Enhancing clinical communication assessments using an audiovisual BCI for patients with disorders of consciousness. (14th June 2017)

• Record Type: Journal Article
• Authors: Wang, Fei; He, Yanbin; Qu, Jun; Xie, Qiuyou; Lin, Qing; Ni, Xiaoxiao; Chen, Yan; Pan, Jiahui; Laureys, Steven; Yu, Ronghao; Li, Yuanqing
• Is Part Of: Journal of neural engineering. Volume 14:Number 4(2017:Aug.)
• Publication Date: 2017-06-14
• Subjects: audiovisual brain-computer interface -- disorders of consciousness (DOC) -- coma recovery scale-revised (CRS-R) -- communication -- assessment; Neurosciences -- Periodicals; Biomedical engineering -- Periodicals; 612.8
• DOI: 10.1088/1741-2552/aa6c31
• Languages: English
• ISSNs: 1741-2560

Abstract

Abstract: Objective . The JFK coma recovery scale-revised (JFK CRS-R), a behavioral observation scale, is widely used in the clinical diagnosis/assessment of patients with disorders of consciousness (DOC). However, the JFK CRS-R is associated with a high rate of misdiagnosis (approximately 40%) because DOC patients cannot provide sufficient behavioral responses. A brain–computer interface (BCI) that detects command/intention-specific changes in electroencephalography (EEG) signals without the need for behavioral expression may provide an alternative method. Approach . In this paper, we proposed an audiovisual BCI communication system based on audiovisual 'yes' and 'no' stimuli to supplement the JFK CRS-R for assessing the communication ability of DOC patients. Specifically, patients were given situation-orientation questions as in the JFK CRS-R and instructed to select the answers using the BCI. Main results . Thirteen patients (eight vegetative state (VS) and five minimally conscious state (MCS)) participated in our experiments involving both the BCI- and JFK CRS-R-based assessments. One MCS patient who received a score of 1 in the JFK CRS-R achieved an accuracy of 86.5% in the BCI-based assessment. Seven patients (four VS and three MCS) obtained unresponsive results in the JFK CRS-R-based assessment but responsive results in the BCI-based assessment, and 4 of those later improved scores in the JFK CRS-R-based assessment. Five patients (four VS and one MCS) obtained usresponsive results in both assessments. Significance . The experimental results indicated that the audiovisual BCI could provide more sensitive results than the JFK CRS-R and therefore supplement the JFK CRS-R.