Cognitive assessment in Amyotrophic Lateral Sclerosis by means of P300-Brain Computer Interface: a preliminary study

<i>Objective</i>: To investigate the use of P300-based Brain Computer Interface (BCI) technology for the administration of motor-verbal free cognitive tests in Amyotrophic Lateral Sclerosis (ALS). <i>Methods</i>: We recruited 15 ALS patients and 15 age- and education-matched healthy subjects. All participants underwent a BCI-based neuropsychological assessment, together with two standard cognitive screening tools (FAB, MoCA), two psychological questionnaires (BDI, STAI-Y) and a usability questionnaire. For patients, clinical and respiratory examinations were also performed, together with a behavioural assessment (FBI). <i>Results</i>: Correlations were observed between standard cognitive and BCI-based neuropsychological assessment, mainly concerning execution times in the ALS group. Moreover, patients provided positive rates concerning the BCI perceived usability and subjective experience. Finally, execution times at the BCI-based neuropsychological assessment were useful to discriminate patients from controls, with patients achieving lower processing speed than controls regarding executive functions. <i>Conclusions</i>: The developed motor-verbal free neuropsychological battery represents an innovative approach, that could provide relevant information for clinical practice and ethical issues. Its use for cognitive evaluation throughout the course of ALS, currently not available by means of standard assessment, must be addressed in further longitudinal validation studies. Further work will be aimed at refining the developed system and enlarging the cognitive spectrum investigated.

研究目的：本研究旨在探讨基于P300的脑机接口（Brain Computer Interface, BCI）技术在肌萎缩侧索硬化症（Amyotrophic Lateral Sclerosis, ALS）患者中实施无需运动-言语参与的认知测试的应用价值。
研究方法：本研究招募15名ALS患者与15名年龄、受教育程度相匹配的健康受试者。所有参与者均接受基于BCI的神经心理学评估，同时完成两项标准认知筛查工具（FAB、MoCA）、两份心理问卷（BDI、STAI-Y）及一份可用性问卷。针对患者群体，还开展了临床与呼吸功能检查，并辅以行为评估（FBI）。
研究结果：标准认知评估与基于BCI的神经心理学评估结果之间存在相关性，其中ALS患者组的执行时长相关性最为显著。此外，患者对BCI的感知可用性与主观体验均给出了积极评价。最后，基于BCI的神经心理学评估中的执行时长可有效区分患者与健康对照人群，患者在执行功能相关的加工速度上显著低于健康对照。
研究结论：本研究所开发的无需运动-言语参与的神经心理学测试组合，代表了一种创新性的研究路径，可为临床实践与伦理议题提供具有参考价值的信息。当前标准评估手段无法实现对ALS患者病程全程的认知评估，因此该测试方案在ALS病程认知评估中的应用价值，有待后续纵向验证研究进一步探讨。后续研究将致力于优化现有系统，并拓展所覆盖的认知测评维度。