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BRAIN COMPUTER INTERFACES &

PARKINSON’S DISEASE
SHANNON KAUPP
NORTHEASTERN UNIVERSITY

Brain Computer Interfaces
• Locked-In Syndrome
• How do BCI’s Work work?
• Research: BCIs for Parkinson’s Disease
• Typing
• Writing
• Reduced Freezing of Gait
• aDBS
• Intendix
• Practicality & Efficacy
• Clinical Trials

Locked-In Syndrome
• A condition where the patient’s awareness of the

environment is intact, but with an inability to
communicate.
• Awareness of the environment is key, since these brainwaves can

be detected with EEG.

• Parkinson’s Disease progressively diminishes motor

function, until the patient is no longer able to move or
speak.
• Voice amplification diminishes slowly, but continually.

How do BCI’s work?
• Brain signals are harnessed by

electroencephalography(EEG).
• These signals are then
transferred to the computer for
analysis.
• A program like Matlab
translates these signals into
computer code.
• These codes are
programmed into commands
that control an external device.

Writing
• 3-axis Quanser Phantom Omnibot: Writes the full

alphabet, numbers 0-9 and a hyphen with 91-96%
accuracy.
• Patients must first go through initial training so that Matlab can

decipher between brainwaves and then pair them with symbols.

Figure 1: Training for letter to
brainwave association was used
with this chart.

Figure 2: 3-Axis Quanser
Phantom Omnibot

Figure 3: An output of the system
from a real patient.

Typing

P300 Speller Program in T9

• Classic P300 Speller: Subject must

choose each letter. This increases both
error and time to completion.
• P300 Speller (modified with T9): The
subject chooses the number
corresponding to the group that has
their letter. The program then suggests
words to speed up the process.

Mean Time in Minutes
• Classic: 3.47±0.98
• T9: 1.67±0.16

Figure 4: In this example, 557 is selected.
Once the computer suggests possible
words, the subject will choose the number
that the word corresponds with; 1-mother,
2-mountain, 3-mouth, etc.

Reduced Freezing of Gait
• Visual cues are well known for helping Parkinson’s patients

continue walking.
• Current technology uses a laser projected from the walker that

creates a single line for patients to step on as they walk.

• Institute for Neural Computation’s Current Project
• A BCI is being designed that would project visual targets on the
ground that move depending on where the person wants to walk.
• This would be more effective than the laser, since predicting the
patient’s movements, could eliminate gait freezing all together.

Adaptive Deep Brain Stimulation
• Standard DBS continually stimulates the STN.
• Is constant stimulation necessary?
• BCI-controlled Adaptive DBS (aDBS)
• BCI instructs the internal electrodes to change stimulation based on

the brainwaves.
• Personalized approach to meet the needs of each patient.

• In a study comparing STN-DBS with aDBS, aDBS was

30% more effective, while also decreasing the amount of
stimulation needed by more than 50%.
• aDBS is still undergoing testing before being scaled, but has so far

had promising results in its trials.

IntendiX
• IntendiX is the only medical BCI available for purchase.
• Almost every BCI is still in the research stage and thus only
accessible by participation in a clinical study.
• Available Versions:

• intendiX Speller: The program not only types text, but can

also read, print, and send it all through email.

Practicality & Efficacy
• EEG cap limits the ability to precisely

pick up brain-waves
• Concurrent waves often create noise, making it difficult to

distinguish the exact signal.

• Training is necessary to associate brain-waves with

command.
• Research is conducted to reduce training time; however,

depending on the machine it can take anywhere from 10 minutes to
3 months.

• BCI Technology is both expensive and personal.
• Currently, BCI’s are not covered by insurance and most cannot be
shared since they adapt to the individual.

Getting Involved: Clinical Trials
• No clinical trials are currently being conducted in USA for

BCI use in PD.
• www.clinicaltrials.gov

• In Italy, clinical study for aDBS in Parkinson’s Disease
• Currently recruiting patients 18-70 years old.
• Principle Investigator Albert Priori – Identifier: NCT02154724
• Massachusetts General Hospital
• RSVP for Health: Program that allows a patient to sign up for alerts

of new clinical trials in their chosen area.
• Staying up-to-date will allow your patients access to the most novel
treatments available.

References
Shih J, Krusienski D, & Wolpaw J. Brain-Computer Interfaces in Medicine.
Mayo Clinic Proceedings 2012; 87(3): 268-79.
Little S, Pogosyan A, Neal S, Zavala B, et al. Adaptive Deep Brain Stimulation
in Advanced Parkinson’s Disease. Annals of Neurology 2013; 74(3): 449-457.
Velu P, Mullen T, Noh E, Valdivia M, et al. Effect of Visual Feedback on the
Occipital-Parietal-Motor Network in Parkinson’s Disease with Freezing of Gait.
Frontiers in Neurology 2014; doi: 10.3389/fneur.2013.00209.
Syan C, Harnarinesingh R, & Beharry R. Investigating the Feasibility of a BCIdriven robot-based Writing Agent for Handicapped Individuals. IOP Conference
Series: Materials Science & Engineering 2014; doi:10.1088/1757899X/65/1/012020.
Akram F, Han S, & Kim T. An Efficient Word Typing P300-BCI System using a
Modified T9 Interface and Random Forest Classifier. Computers in Biology and
Medicine 2015; 56: 30-36.
Priori A. Clinical Study for Adaptive Deep Brain Stimulation (aDBS) Controlled
by Intracerebral Activity in Parkinson’s Disease. Clinicaltrials.gov: A Service of
the U.S. National Institute of Health. May 2014.

Image Citation
Slide 1: Neuroscience in Business [online image]. Retrieved from: http://routetogreatness.com/neuroscience-inbusiness/
Slide 2: [online image]. Retrieved from: http://alsn.mda.org/article/brain-computer-interface-reads-brainwaves
Slide 3: [online image]. Retrieved from:
https://mynameiskavi.wordpress.com/2012/02/27/electroencephalography-or-eeg/.
Matlab [online image]. Retrieved from: https://www.nersc.gov/users/software/data-visualization-andanalytics/matlab/
Integrum [online image]. Retrieved from: http://neurosciencenews.com/neuroprosthetic-arm-implants-technology1410/
[online image]. Retrieved from:
http://writeitright.uelconnect.org.uk/pages/preparation/29/understanding_the_question.html
[online image]. Retrieved from: http://www.quanser.com/products/omni_bundle
Slide 5: Stimulus Presentation Paradigm GUI for Training session [online image]. Retrieved from:
http://iopscience.iop.org/1757-899X/65/1/012020/pdf/1757-899X_65_1_012020.pdf%20(Syan%20C)
Omnibot Generation of ‘POSTPONE’ communicated by Subject 1 [online image]. Retrieved from:
http://iopscience.iop.org/1757-899X/65/1/012020/pdf/1757-899X_65_1_012020.pdf%20(Syan%20C)
[online image]. Retrieved from: http://www.sciencedirect.com/science/article/pii/S0010482514002959
Slide 8: [online image]. Retrieved from: https://www.bigpinekey.com/monday-december-22-2014/walker-oldman/
[online image]. Retrieved from: http://smilingfootprints.com
Slide 9: [screenshot]. Retrieved from: http://intendix.com
Slide 10: An EEG Cap, Photo Courtesy University of Maryland [online image]. Retrieved from:
http://www.tested.com/science/455000-samsung-tests-brain-computer-interface-galaxy-note-101/

Reflective Note
When envisioning this project, I thought not only of who would be
interested in Parkinson’s research, but also about who would be able to
use this information. My target audience is a nursing staff at an elderly
care nursing home. Individual patients would likely benefit from the
presentation as well, but nurses would be able to evaluate which
patients this information would be relevant for.
It is likely that nurses would encounter this document at a meeting.
In my experiences on co-op, PowerPoints are usually sent out to the
attendees afterwards for them to look over. Nurses would have this as
a reference of potential BCI applications that may be suited for their
patient’s needs. In mentioning clinical trials at the end, it would be my
hope that the nurses will use this information to educate patients on the
opportunities available to them. Even without active participation,
knowing that these trials are ongoing gives patients hope for their
disease.