Ms. Mooney: Our goal for the future is to use dry electrodes instead of wet. So right now you observed last night with Greg, they were inserting conducting gel. So we are hoping to go to an electrode system that does not need a gel at all.
Would it have to have that many electrodes?
Ms. Mooney: Probably.
Could it be attached to the cap where you just have someone put the cap on?
Dr. Mooney: Yes there are electrode caps right now that are dry electrode caps that you just put on and you can use. The engineering team still needs to do a lot of work to try and cut out some of the electrical artifacts. A lot of people that who have locked-in syndrome are on respirators or surrounded by other medical machinery that gives off a lot of electrical energy. So we have to still work on filtering out that electrical energy so our P300 signal is very clear.
So it can take a while, but you had mentioned that maybe in the future there might be words that they can choose from instead letters?
Ms. Mooney: Absolutely. It’s like when you’re using text entry on your smart phone and you start to type in something and up pops a word that would be the goal. The goal is to have words selection and word completion as part of the BCI. Our BCI project is using word prediction (similar to cell phones) in the background when a letter is chosen. Soon the RSVP Keyboard will have full sentences being typed and word prediction will appear on the screen as well.
When do you see this getting out there to people?
Ms. Mooney: Well it sounds like it’s a long ways off, but I think we’re still probably seven to eight years for this to be a reality for most patients with locked in syndrome. It doesn’t mean it’s not coming sooner than that. There’s still so much to make it user friendly in the home, easier for people to access, and affordable for people.
It could be used for a lot more than just locked in?
Ms. Mooney: What’s interesting about our research here at Oregon Health and Science University is that we use a definition of functionally locked in. So these are people that have a variety of diagnoses, even end stage ALS, severe Parkinson’s disease, severe MS, and severe spinal cord injury. They may have vertical eye movement and maybe some other small motor movement, maybe a tilt of the chin where they could use a switch but it’s not consistent. So our research is opening up to multiple diagnoses where people are what we’re calling functionally locked in. They don’t have that definition of classic locked in where all they have is eye movement, but their other motor movement is not reliable or efficient for communication. There are many more diagnoses, such as muscular dystrophy, multiple system atrophy, progressive supra-nuclear palsy, just to name a few, where individuals could benefit from a BCI interface as one way for them to control their environment, their computers and communicate. We want to open up the BCI technology to a much larger group of people.
I think the hardest part is people think when you’re locked in, that you’re not intelligent.
Ms. Mooney. Right. Most diagnoses that I’m talking about retain excellent cognitive function. I’ll give the example of ALS, Lou Gehrig’s disease. Even in the end stages there have been multiple studies that show that people can retain excellent thinking skills but they have lost their motor ability to use their speech. So they have intact cognitive skills but almost an inability to communicate their thoughts and feelings.
Do you think there are still a lot of people out there who are locked in that have been diagnosed as brain dead?
Ms. Mooney: Oh absolutely, yes.
How else can you see BCI helping?
Ms. Mooney: Again there are so many different circumstances where we can see this helping. The ICU or even a step down unit in a hospital where people are coming out of coma and regaining consciousness, the BCI has some utilization there. So we’re very proud that Oregon Health and Science University Brain Institute partnered with Northeastern University to bring this BCI technology to fruition. Something that is unique about our research is that we do include people who have the condition on our research team. Greg is part of our team here; he comes to a meeting every six weeks and gives his feedback on the development of this technology. That’s called participatory action research and we’re very enthusiastic to have people like Greg on our team who are really committed to moving this research forward.
Has Greg told you anything that you used for developing?
Ms. Mooney: Absolutely, Greg has a preference for the color of the letters in the RSVP. There were engineers that were kind of playing around with changing the colors and Greg had a very definitive opinion on that. He’s given us feedback about the screen being too busy when we tried to put part of the message up in one corner and part in another. So we absolutely take what Greg says and try and put it in to effect in the program.
Do you have other participants other than Greg?
Ms. Mooney: Well we have eleven and I think three have been part of the team giving input. Community base was the other thing that we go out to people’s homes and they don’t have to come here.
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