The influence of psychological state and motivation on brain-computer interface performance in patients with amyotrophic lateral sclerosis - a longitudinal study

Nijboer Nijboer

doi:10.3389/fnins.2010.00055

Abstract

The current study investigated the effects of psychological well-being measured as quality of life (QoL), depression, current mood and motivation on brain–computer interface (BCI) performance in amyotrophic lateral sclerosis (ALS). Six participants with most advanced ALS were trained either for a block of 20 sessions with a BCI based on sensorimotor rhythms (SMR) or a block of 10 sessions with a BCI based on event-related potentials, or both. Questionnaires assessed QoL and severity of depressive symptoms before each training block and mood and motivation before each training session. The SMR-BCI required more training than the P300-BCI. The information transfer rate was higher with the P300-BCI (3.25 bits/min) than with the SMR-BCI (1.16 bits/min). Mood and motivation were related to the number of BCI sessions. Motivational factors, specifically challenge and mastery confidence, were positively related to BCI performance (controlled for the number of sessions) in tow participants, while incompetence fear was negatively related with performance in one participant. BCI performance was not related to motivational factors in three other participants nor to mood in any of the six participants. We conclude that motivational factors may be related to BCI performance in individual subjects and suggest that motivational factors and well-being should be assessed in standard BCI protocols. We also recommend using P300-based BCI as first choice in severely paralyzed patients who present with a P300 evoked potential.

Highlights

Brain–computer interfaces (BCI) may provide severely paralyzed users communication and control without motor responses (Kübler and Birbaumer, 2008)
Performance increased over the sensorimotor rhythms (SMR) training (F1,18 = 82.166 p < 0.001), whereas performance remained stable during P300 training (F1,8 = 0.018; p = 0.896). (The probability of a type I error was maintained at 0.05 level for all subsequent analysis.)
In this study we investigated the influence of psychological wellbeing measured as current mood, depression and quality of life (QoL), and motivation on brain–computer interface (BCI) performance of severely paralyzed patients with amyotrophic lateral sclerosis (ALS)

Summary

Introduction

Brain–computer interfaces (BCI) may provide severely paralyzed users communication and control without motor responses (Kübler and Birbaumer, 2008). Different EEG signals can be used to control a BCI, e.g., sensorimotor rhythms (SMR; (Pfurtscheller et al, 2000; Kübler et al, 2005a), slow cortical potentials (SCP; (Birbaumer et al, 1999; Kübler et al, 1999) and the P300 event-related potential (ERP; (Farwell and Donchin, 1988; Sellers and Donchin, 2006; Nijboer et al, 2008b; Furdea et al, 2009). Sensorimotor or mu-rhythm (SMR) refers to 8–15 Hz EEG activity which can be recorded over primary sensory and motor cortical areas (Niedermeyer, 2004). It is usually accompanied by 18–26 Hz beta-rhythms. Performance was around chance level during the first 10 sessions, but increased significantly during the last 10 sessions

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