@article{EidelKuebler2020, author = {Eidel, Matthias and K{\"u}bler, Andrea}, title = {Wheelchair Control in a Virtual Environment by Healthy Participants Using a P300-BCI Based on Tactile Stimulation: Training Effects and Usability}, series = {Frontiers in Human Neuroscience}, volume = {14}, journal = {Frontiers in Human Neuroscience}, issn = {1662-5161}, doi = {10.3389/fnhum.2020.00265}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207775}, year = {2020}, abstract = {Tactile stimulation is less frequently used than visual for brain-computer interface (BCI) control, partly because of limitations in speed and accuracy. Non-visual BCI paradigms, however, may be required for patients who struggle with vision dependent BCIs because of a loss of gaze control. With the present study, we attempted to replicate earlier results by Herweg et al. (2016), with several minor adjustments and a focus on training effects and usability. We invited 16 healthy participants and trained them with a 4-class tactile P300-based BCI in five sessions. Their main task was to navigate a virtual wheelchair through a 3D apartment using the BCI. We found significant training effects on information transfer rate (ITR), which increased from a mean of 3.10-9.50 bits/min. Further, both online and offline accuracies significantly increased with training from 65\% to 86\% and 70\% to 95\%, respectively. We found only a descriptive increase of P300 amplitudes at Fz and Cz with training. Furthermore, we report subjective data from questionnaires, which indicated a relatively high workload and moderate to high satisfaction. Although our participants have not achieved the same high performance as in the Herweg et al. (2016) study, we provide evidence for training effects on performance with a tactile BCI and confirm the feasibility of the paradigm.}, language = {en} } @article{VenturaBortWirknerGenheimeretal.2018, author = {Ventura-Bort, Carlos and Wirkner, Janine and Genheimer, Hannah and Wendt, Julia and Hamm, Alfons O. and Weymar, Mathias}, title = {Effects of Transcutaneous Vagus Nerve Stimulation (tVNS) on the P300 and Alpha-Amylase Level: A Pilot Study}, series = {Frontiers in Human Neuroscience}, volume = {12}, journal = {Frontiers in Human Neuroscience}, number = {202}, issn = {1662-5161}, doi = {10.3389/fnhum.2018.00202}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196129}, year = {2018}, abstract = {Recent research suggests that the P3b may be closely related to the activation of the locus coeruleus-norepinephrine (LC-NE) system. To further study the potential association, we applied a novel technique, the non-invasive transcutaneous vagus nerve stimulation (tVNS), which is speculated to increase noradrenaline levels. Using a within-subject cross-over design, 20 healthy participants received continuous tVNS and sham stimulation on two consecutive days (stimulation counterbalanced across participants) while performing a visual oddball task. During stimulation, oval non-targets (standard), normal-head (easy) and rotated-head (difficult) targets, as well as novel stimuli (scenes) were presented. As an indirect marker of noradrenergic activation we also collected salivary alpha-amylase (sAA) before and after stimulation. Results showed larger P3b amplitudes for target, relative to standard stimuli, irrespective of stimulation condition. Exploratory post hoc analyses, however, revealed that, in comparison to standard stimuli, easy (but not difficult) targets produced larger P3b (but not P3a) amplitudes during active tVNS, compared to sham stimulation. For sAA levels, although main analyses did not show differential effects of stimulation, direct testing revealed that tVNS (but not sham stimulation) increased sAA levels after stimulation. Additionally, larger differences between tVNS and sham stimulation in P3b magnitudes for easy targets were associated with larger increase in sAA levels after tVNS, but not after sham stimulation. Despite preliminary evidence for a modulatory influence of tVNS on the P3b, which may be partly mediated by activation of the noradrenergic system, additional research in this field is clearly warranted. Future studies need to clarify whether tVNS also facilitates other processes, such as learning and memory, and whether tVNS can be used as therapeutic tool.}, language = {en} } @article{BertiVosselGamer2017, author = {Berti, Stefan and Vossel, Gerhard and Gamer, Matthias}, title = {The orienting response in healthy aging: Novelty P3 indicates no general decline but reduced efficacy for fast stimulation rates}, series = {Frontiers in Psychology}, volume = {8}, journal = {Frontiers in Psychology}, doi = {10.3389/fpsyg.2017.01780}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-173651}, year = {2017}, abstract = {Automatic orienting to unexpected changes in the environment is a pre-requisite for adaptive behavior. One prominent mechanism of automatic attentional control is the Orienting Response (OR). Despite the fundamental significance of the OR in everyday life, only little is known about how the OR is affected by healthy aging. We tested this question in two age groups (19-38 and 55-72 years) and measured skin-conductance responses (SCRs) and event-related brain potentials (ERPs) to novels (i.e., short environmental sounds presented only once in the experiment; 10\% of the trials) compared to standard sounds (600 Hz sinusoidal tones with 200 ms duration; 90\% of the trials). Novel and standard stimuli were presented in four conditions differing in the inter-stimulus interval (ISI) with a mean ISI of either 10, 3, 1, or 0.5 s (blocked presentation). In both age groups, pronounced SCRs were elicited by novels in the 10 s ISI condition, suggesting the elicitation of stable ORs. These effects were accompanied by pronounced N1 and frontal P3 amplitudes in the ERP, suggesting that automatic novelty processing and orientation of attention are effective in both age groups. Furthermore, the SCR and ERP effects declined with decreasing ISI length. In addition, differences between the two groups were observable with the fastest presentation rates (i.e., 1 and 0.5 s ISI length). The most prominent difference was a shift of the peak of the frontal positivity from around 300 to 200 ms in the 19-38 years group while in the 55-72 years group the amplitude of the frontal P3 decreased linearly with decreasing ISI length. Taken together, this pattern of results does not suggest a general decline in processing efficacy with healthy aging. At least with very rare changes (here, the novels in the 10 s ISI condition) the OR is as effective in healthy older adults as in younger adults. With faster presentation rates, however, the efficacy of the OR decreases. This seems to result in a switch from novelty to deviant processing in younger adults, but less so in the group of older adults.}, language = {en} } @article{ErlbeckMochtyKuebleretal.2017, author = {Erlbeck, Helena and Mochty, Ursula and K{\"u}bler, Andrea and Real, Ruben G. L.}, title = {Circadian course of the P300 ERP in patients with amyotrophic lateral sclerosis - implications for brain-computer interfaces (BCI)}, series = {BMC Neurology}, volume = {17}, journal = {BMC Neurology}, number = {3}, doi = {10.1186/s12883-016-0782-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157423}, year = {2017}, abstract = {Background: Accidents or neurodegenerative diseases like amyotrophic lateral sclerosis (ALS) can lead to progressing, extensive, and complete paralysis leaving patients aware but unable to communicate (locked-in state). Brain-computer interfaces (BCI) based on electroencephalography represent an important approach to establish communication with these patients. The most common BCI for communication rely on the P300, a positive deflection arising in response to rare events. To foster broader application of BCIs for restoring lost function, also for end-users with impaired vision, we explored whether there were specific time windows during the day in which a P300 driven BCI should be preferably applied. Methods: The present study investigated the influence of time of the day and modality (visual vs. auditory) on P300 amplitude and latency. A sample of 14 patients (end-users) with ALS and 14 healthy age matched volunteers participated in the study and P300 event-related potentials (ERP) were recorded at four different times (10, 12 am, 2, \& 4 pm) during the day. Results: Results indicated no differences in P300 amplitudes or latencies between groups (ALS patients v. healthy participants) or time of measurement. In the auditory condition, latencies were shorter and amplitudes smaller as compared to the visual condition. Conclusion: Our findings suggest applicability of EEG/BCI sessions in patients with ALS throughout normal waking hours. Future studies using actual BCI systems are needed to generalize these findings with regard to BCI effectiveness/efficiency and other times of day.}, language = {en} } @article{LugoQuitadamoBianchietal.2016, author = {Lugo, Zulay R. and Quitadamo, Lucia R. and Bianchi, Luigi and Pellas, Fr{\´e}deric and Veser, Sandra and Lesenfants, Damien and Real, Ruben G. L. and Herbert, Cornelia and Guger, Christoph and Kotchoubey, Boris and Mattia, Donatella and K{\"u}bler, Andrea and Laureys, Steven and Noirhomme, Quentin}, title = {Cognitive Processing in Non-Communicative Patients: What Can Event-Related Potentials Tell Us?}, series = {Frontiers in Human Neuroscience}, volume = {10}, journal = {Frontiers in Human Neuroscience}, number = {569}, doi = {10.3389/fnhum.2016.00569}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165165}, year = {2016}, abstract = {Event-related potentials (ERP) have been proposed to improve the differential diagnosis of non-responsive patients. We investigated the potential of the P300 as a reliable marker of conscious processing in patients with locked-in syndrome (LIS). Eleven chronic LIS patients and 10 healthy subjects (HS) listened to a complex-tone auditory oddball paradigm, first in a passive condition (listen to the sounds) and then in an active condition (counting the deviant tones). Seven out of nine HS displayed a P300 waveform in the passive condition and all in the active condition. HS showed statistically significant changes in peak and area amplitude between conditions. Three out of seven LIS patients showed the P3 waveform in the passive condition and five of seven in the active condition. No changes in peak amplitude and only a significant difference at one electrode in area amplitude were observed in this group between conditions. We conclude that, in spite of keeping full consciousness and intact or nearly intact cortical functions, compared to HS, LIS patients present less reliable results when testing with ERP, specifically in the passive condition. We thus strongly recommend applying ERP paradigms in an active condition when evaluating consciousness in non-responsive patients.}, language = {en} } @article{HalderTakanoOraetal.2016, author = {Halder, Sebastian and Takano, Kouji and Ora, Hiroki and Onishi, Akinari and Utsumi, Kota and Kansaku, Kenji}, title = {An Evaluation of Training with an Auditory P300 Brain-Computer Interface for the Japanese Hiragana Syllabary}, series = {Frontiers in Neuroscience}, volume = {10}, journal = {Frontiers in Neuroscience}, number = {446}, doi = {10.3389/fnins.2016.00446}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-165465}, year = {2016}, abstract = {Gaze-independent brain-computer interfaces (BCIs) are a possible communication channel for persons with paralysis. We investigated if it is possible to use auditory stimuli to create a BCI for the Japanese Hiragana syllabary, which has 46 Hiragana characters. Additionally, we investigated if training has an effect on accuracy despite the high amount of different stimuli involved. Able-bodied participants (N = 6) were asked to select 25 syllables (out of fifty possible choices) using a two step procedure: First the consonant (ten choices) and then the vowel (five choices). This was repeated on 3 separate days. Additionally, a person with spinal cord injury (SCI) participated in the experiment. Four out of six healthy participants reached Hiragana syllable accuracies above 70\% and the information transfer rate increased from 1.7 bits/min in the first session to 3.2 bits/min in the third session. The accuracy of the participant with SCI increased from 12\% (0.2 bits/min) to 56\% (2 bits/min) in session three. Reliable selections from a 10 × 5 matrix using auditory stimuli were possible and performance is increased by training. We were able to show that auditory P300 BCIs can be used for communication with up to fifty symbols. This enables the use of the technology of auditory P300 BCIs with a variety of applications.}, language = {en} } @article{SimonKaethnerRufetal.2015, author = {Simon, Nadine and K{\"a}thner, Ivo and Ruf, Carolin A. and Pasqualotto, Emanuele and K{\"u}bler, Andrea and Halder, Sebastian}, title = {An auditory multiclass brain-computer interface with natural stimuli: Usability evaluation with healthy participants and a motor impaired end user}, series = {Frontiers in Human Neuroscience}, volume = {8}, journal = {Frontiers in Human Neuroscience}, number = {1039}, doi = {10.3389/fnhum.2014.01039}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126450}, year = {2015}, abstract = {Brain-computer interfaces (BCIs) can serve as muscle independent communication aids. Persons, who are unable to control their eye muscles (e.g., in the completely locked-in state) or have severe visual impairments for other reasons, need BCI systems that do not rely on the visual modality. For this reason, BCIs that employ auditory stimuli were suggested. In this study, a multiclass BCI spelling system was implemented that uses animal voices with directional cues to code rows and columns of a letter matrix. To reveal possible training effects with the system, 11 healthy participants performed spelling tasks on 2 consecutive days. In a second step, the system was tested by a participant with amyotrophic lateral sclerosis (ALS) in two sessions. In the first session, healthy participants spelled with an average accuracy of 76\% (3.29 bits/min) that increased to 90\% (4.23 bits/min) on the second day. Spelling accuracy by the participant with ALS was 20\% in the first and 47\% in the second session. The results indicate a strong training effect for both the healthy participants and the participant with ALS. While healthy participants reached high accuracies in the first session and second session, accuracies for the participant with ALS were not sufficient for satisfactory communication in both sessions. More training sessions might be needed to improve spelling accuracies. The study demonstrated the feasibility of the auditory BCI with healthy users and stresses the importance of training with auditory multiclass BCIs, especially for potential end-users of BCI with disease.}, language = {en} } @article{KleihHerwegKaufmannetal.2015, author = {Kleih, Sonja C. and Herweg, Andreas and Kaufmann, Tobias and Staiger-S{\"a}lzer, Pit and Gerstner, Natascha and K{\"u}bler, Andrea}, title = {The WIN-speller: a new intuitive auditory brain-computer interface spelling application}, series = {Frontiers in Neuroscience}, volume = {9}, journal = {Frontiers in Neuroscience}, doi = {10.3389/fnins.2015.00346}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125972}, pages = {346}, year = {2015}, abstract = {The objective of this study was to test the usability of a new auditory Brain-Computer Interface (BCI) application for communication. We introduce a word based, intuitive auditory spelling paradigm the WIN-speller. In the WIN-speller letters are grouped by words, such as the word KLANG representing the letters A, G, K, L, and N. Thereby, the decoding step between perceiving a code and translating it to the stimuli it represents becomes superfluous. We tested 11 healthy volunteers and four end-users with motor impairment in the copy spelling mode. Spelling was successful with an average accuracy of 84\% in the healthy sample. Three of the end-users communicated with average accuracies of 80\% or higher while one user was not able to communicate reliably. Even though further evaluation is required, the WIN-speller represents a potential alternative for BCI based communication in end-users.}, language = {en} } @phdthesis{Kaethner2015, author = {K{\"a}thner, Ivo R. J.}, title = {Auditory and visual brain-computer interfaces as communication aids for persons with severe paralysis}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-135477}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2015}, abstract = {Brain-computer interfaces (BCIs) could provide a muscle-independent communication channel to persons with severe paralysis by translating brain activity into device commands. As a means of communication, in particular BCIs based on event-related potentials (ERPs) as control signal have been researched. Most of these BCIs rely on visual stimulation and have been investigated with healthy participants in controlled laboratory environments. In proof-of-principle studies targeted end users gained control over BCI systems; however, these systems are not yet established as an assistive technology for persons who would most benefit from them. The main aim of this thesis is to advance the usability of ERP-BCIs for target users. To this end, five studies with BCIs have been conducted that enabled users to communicate by focusing their attention on external stimuli. Two studies were conducted in order to demonstrate the advantages and to further improve the practical application of visual BCIs. In the first study, mental workload was experimentally manipulated during prolonged BCI operation. The study showed the robustness of the visual ERP-BCI since users maintained a satisfactory level of control despite constant distraction in the form of background noise. Moreover, neurophysiological markers that could potentially serve as indicators of high mental workload or fatigue were revealed. This is a first step towards future applications in which the BCI could adapt to the mental state of the user (e.g. pauses if high mental workload is detected to prevent false selections). In the second study, a head-mounted display (HMD), which assures that stimuli are presented in the field of view of the user, was evaluated. High accuracies and information transfer rates, similar to a conventional display, were achieved by healthy participants during a spelling task. Furthermore, a person in the locked-in state (LIS) gained control over the BCI using the HMD. The HMD might be particularly suited for initial communication attempts with persons in the LIS in situations, where mounting a conventional monitor is difficult or not feasible. Visual ERP-BCIs could prove valuable for persons with residual control over eye muscles and sufficient vision. However, since a substantial number of target users have limited control over eye movements and/or visual impairments, BCIs based on non-visual modalities are required. Therefore, a main aspect of this thesis was to improve an auditory paradigm that should enable motor impaired users to spell by focusing attention on different tones. The two conducted studies revealed that healthy participants were able to achieve high spelling performance with the BCI already in the first session and stress the importance of the choice of the stimulus material. The employed natural tones resulted in an increase in performance compared to a previous study that used artificial tones as stimuli. Furthermore, three out of five users with a varying degree of motor impairments could gain control over the system within the five conducted sessions. Their performance increased significantly from the first to the fifth session - an effect not previously observed for visual ERP-BCIs. Hence, training is particularly important when testing auditory multiclass BCIs with potential users. A prerequisite for user satisfaction is that the BCI technology matches user requirements. In this context, it is important to compare BCIs with already established assistive technology. Thus, the fifth study of this dissertation evaluated gaze dependent methods (EOG, eye tracking) as possible control signals for assistive technology and a binary auditory BCI with a person in the locked-in state. The study participant gained control over all tested systems and rated the ease of use of the BCI as the highest among the tested alternatives, but also rated it as the most tiring due to the high amount of attention that was needed for a simple selection. Further efforts are necessary to simplify operation of the BCI. The involvement of end users in all steps of the design and development process of BCIs will increase the likelihood that they can eventually be used as assistive technology in daily life. The work presented in this thesis is a substantial contribution towards the goal of re-enabling communication to users who cannot rely on motor activity to convey their thoughts.}, subject = {Gehirn-Computer Schnittstelle}, language = {en} } @phdthesis{Real2015, author = {Real, Ruben}, title = {Living with severe motor impairments - from consciousness to quality of life}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-138562}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2015}, abstract = {The impact of acquired severe motor impairments is pervasive and may lead to a complete loss of communication and voluntary motor control, rendering the patient behaviourally unresponsive. In routine clinical care it may thus be unclear, whether some of these patients are even conscious. Given that finding a cure is unlikely, care focuses on providing the best possible quality of life (QoL), and knowing its predictors might contribute to that aim. Patients who still can communicate often report a high QoL, and several predictors have been identified. However, many instruments used to assess QoL require at least residual verbal and motor abilities. Thus, a method to assess QoL independent of these requirements is desirable. In addition, many instruments assume QoL to be temporarily stable, and little information is available on predictors of instantaneous QoL, i.e. QoL as it fluctuates from moment to moment throughout the day.}, subject = {Myatrophische Lateralsklerose}, language = {en} }