A clinical screening protocol for the RSVP Keyboard brain–computer interface

Abstract

Purpose: To propose a screening protocol that identifies requisite sensory, motor, cognitive and communication skills for people with locked-in syndrome (PLIS) to use the RSVP Keyboard™ brain–computer interface (BCI). Method: A multidisciplinary clinical team of seven individuals representing five disciplines identified requisite skills for the BCI RSVP Keyboard™. They chose questions and subtests from existing standardized instruments for auditory comprehension, reading and spelling, modified them to accommodate nonverbal response modalities, and developed novel tasks to screen visual perception, sustained visual attention and working memory. Questions were included about sensory skills, positioning, pain interference and medications. The result is a compilation of questions, adapted subtests and original tasks designed for this new BCI system. It was administered to 12 PLIS and 6 healthy controls. Results: Administration required 1 h or less. Yes/no choices and eye gaze were adequate response modes for PLIS. Healthy controls and 9 PLIS were 100% accurate on all tasks; 3 PLIS missed single items. Conclusions: The RSVP BCI screening protocol is a brief, repeatable technique for patients with different levels of LIS to identify the presence/absence of skills for BCI use. Widespread adoption of screening methods should be a clinical goal and will help standardize BCI implementation for research and intervention.

Implications for Rehabilitation

• People with locked-in syndrome must have certain sensory, motor, cognitive and communication skills to successfully use a brain–computer interface (BCI) for communication.

• A screening profile would be useful in identifying potentially suitable candidates for BCI.

• Augmentative and alternative communication
• brain–computer interface
• cognition
• locked-in syndrome
• screening

Acknowledgements

We wish to acknowledge the contribution of the Cognitive Systems Laboratory at Northeastern University, Boston, Massachusetts, as well as the time commitments of participants with functional LIS. We also wish to thank Meghan Miller for programming the Four Corners and RSVP subtests in E-Prime 2.0®.

Declaration of interest

The authors report no conflicts of interest. This study was supported by a grant from the National Institutes of Health #1RO1DC009834-01. Any opinions, findings, conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the NIH.