Towards Communication in the Completely Locked-In State: Neuroelectric Semantic Conditioning BCI

  • Daniele De MassariEmail author
  • Carolin A. Ruf
  • Adrian Furdea
  • Sebastian Halder
  • Tamara Matuz
  • Niels Birbaumer
Part of the SpringerBriefs in Electrical and Computer Engineering book series (BRIEFSELECTRIC)


We introduced a Pavlovian semantic conditioning paradigm to enable basic communication in completely locked-in state (CLIS). Patients in CLIS have no means of communication and they have represented the target population for brain–computer interface (BCI) research in the last 15 years. Although different paradigms have been tested as well as different physiological signals have been used, to date no documented CLIS patient was able to control a BCI over an extended time period. We designed a novel paradigm based on semantic conditioning for online classification of neuroelectric or any other physiological signals to discriminate between covert (cognitive) ‘yes’ and ‘no’ responses. The paradigm comprised the presentation of affirmative and negative statements used as conditioned stimuli and only affirmative statements were paired with electrical stimulation. A CLIS patient diagnosed with amyotrophic lateral sclerosis (ALS) participated in the study and underwent 37 daily sessions. The online classification accuracies of the slow cortical potentials, identified as the electroencephalographic (EEG) signature differentiating between covert ‘yes’ and ‘no’ responses, were around chance level on average, with peaks of high communication accuracy in some sessions.


Amyotrophic Lateral Sclerosis Conditioned Stimulus Unconditioned Stimulus Functional Electrical Stimulation Slow Cortical Potential 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Supported by the European Commission Framework Programme 7 (FP7), Marie Curie Networks for Initial Training: ITN-LAN and the Deutsche Forschungsgemeinschaft (DFG).


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Copyright information

© The Author(s) 2013

Authors and Affiliations

  • Daniele De Massari
    • 1
    • 2
    • 3
    Email author
  • Carolin A. Ruf
    • 1
  • Adrian Furdea
    • 1
  • Sebastian Halder
    • 4
  • Tamara Matuz
    • 1
  • Niels Birbaumer
    • 1
    • 2
  1. 1.Institute of Medical Psychology and Behavioral NeurobiologyUniversity of TübingenTübingenGermany
  2. 2.IRCCS Fondazione Ospedale San CamilloLidoItaly
  3. 3.Graduate School of Neural & Behavioral SciencesInternational Max Planck Research SchoolTübingenGermany
  4. 4.Department of Psychology I, Section Intervention PsychologyUniversity of WürzburgWürzburgGermany

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