Dataset Information

Detecting Glaucoma With a Portable Brain-Computer Interface for Objective Assessment of Visual Function Loss.

ABSTRACT: Importance:The current assessment of visual field loss in diseases such as glaucoma is affected by the subjectivity of patient responses and the lack of portability of standard perimeters. Objective:To describe the development and initial validation of a portable brain-computer interface (BCI) for objectively assessing visual function loss. Design, Setting, and Participants:This case-control study involved 62 eyes of 33 patients with glaucoma and 30 eyes of 17 healthy participants. Glaucoma was diagnosed based on a masked grading of optic disc stereophotographs. All participants underwent testing with a BCI device and standard automated perimetry (SAP) within 3 months. The BCI device integrates wearable, wireless, dry electroencephalogram and electrooculogram systems and a cellphone-based head-mounted display to enable the detection of multifocal steady state visual-evoked potentials associated with visual field stimulation. The performances of global and sectoral multifocal steady state visual-evoked potentials metrics to discriminate glaucomatous from healthy eyes were compared with global and sectoral SAP parameters. The repeatability of the BCI device measurements was assessed by collecting results of repeated testing in 20 eyes of 10 participants with glaucoma for 3 sessions of measurements separated by weekly intervals. Main Outcomes and Measures:Receiver operating characteristic curves summarizing diagnostic accuracy. Intraclass correlation coefficients and coefficients of variation for assessing repeatability. Results:Among the 33 participants with glaucoma, 19 (58%) were white, 12 (36%) were black, and 2 (6%) were Asian, while among the 17 participants with healthy eyes, 9 (53%) were white, 8 (47%) were black, and none were Asian. The receiver operating characteristic curve area for the global BCI multifocal steady state visual-evoked potentials parameter was 0.92 (95% CI, 0.86-0.96), which was larger than for SAP mean deviation (area under the curve, 0.81; 95% CI, 0.72-0.90), SAP mean sensitivity (area under the curve, 0.80; 95% CI, 0.69-0.88; P?=?.03), and SAP pattern standard deviation (area under the curve, 0.77; 95% CI, 0.66-0.87; P?=?.01). No statistically significant differences were seen for the sectoral measurements between the BCI and SAP. Intraclass coefficients for global and sectoral parameters ranged from 0.74 to 0.92, and mean coefficients of variation ranged from 3.03% to 7.45%. Conclusions and Relevance:The BCI device may be useful for assessing the electrical brain responses associated with visual field stimulation. The device discriminated eyes with glaucomatous neuropathy from healthy eyes in a clinically based setting. Further studies should investigate the feasibility of the BCI device for home-based testing as well as for detecting visual function loss over time.

SUBMITTER: Nakanishi M

PROVIDER: S-EPMC5772598 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Detecting Glaucoma With a Portable Brain-Computer Interface for Objective Assessment of Visual Function Loss.

Nakanishi Masaki M Wang Yu-Te YT Jung Tzyy-Ping TP Zao John K JK Chien Yu-Yi YY Diniz-Filho Alberto A Daga Fabio B FB Lin Yuan-Pin YP Wang Yijun Y Medeiros Felipe A FA

JAMA ophthalmology 20170601 6

<h4>Importance</h4>The current assessment of visual field loss in diseases such as glaucoma is affected by the subjectivity of patient responses and the lack of portability of standard perimeters.<h4>Objective</h4>To describe the development and initial validation of a portable brain-computer interface (BCI) for objectively assessing visual function loss.<h4>Design, setting, and participants</h4>This case-control study involved 62 eyes of 33 patients with glaucoma and 30 eyes of 17 healthy parti ...[more]

PMID: 28448641

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Project description:Background and objectives: Many brain-computer interfaces (BCIs) for people with severe disabilities present stimuli in the visual modality with little consideration of the visual skills required for successful use. The primary objective of this tutorial is to present researchers and clinical professionals with basic information about the visual skills needed for functional use of visual BCIs, and to offer modifications that would render BCI technology more accessible for persons with vision impairments.Methods: First, we provide a background on BCIs that rely on a visual interface. We then describe the visual skills required for BCI technologies that are used for augmentative and alternative communication (AAC), as well as common eye conditions or impairments that can impact the user's performance. We summarize screening tools that can be administered by the non-eye care professional in a research or clinical setting, as well as the role of the eye care professional. Finally, we explore potential BCI design modifications to compensate for identified functional impairments. Information was generated from literature review and the clinical experience of vision experts.Results and conclusions: This in-depth description culminates in foundational information about visual skills and functional visual impairments that affect the design and use of visual interfaces for BCI technologies. The visual interface is a critical component of successful BCI systems. We can determine a BCI system for potential users with visual impairments and design BCI visual interfaces based on sound anatomical and physiological visual clinical science.Implications for RehabilitationAs brain-computer interfaces (BCIs) become possible access methods for people with severe motor impairments, it is critical that clinicians have a basic knowledge of the visual skills necessary for use of visual BCI interfaces.Rehabilitation providers must have a knowledge of objectively gathering information regarding a potential BCI user's functional visual skills.Rehabilitation providers must understand how to modify BCI visual interfaces for the potential user with visual impairments.Rehabilitation scientists should understand the visual demands of BCIs as they develop and evaluate these new access methods.

Project description:BACKGROUND: In a visual oddball paradigm, attention to an event usually modulates the event-related potential (ERP). An ERP-based brain-computer interface (BCI) exploits this neural mechanism for communication. Hitherto, it was unclear to what extent the accuracy of such a BCI requires eye movements (overt attention) or whether it is also feasible for targets in the visual periphery (covert attention). Also unclear was how the visual design of the BCI can be improved to meet peculiarities of peripheral vision such as low spatial acuity and crowding. METHOD: Healthy participants (N = 13) performed a copy-spelling task wherein they had to count target intensifications. EEG and eye movements were recorded concurrently. First, (c)overt attention was investigated by way of a target fixation condition and a central fixation condition. In the latter, participants had to fixate a dot in the center of the screen and allocate their attention to a target in the visual periphery. Second, the effect of visual speller layout was investigated by comparing the symbol Matrix to an ERP-based Hex-o-Spell, a two-levels speller consisting of six discs arranged on an invisible hexagon. RESULTS: We assessed counting errors, ERP amplitudes, and offline classification performance. There is an advantage (i.e., less errors, larger ERP amplitude modulation, better classification) of overt attention over covert attention, and there is also an advantage of the Hex-o-Spell over the Matrix. Using overt attention, P1, N1, P2, N2, and P3 components are enhanced by attention. Using covert attention, only N2 and P3 are enhanced for both spellers, and N1 and P2 are modulated when using the Hex-o-Spell but not when using the Matrix. Consequently, classifiers rely mainly on early evoked potentials in overt attention and on later cognitive components in covert attention. CONCLUSIONS: Both overt and covert attention can be used to drive an ERP-based BCI, but performance is markedly lower for covert attention. The Hex-o-Spell outperforms the Matrix, especially when eye movements are not permitted, illustrating that performance can be increased if one accounts for peculiarities of peripheral vision.

Dataset Information

Detecting Glaucoma With a Portable Brain-Computer Interface for Objective Assessment of Visual Function Loss.

Publications

Detecting Glaucoma With a Portable Brain-Computer Interface for Objective Assessment of Visual Function Loss.

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