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Amyotroph Lateral Scler Frontotemporal Degener. 2014 Jun;15(3-4):207-15. doi: 10.3109/21678421.2013.865750. Epub 2014 Feb 20.

Brain-computer interface (BCI) evaluation in people with amyotrophic lateral sclerosis.

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Laboratory of Neural Injury and Repair, Wadsworth Center, New York State Department of Health , Albany , New York , and Helen Hayes Rehabilitation Hospital, New York State Department of Health , West Haverstraw, New York , USA.


Brain-computer interfaces (BCIs) might restore communication to people severely disabled by amyotrophic lateral sclerosis (ALS) or other disorders. We sought to: 1) define a protocol for determining whether a person with ALS can use a visual P300-based BCI; 2) determine what proportion of this population can use the BCI; and 3) identify factors affecting BCI performance. Twenty-five individuals with ALS completed an evaluation protocol using a standard 6 × 6 matrix and parameters selected by stepwise linear discrimination. With an 8-channel EEG montage, the subjects fell into two groups in BCI accuracy (chance accuracy 3%). Seventeen averaged 92 (± 3)% (range 71-100%), which is adequate for communication (G70 group). Eight averaged 12 (± 6)% (range 0-36%), inadequate for communication (L40 subject group). Performance did not correlate with disability: 11/17 (65%) of G70 subjects were severely disabled (i.e. ALSFRS-R < 5). All L40 subjects had visual impairments (e.g. nystagmus, diplopia, ptosis). P300 was larger and more anterior in G70 subjects. A 16-channel montage did not significantly improve accuracy. In conclusion, most people severely disabled by ALS could use a visual P300-based BCI for communication. In those who could not, visual impairment was the principal obstacle. For these individuals, auditory P300-based BCIs might be effective.


Amyotrophic lateral sclerosis (ALS); P300; augmentative and alternative communication (AAC); brain-computer interface (BCI); event-related potentials (ERP); rehabilitation

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