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virtually unparalyzed

Proposal for a Brain Computer Interface + VR Game Integration

User:    I can’t.
me:     Let’s just give it a try.
User:   I don’t know.
me:     Close your eyes.
User:  Ok.

me:     Now open them.

EEG-based communication systems realize a direct connection between the human brain and the computer. They represent an important area of EEG analysis and can help patients who suffer from severe motor impairments (e.g. Amyotrophic Lateral Sclerosis). A patient without control of voluntary movements could use such a system to install an alternative communication channel through thoughts, whereby such an interaction must be realized in real-time. A possible application of such an EEG-based brain-computer interface (BCI) is not only to move a cursor by mental control, which allows the patient to select letters or words, but also the control of e.g. a Functional Electrical Stimulation device for patients with spinal cord lesions.

Example for a BCI setup

Learning about the usage of BCIs in rehabilitation of patients suffering from hemiplegia I came to the realisation that the design of the rehabilitation process can hinder patients’ recovery.

The rehabilitation from an event like a stroke is a long process and the training to regain motor function can be extremely painful and frustrating. 

Using a BCI within the rehabilitation program can be extremely unappealing. Patients train in sterile environments such as laboratories, with devices attached to their bodies designed mostly for function. Boredom and frustration can lead to a decrease in motivation.

When humans learns to interact with their environment they learn within context and positive motivation. They reach for an object and grab it when it catches their interested. They start to walk because they walk towards an object.

How can the rehabilitation process be made more appealing to patients? How can an environment be designed to create positive motivation for the patient to interact with the BCI and their surrounding?

Most virtual experience and augmented experience devices are developed for able bodied consumer.

Can VR games be used to help patients to recover?
Can missions within a game give context to a rather frustrating and slow-moving process and even make the excercises enjoyable for the patient?

Theoretical functional principle

Some patients experience permanent damage of brain areas such  as the motor cortex which is responsible for movement. This can lead to hemi/paraplegia. Some patients recover gradually and regain motor function, some may regain them only partially or remain paralysed.

  1. Patient wears VR-Set and is logged into interactive Virtual Reality game. Electrodes in hood measure brain activity.

  2. Patient plays quests within the game. Patient needs to use both paralysed and intact extremity to solve quests (e.g. opening a tresor box). Conscious thought of the individual (I am lifting my arm) is recorded as cortical activity by electrodes.

  3. Device translates brain activity into electric impulses distributed through electrodes attached to extremities and consequently leading to contraction of the muscle.

  4. Body sends feedback to brain observable to the patient as visual feedback. Visual feedback is enhanced through VR-Set.

  5. Neuroplasticity leads to rewiring the affected extremities and their motor function to the initially active brain areas by conditioning. Body bypasses damaged motor cortical areas and learns to associate them with intact and neighbouring cortical areas. Gamifaction of the rehabilitation process prevents fatigue.

sketches + mockup for the virtual represenation of the BCI within the video game  
design references science fiction elements making play with VR headset more appealing

Example of possible integration of therapy excercises within a VR game (Images from Final Fantasy gameplay)

keywords: brain computer interface, paralysis, therapy, stroke rehabilitation, virtual reality, augmented reality