Our overall objective is to provide both new brain-computer interface (BCI) technologies and an innovative business model focused on user-centered assessment and communication for persons with disorders of consciousness (DOCs). We have recently shown that present clinical tools to assess DOC are inadequate. Across different studies, up to 43% of patients who had been designated as nonresponsive (including in a vegetative state (VS) or minimally conscious state (MCS) were in fact able to communicate through new BCI systems developed for such patients. For example, patients could produce reliable changes in motor activity in the EEG when asked via headphones to imagine left hand movement or walking through the house if their father was named (the correct name). In related work, patients could produce differential responses to YES/NO/SKIP questions (based on the P300 component) by counting vibrations of one out of three different tactors placed on the body. This creates a pressing social and economic challenge to provide more accurate information about these patients’ cognitive abilities to families, clinicians and the patients themselves about their long-term options. By providing BCI-based assistive technology (AT) for communication and control, we will allow patients to not only make their own decisions but also interact with their environments, the internet and other people, fostering inclusion and accessibility. The main outcome will be a life-changing experience for many patients: being recognized as someone who can communicate. They will once again be able to convey their needs and desires to carers, and may influence decisions about therapy, end-of-life, living environments, long term care and use of ComAware products and services. Carers and medical staff will be able to better identify patients’ needs and provide care and help accordingly. Family and friends will again be able to communicate with someone they had been (mistakenly) told could not communicate.

Despite very extensive efforts to help millions of people in the EU alone who seek therapy to improve motor function after a stroke, most stroke patients are left with lifelong motor disability. Recent work from our group and others has shown that new methods and devices that can noninvasively monitor and stimulate brain activity could substantially improve recovery. EEG data collected from portable electrode caps can detect each patient’s motor imagery and thereby influence multimodal feedback in real-time. This feedback may include virtual reality avatars, rewarding music or tones, functional electrical stimulation, and potentially even magnetic or electrical stimulation of motor areas of the cortex. This promising new research direction requires extensive collaboration across disciplines and sectors, and experienced researchers (ERs) with relevant experience. The MoveAGAIN project will explore new classifiers, experimental paradigms, and software in tandem with an existing commercial system to create a new system that will be used to collect data with stroke patients in two real-world settings. We will analyze the resulting data to develop new knowledge and contribute to improved tools that therapists and physicians can use with patients. MoveAGAIN includes extensive dissemination and communication activities to convey our project results to numerous audiences. The varied training activities will supplement the ER’s training-by-research to help prepare him for a high-impact career working across industrial, academic, and medical sectors.

Imagine being able to hear, feel, and think – but not see or move. You cannot communicate in any way, but can hear doctors and family members saying that you are comatose and cannot understand or make decisions. Recent work has shown that this nightmarish situation is a reality for tens of thousands of people worldwide, who have been diagnosed as comatose but may in fact have some ability to understand. More recent work has shown that brain-computer interface (BCI) systems can help with re-assessment of these patients, and can even provide communication. Our Feasibility Assessment in ComaWare Phase I, and other very recent developments, have strongly supported our plan to provide new technology to help these patients. In addition to providing assessment and communication, our new mindBEAGLE prototype will also be able to provide prediction and rehabilitation. This is a highly disruptive technology that will create a new market and buyer group: patients who have been (mis)- diagnosed as unable to communicate. These persons, and their physicians and families, will be very highly motivated to convey their basic needs and desires, and seek rehabilitation to regain some cognitive and motor function. In addition to creating a new mindBEAGLE-Pro system specialized for severely disabled persons without vision, we will also develop, pilot-test, and launch a novel business focused on providing support for patients, their carers and clinicians. This evaluation will support our Commercialization Plan, along with user, market and IP research, targeted surveys of end users, business experts, researchers and other groups, Workshop Tours, and other activities. Our efforts will be supported by a strong Advisory Board and subcontractors with specific, targeted expertise. Overall, ComaWare will create a paradigm shift in assessment and treatment of persons diagnosed with disorders of consciousness.