BCI NEUROTECHNOLOGY FOR NOVEL REHABILITATION APPROACHES IN STROKE-INDUCED COGNITIVE DEFECTS
Relevant for Research Area
Dr. Michael Tangermann (Contact PI)
The main goal of the Cognitive Rehabilitation project is to develop and evaluate assessment and training protocols based on Brain-Computer Interfaces (BCI) for (a) subacute patients with hemispatial neglect and (b) chronic patients with aphasia after stroke. After initial piloting with both stroke conditions until the end of 2015, CogReha has further on focussed its activities on aphasia as the preferred clinical target due to superior results and better recruitment opportunities. For aphasia, we developed and implemented an auditory training protocol where patients receive feedback based on their task-relevant electroencephalography (EEG) activity. Feasibility and user acceptance of this BCI-protocol was shown in 20 normally-aged controls. The complete language training was performed with 8 aphasic stroke patients. The training was in high-intensity with a goal of 4 sessions per week and 30 hours of effective training time. Clinical tests show that the novel BCI-supported training has induced significant, strong and lasting improvements not only in language comprehension, but also in language production and writing. The effect size is very high compared to other language therapies with comparable intensity and duration. In addition, the EEG data shows that the timing of the word-induced brain responses became more similar to those of healthy controls. Cognitive tests showed no significant training-induced changes. This indicates that the training does not target broad cognitive functions, but specifically improves language. Going beyond these initial 8 patients, we started a randomized controlled trial to investigate if the BCI-based feedback is indeed the key for the observed training effect size or whether a similar effect can be achieved with a simple button press based feedback. This ongoing study should help to establish this novel and highly promising therapy to counteract the growing number of chronic aphasia patients.
[A1] Höhne, Tangermann (2014). “Towards User-Friendly Spelling with an Auditory Brain-Computer Interface: The CharStreamer Paradigm”. PLoS ONE 9(6): e98322.
[A2] Hübner, Schall, Prange and Tangermann (2018), "Eyes-closed increases the usability brain-computer interfaces based on auditory event-related potentials", Frontiers in Human Neuroscience. Vol. 12, pp. 391.
[A3] Tangermann, Schnorr, Musso (2014). “Towards Aphasia Rehabilitation with BCI”. Proc. of the 6th Int. BCI Conference, Graz. DOI:10.3217/978-3-85125-378-8-93
[A4] Musso, Bambadian, Denzer, Umarova, Hübner and Tangermann (2016). "A novel BCI based rehabilitation approach for aphasia rehabilitation", In Proceedings of the Sixth International Brain-Computer Interface Meeting. Graz, p. 104.
[A5] Bamdadian, Denzer, Musso, Tangermann (2016). “ERP Responses of the Elderly for Bisyllabic Word Stimuli”. In Proceedings of the Sixth International Brain-Computer Interface Meeting, Graz, p. 180.
[A6] Marrett, Wronkiewicz, Tangermann, Lee (2016). A User-Focused Study of Auditory P300 Brain-Computer Interface Design. In Proceedings of the Sixth International Brain-Computer Interface Meeting, Graz, p. 17.
[A7] Castaño-Candamil, Bamdadian, Kübel, Umarova, Tangermann (2016). “ERP Features Correlate with Reaction Time in a Covert-Attention Task”. In Proceedings of the Sixth International Brain-Computer Interface Meeting, Graz, p. 179.
[A8] Umarova, Castaño-Candamil, Bamdadian, Kübel, Musso, Kloeppel, Tangermann (2016). “BCI-Approach for Cognitive Rehabilitation in Stroke: Pilot Data from Patient with Spatial Neglect”. In Proceedings of the Sixth International Brain-Computer Interface Meeting, Graz, p. 135.
[A9] Musso, Tangermann, Bamdadian, Denzer, Hübner, Rijntjes, Umarova, Spende, Weiller (2016). “Using brain computer interface for feedback in aphasia treatment: proof-of-concept.“ Deutsche Gesellschaft für Neurologie (DGN), FV 656.
[A10] Hübner, Tangermann (2017). “Challenging the assumption that auditory event-related potentials are independent and identically distributed.” Proceedings of the 7th International Brain-Computer Interface Meeting, Asilomar, pp. 192-197.
[A11] Tangermann, Hübner, Schwarzkopf, Weiller, Musso (2018). “Effects on language ability induced by BCI-based training of patients with aphasia”, Proc. of the 7th Int. BCI Meeting, Asilomar.
[A12] Musso, Hübner, Schwarzkopf, Weiller, Tangermann (2018). “A novel aphasia training based on brain-computer interface”. European Stroke Journal, Vol. 3(1S), pp. 205-206.
[A13] Hübner, Schwarzkopf, Musso, Tangermann (2018). “BCI-based Language Training Induces Changes in ERP Responses in Chronic Post-stroke Aphasia Patients”. Proc. of the 7th Int. BCI Meeting, Asilomar.
[A14] Musso, Hübner, Schwarzkopf, Weiller, Tangermann (2018). “Evidence for language-specificity of a BCI-based language training”. Front. Hum. Neurosci. Conference Abstract: Academy of Aphasia 56th Annual Meeting, Montreal, Canada. doi: 10.3389/conf.fnhum.2018.228.00069
[A15] Musso, Hübner, Schwarzkopf, Weiller, Tangermann (2018). “A BCI-supported online language training: A novel and effective approach for training basic and distinctive aspects of language-processing”. Deutsche Gesellschaft für Neurologie (DGN). Abstract available from https://www.dgnvirtualmeeting.org/users/48240.