Table_2_A systematic review of research on augmentative and alternative communication brain-computer interface systems for individuals with disabilities.docx

Augmentative and alternative communication brain-computer interface (AAC-BCI) systems are intended to offer communication access to people with severe speech and physical impairment (SSPI) without requiring volitional movement. As the field moves toward clinical implementation of AAC-BCI systems, research involving participants with SSPI is essential. Research has demonstrated variability in AAC-BCI system performance across users, and mixed results for comparisons of performance for users with and without disabilities. The aims of this systematic review were to (1) describe study, system, and participant characteristics reported in BCI research, (2) summarize the communication task performance of participants with disabilities using AAC-BCI systems, and (3) explore any differences in performance for participants with and without disabilities. Electronic databases were searched in May, 2018, and March, 2021, identifying 6065 records, of which 73 met inclusion criteria. Non-experimental study designs were common and sample sizes were typically small, with approximately half of studies involving five or fewer participants with disabilities. There was considerable variability in participant characteristics, and in how those characteristics were reported. Over 60% of studies reported an average selection accuracy ≤70% for participants with disabilities in at least one tested condition. However, some studies excluded participants who did not reach a specific system performance criterion, and others did not state whether any participants were excluded based on performance. Twenty-nine studies included participants both with and without disabilities, but few reported statistical analyses comparing performance between the two groups. Results suggest that AAC-BCI systems show promise for supporting communication for people with SSPI, but they remain ineffective for some individuals. The lack of standards in reporting outcome measures makes it difficult to synthesize data across studies. Further research is needed to demonstrate efficacy of AAC-BCI systems for people who experience SSPI of varying etiologies and severity levels, and these individuals should be included in system design and testing. Consensus in terminology and consistent participant, protocol, and performance description will facilitate the exploration of user and system characteristics that positively or negatively affect AAC-BCI use, and support innovations that will make this technology more useful to a broader group of people.
Clinical trial registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018095345, PROSPERO: CRD42018095345.

辅助与替代沟通脑机接口（Augmentative and Alternative Communication Brain-Computer Interface, AAC-BCI）系统旨在为重度言语与肢体障碍（Severe Speech and Physical Impairment, SSPI）人群提供沟通渠道，且无需自主肢体运动。随着该领域向AAC-BCI系统的临床应用推进，针对SSPI人群的研究至关重要。已有研究表明，不同使用者的AAC-BCI系统性能存在显著差异，且针对残疾与非残疾使用者的性能对比结果并不一致。

本系统综述的研究目标如下：（1）梳理脑机接口（Brain-Computer Interface, BCI）研究中所报道的研究、系统及受试者特征；（2）总结使用AAC-BCI系统的残疾受试者的沟通任务性能；（3）探究残疾与非残疾受试者的性能差异。

研究团队分别于2018年5月与2021年3月检索了电子数据库，共检索到6065条相关记录，其中73条符合纳入标准。非实验性研究设计较为常见，且样本量普遍偏小，约半数研究的残疾受试者人数不超过5名。受试者特征及其报道方式均存在较大差异。超过60%的研究报道称，在至少一种测试条件下，残疾受试者的平均选择准确率≤70%。但部分研究剔除了未达到特定系统性能标准的受试者，另有部分研究未说明是否基于性能指标剔除受试者。

共有29项研究同时纳入了残疾与非残疾受试者，但仅有极少数研究报道了针对两组受试者性能差异的统计学分析。研究结果表明，AAC-BCI系统在为SSPI人群提供沟通支持方面具有应用前景，但仍有部分使用者无法从中获益。结局指标报道缺乏统一标准，导致不同研究间的数据整合难度较大。未来需开展更多研究，以验证AAC-BCI系统在不同病因与严重程度的SSPI人群中的应用效果，且应将此类人群纳入系统设计与测试环节。统一术语标准，并对受试者、研究方案及性能指标采用一致的报道方式，将有助于探究影响AAC-BCI使用效果的正负向使用者与系统特征，同时推动技术创新，从而让更多人群能够受益于该技术。

临床试验注册：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018095345，PROSPERO注册号：CRD42018095345。