Wednesday, August 15, 2007

Locked-in


BoingBoing picked up on a Mind Hacks post on the topic of Locked-In Syndrome. Locked-In Syndrome refers to a condition caused by any number of disorders or injuries which leave a patient mentally intact, but unable to communicate with the outside world. Essentially, these people are prisoners in their own minds. I've worked with several of these people during my time with Phil Kennedy and John Donoghue, and know this is generally a misnomer.

Most Locked-in patients retain some ability to communicate, using either eye blinks, directional gaze, or binary interfaces to signal intent (especially true for patients in BCI clinical trials, since consent is needed). These folks are generally referred to as 'partially locked-in'. Many conditions eventually lead to becoming 'fully locked-in', such as ALS or mitochondrial myopathy. When people ask why we want to control a simple cursor, this would be a prime example. Even reliable binary control without supervision would be a huge improvement over the current state of affairs.

So, while I know the juicy bits come from robotic arms and exoskeletons, let's keep it grounded. The main reason prosthetic control, cursor control, and switches are worked on all at once is that we have some understanding of limb control by the nervous system. I guess you can consider limb control more 'natural', or more crystallized in the motor system's organization by the time these disorders and injuries are relevant.

They mention Jean-Dominique Bauby, who wrote the book The Diving Bell and the Butterfly while locked-in, using eye blinks. It is a great read, and I would say it is essential for anyone in BCI that hasn't read it, should.

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