Difficulty with communication is a widespread problem, reported by more than 2 million people in the US. Communication may be a particular challenge for people with total paralysis (Locked-in Syndrome or LIS) from disorders such as brainstem strokes or advanced Amyotrophic Lateral Sclerosis (ALS). People with these disorders rely on augmentative and alternative communication (AAC) technology that can be inefficient, often not designed with their unique access needs in mind, and therefore frustrating to implement successfully. Brain-computer interface (BCI) systems provide one promising avenue for restoring communication capabilities to people with LIS. However, these systems currently offer performance well below that achievable by able-bodied computer users. The overall objective of the proposed research is to evaluate advanced neural decoding methods and interfaces for a high-performance communication system for people with LIS. To accomplish this, we propose 3 Specific Aims as follows.
Aim 1 : We will evaluate whether advanced decoding techniques developed in the animal laboratory can improve continuous point-and-click control of a computer cursor from signals decoded from human motor cortex.
Aim 2 : We will optimize parameters for high-speed discrete target selection (i.e., typing) by decoding movement intent from pre-motor cortex.
Aim 3 : We will test new communication interfaces based on the results of Aims 1 and 2 against each participant's usual AAC system, with the goal of providing faster and easier communication. Finally, we will assess the ability of research participants to control a commercial computer GUI and typing interface while switching between continuous and discrete decoding.

Public Health Relevance

Difficulty in communication is a widespread problem, with an estimated 2.5 million people in the US reporting trouble with speech and communication. People with late stage amyotrophic lateral sclerosis (ALS) and locked in syndrome (LIS) from brainstem stroke have unique communication needs that are difficult to address with augmentative and alternative communication technology. Our proposed research aims to dramatically increase the performance of computerized communication systems driven by decoded brain activity, with the goal of improving the quality of life for people with unique communication needs.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
1R01DC014034-01A1
Application #
8878006
Study Section
Special Emphasis Panel (ZDC1)
Program Officer
Miller, Roger
Project Start
2015-04-01
Project End
2020-03-31
Budget Start
2015-04-01
Budget End
2016-03-31
Support Year
1
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Stanford University
Department
Neurosurgery
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94304
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