Picture System (IAPS) were verbally judged by 12 moderately affected ALS patients with a spinal onset and a slow progression and 18 age-matched controls, and data were compared with psychophysiological responses. Verbal emotional judgments of patients were more positive than ratings of controls. Regarding arousal, patients neutralized extreme pictures, in that they rated calm pictures as more exciting than controls and exciting pictures as more calm. These changes of emotional processing were unrelated to depression or frontal lobe dysfunction. There were no major differences between patients and controls concerning physiological responses to emotional stimuli. We conclude that emotional responses of ALS patients tend to be altered towards positive valence and towards a more balanced arousal state in early stages of the disease. These findings contradict assumptions of a generally negative impact of the disease on the emotional disposition and may indicate compensatory cognitive or neuroplastic changes.

Aged↗

PubMed2005

Brain-computer interfaces--the key for the conscious brain locked into a paralyzed body.

Brain-computer interfaces (BCIs) are systems that allow us to translate in real-time the electrical activity of the brain in commands to control devices. They do not rely on muscular activity and can therefore provide communication and control for those who are severely paralyzed (locked-in) due to injury or disease. It has been shown that locked-in patients are able to achieve EEG-controlled cursor or limb movement and patients have successfully communicated by means of a BCI. Current BCIs differ in how the neural activity of the brain is recorded, how subjects (humans and animals) are trained to produce a specific EEG response, how the signals are translated into device commands, and which application is provided to the user. The present review focuses on approaches to BCIs that process the EEG on-line and provide EEG feedback or feedback of results to the user. We regard online processing and feedback cornerstones for routine application of BCIs in the field. Because training patients in their home environment is effortful and personal and financial resources are limited, only few studies on BCI long-term use for communication with paralyzed patients are available. The need for multidisciplinary research, comprising computer science, engineering, neuroscience, and psychology is now being acknowledged by the BCI community. A standard BCI platform, referred to as BCI2000, has been developed, which allows us to better combine and compare the different BCI approaches of different laboratories. As BCI laboratories now also join to unify their expertise and collaborations are funded, we consider it realistic that within few years we will be able to offer a BCI, which will be easy to operate for patients and caregivers.

Animals↗

PubMed2005

An auditory brain-computer interface based on the self-regulation of slow cortical potentials.

OBJECTIVES: Communication support for severely paralyzed patients with visual impairment is needed. Therefore, the feasibility of a brain-computer interface (BCI) using auditory stimuli alone, based on the self-regulation of slow cortical potentials (SCPs), was investigated. METHODS: Auditory stimuli were used for task and feedback presentation in an SCP self-regulation paradigm. Voluntarily produced SCP responses and measures of communication performance were compared between 3 groups (total of N = 59) of visual, auditory, and cross-modal visual-auditory modality. Electroencephalogram recordings and training from Cz-mastoids were carried out on 3 consecutive sessions. Data of 1500 trials per subject were collected. RESULTS: Best performance was achieved for the visual, followed by the auditory condition. The performance deficit of the auditory condition was partly due to decreased self-produced positivity. Larger SCP response variability also accounted for lower performance of the auditory condition. Cross-modally presented stimuli did not lead to significant learning and control of SCP. CONCLUSIONS: Brain-computer communication using auditory stimuli only is possible. Smaller cortical positivity achieved in the auditory condition, as compared to the visual condition, may be a consequence of increased selective attention to simultaneously presented auditory stimuli. To optimize performance, auditory stimuli characteristics may have to be adapted. Other suggestions for enhancement of communication performance with auditory stimuli are discussed.

Adult↗

PubMed2004

Assessment of cognitive functions in severely paralysed and severely brain-damaged patients: neuropsychological and electrophysiological methods.

A systematic neuropsychological assessment technique is described for use with severely physically disabled individuals, possibly with combined motor and cognitive disorders. Target neurological conditions may be, e.g., an incomplete locked-in state, a minimally conscious state, or severe combinations of paralysis, agnosia, and apraxia. Neuropsychological assessment in these patients is difficult, because standard neuropsychological tests require fast motor responses, which can be manual, verbal, or both. To assess the cognitive status of patients with residual motor function, tests have been applied that can be answered by a binary (yes/no) signal and whose outcomes were not based on reaction times. Further, a battery of neurophysiological examination procedures based on event-related brain potentials has been developed. These procedures can be performed directly at a patient's bedside (at home or in a hospital) and applied for assessment of cognitive functions even in patients without residual motor function.

Brain Injuries↗

PubMed2004

Brain-computer communication and slow cortical potentials.

A thought translation device (TTD) has been designed to enable direct brain-computer communication using self-regulation of slow cortical potentials (SCPs). However, accuracy of SCP control reveals high intersubject variability. To guarantee the highest possible communication speed, some important aspects of training SCPs are discussed. A baseline correction of SCPs can increase performance. Multichannel recordings show that SCPs are of highest amplitude around the vertex electrode used for feedback, but in some subjects more global distributions were observed. A new method for control of eye movement is presented. Sequential effects of trial-to-trial interaction may also cause difficulties for the user. Finally, psychophysiological factors determining SCP communication are discussed.

Adult↗

PubMed2003

A multimodal brain-based feedback and communication system.

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.

Acoustic Stimulation↗

PubMed2003

Conscious perception of brain states: mental strategies for brain-computer communication.

Direct brain-computer communication utilises self-regulation of brain potentials to select letters, words or symbols from a computer menu. In this study a completely paralysed (locked-in) patient learnt to produce slow cortical potential (SCP) shifts to operate a binary spelling device. After hundreds of training sessions he gave a detailed description of his mental strategies for self-regulation. His cognitive strategies matched with the electrocortical changes perfectly. Thus he produced a contingent negative variation (CNV) with images of preparation such as an arrow being drawn on a bow. To produce a positive potential shift he imagined the arrow shooting up from the bow. To suppress potential shifts he tried to stop thinking. The study demonstrates that patients become sensitive for their brain states with increasing self-regulation practice. The use of conscious cognitive strategies may, however, be incompatible with the complete automatization of the self-regulation skill.

Amyotrophic Lateral Sclerosis↗

PubMed2003

A brain-computer interface (BCI) for the locked-in: comparison of different EEG classifications for the thought translation device.

OBJECTIVE: The Thought Translation Device (TTD) for brain-computer interaction was developed to enable totally paralyzed patients to communicate. Patients learn to regulate slow cortical potentials (SCPs) voluntarily with feedback training to select letters. This study reports the comparison of different methods of electroencephalographic (EEG) analysis to improve spelling accuracy with the TTD on a data set of 6,650 trials of a severely paralyzed patient. METHODS: Selections of letters occurred by exceeding a certain SCP amplitude threshold. To enhance the patient's control of an additional event-related cortical potential, a filter with two filter characteristics ('mixed filter') was developed and applied on-line. To improve performance off-line the criterion for threshold-related decisions was varied. Different types of discriminant analysis were applied to the EEG data set as well as on wavelet transformed EEG data. RESULTS: The mixed filter condition increased the patients' performance on-line compared to the SCP filter alone. A threshold, based on the ratio between required selections and rejections, resulted in a further improvement off-line. Discriminant analysis of both time-series SCP data and wavelet transformed data increased the patient's correct response rate off-line. CONCLUSIONS: It is possible to communicate with event-related potentials using the mixed filter feedback method. As wavelet transformed data cannot be fed back on-line before the end of a trial, they are applicable only if immediate feedback is not necessary for a brain-computer interface (BCI). For future BCIs, wavelet transformed data should serve for BCIs without immediate feedback. A stepwise wavelet transformation would even allow immediate feedback.

Communication Devices for People with Disabilities↗

PubMed2003

Training locked-in patients: a challenge for the use of brain-computer interfaces.

Training severely paralyzed patients to use a brain-computer interface (BCI) for communication poses a number of issues and problems. Over the past six years, we have trained 11 patients to self-regulate their slow cortical brain potentials and to use this skill to move a cursor on a computer screen. This paper describes our experiences with this patient group including the problems of accepting and rejecting patients, communicating and interacting with patients, how training may be affected by social, familial, and institutional circumstances, and the importance of motivation and available reinforcers.

Adaptation, Physiological↗

PubMed2003

The thought-translation device (TTD): neurobehavioral mechanisms and clinical outcome.

The thought-translation device (TTD) consists of a training device and spelling program for the completely paralyzed using slow-cortical brain potentials (SCP). During the training phase, the self-regulation of SCPs is learned through visual-auditory feedback and positive reinforcement of SCPs; during the spelling phase, patients select letters or words with their SCPs. A psychophysiological system for detection of cognitive functioning in completely paralyzed patients is an integral part of the TTD. The neurophysiological and anatomical basis of SCP-regulation was investigated by recording of BOLD-response in functional magnetic resonance imaging. Results showed involvement of basal ganglia and premotor cortex for required SCP positivity. The clinical outcome of 11 paralyzed patients using the TTD and quality of life of severely paralyzed patients is described. First attempts to improve learning of brain regulation with transcranial magnetic stimulation were successful.

Amyotrophic Lateral Sclerosis↗