A decision tree for brain-computer interface devices

This paper is a first attempt to present a "decision tree" to assist in choosing a brain-computer interface device for patients who are nearly or completely "locked-in" (cognitively intact but unable to move or communicate.) The first step is to assess any remaining function. There are six inflexion points in the decision-making process. These depend on the functional status of the patient: 1) some residual movement; 2) no movement, but some residual electromyographic (EMG) activity; 3) fully locked-in with no EMG activity or movements but with conjugate eye movements; 4) same as 3 but with disconjugate eye movements; 5) same as 4 but with inadequate assistance from the available EEG-based systems; 6) same as 5 and accepting of an invasive system.