Mental imagery for brain-computer interface control and communication in non-responsive individuals

Zulay R Lugo*, Christoph Pokorny, Fréderic Pellas, Quentin Noirhomme, Steven Laureys, Gernot Müller-Putz, Andrea Kübler

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: People who survive severe brain damage may eventually develop a prolonged consciousness disorder. Others can regain full consciousness but remain unable to speak or move because of the severity of the lesions, as for those with locked-in syndrome (LIS). Brain-computer interface techniques can be useful to disentangle these states by detecting neurophysiological correlates of conscious processing of information to enable communication with these individuals after the diagnosis.

OBJECTIVE: The goal of our study was to evaluate with a user-centered design approach the usability of a mental imagery task to detect signs of voluntary information processing and enabling communication in a group of severely disabled individuals.

METHODS: Five individuals with LIS participated in the study. Participants were instructed to imagine hand, arm or feet movements during electroencephalography (EEG) to detect patterns of event-related synchronization/desynchronization associated with each task. After the user-centered design, usability was evaluated (i.e., efficiency, effectiveness and satisfaction).

RESULTS: Two participants achieved significant levels of accuracy in 2 different tasks. The associated workload and levels of satisfaction perceived by the users were moderate and were mainly related to the time demand of the task.

CONCLUSION: Results showed lack of effectiveness of the task to detect voluntary brain activity and thus detect consciousness or communicate with non-responsive individuals. The application must be modified to be sufficiently satisfying for the intended end-users and suggestions are made in this regard.

Original languageEnglish
Pages (from-to)21-27
Number of pages7
JournalAnnals of Physical and Rehabilitation Medicine
Issue number1
Publication statusPublished - Jan 2020


  • Brain-computer interface
  • Locked-in syndrome
  • User-centered design
  • Disorders of consciousness
  • EEG


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