Tuesday, March 18, 2003
By Michael Smith
United Press International
A German researcher Tuesday described a new technique in which paralyzed patients can use their brain waves to communicate with loved ones and caregivers.
The technique, which allows patients to spell out words on a computer screen, works well, but only as long as patients learn to use it before they become completely paralyzed, University of Tubingen psychology professor Niels Birbaumer told United Press International.
"If the patient is already completely locked in, so that he cannot move anything any more, then we didn't succeed in getting those patients to communicate words and sentences," Birbaumer said. However, he added, even such cases, patients can be trained to say "yes" or "no" using the equipment, which he calls the "thought-translation device."
Speaking at a meeting held by Toronto's Rotman Research Institute, Birbaumer explained the device works best when patients who are developing complete paralysis begin training before their deterioration becomes complete. "The earlier these patients (learn to use the device) the better it is," he said. "Then they can communicate up to the end of their lives."
Becoming "locked in" -- unable to move any muscle -- commonly occurs late in such diseases as amyotrophic lateral sclerosis, or ALS, also known as Lou Gehrig's disease and occurs in other illnesses as well, he said.
Birbaumer said he estimates 95 percent of ALS patients never reach that stage because, faced with the isolation of being unable to communicate with loved ones -- even though they remain fully aware -- they lose their will to live and refuse to be put on a respirator.
He said his first patient -- a 59-year-old German lawyer on a respirator for the past eight years -- has mastered the process so well he was able to write a letter describing how he feels as he prepares to select a letter to display on the computer screen. Birbaumer presented part of the letter at the meeting.
"Within the next decade or so, we're going to see a huge leap in the clinical use of this technology," Rotman Institute neuroscientist Randy McIntosh, the conference chairman, told UPI.
Birbaumer's device registers the brain's electrical activity. Patients learn to make their brains generate different kinds of waves in order to produce letters on a computer screen linked to the electrical sensor. The equipment is not relatively expensive. "You can buy the pieces off the shelf at Radio Shack" for less than $10,000, he said.
The technique is similar to the biofeedback systems that were a popular fad in the 1960s, said McIntosh, except today's equipment is much more sensitive. "We understand much more about the brain's physiology today," he added.
Despite the device's apparent success, Birbaumer said he does not know how his patients control their brain waves.
"We tell them, 'watch the screen and do what the computer tells you,'" he said. It could be each patient learns to do it in a different way, he noted.
Birbaumer said he has used the technique on dozens of patients so far, with the unexpected result of extending their lives. Most ALS patients die within five years of being diagnosed, he said.
"We believe this is a result of the psychological problems and not a
result of the disease," he said. "None of our patients who can communicate
© Copyright 2003 by United Press International