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      Brain–computer interface in critical care and rehabilitation

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          Abstract

          This comprehensive review explores the broad landscape of brain–computer interface (BCI) technology and its potential use in intensive care units (ICUs), particularly for patients with motor impairments such as quadriplegia or severe brain injury. By employing brain signals from various sensing techniques, BCIs offer enhanced communication and motor rehabilitation strategies for patients. This review underscores the concept and efficacy of noninvasive, electroencephalogram-based BCIs in facilitating both communicative interactions and motor function recovery. Additionally, it highlights the current research gap in intuitive “stop” mechanisms within motor rehabilitation protocols, emphasizing the need for advancements that prioritize patient safety and individualized responsiveness. Furthermore, it advocates for more focused research that considers the unique requirements of ICU environments to address the challenges arising from patient variability, fatigue, and limited applicability of current BCI systems outside of experimental settings.

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          Most cited references78

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          Event-related EEG/MEG synchronization and desynchronization: basic principles.

          An internally or externally paced event results not only in the generation of an event-related potential (ERP) but also in a change in the ongoing EEG/MEG in form of an event-related desynchronization (ERD) or event-related synchronization (ERS). The ERP on the one side and the ERD/ERS on the other side are different responses of neuronal structures in the brain. While the former is phase-locked, the latter is not phase-locked to the event. The most important difference between both phenomena is that the ERD/ERS is highly frequency band-specific, whereby either the same or different locations on the scalp can display ERD and ERS simultaneously. Quantification of ERD/ERS in time and space is demonstrated on data from a number of movement experiments.
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            BCI2000: a general-purpose brain-computer interface (BCI) system.

            Many laboratories have begun to develop brain-computer interface (BCI) systems that provide communication and control capabilities to people with severe motor disabilities. Further progress and realization of practical applications depends on systematic evaluations and comparisons of different brain signals, recording methods, processing algorithms, output formats, and operating protocols. However, the typical BCI system is designed specifically for one particular BCI method and is, therefore, not suited to the systematic studies that are essential for continued progress. In response to this problem, we have developed a documented general-purpose BCI research and development platform called BCI2000. BCI2000 can incorporate alone or in combination any brain signals, signal processing methods, output devices, and operating protocols. This report is intended to describe to investigators, biomedical engineers, and computer scientists the concepts that the BC12000 system is based upon and gives examples of successful BCI implementations using this system. To date, we have used BCI2000 to create BCI systems for a variety of brain signals, processing methods, and applications. The data show that these systems function well in online operation and that BCI2000 satisfies the stringent real-time requirements of BCI systems. By substantially reducing labor and cost, BCI2000 facilitates the implementation of different BCI systems and other psychophysiological experiments. It is available with full documentation and free of charge for research or educational purposes and is currently being used in a variety of studies by many research groups.
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              Talking off the top of your head: toward a mental prosthesis utilizing event-related brain potentials

              This paper describes the development and testing of a system whereby one can communicate through a computer by using the P300 component of the event-related brain potential (ERP). Such a system may be used as a communication aid by individuals who cannot use any motor system for communication (e.g., 'locked-in' patients). The 26 letters of the alphabet, together with several other symbols and commands, are displayed on a computer screen which serves as the keyboard or prosthetic device. The subject focuses attention successively on the characters he wishes to communicate. The computer detects the chosen character on-line and in real time. This detection is achieved by repeatedly flashing rows and columns of the matrix. When the elements containing the chosen character are flashed, a P300 is elicited, and it is this P300 that is detected by the computer. We report an analysis of the operating characteristics of the system when used with normal volunteers, who took part in 2 experimental sessions. In the first session (the pilot study/training session) subjects attempted to spell a word and convey it to a voice synthesizer for production. In the second session (the analysis of the operating characteristics of the system) subjects were required simply to attend to individual letters of a word for a specific number of trials while data were recorded for off-line analysis. The analyses suggest that this communication channel can be operated accurately at the rate of 0.20 bits/sec. In other words, under the conditions we used, subjects can communicate 12.0 bits, or 2.3 characters, per min.
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                Author and article information

                Journal
                Acute Crit Care
                Acute Crit Care
                ACC
                Acute and Critical Care
                Korean Society of Critical Care Medicine
                2586-6052
                2586-6060
                February 2024
                12 January 2024
                : 39
                : 1
                : 24-33
                Affiliations
                [1 ]Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan, Korea
                [2 ]Department of Mechanical Engineering, Sungkyunkwan University, Suwon, Korea
                Author notes
                Corresponding author: Sung-Phil Kim Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50 UNIST-gil, Eonyang-eup, Ulju-gun, Ulsan 44919, Korea Tel: +82-52-217-2727, E-mail: spkim@ 123456unist.ac.kr
                Author information
                http://orcid.org/0009-0004-2888-305X
                http://orcid.org/0009-0003-0667-8138
                http://orcid.org/0000-0001-6665-3475
                Article
                acc-2023-01382
                10.4266/acc.2023.01382
                11002623
                38224957
                3aac8ffd-2bb6-4829-ba78-ce1cadadc5a0
                © 2024 The Korean Society of Critical Care Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 October 2023
                : 8 November 2023
                Categories
                Review Article
                Basic Science and Research

                brain–computer interface,communication,intensive care unit,muscular weakness,neurorehabilitation

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