Assessment and Communication for People with Disorders of Consciousness

The overall goal of this system is to detect consciousness in people with disorders of consciousness and to create a simple communication channel that enables people to give yes no answers to questions. The main advantage of the system is that it is effective even for patients without any motor response. This method can help answer key questions in the medical, such as whether patient with disorders of consciousness are aware of themselves and the outside world.

This technology can be used for patients with disorders of consciousness, but recently, we've even established communication for completely locked in patients. Begin by connecting the amplifier to the software computer with a USB cable. Plug in the hardware dongle and turn on the amplifier.

Use a USB cable to connect the driver box to a free slot on the computer. Then connect the out five, out six, and out seven labeled connectors to out five, six, and seven of the driver box respectively. Connect the D I/O-1 labeled connector to the DIG I/O-1 socket.

Next, connect the three tactors to out one, out two, and out three of the driver box and connect the trig outlabled connector to the trig out socket of the audio trigger adapter box. Put the antistatic wrist band onto the subject's wrist and connect it to a free power plug. Then take adhesive tap and fix tactor on the left wrist, another one on the right wrist, and a third one on the right ankle.

Connect one side of a male, male audio connector cable to the audio output of the computer and the other to the socket of the audio trigger adapter box that is labeled audio in. Turn on the audio trigger adapter box and check if the battery status LED is green. Next start the software and observe a window called Add Physician.

Type the title, name, institution, and department into the empty fields. Click on add to open another window. Then enter the patients name, city, country, birthdate, and check in date into the window.

Then click the green plus button below the blue arrow in the bottom right section of the program. Enter the text, first test into the name field and getting familiar with the software into the empty details field. Finally click on the select this patient button.

First, properly position an electrode cap on the subjects head. Then use a tape measure to measure the distance between the nasion and inion as well as the distance between the left and right preauricular points. Ensure that the electrode in the vertex position, CZ, is at the midpoint of these two distances.

Use electrode gel to attach 16 electroencephalography, or EEG channels to the subjects head, according to the extended International 10-20 system. Place a reference electrode on the right earlobe and a ground electrode on the forehead. Connect the electrodes to the electrode connection box.

Then connect the electrode connection box to the biosignal amplifier and ensure that the amplifier and connection box are switched on. Next, on the computer, click the Vibrotactile 3 tactor button on the left side of the screen. Then click the assessment button on the bottom right to start the assessment run.

Check the signal quality of the EEG. Open the settings menu via the settings button to confirm that the vibrations of the tactors can be felt. Then instruct the subject that he or she will feel vibrations on the left and right wrists, on the right ankle, as well as hear the command left or right via the headphones.

Ask the subject to collect the stimuli on the selected hand until the next command appears or the run is over. Place the earphones into the subjects ears and click the start button. After finishing the assessment run, check the results page and the accuracy plot.

Then click the Vibrotactile 3 tactor button on the left side of the screen. Click the communication button on the bottom to start to the communication run. Again, check the signal quality of the EEG.

Open the settings menu via the settings button and confirm that the vibrations of the tactors can be felt. Then, select the classifier with the highest accuracy level calculated. For this run, instruct the subject that he or she will feel vibrations on the left and write wrists and on the right ankle.

Instruct the subject that he or she will hear a question and should answer either yes or no. To answer yes, ask the subject to count the stimuli on the left hand. To answer no, ask the subject to count the stimuli on the right hand.

Finally ask the patient a question that could answered with either yes or no. After that, click the start new question button. Watch the lens moving to the answer yes.

Notice, the accuracy increases after the command presentation to more than 90%meaning the individual was consciously aware, because he was able to follow the randomized commands. On the other hand, these results show the classification accuracy fluctuating around 12.5%This means that the system was not able to detect a brain response following the presented commands and stimuli. Once people are trained to use the system, they can do the assessment within 20 minutes only.

While attempting this procedure, it's important to remember that patient can expect fluctuations in consciousness, thus if a test does reveal consciousness awareness, testing again could produce different results. Following this procedure, other methods can be done, like additional EEG assessment in order to answer questions like rehabilitation could help improving his or her condition. After its development, the technique paved the way for researchers in the fields of medicine, neuroscience, and engineering to explore consciousness assessment in patients with disorders of consciousness.

After watching the video, you should have a good idea of how to do assessment of cognitive functions and of how to establish communication with the system. The approach is not dangerous. It only requires placing an EEG cap on the head.

It does not require any additional tracks or painful procedures.