Future directions

A consortium consisting of 12 European partners has completed a roadmap to support the European Commission in their funding decisions for the new framework program Horizon 2020. The project, which was funded by the European Commission, started in November 2013 and published a roadmap in April 2015. A 2015 publication led by Dr. Clemens Brunner describes some of the analyses and achievements of this project, as well as the emerging Brain-Computer Interface Society. For example, this article reviewed work within this project that further defined BCIs and applications, explored recent trends, discussed ethical issues, and evaluated different directions for new BCIs. As the article notes, their new roadmap generally extends and supports the recommendations from the Future BNCI project managed by Dr. Brendan Allison, which conveys substantial enthusiasm for emerging BCI directions.

Other recent publications too have explored future BCI directions for new groups of disabled users (e.g.,). Some prominent examples are summarized below.

Disorders of consciousness (DOC)edit

Some persons have a disorder of consciousness (DOC). This state is defined to include persons with coma, as well as persons in a vegetative state (VS) or minimally conscious state (MCS). New BCI research seeks to help persons with DOC in different ways. A key initial goal is to identify patients who are able to perform basic cognitive tasks, which would of course lead to a change in their diagnosis. That is, some persons who are diagnosed with DOC may in fact be able to process information and make important life decisions (such as whether to seek therapy, where to live, and their views on end-of-life decisions regarding them). Some persons who are diagnosed with DOC die as a result of end-of-life decisions, which may be made by family members who sincerely feel this is in the patient's best interests. Given the new prospect of allowing these patients to provide their views on this decision, there would seem to be a strong ethical pressure to develop this research direction to guarantee that DOC patients are given an opportunity to decide whether they want to live.

These and other articles describe new challenges and solutions to use BCI technology to help persons with DOC. One major challenge is that these patients cannot use BCIs based on vision. Hence, new tools rely on auditory and/or vibrotactile stimuli. Patients may wear headphones and/or vibrotactile stimulators placed on the wrists, neck, leg, and/or other locations. Another challenge is that patients may fade in and out of consciousness, and can only communicate at certain times. This may indeed be a cause of mistaken diagnosis. Some patients may only be able to respond to physicians' requests during a few hours per day (which might not be predictable ahead of time) and thus may have been unresponsive during diagnosis. Therefore, new methods rely on tools that are easy to use in field settings, even without expert help, so family members and other persons without any medical or technical background can still use them. This reduces the cost, time, need for expertise, and other burdens with DOC assessment. Automated tools can ask simple questions that patients can easily answer, such as "Is your father named George?" or "Were you born in the USA?" Automated instructions inform patients that they may convey yes or no by (for example) focusing their attention on stimuli on the right vs. left wrist. This focused attention produces reliable changes in EEG patterns that can help determine that the patient is able to communicate. The results could be presented to physicians and therapists, which could lead to a revised diagnosis and therapy. In addition, these patients could then be provided with BCI-based communication tools that could help them convey basic needs, adjust bed position and HVAC (heating, ventilation, and air conditioning), and otherwise empower them to make major life decisions and communicate.

Motor recoveryedit

People may lose some of their ability to move due to many causes, such as stroke or injury. Several groups have explored systems and methods for motor recovery that include BCIs. In this approach, a BCI measures motor activity while the patient imagines or attempts movements as directed by a therapist. The BCI may provide two benefits: (1) if the BCI indicates that a patient is not imagining a movement correctly (non-compliance), then the BCI could inform the patient and therapist; and (2) rewarding feedback such as functional stimulation or the movement of a virtual avatar also depends on the patient's correct movement imagery.

So far, BCIs for motor recovery have relied on the EEG to measure the patient's motor imagery. However, studies have also used fMRI to study different changes in the brain as persons undergo BCI-based stroke rehab training. Future systems might include the fMRI and other measures for real-time control, such as functional near-infrared, probably in tandem with EEGs. Non-invasive brain stimulation has also been explored in combination with BCIs for motor recovery. In 2016, scientists out of the University of Melbourne published preclinical proof-of-concept data related to a potential brain-computer interface technology platform being developed for patients with paralysis to facilitate control of external devices such as robotic limbs, computers and exoskeletons by translating brain activity. Clinical trials are currently underway.

Functional brain mappingedit

Each year, about 400,000 people undergo brain mapping during neurosurgery. This procedure is often required for people with tumors or epilepsy that do not respond to medication. During this procedure, electrodes are placed on the brain to precisely identify the locations of structures and functional areas. Patients may be awake during neurosurgery and asked to perform certain tasks, such as moving fingers or repeating words. This is necessary so that surgeons can remove only the desired tissue while sparing other regions, such as critical movement or language regions. Removing too much brain tissue can cause permanent damage, while removing too little tissue can leave the underlying condition untreated and require additional neurosurgery. Thus, there is a strong need to improve both methods and systems to map the brain as effectively as possible.

In several recent publications, BCI research experts and medical doctors have collaborated to explore new ways to use BCI technology to improve neurosurgical mapping. This work focuses largely on high gamma activity, which is difficult to detect with non-invasive means. Results have led to improved methods for identifying key areas for movement, language, and other functions. A recent article addressed advances in functional brain mapping and summarizes a workshop.

Flexible devicesedit

Flexible electronics are polymers or other flexible materials (e.g. silk, pentacene, PDMS, Parylene, polyimide) that are printed with circuitry; the flexible nature of the organic background materials allowing the electronics created to bend, and the fabrication techniques used to create these devices resembles those used to create integrated circuits and microelectromechanical systems (MEMS).citation needed Flexible electronics were first developed in the 1960s and 1970s, but research interest increased in the mid-2000s.

Neural dustedit

Neural dust is a term used to refer to millimeter-sized devices operated as wirelessly powered nerve sensors that were proposed in a 2011 paper from the University of California, Berkeley Wireless Research Center, which described both the challenges and outstanding benefits of creating a long lasting wireless BCI. In one proposed model of the neural dust sensor, the transistor model allowed for a method of separating between local field potentials and action potential "spikes", which would allow for a greatly diversified wealth of data acquirable from the recordings.