Median Nerve Stimulation Based BCI: A New Approach to Detect Intraoperative Awareness During General Anesthesia
Résumé
Hundreds of millions of general anesthesia are performed each year on patients all over
the world. Among these patients, 0.1–0.2% are victims of Accidental Awareness during
General Anesthesia (AAGA), i.e., an unexpected awakening during a surgical procedure
under general anesthesia. Although anesthesiologists try to closely monitor patients
using various techniques to prevent this terrifying phenomenon, there is currently no
efficient solution to accurately detect its occurrence. We propose the conception of an
innovative passive brain-computer interface (BCI) based on an intention of movement
to prevent AAGA. Indeed, patients typically try to move to alert the medical staff during
an AAGA, only to discover that they are unable to. First, we examine the challenges
of such a BCI, i.e., the lack of a trigger to facilitate when to look for an intention to
move, as well as the necessity for a high classification accuracy. Then, we present a
solution that incorporates Median Nerve Stimulation (MNS). We investigate the specific
modulations that MNS causes in the motor cortex and confirm that they can be altered
by an intention of movement. Finally, we perform experiments on 16 healthy participants
to assess whether an MI-based BCI using MNS is able to generate high classification
accuracies. Our results show that MNS may provide a foundation for an innovative BCI
that would allow the detection of AAGA.
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