Each year, a large number of people are diagnosed with a disorder of consciousness or a disorder leading to motor impairment. Such people are then confronted with two severe gaps of knowledge:
We may classify non-responsive patients according to their aetiology in two large groups:
Brain disorders (psychiatric, neurological diseases together) are amongst the leading causes of disease and disability. Data from WHO suggest that brain disorders cause 35% of the burden of all diseases in Europe. Among brain disorders, those of interest in DECODER can represent the cause of the most severe levels of disability.
It is important to mention that it is not only the patients themselves who are affected by these diseases. The uncertainty of diagnosis strongly affects partners and relatives of patients and the inability to communicate poses a tremendous burden for those who are caring for the patients. Thus, the diagnostic battery and the ssBCI with its applications developed by DECODER will bring a significant improvement of the quality of life of patients and their families.
Most of the listed diseases may lead to a non-responsive state in which no communication is possible between the patient and other people or the environment. For patients with disorders of consciousness (DOC) like persistent vegetative state (PVS) and minimally conscious state (MCS) non-responsiveness is even a criterion for diagnosis of the disease. Patients with DOC present a great challenge to diagnostics, prognostics and therapeutics.
The non-responsiveness of such patients implies that they can only be diagnosed by means of exclusion criteria like “no goal-directed eye movement” or “no execution of commands”.
Those behavioural signs may be very discrete, short-termed and the performance may be fluctuating. The signs may therefore pass without being noticed. Thus, there is an urgent NEED for a hierarchical approach to diagnosis of consciousness. DECODER would greatly improve diagnosis, because it included active components.
There are two equivalent primary aims of DECODER:
What we propose with DECODER will merge the so far independent streams of research: detection of consciousness and BCI-based communication and control for the benefit of the patients.
At least, DECODER’s results have to be then disseminated as guidelines, manuals and tools among other non-benefit research and commercial research groups to boost further development.
Possible inaccuracies of information are under the responsability of the project team. The text reflects solely the authors´views. The European Commission is not liable for any use that may be made of the information contained therein.
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