Background
Ability Expectations
Methods and Study Participants
Participants (name, age) | Diagnosis | Technologies used | BCI technology (applications) | Number of BCI (training) sessions |
---|---|---|---|---|
Stefan, 24 | Generalized dystonia | Wheelchair, eye tracker, computer | NIRS-BCI (near-infrared spectroscopy), non-invasive | 1 |
Walter, 32 | Muscle atrophy | Wheelchair, email/typing and voice recognition software, computer, respiration apparatus | P300-BCI (email-Software, Brain Painting), non-invasive | 3 |
Wolfgang, 31 | Muscle atrophy | Wheelchair, email/typing and voice recognition software, computer, respiration apparatus | P300-BCI (email-Software, Brain Painting), non-invasive | 3 |
Karl, 46 | Duchenne muscle dystrophy | Wheelchair, email/typing software, computer, respiration apparatus | P300-BCI (email-Software, Brain Painting), non-invasive | Ca. 20 |
Mrs. Edlinger, 77 | Amyotrophic lateral sclerosis | Wheelchair, email/typing software, computer, BCI | P300-BCI (Brain Painting), non-invasive | > 100 (ongoing) |
Rudi, 27 | Tetraplegia | Wheelchair, computer | MI-BCI (motor imagery) (BrainRunners), non-invasive | > 50 |
Robert, 51 | Paraplegia | Wheelchair, computer | MI-BCI (+exoskeleton training), non-invasive | > 50 (ongoing) |
Neil, 30 | Tetraplegia | Wheelchair, email/typing and voice recognition software, computer | MI-BCI (+ robotic arm), invasive (implanted electrodes) | > 50 (ongoing) |
Nicole, 58 | Spinocerebellar ataxia | Wheelchair, email/typing and voice recognition software, computer, respiration apparatus | MI-BCI (+ robotic arm), invasive (implanted electrodes) | > 100 |
Brain-Computer Interfaces and Expected Abilities
Explicit Ability Expectations
Implicit Ability Expectations
In practice, the task proves to be quite challenging, however:“It’s not very difficult as such. To get the idea of it, to comprehend its principle, is not difficult. But it is hard to execute without any mistakes—that it always recognizes what you want it to do. But as such it’s not difficult to comprehend” (Wolfgang).
This view is shared by the users operating a reactive BCI:“I had to concentrate on what to choose. That requires – that wasn’t easy. You really need to focus. You mustn’t get distracted somehow” (Wolfgang).
According to these accounts, BCI training is described as hard work where each command needs to be “fought for”. But also sensomotoric BCIs, i.e. BCIs working with motor imagery, are experienced as exhausting.“Well, for each and every letter you have to fight actually” (Wolfgang).
There are tasks that are perceived as more challenging and exhausting than others.“It’s intense. After training I always feel like I’m knocked out. You could chuck me in the dustbin. There is not much I still can do” (Rudi).
Trying to think of nothing has been perceived as particularly difficult. For this exercise, you are supposed to be as relaxed as possible as the kind of brain signals that are required for the task are associated with a state of relaxation. At the same time, you are supposed to perform a task which is perceived as difficult. This leads to quite a challenging task when you need to bring these opposing targets into balance.“Training was once a week […] then twice a week and at the end […] we met three times a week, which was super exhausting. […] Training was super exhausting because you had to think the whole time—that is, you may think and you may not think or to think of particular things and not to think. These were about the commands which I had for the competition. Especially NOT to think is ULTRA difficult and also as good as not possible, because every human is thinking somewhat all the time” (Rudi).
Paying attention to your own body and its bodily sensations can be an unfamiliar task and something which is not achieved easily when you are not used to these things. Rudi also indicated that BCI training was not only physically but also mentally tiring.“After a while, coming regularly twice a week and after a while once a week, it was useful also to try to figure out my body. It's something that I never did before and it was quite difficult. It seems easy but it was quite difficult” (Robert).
However, in sensomotoric BCI training, routinization is possible and the initial feeling (“quite strange at the beginning”) may be replaced by routine and ease of use.“When you have to concentrate the whole time and to concentrate profoundly—I had to concentrate SO hard, as I have never done in my life before. And I needed to be in control of myself. […] When you just think of your right hand and when you look at my right hand now, then there are muscles twitching. In my tendons there is some minimal movement and I had to control this somehow. That is—I did get to know my body in a new way. The one command, for example, was to step on the brakes. My legs were so heavy and did hurt so badly. […] Or my arms were cramping because I was drawing eights with my right hand, the infinity symbol. Mentally, that’s just about the limit! I completely underestimated that in the beginning because I hadn’t thought that it will be that intense and it wears you out in such a way” (Rudi).
So far, we have seen that BCI training requires a level of concentration which is out of the ordinary and therefore is experienced as tiring and exhausting. Furthermore, BCI training can be very challenging on the body and can cause bodily pain. Also, being in the same position as well as wearing the EEG cap for a long time has been described as uncomfortable. One user volunteered for using metallic syringes instead of the plastic ones to apply the gel on the scalp to fix the electrodes as the plastic ones did not seem to work.“I should say, a little bit exhausted at the beginning when I was doing on my wheelchair. I was more exhausted at the beginning, when I was in the exosquelette [sic]. […]but after a while I get used to and it was better, better and better, I should say” (Robert).
Hence, having a high level of pain tolerance is of advantage in at least some BCI training. As not all BCI activities are successful, especially in the beginning of the training, patience and being able to cope with frustration is a necessary ability.“Then I said ‘Well, the metallic syringes then!’ They hurt and I tended to bleed a little on my head, but I didn’t care. Most importantly we got the perfect results” (Rudi).
Another cause of frustration can be boredom, as not all exercises are experienced as exciting or challenging.“Everything needs to be set up perfectly and the electrodes need to be applied correctly. Otherwise the success rate is low or it doesn’t work at all and you get frustrated” (Mrs. Edlinger).
Robert who started training with a BCI that was connected to an exoskeleton reports of his state of mind when finding himself in an upright position after having got used to sitting in a wheelchair.“I pick whatever numbers there are, and the rules are, if it feels double what the last was, say a number that's double, it feels half, I say half. And it's really boring and sometimes I just feel weird because I feel like I'm just making numbers up but then they keep telling me, like, when they actually analyse the data, like, you know, they go ‘Oh you're really good at it, like, you know, you're telling us 16, you know, it makes a nice straight line on the path’, but it's really boring. Well, science can't all be super fun, so I get a lot of it” (Neil).
As exciting as BCI training may be for its users, it does not come without moments of stress and anxiety.“At the beginning, since I haven't been standing for years or ages, I was frightened […] I was stressed, really stressed, scared and they were really there to help me, to say, secure the—they attach things in the exosquelette [sic] in case I was rolling or whatever. Everything was in a perfect thing, but it was me to be stressful. But after some weeks, it was fine” (Robert).
One user reports of a day when the success rate of the BCI training was quite low:“It depends on how concentrated you are. The more you are concentrated and the less distraction there is, the better it works” (Karl).
Besides external sources for distraction, they can also have an internal cause.“You mustn’t get distracted in any way. I can remember one time there was a construction site outside. The room had a window and underneath that window was a construction site with construction vehicles and they made a noise and on this day my measurements didn’t work very well. […] It may be that this was due to the noise of the construction site that distracted me” (Wolfgang).
Being tired can be an issue during BCI training, and affective factors can contribute to poor BCI outcomes.“I always say brains are dumb but really it's sometimes, computers are dumb at figuring out what your brains are thinking, so some days it's, especially if I haven't slept well the night before and I'm already tired, sometimes the stuff just doesn't work super good. […] Sometimes the, the programming isn't that great. But yes, and then sometimes robots are super durable, sometimes they just wear down or overheat and so there are still many points of failure that are possible in these systems” (Neil).
Getting emotional or being preoccupied with different thoughts can have a negative impact on the BCI training. The BCI training can easily lead to a vicious circle of frustration and unsuccessful BCI output because unsuccessful commands can lead to further frustration.“I still remember my first training. I started to get to know somebody and then she said before the training ‘It’s not working out with the two of us.’ Well, then my thoughts were completely somewhere else and then trying to calm down—hence, logically that training session was shit. You have these influences. Or when my pet died—you naturally have these influences, every human. That’s the thing with not thinking. You automatically have something your mind wanders to. That’s how it is” (Rudi).
This imperative of no emotions has also been reported by other users. Robert, for example, reports of this issue in particular in case of wrong commands that came as a surprise:“I was NOT allowed to get upset in that moment because that would have been a wrong signal and would have distorted the training and the competition. You really must NOT have emotions, none whatsoever—completely, you had to be completely dead inside, in that sense” (Rudi).
Distractions, such as emotional baggage you are carrying as well as feeling surprise in situations where you are confronted with an unexpected outcome and start to doubt yourself as a consequence, are very common and very human processes. To suppress these emotional factors in order to focus on cognitive exercises appears to be a very challenging task.“That's quite difficult for me, because sometimes I thought I could really focus and concentrate and it was quite a surprise. For instance, you don't answer properly. That means, [I] was thinking on the right and it was the left and when it was like that I shouldn't have—I should really not care about because if I care it's even worse. That means that the next round, it goes wrong also. Next try sorry, it goes wrong because I have too much focus on why, why, why so I try to say ‘Okay, I don't know’ […] so I try not to figure out why because I don't—frankly I don't understand. If I try to really focus too much, this has an impact on the second try or the third try” (Robert).
This may be due to the fact that he has implanted electrodes or maybe he knows how to control his emotions better or a mix of both. Nevertheless, keeping your emotional side out of BCI training is a challenge for many users and must seem like a super-human endeavour. The super-human here refers to an individual that is capable of retaining control of oneself in terms of calling up one’s cognitive abilities (first of all concentration) while at the same time suppressing any potential causes of distraction (noise, fatigue, boredom, emotions, and affective reactions).“I always say it was really cool at first and now it's just second nature. Like, it's just, it's a thing I can do at this point. I mean, it's still really cool, but it's just a thing I can do and it's pretty easy to do. It's just almost like I could always have done it before” (Neil).
Towards a “Disembodied Mind”?
BCI training gave Nicole a feeling of empowerment and had a positive impact on her self-esteem. At the same time, the BCI training gave rise to some “brainification” process. Nicole adjusts her self-image and body-image in a way that prioritizes her brain. It may be telling that she does not refer to her mind or her power of thought, but her brain. During BCI training she made the experience that “my brain had not forgotten” (Nicole). In virtue of her brain, which is still as functional as before, she becomes empowered over her body. As we do not have introspection of our brain, but just of our mind, it can be argued that Nicole actually refers to her mind when making these statements, and because the brain is broadly regarded—according to a dualistic or “Cartesian world view”—as the carrier or physical substrate for the mind, she speaks of the brain instead. Within the research situation and the BCI set-up, this is logical, as what is measured is brain activity and not her thoughts or mental processes.“Oh, God, it really changed my self-image. It changed, as I said, the empowerment, the feeling, ‘I did this, look what I can do.’ It helped me realize that—I have a saying up on my wall, ‘You are more than the body you live in.’ I just realized the truth of that statement, that my brain was the most important part of me, and that working meant I could do a lot” (Nicole).