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BACKGROUND: The locked-in syndrome (LIS), due to a lesion in the pons, impedes communication. This situation can also be met after some severe brain injury or in advanced Amyotrophic Lateral Sclerosis (ALS). In the most severe condition, the persons cannot communicate at all because of a complete oculomotor paralysis (Complete LIS or CLIS). This even prevents the detection of consciousness. Some studies suggest that auditory brain-computer interface (BCI) could restore a communication through a « yes-no¼ code. METHODS: We developed an auditory EEG-based interface which makes use of voluntary modulations of attention, to restore a yes-no communication code in non-responding persons. This binary BCI uses repeated speech sounds (alternating "yes" on the right ear and "no" on the left ear) corresponding to either frequent (short) or rare (long) stimuli. Users are instructed to pay attention to the relevant stimuli only. We tested this BCI with 18 healthy subjects, and 7 people with severe motor disability (3 "classical" persons with locked-in syndrome and 4 persons with ALS). RESULTS: We report online BCI performance and offline event-related potential analysis. On average in healthy subjects, online BCI accuracy reached 86% based on 50 questions. Only one out of 18 subjects could not perform above chance level. Ten subjects had an accuracy above 90%. However, most patients could not produce online performance above chance level, except for two people with ALS who obtained 100% accuracy. We report individual event-related potentials and their modulation by attention. In addition to the classical P3b, we observed a signature of sustained attention on responses to frequent sounds, but in healthy subjects and patients with good BCI control only. CONCLUSIONS: Auditory BCI can be very well controlled by healthy subjects, but it is not a guarantee that it can be readily used by the target population of persons in LIS or CLIS. A conclusion that is supported by a few previous findings in BCI and should now trigger research to assess the reasons of such a gap in order to propose new and efficient solutions. CLINICAL TRIAL REGISTRATIONS: No. NCT02567201 (2015) and NCT03233282 (2013).

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Non-invasive brain-computer interfaces (BCIs) based on an event-related potential (ERP) component, P300, elicited via the oddball paradigm, have been extensively developed to enable device control and communication. While most P300-based BCIs employ visual stimuli in the oddball paradigm, auditory P300-based BCIs also need to be developed for users with unreliable gaze control or limited visual processing. Specifically, auditory BCIs without additional visual support or multi-channel sound sources can broaden the application areas of BCIs. This study aimed to design optimal stimuli for auditory BCIs among artificial (e.g., beep) and natural (e.g., human voice and animal sounds) sounds in such circumstances. In addition, it aimed to investigate differences between auditory and visual stimulations for online P300-based BCIs. As a result, natural sounds led to both higher online BCI performance and larger differences in ERP amplitudes between the target and non-target compared to artificial sounds. However, no single type of sound offered the best performance for all subjects; rather, each subject indicated different preferences between the human voice and animal sound. In line with previous reports, visual stimuli yielded higher BCI performance (average 77.56%) than auditory counterparts (average 54.67%). In addition, spatiotemporal patterns of the differences in ERP amplitudes between target and non-target were more dynamic with visual stimuli than with auditory stimuli. The results suggest that selecting a natural auditory stimulus optimal for individual users as well as making differences in ERP amplitudes between target and non-target stimuli more dynamic may further improve auditory P300-based BCIs. Supplementary Information: The online version contains supplementary material available at 10.1007/s11571-022-09901-3.

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BACKGROUND AND OBJECTIVE: Brain-Computer Interfaces (BCIs) based on auditory selective attention have been receiving much attention because i) they are useful for completely paralyzed users since they do not require muscular effort or gaze and ii) focusing attention is a natural human ability. Several techniques - such as recently developed Spatial Coherence (SC) - have been proposed in order to optimize the BCI procedure. Thus, this work aims at investigating and comparing two strategies based on spatial coherence detection: contralateral and modular classifiers. The latter is a new method using modular attention index. The new classifier was developed to implement an auditory BCI where a volunteer makes binary choices using selective attention under the amplitude-modulated tones stimulation. METHODS: Contralateral and modular classifiers were applied to the electroencephalogram (EEG) recorded from 144 subjects under the BCI protocol. The best set of parameters (carriers of the stimulus, channels and trials of signal) for this BCI was investigated taking into consideration the hit rate and the information transfer rate. RESULTS: The best result obtained using the modular classifier was a hit rate of 91.67% and information transfer rate of 6.74 bits/min using 0.5 kHz/4.0 kHz as stimuli and three windows (5.10 sec of EEG signal). These results were obtained with five electrodes (C3, P3, F8, P4, O2) using exhaustive search to identify regions with greater coherence. CONCLUSION: The modular classifier - using electroencephalogram channels from the central, frontal, occipital and parietal areas - improves the performance of auditory BCIs based on selective attention.

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