KITE-BCI: A brain-computer interface system for functional electrical stimulation therapy

Abstract

Context/Objective

Integrating brain-computer interface (BCI) technology with functional electrical stimulation therapy (FEST) is an emerging strategy for upper limb motor rehabilitation after spinal cord injury (SCI). Despite promising results, the combined use of these technologies (BCI-FEST) in clinical practice is minimal. To address this issue, we developed KITE-BCI, a BCI system specifically designed for clinical application and integration with dynamic FEST. In this paper, we report its technical features and performance. In addition, we discuss the differences in distributions of the BCI- and therapist-triggered stimulation latencies.

Design

Two single-arm 40-session interventional studies to test the feasibility of BCI-controlled FEST for upper limb motor rehabilitation in individuals with cervical SCI

Setting

Rehabilitation programs within the University and Lyndhurst Centres of the Toronto Rehabilitation Institute – University Health Network, Toronto, Canada

Participants

Five individuals with sub-acute (< 6 months post-injury) SCI at the C4-C5 level, AIS B-D, and three individuals with chronic (> 24 months post-injury) SCI at C4 level, AIS B-C.

Outcome Measures

We measured BCI setup duration, and to characterize the performance of KITE-BCI, we recorded BCI sensitivity, defined as the percentage of successful BCI activations out of the total number of cued movements.

Results

The overall BCI sensitivities were 74.46% and 79.08% for the sub-acute and chronic groups, respectively. The average KITE-BCI setup duration across the two studies was 11 min and 13 s.

Conclusion

KITE-BCI demonstrates a clinically viable single-channel BCI system for integration with FEST resulting in a versatile technology-enhanced upper limb motor rehabilitation strategy after SCI.

KEYWORDS:

• brain-computer interface
• electroencephalography
• functional electrical stimulation
• functional electrical stimulation therapy
• restoration of function
• neuroplasticity
• spinal cord injury
• tetraplegia

Disclaimer statements

Conflict of interest Lazar I. Jovanovic has no conflict of interest to disclose. Milos R. Popovic is the co-founder and Director of MyndTec, a company that manufactures transcutaneous functional electrical stimulators. Cesar Marquez-Chin is the Treasurer of the International Functional Electrical Stimulation Society, a not-for-profit organization that promotes the awareness, knowledge, and understanding of electrical stimulation technologies and their application.

Notes

1 Sensitivity = True Positives / (True Positives + False Negatives)

Additional information

Funding

The work presented here had been financially supported by the Ontario Neurotrauma Foundation, in partnership with Praxis Spinal Cord Institute, and the Morton Cure Paralysis Fund.