@article{AcqualagnaBotrelVidaurreetal.2016, author = {Acqualagna, Laura and Botrel, Loic and Vidaurre, Carmen and K{\"u}bler, Andrea and Blankertz, Benjamin}, title = {Large-Scale Assessment of a Fully Automatic Co-Adaptive Motor Imagery-Based Brain Computer Interface}, series = {PLoS ONE}, volume = {11}, journal = {PLoS ONE}, number = {2}, doi = {10.1371/journal.pone.0148886}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-167230}, pages = {e0148886}, year = {2016}, abstract = {In the last years Brain Computer Interface (BCI) technology has benefited from the development of sophisticated machine leaning methods that let the user operate the BCI after a few trials of calibration. One remarkable example is the recent development of co-adaptive techniques that proved to extend the use of BCIs also to people not able to achieve successful control with the standard BCI procedure. Especially for BCIs based on the modulation of the Sensorimotor Rhythm (SMR) these improvements are essential, since a not negligible percentage of users is unable to operate SMR-BCIs efficiently. In this study we evaluated for the first time a fully automatic co-adaptive BCI system on a large scale. A pool of 168 participants naive to BCIs operated the co-adaptive SMR-BCI in one single session. Different psychological interventions were performed prior the BCI session in order to investigate how motor coordination training and relaxation could influence BCI performance. A neurophysiological indicator based on the Power Spectral Density (PSD) was extracted by the recording of few minutes of resting state brain activity and tested as predictor of BCI performances. Results show that high accuracies in operating the BCI could be reached by the majority of the participants before the end of the session. BCI performances could be significantly predicted by the neurophysiological indicator, consolidating the validity of the model previously developed. Anyway, we still found about 22\% of users with performance significantly lower than the threshold of efficient BCI control at the end of the session. Being the inter-subject variability still the major problem of BCI technology, we pointed out crucial issues for those who did not achieve sufficient control. Finally, we propose valid developments to move a step forward to the applicability of the promising co-adaptive methods.}, language = {en} } @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{ErlbeckKueblerKotchoubeyetal.2014, author = {Erlbeck, Helena and K{\"u}bler, Andrea and Kotchoubey, Boris and Veser, Sandra}, title = {Task instructions modulate the attentional mode affecting the auditory MMN and the semantic N400}, series = {Frontiers in Human Neuroscience}, volume = {8}, journal = {Frontiers in Human Neuroscience}, number = {654}, doi = {10.3389/fnhum.2014.00654}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-115553}, year = {2014}, abstract = {Event-related potentials (ERPs) have been proven to be a useful tool to complement clinical assessment and to detect residual cognitive functions in patients with disorders of consciousness. These ERPs are of ten recorded using passive or unspecific instructions. Patient data obtained this way are then compared to data from healthy participants, which are usually recorded using active instructions. The present study investigates the effect of attentive modulations and particularly the effect of activevs. passive instruction on the ERP components mismatch negativity (MMN) and N400. A sample of 18 healthy participants listened to three auditory paradigms: anoddball, aword priming, and a sentence paradigm. Each paradigm was presented three times with different instructions: ignoring auditory stimuli, passive listening, and focused attention on the auditory stimuli. After each task, the participants indicated their subjective effort. The N400 decreased from the focused task to the passive task, and was extinct in the ignore task. The MMN exhibited higher amplitudes in the focused and passive task compared to the ignore task. The data indicate an effect of attention on the supratemporal component of the MMN. Subjective effort was equally high in the passive and focused tasks but reduced in the ignore task. We conclude that passive listening during EEG recording is stressful and attenuates ERPs, which renders the interpretation of the results obtained in such conditions difficult.}, 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} } @misc{FazelRezaiAllisonGugeretal.2012, author = {Fazel-Rezai, Reza and Allison, Brendan Z. and Guger, Christoph and Sellers, Eric W. and Kleih, Sonja C. and K{\"u}bler, Andrea}, title = {P300 brain computer interface: current challenges and emerging trends}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75941}, year = {2012}, abstract = {A brain-computer interface (BCI) enables communication without movement based on brain signals measured with electroencephalography (EEG). BCIs usually rely on one of three types of signals: the P300 and other components of the event-related potential (ERP), steady state visual evoked potential (SSVEP), or event related desynchronization (ERD). Although P300 BCIs were introduced over twenty years ago, the past few years have seen a strong increase in P300 BCI research. This closed-loop BCI approach relies on the P300 and other components of the ERP, based on an oddball paradigm presented to the subject. In this paper, we overview the current status of P300 BCI technology, and then discuss new directions: paradigms for eliciting P300s; signal processing methods; applications; and hybrid BCIs. We conclude that P300 BCIs are quite promising, as several emerging directions have not yet been fully explored and could lead to improvements in bit rate, reliability, usability, and flexibility.}, subject = {Psychologie}, language = {en} } @article{FroehlichZahnerSchmalzingetal.2023, author = {Froehlich, Matthias and Zahner, Antonia and Schmalzing, Marc and Gernert, Michael and Strunz, Patrick-Pascal and Hueper, Sebastian and Portegys, Jan and Schwaneck, Eva Christina and Gadeholt, Ottar and K{\"u}bler, Andrea and Hewig, Johannes and Ziebell, Philipp}, title = {Patient-reported outcomes provide evidence for increased depressive symptoms and increased mental impairment in giant cell arteritis}, series = {Frontiers in Medicine}, volume = {10}, journal = {Frontiers in Medicine}, doi = {10.3389/fmed.2023.1146815}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-319761}, year = {2023}, abstract = {Objectives The spectrum of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) represents highly inflammatory rheumatic diseases. Patients mostly report severe physical impairment. Possible consequences for mental health have been scarcely studied. The aim of this study was to investigate psychological well-being in the context of GCA and PMR. Methods Cross-sectional study with N = 100 patients with GCA and/or PMR (GCA-PMR). Patient-reported outcomes (PROs) were measured using the Short Form 36 Version 2 (SF-36v2) and visual analog scale (VAS) assessment. Moreover, the Patient Health Questionnaire 9 (PHQ-9) was used in 35 of 100 patients to detect depression. To compare PROs with physician assessment, VAS was also rated from physician perspective. To assess a possible association with inflammation itself, serological parameters of inflammation (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) were included. Results In all scales of the SF-36v2 except General Health (GH) and in the physical and mental sum score (PCS, MCS), a significant impairment compared to the German reference collective was evident (MCS: d = 0.533, p < 0.001). In the PHQ-9 categorization, 14 of the 35 (40\%) showed evidence of major depression disorder. VAS Patient correlated significantly with PHQ-9 and SF-36 in all categories, while VAS Physician showed only correlations to physical categories and not in the mental dimensions. Regarding inflammatory parameters, linear regression showed CRP to be a complementary significant positive predictor of mental health subscale score, independent of pain. Conclusion PRO show a relevant impairment of mental health up to symptoms of major depression disorder. The degree of depressive symptoms is also distinctly associated with the serological inflammatory marker CRP.}, language = {en} } @article{GrappEllKiermeieretal.2022, author = {Grapp, Miriam and Ell, Johanna and Kiermeier, Senta and Haun, Markus W. and K{\"u}bler, Andrea and Friederich, Hans-Christoph and Maatouk, Imad}, title = {Feasibility study of a self-guided internet-based intervention for family caregivers of patients with cancer (OAse)}, series = {Scientific Reports}, volume = {12}, journal = {Scientific Reports}, doi = {10.1038/s41598-022-21157-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300537}, year = {2022}, abstract = {Despite high levels of distress, family caregivers of patients with cancer rarely seek psychosocial support and Internet-based interventions (IBIs) are a promising approach to reduce some access barriers. Therefore, we developed a self-guided IBI for family caregivers of patients with cancer (OAse), which, in addition to patients' spouses, also addresses other family members (e.g., adult children, parents). This study aimed to determine the feasibility of OAse (recruitment, dropout, adherence, participant satisfaction). Secondary outcomes were caregivers' self-efficacy, emotional state, and supportive care needs. N = 41 family caregivers participated in the study (female: 65\%), mostly spouses (71\%), followed by children (20\%), parents (7\%), and friends (2\%). Recruitment (47\%), retention (68\%), and adherence rates (76\% completed at least 4 of 6 lessons) support the feasibility of OAse. Overall, the results showed a high degree of overall participant satisfaction (96\%). There were no significant pre-post differences in secondary outcome criteria, but a trend toward improvement in managing difficult interactions/emotions (p = .06) and depression/anxiety (p = .06). Although the efficacy of the intervention remains to be investigated, our results suggest that OAse can be well implemented in caregivers' daily lives and has the potential to improve family caregivers' coping strategies.}, language = {en} } @article{HalderHammerKleihetal.2013, author = {Halder, Sebastian and Hammer, Eva Maria and Kleih, Sonja Claudia and Bogdan, Martin and Rosenstiel, Wolfgang and Birbaumer, Niels and K{\"u}bler, Andrea}, title = {Prediction of Auditory and Visual P300 Brain-Computer Interface Aptitude}, series = {PLoS ONE}, volume = {8}, journal = {PLoS ONE}, number = {2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130327}, pages = {e53513}, year = {2013}, abstract = {Objective Brain-computer interfaces (BCIs) provide a non-muscular communication channel for patients with late-stage motoneuron disease (e.g., amyotrophic lateral sclerosis (ALS)) or otherwise motor impaired people and are also used for motor rehabilitation in chronic stroke. Differences in the ability to use a BCI vary from person to person and from session to session. A reliable predictor of aptitude would allow for the selection of suitable BCI paradigms. For this reason, we investigated whether P300 BCI aptitude could be predicted from a short experiment with a standard auditory oddball. Methods Forty healthy participants performed an electroencephalography (EEG) based visual and auditory P300-BCI spelling task in a single session. In addition, prior to each session an auditory oddball was presented. Features extracted from the auditory oddball were analyzed with respect to predictive power for BCI aptitude. Results Correlation between auditory oddball response and P300 BCI accuracy revealed a strong relationship between accuracy and N2 amplitude and the amplitude of a late ERP component between 400 and 600 ms. Interestingly, the P3 amplitude of the auditory oddball response was not correlated with accuracy. Conclusions Event-related potentials recorded during a standard auditory oddball session moderately predict aptitude in an audiory and highly in a visual P300 BCI. The predictor will allow for faster paradigm selection. Significance Our method will reduce strain on patients because unsuccessful training may be avoided, provided the results can be generalized to the patient population.}, language = {en} } @article{HalderHammerKleihetal.2013, author = {Halder, Sebastian and Hammer, Eva Maria and Kleih, Sonja Claudia and Bogdan, Martin and Rosenstiel, Wolfgang and Birbaumer, Nils and K{\"u}bler, Andrea}, title = {Prediction of Auditory and Visual P300 Brain-Computer Interface Aptitude}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-77992}, year = {2013}, abstract = {Objective: Brain-computer interfaces (BCIs) provide a non-muscular communication channel for patients with late-stage motoneuron disease (e.g., amyotrophic lateral sclerosis (ALS)) or otherwise motor impaired people and are also used for motor rehabilitation in chronic stroke. Differences in the ability to use a BCI vary from person to person and from session to session. A reliable predictor of aptitude would allow for the selection of suitable BCI paradigms. For this reason, we investigated whether P300 BCI aptitude could be predicted from a short experiment with a standard auditory oddball. Methods: Forty healthy participants performed an electroencephalography (EEG) based visual and auditory P300-BCI spelling task in a single session. In addition, prior to each session an auditory oddball was presented. Features extracted from the auditory oddball were analyzed with respect to predictive power for BCI aptitude. Results: Correlation between auditory oddball response and P300 BCI accuracy revealed a strong relationship between accuracy and N2 amplitude and the amplitude of a late ERP component between 400 and 600 ms. Interestingly, the P3 amplitude of the auditory oddball response was not correlated with accuracy. Conclusions: Event-related potentials recorded during a standard auditory oddball session moderately predict aptitude in an audiory and highly in a visual P300 BCI. The predictor will allow for faster paradigm selection. Significance: Our method will reduce strain on patients because unsuccessful training may be avoided, provided the results can be generalized to the patient population.}, subject = {Psychologie}, language = {en} } @article{HalderRufFurdeaetal.2013, author = {Halder, Sebastian and Ruf, Carolin Anne and Furdea, Adrian and Pasqualotto, Emanuele and De Massari, Daniele and van der Heiden, Linda and Bogdan, Martin and Rosenstiel, Wolfgang and Birbaumer, Niels and K{\"u}bler, Andrea and Matuz, Tamara}, title = {Prediction of P300 BCI Aptitude in Severe Motor Impairment}, series = {PLoS ONE}, journal = {PLoS ONE}, doi = {10.1371/journal.pone.0076148}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97268}, year = {2013}, abstract = {Brain-computer interfaces (BCIs) provide a non-muscular communication channel for persons with severe motor impairments. Previous studies have shown that the aptitude with which a BCI can be controlled varies from person to person. A reliable predictor of performance could facilitate selection of a suitable BCI paradigm. Eleven severely motor impaired participants performed three sessions of a P300 BCI web browsing task. Before each session auditory oddball data were collected to predict the BCI aptitude of the participants exhibited in the current session. We found a strong relationship of early positive and negative potentials around 200 ms (elicited with the auditory oddball task) with performance. The amplitude of the P2 (r = -0.77) and of the N2 (r = -0.86) had the strongest correlations. Aptitude prediction using an auditory oddball was successful. The finding that the N2 amplitude is a stronger predictor of performance than P3 amplitude was reproduced after initially showing this effect with a healthy sample of BCI users. This will reduce strain on the end-users by minimizing the time needed to find suitable paradigms and inspire new approaches to improve performance.}, language = {en} }