• Nicholas D Schiff, Michael Diringer, Karin Diserens, Brian L Edlow, Olivia Gosseries, N Jeremy Hill, Leigh R Hochberg, Fatima Y Ismail, Ivo A Meyer, Charles B Mikell, Sima Mofakham, Erika Molteni, Leonard Polizzotto, Sudhin A Shah, Robert D Stevens, Daniel Thengone, and and the Curing Coma Campaign and its Contributing Members.
• Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA. nds2001@med.cornell.edu.
• Neurocrit Care. 2024 Aug 1; 41 (1): 129145129-145.

BackgroundWe developed a gap analysis that examines the role of brain-computer interfaces (BCI) in patients with disorders of consciousness (DoC), focusing on their assessment, establishment of communication, and engagement with their environment.MethodsThe Curing Coma Campaign convened a Coma Science work group that included 16 clinicians and neuroscientists with expertise in DoC. The work group met online biweekly and performed a gap analysis of the primary question.ResultsWe outline a roadmap for assessing BCI readiness in patients with DoC and for advancing the use of BCI devices in patients with DoC. Additionally, we discuss preliminary studies that inform development of BCI solutions for communication and assessment of readiness for use of BCIs in DoC study participants. Special emphasis is placed on the challenges posed by the complex pathophysiologies caused by heterogeneous brain injuries and their impact on neuronal signaling. The differences between one-way and two-way communication are specifically considered. Possible implanted and noninvasive BCI solutions for acute and chronic DoC in adult and pediatric populations are also addressed.ConclusionsWe identify clinical and technical gaps hindering the use of BCI in patients with DoC in each of these contexts and provide a roadmap for research aimed at improving communication for adults and children with DoC, spanning the clinical spectrum from intensive care unit to chronic care.© 2024. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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