Portable Brain-Computer Interface for the Intensive Care Unit Patient Communication Using Subject-Dependent SSVEP Identification

A major predicament for Intensive Care Unit (ICU) patients is inconsistent and ineffective communication means. Patients rated most communication sessions as difficult and unsuccessful. This, in turn, can cause distress, unrecognized pain, anxiety, and fear. As such, we designed a portable BCI system for ICU communications (BCI4ICU) optimized to operate effectively in an ICU environment. The system utilizes a wearable EEG cap coupled with an Android app designed on a mobile device that serves as visual stimuli and data processing module. Furthermore, to overcome the challenges that BCI systems face today in real-world scenarios, we propose a novel subject-specific Gaussian Mixture Model- (GMM-) based training and adaptation algorithm. First, we incorporate subject-specific information in the training phase of the SSVEP identification model using GMM-based training and adaptation. We evaluate subject-specific models against other subjects. Subsequently, from the GMM discriminative scores, we generate the transformed vectors, which are passed to our predictive model. Finally, the adapted mixture mean scores of the subject-specific GMMs are utilized to generate the high-dimensional supervectors. Our experimental results demonstrate that the proposed system achieved 98.7% average identification accuracy, which is promising in order to provide effective and consistent communication for patients in the intensive care.

[1]  Reinhold Scherer,et al.  Steady-state visual evoked potential (SSVEP)-based communication: impact of harmonic frequency components , 2005, Journal of neural engineering.

[2]  K. Priftis,et al.  Brain–computer interfaces in amyotrophic lateral sclerosis: A metanalysis , 2015, Clinical Neurophysiology.

[3]  L R Cronin,et al.  The computer as a communication device for ventilator and tracheostomy patients in the intensive care unit. , 1984, Critical care nurse.

[4]  Roozbeh Jafari,et al.  Maximizing information transfer rates in an SSVEP-based BCI using individualized Bayesian probability measures , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[5]  Daniel Friedman,et al.  Continuous Electroencephalogram Monitoring in the Intensive Care Unit , 2009, Anesthesia and analgesia.

[6]  D. Debicki,et al.  EEG utilization in Canadian intensive care units: A multicentre prospective observational study , 2016, Seizure.

[7]  Harikumar Rajaguru,et al.  GMM better than SRC for classifying epilepsy risk levels from EEG signals , 2015, 2015 International Conference on Intelligent Informatics and Biomedical Sciences (ICIIBMS).

[8]  Roozbeh Jafari,et al.  A novel stimulation for multi-class SSVEP-based brain-computer interface using patterns of time-varying frequencies , 2014, 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[9]  J. Huggins,et al.  Brain-computer interface: current and emerging rehabilitation applications. , 2015, Archives of physical medicine and rehabilitation.

[10]  A Kübler,et al.  A P 300-based brain-computer interface for people with amyotrophic lateral sclerosis , 2010 .

[11]  J S Hammond,et al.  Patient Recall of Therapeutic Paralysis in a Surgical Critical Care Unit , 1998, Pharmacotherapy.

[12]  J. C. Sackellares,et al.  Inter-rater agreement on identification of electrographic seizures and periodic discharges in ICU EEG recordings , 2015, Clinical Neurophysiology.

[13]  J. Wolpaw,et al.  A P300-based brain–computer interface for people with amyotrophic lateral sclerosis , 2008, Clinical Neurophysiology.

[14]  C. Gregoretti,et al.  Gaze-controlled, computer-assisted communication in Intensive Care Unit: "speaking through the eyes". , 2013, Minerva anestesiologica.

[15]  Helge J. Ritter,et al.  Improving Transfer Rates in Brain Computer Interfacing: A Case Study , 2002, NIPS.

[16]  J. Selhorst,et al.  "Locked-in" syndrome. , 1987, Stroke.

[17]  Mitchel Weintraub,et al.  LVCSR log-likelihood ratio scoring for keyword spotting , 1995, 1995 International Conference on Acoustics, Speech, and Signal Processing.

[18]  N. Birbaumer,et al.  Brain-machine interface (BMI) in paralysis. , 2015, Annals of physical and rehabilitation medicine.

[19]  I Bergbom-Engberg,et al.  Assessment of patients' experience of discomforts during respirator therapy , 1989, Critical care medicine.

[20]  V. Melby,et al.  An investigation into the attitudes and practices of intensive care nurses towards verbal communication with unconscious patients. , 1996, Journal of clinical nursing.

[21]  Isabelle Durand-Zaleski,et al.  Paresis acquired in the intensive care unit: a prospective multicenter study. , 2002, JAMA.

[22]  Omid Dehzangi,et al.  High accuracy wearable SSVEP detection using feature profiling and dimensionality reduction , 2017, 2017 IEEE 14th International Conference on Wearable and Implantable Body Sensor Networks (BSN).

[23]  Keum Shik Hong,et al.  Hybrid Brain–Computer Interface Techniques for Improved Classification Accuracy and Increased Number of Commands: A Review , 2017, Front. Neurorobot..

[24]  L K Menzel,et al.  Factors related to the emotional responses of intubated patients to being unable to speak. , 1998, Heart & lung : the journal of critical care.

[25]  Wei Wu,et al.  Frequency recognition based on canonical correlation analysis for SSVEP-based BCIs , 2007, IEEE Transactions on Biomedical Engineering.

[26]  Ioan V. Lemeni,et al.  A Method for Detecting Discontinuous Probability Density Function from Data , 2011 .

[27]  Bo Hong,et al.  A practical VEP-based brain-computer interface , 2006, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[28]  Grant Bochicchio,et al.  Computer-assisted communication for critically ill patients: a pilot study. , 2004, The Journal of trauma.

[29]  E. Rudy,et al.  Comparison of two types of communication methods used after cardiac surgery with patients with endotracheal tubes. , 1988, Heart & lung : the journal of critical care.

[30]  Rita Seeger Jablonski,et al.  The Experience of Being Mechanically Ventilated , 1994 .

[31]  Theodore Speroff,et al.  Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. , 2004, JAMA.

[32]  Mary Beth Happ,et al.  Nurse-patient communication interactions in the intensive care unit. , 2011, American journal of critical care : an official publication, American Association of Critical-Care Nurses.

[33]  Qiang Ji,et al.  In the Eye of the Beholder: A Survey of Models for Eyes and Gaze , 2010, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[34]  A J Leathart,et al.  Communication and socialisation (1): An exploratory study and explanation for nurse-patient communication in an ITU. , 1994, Intensive & critical care nursing.

[35]  Eric W. Sellers,et al.  Noninvasive brain-computer interface enables communication after brainstem stroke , 2014, Science Translational Medicine.

[36]  Brendan Z. Allison,et al.  The Hybrid BCI , 2010, Frontiers in Neuroscience.

[37]  S. Carroll Nonvocal Ventilated Patients Perceptions of Being Understood , 2004, Western journal of nursing research.

[38]  Ma Chong-Xiao,et al.  GMM-based Detection Methods in EEG-based Brain-Computer Interfaces , 2010, 2010 First International Conference on Pervasive Computing, Signal Processing and Applications.

[39]  Peng Yuan,et al.  A study of the existing problems of estimating the information transfer rate in online brain–computer interfaces , 2013, Journal of neural engineering.

[40]  Liqing Zhang,et al.  Gaussian mixture modeling in stroke patients' rehabilitation EEG data analysis , 2013, 2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[41]  J. Wolpaw,et al.  A P300-based brain–computer interface for people with amyotrophic lateral sclerosis , 2008, Clinical Neurophysiology.

[42]  C. Herrmann Human EEG responses to 1–100 Hz flicker: resonance phenomena in visual cortex and their potential correlation to cognitive phenomena , 2001, Experimental Brain Research.

[43]  M. Happ Interpretation of nonvocal behavior and the meaning of voicelessness in critical care. , 2000, Social science & medicine.

[44]  D. Sexton,et al.  Distress during mechanical ventilation: patients' perceptions. , 1990, Critical care nurse.