Where Complexity Meets Innovation: The Application of Brain-Computer Interfaces on Neurological Activity
By Raya Chandok
“The human brain is probably one of the most complex single objects, on the face of the earth; I think it is, quite honestly” — Bill Viola
Introduction
Imagine this 🤔: You’re in a neurology bed in a hospital ward; you’ve just woken up in a haze and see flashing lights. You hear the muffled noises of nurses and physicians speaking. You are thinking to yourself, “Where am I”? and “How did I end up in a hospital bed”? You try moving your legs and arms in desperation but are unable to do so. Then a physician walks toward you to inform you that you just had a stroke and that your brain is severely damaged. You will be able to recover, but long hours of rehabilitation await you. You ask the physician 👩⚕️, “Is there some technology that's available that can help me”? She responds by saying, “Brain-computer interfaces, known as BCIs, are the answer”.
A brain-computer interface enables a person to control an external device using brain signals 🧠. Brain-computer interfaces acquire, analyze, and translate brain signals into commands that carry out desired actions. Examples of early use of BCI systems include spelling, controlling prosthetic devices, or moving cursors on a computer screen 🖥️. Nowadays, many more clinical applications of BCI technology are being developed. As you read through this article, I have focused on highlighting the value of BCIs in improving neurological rehabilitation outcomes/experiences. I am excited to share my findings with you!
Defining the Problem
The “bigger problem” we need to focus on is how to accelerate recovery from a brain injury, improve the quality of life and build independence to support well-being.
After experiencing any brain injury, such as a stroke, the recovery time is different for everyone. For some, it can take weeks, months, or possibly even years depending on the severity of the stroke. Apart from the recovery process, a brain injury, and in this case, a stroke, can cause a variety of effects that could potentially be life-changing. For example, some people are left unable to speak, while others, may have memory issues or could be more emotionally unstable. Below are further examples of changes one may experience:
🥴 Changes in Behaviour and Emotion: A stroke damages our brain which is what drives our behaviour and emotions. After experiencing a stroke, episodes of anger, confusion, anxiety, irritability, and depression are more likely to occur due to the biochemical changes in our brains.
🧠 Changes in Memory: In some cases, a stroke can have a profound impact on the memory of someone. For instance, they may appear to be more forgetful or neglectful at times. They could also develop poor judgment impacting their choices as well.
🪥 Changes in Lifestyle: After experiencing a stroke, someone may need to relearn occupational skills, and survivors unfortunately may not be able to perform daily tasks like walking, getting dressed, eating, bathing, or speaking. Since the situation is different for everyone, survivors of a stroke will receive rehabilitation services based on their recovery needs.
❤️ Changes in Relationships: Unfortunately, the families and caregivers of a survivor may also experience difficult changes during the recovery process of a loved one. Watching someone you care for struggle can be hard and difficult to endure. This is why it is extremely important to consider everyone’s needs when approaching a solution.
Based on the above reasoning, I believe that addressing the concerns of the “bigger problem” and changes someone may experience after a brain injury is one that BCIs can play a significant role in.
💡💡Approaching the Solution💡💡
You may be asking yourself, “What are supposed to do now”? We have all of the background knowledge of the challenges one may experience in rehabilitation, but how do we help these patients get a better quality of life? Well, by applying BCIs, you can reteach the brain to complete assisted daily living (ADL).
For those lucky enough to survive the traumatic experience of a stroke, the rehabilitation process is different for everyone. Some people may require speech therapy, while others, may require occupational therapy. BCIs are effective in this way as they measure the neuro connections in your brain so you can quantify the progress you made during the recovery stage. By using a BCI, you will be able to determine which treatment care processes you are succeeding more in. For example, if you are forming more neuro-connections in speech therapy and less in physical therapy, you will be able to change your care plan 📝.
Another exciting aspect of the solution is how physicians/therapists will be able to measure your neurological activity using a BCI. They can better track the areas you have made more progress in and areas in which you are sufficient, by comparing it to medical standards 📈. For example, by applying a BCI and your current state as a comparison to the medical standard, they can determine the progress you should have made, based on your stage in the recovery process.
Overall, this solution will help all survivors of brain injuries achieve a successful care plan, allowing them to recover in the most efficient way possible.
Application of BCIs in Medicine 🩺
There are many different kinds of BCIs and methods we can apply when trying to improve neurological rehabilitation outcomes/experiences. Don’t worry, I can break it down for you!
Non-invasive BCI: Non-invasive BCIs are devices that allow individuals to send actions or messages to family, friends, or others through the direct non-invasive action of brain activity 🌌. Non-invasive BCIs record and deliver information from sensors that are placed on the surface of the head and do not use any painful or hazardous methods. Non-invasive BCIs collect information about brain activity without actually requiring neurosurgery, however, the accuracy is not as strong as it is when using a partially invasive or invasive BCI device.
Partially invasive BCI: Partially invasive BCIs are devices that are implanted permanently inside the skull, but stay on the surface of the brain during neurosurgery. Partially invasive BCIs also spread out electrode arrays throughout the surface of your brain, rather than just staying inside. The biggest advantage of using partially invasive BCIs is that you are not cutting inside a living brain, so the accuracy is stronger than using non-invasive BCIs but not as strong as invasive. However, using partially invasive BCIs means a permanent hole is put in your skull 💀.
Invasive BCIs: Invasive BCIs are devices that are directly implanted inside your brain during neurosurgery. They have been created to analyze the direct communication between the brain and an external device, as they have the potential to record the single activity of neurons. This technology has been used to understand and interact with human brains on a single neuron level, while an individual is thinking and acting. Due to the high use of invasive BCIs, we will have an increasing number of neuronal recordings, allowing us to discover as well as value new insights into the living human brain 🧠.
Examples of BCIs
Electroencephalogram (EEG)
Invasiveness: Non-invasive BCI
An EEG is a test that is used to measure brain activity by placing electrodes on the surface of the scalp. EEGs track the electric signals in the brain as they occur. When the electrical activity inside a brain is normal, recognizable patterns of brain waves will be produced in an EEG graph 📈. Thus, through an EEG graph, doctors will be able to look for abnormal patterns that could lead to seizures, sleep patterns, loss of awareness, and more.
Electrocorticography (ECoG)
Invasiveness: Partially invasive BCI
An ECoG is very similar to an EEG as it implements surface electrodes, however, in this method, electrodes are put beneath the skull and directly on the surface of the brain. Since the electrodes are placed inside the skull, an ECoG is already much more efficient than an EEG. ECog electrodes can either be placed above or below the dura mater (a thick tissue that surrounds the brain). The only negative part of using the device is that it requires neurosurgery, but it is not too invasive 🔌.
Local Field Potential (LFP)
Invasiveness: Invasive BCIs
Unlike an EEG and ECoG, an LFP does not use surface electrodes but instead uses microelectrodes (small needles that a neurosurgeon would put in the brain). LFPs are made up of small needles that pick up an average of the electrical charge from those neurons. Although an LFP has a great temporal resolution, this device is far more invasive since it is entering the brain 🧠.
My 👀 Insight on BCIs in Medicine
BCIs have value in medicine as they can help accelerate recovery by providing physicians with reliable information to make decisions. For instance, imagine two patients who are recovering from a concussion. The first patient has access to a BCI, while the second does not. Since the first patient has access to a BCI, the most responsible physician (MLP) treating them will have stronger visibility into progress made during the recovery stage so that they make better decisions in designing a care plan. Conversely, the physician treating the patient who does not have access to a BCI may not have all the necessary information to make the best desicion on the care plan.
Ultimately, using a BCI enables physicians to help design a successful care plan for the patient.
TL;DR
- Introduction: Think about a world where people will still be able to live a normal life after surviving a brain injury by using BCIs. How will we make this happen?
- Defining the problem: The key problem we need to focus on after a patient survives a brain injury is how to accelerate recovery, improve the quality of life and build independence to support well-being.
- Approaching the solution: BCIs will help us solve our problem as they measure the neuro connections in your brain so you can quantify the progress you made during the recovery stage, ultimately improving the quality of life of a patient.
- Application of BCIs in medicine: There are many different kinds of BCIs we can apply that all come with their risks/benefits. The main three kinds are non-invasive, partially invasive, and an invasive BCI.
- Examples of BCIs: An electroencephalogram (non-invasive BCI), an electrocorticography (partially invasive BCI), and local field potential (invasive BCI) are three of the devices I outlined in this section.
- My insight on BCIs in Medicine: BCIs have value in medicine as they can help accelerate recovery by providing physicians with reliable information to make decisions.
Citations
How Does Life Change Following a Stroke?” C-Care Health Services, 22 March 2019, https://www.c-care.ca/blog/stroke/how-does-life-change-following-a-stroke/. Accessed 24 October 2023.
“Brain-Computer Interfaces in Medicine — PMC.” NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3497935/. Accessed 24 October 2023.
“VWN Virtual Dictionary: Partially-invasive BCI.” Virtual Worldlets Network, http://www.virtualworldlets.net/Resources/Dictionary.php?Term=Partially-invasive%20BCI. Accessed 24 October 2023. (“VWN Virtual Dictionary: Partially-invasive BCI”)
“brain-computer interface News Research Articles.” Neuroscience News, https://neurosciencenews.com/neuroscience-terms/brain-computer-interface/. Accessed 24 October 2023.
“Brain-computer interfaces in medicine.” PubMed, https://pubmed.ncbi.nlm.nih.gov/22325364/. Accessed 25 October 2023.
“Breakthrough BCI Applications in Medicine.” Frontiers, https://www.frontiersin.org/research-topics/6300/breakthrough-bci-applications-in-medicine. Accessed 25 October 2023.
