syndrome is a rare neurological disorder in which the patient cannot move
or communicate verbally due to complete paralysis of all the voluntary
suffering from locked-in syndrome
were able to communicate through the brain-computer interface, using only
brain-computer interface used near-infrared spectroscopy combined with
electroencephalography (EEG) to interpret thoughts by measuring blood
oxygenation and electrical activity in the brain.
thoughts of people who suffer from locked-in syndrome and who are not able to
communicate, could be interpreted using a brain-computer interface.
could revolutionize the lives of those living with completely locked-in
‘The non-invasive brain-computer interface detects the responses of patients suffering from locked-in syndrome by measuring changes in levels of blood oxygen in the brain.’
participants in the study reported being "happy", despite their
is the process of expressing and sharing feelings, thoughts, and intentions
with one another by verbal and various non-verbal means.
individuals who are affected by motor neuron condition, normal communication
faces several hurdles and challenges.
syndrome is a rare neurological disorder that leads to complete paralysis of
all the voluntary muscles. But awareness, cognitive function
, eye movements and also blinking
are usually unaffected. These individuals communicate through eye movements or
blinking. Hence, it is also called a pseudo-coma
syndrome is most often caused by damage to a specific part of the brainstem
known as the pons
Damage to the pons results from lack of blood flow and tissue death (infarct)
pons contains important neuronal pathways between the cerebrum, spinal cord and
the pons is affected, all the motor fibers running from the gray matter in the
via the spinal cord to the body's muscles are
interrupted and the centers in the brainstem that are important for facial
control and speaking are also damaged.
causes of locked-in syndrome include infection in certain portions of the
brain, tumors, loss of the protective insulation (myelin) that surrounds nerve
cells, inflammation of the nerves, and certain disorders such as amyotrophic lateral sclerosis
with locked-in syndrome classically cannot consciously or voluntarily chew,
swallow, breathe, speak, or produce any movements other than those involving
the eyes or eyelids.
can affect individuals of any age including children.
locked-in syndrome refers to the state where there is complete motor paralysis
including loss of eye movements. But the emotional and cognitive processes
it was thought that people suffering from completely locked-in syndrome are
incapable of communicating and that they lack the goal-directed thinking
necessary to use a brain-computer interface.
with completely locked-in syndrome were able to respond "yes" or
"no" to spoken questions, by thinking the answers during the trial.
non-invasive brain-computer interface detected their responses by measuring
changes in blood oxygen levels in the brain.
interpret the thoughts of the patients, the brain-computer interface used
functional near-infrared spectroscopy (fNRIS) combined with electroencephalography
(EEG) to measure blood oxygenation and electrical activity
in the brain.
communication among paralyzed patients has been possible by brain-computer
interfaces previously, near-infrared spectroscopy has been the only successful
approach to restore communication in patients suffering from completely
patients with ALS (amyotrophic lateral sclerosis, also known as Lou Gehrig's
disease), were included for the study.
is a progressive motor neuron disease
that affects the nerve cells
of the brain and spinal cord.
leads to complete destruction of the part of the nervous system responsible for
movement. When the nerve cells are affected, the muscles being supplied by the
nerve, do not get any nourishment and as a result, they waste (atrophy) away.
There is no known cure for ALS.
2011, its prevalence was estimated to be 3.9 cases per 100,000 persons in the
general population in the United States.
the disorder progresses, all muscular functions are lost and eventually it
destroys the respiratory and bulbar functions, forcing the individual to make
the individuals opt for life and accept artificial respiration, they can no
longer communicate verbally. They use assistive communication devices that rely
on non-verbal signals such as finger movement and gaze fixation.
ALS, the disorder progresses to a stage where the patients loses control of the
last muscular response, usually the eye muscles, a condition known as
completely locked-in state.
researchers asked personal questions and open-ended questions like "Your
husband's name is Joachim?" and "Are you happy?", the answers to
which were familiar to the patient.
70% of the trials, correct responses were elicited by the questions.
Birbaumer said, "The striking results overturn my own theory that people
with completely locked-in syndrome are not capable of communication. We found
that all four patients we tested were able to answer the personal questions we
asked them, using their thoughts alone. If we can replicate this study in more
patients, I believe we could restore useful communication in completely
locked-in states for people with motor neuron diseases."
of the question "Are you happy?", over weeks resulted in a consistent
"yes" response from the four people.
Birbaumer added, "We were initially surprised at the positive responses
when we questioned the four completely locked-in patients about their quality
of life. All four had accepted artificial ventilation in order to sustain their
life, when breathing became impossible; thus, in a sense, they had already
chosen to live. What we observed was that as long as they received satisfactory
care at home, they found their quality of life acceptable. It is for this
reason, if we could make this technique widely clinically available, it could
have a huge impact on the day-to-day life of people with completely locked-in
John Donoghue, Director of the Wyss Center, said, "Restoring communication
for completely locked-in patients is a crucial first step in the challenge to
regain movement. The Wyss Center plans to build on the results of this study to
develop clinically useful technology that will be available to people with
paralysis resulting from ALS, stroke
, or spinal cord
. The technology
used in the study also has broader applications that we believe could be
further developed to treat and monitor people with a wide range of
research was conducted by a multinational team, led by Professor Niels
Birbaumer, at the Wyss Center for Bio and Neuroengineering in Geneva,
Switzerland and published in PLOS Biology
- Niels Birbaumer et al. Brain-Computer Interface-Based Communication in the Completely Locked-In State. PLOS Biology ; (2017) doi.org/10.1371/journal.pbio.1002593
- Locked In Syndrome - (https://rarediseases.org/rare-diseases/locked-in-syndrome/)
- Locked-in Syndrome - (http://cirrie.buffalo.edu/encyclopedia/en/article/303/)
- What is ALS? - (http://www.alsa.org/about-als/what-is-als.html?referrer=https://www.google.co.in/)
- Prevalence of Amyotrophic Lateral Sclerosis — United States, 2012-2013 - (https://www.cdc.gov/mmwr/volumes/65/ss/ss6508a1.htm)