Taking NIRS-BCIs outside the lab: towards achieving robustness against environment noise.

This paper reported initial findings on the effects of environmental noise and auditory distractions on the performance of mental state classification based on near-infrared spectroscopy (NIRS) signals recorded from the prefrontal cortex. Characterization of the performance losses due to environmental factors could provide useful information for the future development of NIRS-based brain-computer interfaces that can be taken beyond controlled laboratory settings and into everyday environments. Experiments with a hidden Markov model-based classifier showed that while significant performance could be attained in silent conditions, only chance levels of sensitivity and specificity were obtained in noisy environments. In order to achieve robustness against environment noise, two strategies were proposed and evaluated. First, physiological responses harnessed from the autonomic nervous system were used as complementary information to NIRS signals. More specifically, four physiological signals (electrodermal activity, skin temperature, blood volume pulse, and respiration effort) were collected in synchrony with the NIRS signals as the user sat at rest and/or performed music imagery tasks. Second, an acoustic monitoring technique was proposed and used to detect startle noise events, as both the prefrontal cortex and ANS are known to involuntarily respond to auditory startle stimuli. Experiments with eight participants showed that with a startle noise compensation strategy in place, performance comparable to that observed in silent conditions could be recovered with the hybrid ANS-NIRS system.

Multivariate prediction of upper limb prosthesis acceptance or rejection.

OBJECTIVE: To develop a model for prediction of upper limb prosthesis use or rejection. DESIGN: A questionnaire exploring factors in prosthesis acceptance was distributed internationally to individuals with upper limb absence through community-based support groups and rehabilitation hospitals. SUBJECTS: A total of 191 participants (59 prosthesis rejecters and 132 prosthesis wearers) were included in this study. METHODS: A logistic regression model, a C5.0 decision tree, and a radial basis function neural network were developed and compared in terms of sensitivity (prediction of prosthesis rejecters), specificity (prediction of prosthesis wearers), and overall cross-validation accuracy. RESULTS: The logistic regression and neural network provided comparable overall accuracies of approximately 84 +/- 3%, specificity of 93%, and sensitivity of 61%. Fitting time-frame emerged as the predominant predictor. Individuals fitted within two years of birth (congenital) or six months of amputation (acquired) were 16 times more likely to continue prosthesis use. CONCLUSIONS: To increase rates of prosthesis acceptance, clinical directives should focus on timely, client-centred fitting strategies and the development of improved prostheses and healthcare for individuals with high-level or bilateral limb absence. Multivariate analyses are useful in determining the relative importance of the many factors involved in prosthesis acceptance and rejection.

Upper limb prosthesis use and abandonment: a survey of the last 25 years.

This review presents an analytical and comparative survey of upper limb prosthesis acceptance and abandonment as documented over the past 25 years, detailing areas of consumer dissatisfaction and ongoing technological advancements. English-language articles were identified in a search of Ovid, PubMed, and ISI Web of Science (1980 until February 2006) for key words upper limb and prosthesis. Articles focused on upper limb prostheses and addressing: (i) Factors associated with abandonment; (ii) Rejection rates; (iii) Functional analyses and patterns of wear; and (iv) Consumer satisfaction, were extracted with the exclusion of those detailing tools for outcome measurement, case studies, and medical procedures. Approximately 200 articles were included in the review process with 40 providing rates of prosthesis rejection. Quantitative measures of population characteristics, study methodology, and prostheses in use were extracted from each article. Mean rejection rates of 45% and 35% were observed in the literature for body-powered and electric prostheses respectively in pediatric populations. Significantly lower rates of rejection for both body-powered (26%) and electric (23%) devices were observed in adult populations while the average incidence of non-wear was similar for pediatric (16%) and adult (20%) populations. Documented rates of rejection exhibit a wide range of variance, possibly due to the heterogeneous samples involved and methodological differences between studies. Future research should comprise of controlled, multifactor studies adopting standardized outcome measures in order to promote comprehensive understanding of the factors affecting prosthesis use and abandonment. An enhanced understanding of these factors is needed to optimize prescription practices, guide design efforts, and satiate demand for evidence-based measures of intervention.