Brain-neural computer interfaces on track to homeDevelopment of a practical generation ofBNCI for independent home use(proposal nº 288566)ICT-2011-7 5.5c) ICT for smart and personalised inclusionBrussels, 27th May 2011
3Partners (6)Barcelona Digital Centre Tecnològic [SPAIN]Technische Universitaet Graz [AUSTRIA]University of Würzburg [GERMANY]The Cedar Foundation [UNITED KINGDOM]Guger technologies OG [AUSTRIA]Telehealth Solutions Ltd. [UNITED KINGDOM]
Coordinator (01) BDIGITAL4• The eHealth R&D department applies Information technology to the health sector asan aid to medical personnels work, simplifying illness prevention, diagnosis andtreatment processes, developing bio-medical instrumentation, and helping attainbetter healthcare overall, as well as many other benefits. The eHealth team, lead byMr Felip Miralles and responsible for coordination of 2 other FP7 projects(BrainAble, 247447 and Synergy-COPD, 270086), is currently composed by 15staff people, four of them being PhD senior researchers.Fundació Privada Barcelona Digital Centre TecnològicBarcelona (Spain)Barcelona Digital Technology Centre is a technologycentre specialised in the application of Information andCommunication Technologies (ICTs).By today, BDIGITAL’s staff consists of 80 professionalswith multidisciplinary and complementary background inthe following areas of specialization: healthcare, security,mobility and energy, and food and environment.
5Role in BackHome:BDIGITAL is the project coordinator, and leader of WP5 (Telemonitoring and homesupport) as research and technology provider in intelligent eHealth telemonitoring andhome support tools.BDIGITAL’s qualification for these roles derives from the experience of its personnel inR&D management. BDIGITAL will bring knowledge acquired in related projects such asBrainAble (FP7), Neurorehabilitation 3E+D, Circles of Care and Digital Primary Care.Coordinator (01) BDIGITALThe Project Management Office (PMO) of BDIGITAL, led by Mrs. BernadetteGrabenbauer-Nagl, runs all central administrative and coordination activities on non-technical matters related to projects, such as: set-up and maintenance of guidelines,procedures and structures for communication and documentation, administrative andfinancial management and controlling,, logistics and preparation of meetings minutesand documentation of meetings, coordination of inputs on IPR and ethics and thesupport to the projects teams in the mediation and resolution of conflicts
(Partner 02) TUG6Graz University of Technology200 years 1811-2011Krenngasse 37/IV8010 Graz, AustriaTel: +43 316 873 5301, Fax: +43 316 873 5349Mail: email@example.com / Home: http://bci.tugraz.at/Institute for Knowledge DiscoveryLaboratory of Brain-Computer Interfaces… BCI research since1991
7The BCI Lab is one of the leading labs inbrain-computer communication. It is aninternationally renowned research institutionwith a research focus on brain-computercommunication, dynamics of brainoscillations and evoked potentials.More specifically, the lab has extensiveexpertise in EEG recording, offline andonline processing of brain signals andother biosignals (ECG, EMG, …) ingeneral, feature extraction, detection andclassification of brain patterns, andneurofeedback systems. Furthermore, ourexpertise ranges from softwaredevelopment, experimental design toclinical application.Research areas(Partner 02) TUGEuropean Projects•The BCI Lab recently completed theEU projects:Presenccia (2006-2009) andEye-To-IT (2006-2009)•Our group is currently involved inthe EU projects:TOBI (2008-2012),DECODER (2010-2012),BETTER (2010-2013),BrainAble (2010-2012), andFuture BNCI (2010-2011)•National Projects:FWF, Land Steiermark, AUVA
8Role in BackHome:(Partner 02) TUG• Leverage its very strong experience with BNCI research,telemonitoring and human-subjects research within this project• TUG will lead WP3 (BNCI systems) and WP4 (practicalelectrodes)• TUG will contribute to all other WPs except management.
(Partner 03) UNIWUE9The University of Würzburg will be mainly represented by itsDepartment of Psychology, where Prof. Kübler holds theprofessorship of intervention psychology.The department has fully equipped psychophysiology laboratories withEEG and peripheral measures such as heart rate, skin conductance,and EMG; altogether 10 laboratories exist for experiments withpatients and healthy volunteers.).The University of Würzburg has a large university hospital withdifferent outpatient clinics for patients. Thus, patients for pilot testingand further training will be available locally.At present UNIWUE is partner of the EU-project TOBI (2008-2012)and DECODER (2010-2013). Gained knowledge will be directlyincorporated in BackHome. In both projects evaluation plays a keyrole.
10Role in BackHome:(Partner 03) UNIWUE• UNIWUE leads WP6 (User evaluation and home testing) and willstrongly contribute to WP3 and WP4. Prof. Kübler and her teamhave extended experience on applying BCIs to severely impairedand locked-in patients at their home and in evaluation of BCI byend-users. Due to her long standing experience with conductingresearch with severely impaired, locked-in and even non-responsive patients.• Prof. Kübler will also provided expert guidance to the Ethicalaspects of the BackHome Project (this includes the generation of adeliverable on the adherence to ethical guidelines)
(Partner 04) CF11• Established in 1941• Registered Charity &Company Limited byGuarantee• Services for people withPhysical Disability / BrainInjury• Regional Organisation / 23service locations• Budget £6.5m• 250 Staff• 1,700 Service Userswww.cedar-foundation.orgThe Cedar Foundation’sVision is a society in whichdisabled adults and childrenare fully included citizens.Our Mission is to providequalitysupport, care, accommodation and training services toenable disabled adults andchildren to participate in allaspects of community life.
12Role in BackHome: enabling userparticipation(Partner 04) CF• Ethical governance• Mainly involved in WP5 (Telemonitoring and home support) andWP6 (user evaluation and home testing), CEDAR will promoteand enhance users participation: supporting engagement ofpeople with acquired brain injury in BackHome• Facilitating user centred design for technical innovation
(Partner 05) GTEC13SME in Austria that develops and sells systems for the acquisition andprocessing of biosignals.g.tec is a private company that was established 1999 as a spin-off ofthe University of Technology Graz, Austria.g.tec’s staff consists of about 30 professionals with multidisciplinaryand complementary background in biomedical engineering,informatics, signal processing and neural engineering.One of the most important products is a brain-computer interface fornon-invasive and invasive usage.g.tec is involved in the following operative European projectsdeveloping BCI technology:• BrainAble, Decoder, Better, Vere, SM4all
14Role in BackHome:(Partner 05) GTECg.tec is the leader of WP2 System integration and presentation toensure a seamless combination of system components.g.tec is leading the Rapid prototyping platform, the State of the artreview and Development and integration of a complete practicalelectrode and amplifier system tasks.g.tec has a complete development team for software and hardwarecomponents for electrodes, amplifiers and real-time processingsoftware in house.Cofinancing of BackHome: g.tec will co-finance BackHome with it’sown capital. g.tec is currently selling products together with 20 salespartners worldwide and is increasing its turnover every yearsignificantly.
(Partner 06) THSL15Formed 2006, Telehealth Solutions Limited specialises in the designand application of telehealth solutions for deployment withinhealthcare services in the UK and overseas.The company has an established track record in sales to NHS withapproximately 30 staff and operates its own medical call centre.To fulfil its objectives, the company currently offers several productlines:• The Surgery Pod enables patients, withoutclinical supervision, to perform their owntests which post directly into their patientrecord..• The Home Pod provides clinical monitoringof patients in their homes, without expertsupervision.• The Cardio Pod is an easily portablesystem which facilitates public healthscreening services.
16Role in BackHome:(Partner 06) THSLTelehealth Solutions is leader of WP7 - Exploitation andDissemination and is the provider of the telehealth element of theproject, including local data acquisition, transmission, triage,recording and clinician presentation. THSL participates actively indesign and implementation tasks within WP5 Telemonitoring and homesupportPost-development, the companywill lead the commercialisation ofthe solution The company offerssolutions across the wholespectrum of the health triangle,with the exception of the highest,continuous care area where nocurrent benefit can be derivedNotApplicableHome SystemsKiosk SystemsCommunity Systems
Partners expertiseThe consortium represents all necessary competences to carry out the project(no subcontracting is foreseen in BackHome for the content tasks) and thedistribution of work and responsibility reflects the competence-basedassignment of workCoordination. R&D on eHealth, mobility and security, and more specifically, on support technologies forneurorehabilitation, AmI and ubiquitous computing, interoperable and accessible devices, KM andontologies, web 2.0, security and integrity of data.BCIs based on different approaches, signal processing, affective computing, BCIs in virtual and realenvironments, BCIs with patients.User evaluation and home testing. Application of BCIs to severely impaired and locked-in people at theirhomes. Evaluation of BCI by end users. Capture of user requirements.Enabling user participation. Ethical governance. Telemonitoring and home support. User evaluation andhome testing. Promotion and enhancement of user participation. Supporting engagement of people withacquired brain injury. Facilitating user centred design for technical innovation.Biomedical engineering, biofeedback, human-computer communication systems, BCI and affectivecomputingDesign and implementation of telehealth systems for home. Devices interfacing, API design andimplementation for multi-platform interfaces to instruments and remote systems. Clinical and patient userinterface (CUI, PUI) design and implementation. Exploitation of technology to public and private sector.17
18Organisation BNCIsPracticalelectrodesTelemonitoring, home supportSmarthomesEnd usersin homesBDIGITAL X XX XXX XTUG XXX X XX X XXXUNIWUE XXX X XX X XXXCEDAR X X XX XX XXXG.TEC XXX XXX XX XX XXTHSL XXX XXX XXConsortium competencies(X = some expertise; XX = strong expertise; XXX = top institute)Partners expertise
Socio-economic problem20Brain disorders cause 35% of the burden of all Europeandisorders• EU: incidence of SCI is 3 per 100.000 (1500 a year in Germany).• EU: incidence of TBI is estimated 180 and 200 cases per 100.000inhabitants per year.• Germany: 300.000-400.000; Italy: 250.000-300.000 live withParkinson’s disease.• EU: Stroke incidence 150 per 100.000 inhabitants.• 7.000-8.000 people are newly diagnosed with ALS each year.
Socio-economic problem21•SCI, TBI, stroke generate physical functional diversity. In manyof the cases, despite rehabilitation, subjects remain with motordeficit that restrain their participation, challenge their socialinclusion and impair their quality of life.•Brain injury, in addition to causing cognitive impairment, willmake the aging process even harder, increasing behaviouralimpairment and enhancing risk of developing Alzheimersdisease and others degenerative CNS diseases.
Socio-economic problem22•Modern societies recognise their commitment of taking care ofall citizens, but new and innovative approaches are necessaryto assist with the forecast burden of care and to guaranteethe sustainability of the healthcare system.• There is a need to anticipate hospital discharge.•The transition to the home is often very difficult andtraumatic; there is little or no support for transitionalrehabilitation systems, telemonitoring or tools to keep in touchwith key people.
Solving concept23To advance existing BNCI systems into a more practical solution for home use:• software and hardware development• applied research for defining outcome measures• basic research into BNCI-elicited brain plasticity• maintenance and restoration of cognitive and physical functioning.• more efficient BNCI in a community setting• more commercially competitive products• practical electrodes• telemonitoring and software support• easy-to-use applications to facilitate activities of daily living andentertainment• improvement of social integration and quality of life
24General objectives:• To study the transition from the hospital to the home, focusing on howpeople use BNCIs in both settings• To learn how different BNCIs and other assistive technologies worktogether• To learn how different BNCIs and other assistive technologies can helpclinicians, people with functional diversity and family in the transition fromthe hospital to the home• To reduce the cost and hassle of the transition from the hospital to thehome by developing improved products and disseminating information fordifferent developers and users.• To produce applied results, developing:• a new and better integrated practical electrode system• friendlier and more flexible BNCI software• better telemonitoring and home support tools• a better support infrastructureSolving concept
Technical, operational and legalfeasibility• BNCI, AmI, social networks, smart homes –experts inside the consortium that work already inthe field• Deep knowledge of state of the art• New Science and technology based on experiencein the field• Monitoring of developments in the field to avoidlegal problems• Partners have experience with people using BNCItechnology25
Validation with intended users• Defining users to ensure diversity ofsample• Individual needs• Age• ICT knowledge and experience• Setting/environment• Prognosis and diagnosis26
Validation with intended users• Subjective and objective measures of validation, forexample– Communicative Ability– Social Inclusion– Self esteem– Independence– Health and well being27
Validation with intended users28TOBI-ToolsforBrain-ComputerInteraction23QUEST: Reasons for Dissatisfaction• Dimensions: „the cap covers too much of the head“, „The cap is uncomfortablewhen lying in bed“• Adjusting the cap and electrodes:o takes long, takes 0,5-1hour of the available timeo Is „uncomfortable“ (adjustment)o Need to wash the hair afterwards Hardware: „a lot of different parts to set up“ Software: „very technical, not really for end users“• Effectiveness More elaborated programs on the market• Speed Not fast enough (5 times faster would be ok)• Aesthetic Design Cap: “Very visible. That is a little bit embarrasing.“„I do not want too much attention drawn on me“.
29Validation with intended users• Systematic evaluation of BCI use in home environment – user groups,compliance• High performance when using an application• However, some users have only moderate or not enough control on certaindays.• Uncontrollable noise – failure to record EEG• Patient may not be able to conduct a session albeit scheduled.• User satisfaction with Brain Painting is rather high and users would like to useit in daily life.• Moderate user-satisfaction with BCI-controlled Qualilife software – not usablein daily life unless faster and less complicated• The hardware (EEG cap, electrodes/gel, electrode hurt) imposes the greatestobstacles.
30Validation with intended users• Objectives– specifying BCIrequirements from a user’spoint of view– definition of usability goals– summary of requirements– providing templates forevaluation– measures on 3 levels• technical• practical• psychological– N=20 end-users in realworld scenarios