Publication

Behavioral and cortical effects during attention driven brain-computer interface operations in spatial neglect: A feasibility case study

Abstract

During the last years, several studies have suggested that Brain-Computer Interface (BCI) can play a critical role in the field of motor rehabilitation. In this case report, we aim to investigate the feasibility of a covert visuospatial attention (CVSA) driven BCI in three patients with left spatial neglect (SN). We hypothesize that such a BCI is able to detect attention task-specific brain patterns in SN patients and can induce significant changes in their abnormal cortical activity (alpha-power modulation, feature recruitment, and connectivity). The three patients were asked to control online a CVSA BCI by focusing their attention at different spatial locations, including their neglected (left) space. As primary outcome, results show a significant improvement of the reaction time in the neglected space between calibration and online modalities (p < 0.01) for the two out of three patients that had the slowest initial behavioral response. Such an evolution of reaction time negatively correlates (p < 0.05) with an increment of the Individual alpha-Power computed in the pre-cue interval. Furthermore, all patients exhibited a significant reduction of the inter-hemispheric imbalance (p < 0.05) over time in the parieto-occipital regions. Finally, analysis on the inter-hemispheric functional connectivity suggests an increment across modalities for regions in the affected (right) hemisphere and decrement for those in the healthy. Although preliminary, this feasibility study suggests a possible role of BCI in the therapeutic treatment of lateralized, attention-based visuospatial deficits.

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Related concepts (35)
Brain–computer interface
A brain–computer interface (BCI), sometimes called a brain–machine interface (BMI) or smartbrain, is a direct communication pathway between the brain's electrical activity and an external device, most commonly a computer or robotic limb. BCIs are often directed at researching, mapping, assisting, augmenting, or repairing human cognitive or sensory-motor functions. They are often conceptualized as a human–machine interface that skips the intermediary component of the physical movement of body parts, although they also raise the possibility of the erasure of the discreteness of brain and machine.
Hemispatial neglect
Hemispatial neglect is a neuropsychological condition in which, after damage to one hemisphere of the brain (e.g. after a stroke), a deficit in attention and awareness towards the side of space opposite brain damage (contralesional space) is observed. It is defined by the inability of a person to process and perceive stimuli towards the contralesional side of the body or environment. Hemispatial neglect is very commonly contralateral to the damaged hemisphere, but instances of ipsilesional neglect (on the same side as the lesion) have been reported.
Attention
Attention is the concentration of awareness on some phenomenon to the exclusion of other stimuli. It is a process of selectively concentrating on a discrete aspect of information, whether considered subjective or objective. William James (1890) wrote that "Attention is the taking possession by the mind, in clear and vivid form, of one out of what seem several simultaneously possible objects or trains of thought. Focalization, concentration, of consciousness are of its essence.
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