Editing Brain–computer interface (section)

===Disorders of consciousness (DOC)===
Some people have a [[disorder of consciousness]] (DOC). This state is defined to include people in a coma and those in a [[vegetative state]] (VS) or [[minimally conscious state]] (MCS). BCI research seeks to address DOC. A key initial goal is to identify patients who can perform basic cognitive tasks, which would change their diagnosis, and allow them to make important decisions (such as whether to seek therapy, where to live, and their views on end-of-life decisions regarding them). Patients incorrectly diagnosed may die as a result of end-of-life decisions made by others. The prospect of using BCI to communicate with such patients is a tantalizing prospect.<ref>{{cite book | vauthors = Edlinger G, Allison BZ, Guger C | chapter = How many people could use a BCI system? | pages = 33–66 | veditors = Kansaku K, Cohen L, Birbaumer N |title=Clinical Systems Neuroscience |date=2015 |location=Tokyo  | publisher = pringer Verlag Japan |isbn=978-4-431-55037-2}}</ref><ref>{{cite journal | vauthors = Chatelle C, Chennu S, Noirhomme Q, Cruse D, Owen AM, Laureys S | title = Brain-computer interfacing in disorders of consciousness | journal = Brain Injury | volume = 26 | issue = 12 | pages = 1510–1522 | year = 2012 | pmid = 22759199 | doi = 10.3109/02699052.2012.698362 | s2cid = 6498232 | hdl = 2268/162403 | hdl-access = free }}</ref>

Many such patients cannot use BCIs based on vision. Hence, tools must rely on auditory and/or vibrotactile stimuli. Patients may wear headphones and/or vibrotactile stimulators placed on responsive body parts. Another challenge is that patients may be able to communicate only at unpredictable intervals. Home devices can allow communications when the patient is ready. 

Automated tools can ask questions that patients can easily answer, such as "Is your father named George?" or "Were you born in the USA?" Automated instructions inform patients how to convey yes or no, for example by focusing their attention on stimuli on the right vs. left wrist. This focused attention produces reliable changes in [[electroencephalography|EEG patterns]] that can help determine whether the patient is able to communicate.<ref name="BolyMassimini2012">{{cite journal | vauthors = Boly M, Massimini M, Garrido MI, Gosseries O, Noirhomme Q, Laureys S, Soddu A | title = Brain connectivity in disorders of consciousness | journal = Brain Connectivity | volume = 2 | issue = 1 | pages = 1–10 | year = 2012 | pmid = 22512333 | doi = 10.1089/brain.2011.0049 | hdl-access = free | s2cid = 6447538 | hdl = 2268/131984 }}</ref><ref>{{cite journal | vauthors = Gibson RM, Fernández-Espejo D, Gonzalez-Lara LE, Kwan BY, Lee DH, Owen AM, Cruse D | title = Multiple tasks and neuroimaging modalities increase the likelihood of detecting covert awareness in patients with disorders of consciousness | journal = Frontiers in Human Neuroscience | volume = 8 | pages = 950 | year = 2014 | pmid = 25505400 | pmc = 4244609 | doi = 10.3389/fnhum.2014.00950 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Risetti M, Formisano R, Toppi J, Quitadamo LR, Bianchi L, Astolfi L, Cincotti F, Mattia D | display-authors = 6 | title = On ERPs detection in disorders of consciousness rehabilitation | journal = Frontiers in Human Neuroscience | volume = 7 | pages = 775 | year = 2013 | pmid = 24312041 | pmc = 3834290 | doi = 10.3389/fnhum.2013.00775 | doi-access = free }}</ref>