The thought-translation device (TTD): neurobehavioral mechanisms and clinical outcome

Author

Birbaumer, Niels ; Hinterberger, Thilo ; Kübler, Andrea ; Neumann, Nicola

Author_Institution

Inst. of Med. Psychol. & Behavioral Neurobiol., Univ. of Tubingen, Germany

Volume

11

Issue

2

fYear

2003

fDate

6/1/2003 12:00:00 AM

Firstpage

120

Lastpage

123

Abstract

The thought-translation device (TTD) consists of a training device and spelling program for the completely paralyzed using slow-cortical brain potentials (SCP). During the training phase, the self-regulation of SCPs is learned through visual-auditory feedback and positive reinforcement of SCPs; during the spelling phase, patients select letters or words with their SCPs. A psychophysiological system for detection of cognitive functioning in completely paralyzed patients is an integral part of the TTD. The neurophysiological and anatomical basis of SCP-regulation was investigated by recording of BOLD-response in functional magnetic resonance imaging. Results showed involvement of basal ganglia and premotor cortex for required SCP positivity. The clinical outcome of 11 paralyzed patients using the TTD and quality of life of severely paralyzed patients is described. First attempts to improve learning of brain regulation with transcranial magnetic stimulation were successful.

Keywords

biomedical MRI; electroencephalography; handicapped aids; neurophysiology; BOLD-response; amyotrophic lateral sclerosis; anatomical basis; basal ganglia; brain regulation; clinical outcome; completely paralyzed people; functional magnetic resonance imaging; learning improvement; locked-in-syndrome; neurobehavioral mechanisms; neurophysiological basis; physiological brain regulation; premotor cortex; quality of life; severely paralyzed patients; slow-cortical brain potentials; spelling program; thought-translation device; training device; transcranial magnetic stimulation; Basal ganglia; Biomedical imaging; Biomedical monitoring; Electroencephalography; Enterprise resource planning; Magnetic recording; Magnetic resonance imaging; Magnetic stimulation; Neurofeedback; Psychology; Amyotrophic Lateral Sclerosis; Biofeedback (Psychology); Cerebral Cortex; Communication Aids for Disabled; Electroencephalography; Evoked Potentials; Humans; Quadriplegia; Signal Processing, Computer-Assisted; Thinking; User-Computer Interface;

fLanguage

English

Journal_Title

Neural Systems and Rehabilitation Engineering, IEEE Transactions on

Publisher

ieee

ISSN

1534-4320

Type

jour

DOI

10.1109/TNSRE.2003.814439

Filename

1214698