The feasibility of combining communication BCIs with FES for individuals with locked-in syndrome

TL;DR

This paper explores combining brain-computer interfaces with functional electrical stimulation to enhance communication and expressiveness in individuals with locked-in syndrome, reviewing current technologies and proposing a novel integrated approach.

Contribution

It proposes a new combined BCI-FES approach for locked-in individuals, building on successes in stroke and spinal cord injury applications.

Findings

BCI can decode intended movements for communication.

FES can restore facial and limb movements.

Combined BCI-FES enhances expressive communication.

Abstract

Individuals with a locked-in state live with severe whole-body paralysis that limits their ability to communicate with family and loved ones. Recent advances in the brain-computer interface (BCI) technology have presented a potential alternative for these people to communicate by detecting neural activity associated with attempted hand or speech movements and translating the decoded intended movements to a control signal for a computer. A technique that could potentially enrich the communication capacity of BCIs is functional electrical stimulation (FES) of paralyzed limbs and face to restore body and facial movements of paralyzed individuals, allowing to add body language and facial expression to communication BCI utterances. Here, we review the current state of the art of existing BCI and FES work in people with paralysis of body and face and propose that a combined BCI-FES approach, which has already proved successful in several applications in stroke and spinal cord injury, can provide a novel promising mode of communication for locked-in individuals.