Paralyzed Patients "Speak" With Their Pupils

sciencehabit writes "Lying in bed, unable to move a muscle, so-called locked-in patients have few ways to communicate with the outside world. But researchers have now found a way to use the widening and narrowing of the pupils to send a message, potentially helping these patients break the silence. The trick is a webcam-like setup that tracks pupil dilation. When people focus on a hard problem--say a math problem--their pupils dilate. Employing the approach, some locked-in patients could answer 'yes' and 'no' questions just by dilating their eyes."

Comments

Why are they even teaching anyone?

[ZaMoose]

I mean, seriously, paralyzed people would probably be bad candidates for teaching anyone anyth...

OHHHHH. Those kinds of pupils!

Re:Why are they even teaching anyone?

[erroneus]

Let's vote on it. The eyes have it!

She couldn't say no, but her eyes said yes!

Sure, it's impressive, but if looks could kill, she'd have a future in the US armed services!

Re:Why are they even teaching anyone?

[gomiam]

"...involuntary dilation of the... iris?"

The first thing I'd "speak" with my pupils

[NobleSavage]

KILL ME

Re:The first thing I'd "speak" with my pupils

[Xicor]

you can only speak yes or no, lol

Re:The first thing I'd "speak" with my pupils

[jovius]

A movie worth seeing: The Diving Bell and the Butterfly

That's about the first thing the locked-in patient Jean-Dominique Bauby, who wrote a book by blinking his eyes, said. The book is an amazing read, breathtakingly beautiful and intelligent. Bauby died a bit after the book was released..

Re:The first thing I'd "speak" with my pupils

[Impy the Impiuos Imp]

JERK ME OFF

Should I post this anon? Naaaaah.

Re:The first thing I'd "speak" with my pupils

[houghi]

01101011 01101001 01101100 01101100 00100000 01101101 01100101

HTH. HAND.

Re:The first thing I'd "speak" with my pupils

[GameboyRMH]

This. And then "KILL ME" :-P

Why bother with pupil dilation?

[Conspiracy_Of_Doves]

Why don't they go straight to neurofeedback? The hardware is getting a lot less expensive.

Re:Why bother with pupil dilation?

[Shadow of Eternity]

afaik a lot of those systems work based on tying in to moving an arm or something.

Re:Why bother with pupil dilation?

[Conspiracy_Of_Doves]

I'm talking about the systems where you wear a sort of helmet or other headgear.

Re:Why bother with pupil dilation?

[Twylite]

Certainly seems like a more promising idea than pupil dilation. Wikipedia has a comparison of BCI hardware.

Re:Why bother with pupil dilation?

[Conspiracy_Of_Doves]

Was it your first ever attempt at neurofeedback? If so, of course you didn't do that great.

Learning to take control of any kind of semi-autonomous response is easy if you can see some kind of visible measure of it. In this case it would be a monitor showing the feedback of your brain.

Pike

[Master Moose]

With this type of tech, pretty soon we will be able to hook them all up to motorised boxes with a single light that can blink once for yes and twice for no.

Re:Pike

[The_Wilschon]

They couldn't even afford two lights. Or maybe this was on purpose, as it allowed Pike to have dramatic pauses: "yesssssssss...... I MEAN NO!"

Facilitated Communication Hoax

[chuckinator]

While I am genuinely interested in seeing real, functional communication with a demographic that is typically cut off from being able to communicate with the rest of the world, I am very skeptical that this is going to turn into yet another facilitated communication hoax.

Re:Facilitated Communication Hoax

[fuzzyfuzzyfungus]

On the plus side (and notably unlike 'facilitated communication', which required a true-believer to be in immediate contact with the patient), it would be reasonably trivial to pipe eyeball-cam footage to an otherwise blinded observer.

Doesn't mean that hopefully families won't be conned (or con themselves) into playing sick human-Ouija-board games with locked-in patients; but "Is this pupil dilation pattern conveying information?" should be a pretty testable question.

Re:Facilitated Communication Hoax

[Black Parrot]

'facilitated communication', which required a true-believer to be in immediate contact with the patient

Gee, I can't imagine any fraud or self-delusion creeping into that.

No more than, say, a medium providing 'facilitated communication' with the dead.

Re:Facilitated Communication Hoax

[sconeu]

Bullshit. It's real. My late wife had ALS, and her eyegaze computer was worth every penny. Even if it wasn't *HER* voice (we didn't bank it early enough), she could still talk with us.

Re:Facilitated Communication Hoax

[chuckinator]

Thank you for your feedback. I was actually hoping to hear someone with specific experience with these techniques share their impression of the technique.

Can you expand on your experience with this technique? How did it work in your late wife's case? What was the latency of the communication like due to the obvious bandwidth constraints of this particular medium?

Re:Facilitated Communication Hoax

[sconeu]

It was slow. There was no blink required. The scanner registered how long the eye focused on a particular point to activate the "click". The dwell time was tunable, so you could adjust it as you became more practiced at it.

Because *everything* for an ALS patient is exhausting, it was very tiring for her to use. But it was worth it, even if it took a long time for her to spell out what she wanted. Predictive text also helped.

The biggest PITA was getting the positioning "just right" when we moved it from the rolling rack for her bed, to the wheelchair mounted rack, and vice versa.

Re:Facilitated Communication Hoax

[yndrd1984]

Bullshit. It's real. My late wife had ALS, and her eyegaze computer was worth every penny.

I understand, but I don't think that eyegaze was the kind of facilitated communication the GP was calling a hoax.

Re:Facilitated Communication Hoax

[fuzzyfuzzyfungus]

Oh, 'facilitated communication' was quite the clusterfuck. Mostly preyed on severely autistic or otherwise nonverbal children (and if you think that dead people have an affective grip on our little hominid brains, try crippled kids...) Eventually started to come unglued when some of the communications facilitators began making (by means of their helpless meat-puppets) allegations of child sexual abuse against parents... Thankfully, 'facilitated communication' mostly crumbled under the onslaught of actual testing (shockingly, when the 'facilitator' couldn't see the stimulus; but only the kid could, performance on questions about it plummeted to chance. Funny how that happens), rather than a recap of the 'satanic panic' incident.

(A less dramatic; but also scientifically problematic, source of criticism was the 'we can place electrodes on every inch of kiddo, to discern the slightest volitional muscle movements, and nothing. Why, again, is it that "facilitators" are magically getting all kinds of output?' school of assistive tech people, who understandably had questions about what, exactly, the 'facilitator' could be detecting that instruments couldn't.)

Re:The first question I want them to ask me...

[fuzzyfuzzyfungus]

We're sorry; but your 'intrinsic human dignity' would be violated by following your wishes. Have a nice day.

paralysis of the eyes

[bugnuts]

So in all seriousness, if you're paralyzed down to your eyeballs, how can your pupils dilate/contract? That's not a nerve thing? According to TFA, the dilation shows your brain stem is intact, but that some people couldn't even move or blink their eyes for yes/no responses. If they can't move their eyes, how can the nerves dilate them? I can see the blinking being separate nerves, but would think moving and dilation and focusing would be pretty closely related? Bad assumption?

Is there a doctor in the house?

oblig TOS joke:
Q. What did Captain Pike name his dog?
A. "Beeeeeeeep!"

Re:paralysis of the eyes

[dgatwood]

Unable to blink, I can understand. The muscles that point your eyes and close and open the iris are cranial nerves that begin inside the brain. The muscles that are used to blink are facial nerves, which start at the brain stem.

That said, I have a hard time believing that someone can change the iris but cannot move the eyeball. I think those are fed by the same nerve bundle.

Re:paralysis of the eyes

[Shadow of Eternity]

pupil dilation is more akin to peristalsis than blinking.

Re:paralysis of the eyes

[TheSpoom]

I was wondering about this, and if they can move their eyes, with eye-tracking software they can do a hell of a lot better than binary Y/N. That said, I'm very sure the people in charge of this know way better than I do.

Re:paralysis of the eyes

[sconeu]

They do.

http://www.tobii.com/en/assistive-technology/north-america/

Disclaimer: My late wife used a Tobii C17 for communication before she passed away.

Re:paralysis of the eyes

[Black Parrot]

That said, I have a hard time believing that someone can change the iris but cannot move the eyeball. I think those are fed by the same nerve bundle.

The circuitry is pretty complicated. As best I can tell from my books, most of the controls for eye movements run through cranial nerve III, but some run through cranial nerves IV, and VI. The axons that control dialation and constriction also run through cranial nerve III. So if III is intact and the other damaged, you could lose at least partial control of eye movement without effect on control of the pupil.

And "upstream" of the nerves, control of the pupil (and focus) is part of the autonomic nervous system, whereas control of eye direction isn't.

Oddly enough, even dilation and constriction of the pupils have separate control systems. Control for constriction is based on a ganglion right behind the eye, whereas control for dilation is via a cervical ganglion, in your neck. So the paths of those opposing functions run separately for at least part of their length.

And who knows what parts of the brain are involved in generating the control signals for the various movements.

Re:paralysis of the eyes

[wonkey_monkey]

That said, I'm very sure the people in charge of this know way better than I do.

Careful now. That's close to subversive on Slashdot.

Re:paralysis of the eyes

[Guppy]

That said, I have a hard time believing that someone can change the iris but cannot move the eyeball. I think those are fed by the same nerve bundle.

From what the article is describing, I'd have to say this is not an example where you simply have interruption of outgoing "twitch this muscle fiber" signals along a particular tract. As mentioned before by other posters, the Cranial Nerves emerge from the brain prior to where the spinal cord exits (except for CN 11, which is an oddball), so even a completely cut cord will leave them working.

Rather, the damage has occurred at a higher level such that the message isn't being sent in the first place. Trick is, the dilation of the Iris happens to be controlled through sympathetic nerves, rather than motor. So it is being controlled by a different system that apparently is still functioning.

Euthanasia Please

[nukenerd]

I sincerely hope that by the time I might get to that state that the idiots who oppose euthanasia have been recognised as the nutjobs that they are and that I can be put out of my misery. If you kept a dog in that state (in the UK at least) you would be prosecuted for cruelty.

Re:Euthanasia Please

[l0ungeb0y]

We let dogs die as quickly and painlessly as possible because they have no soul. A person, especially a good Christian must receive all the medical care possible to maximize your suffering, because it's clearly god's will that you are suffering and just letting you die would be a sin. You do know that if you take your own life you'll burn in hell forever, don't you? Anyway, if god doesn't want you to suffer, he would have seen to it that you don't -- so you must have done something to deserve it if you are dying a slow, agonizing death. Perhaps he's preparing you for eternal damnation or maybe you need to suffer to let Jesus in on your death bed. Anyway, it's all in god's perfect little plan.

Isn't religion grand? Mono-theism has brought so much enlightenment and prosperity to our world.

Re:Euthanasia Please

[trout007]

I oppose euthanasia because history shows that time and time again it leads to the devaluing of human life and the horrors it brings with it like eugenics and genocides.

If you want to kill yourself go ahead. If you want to kill your paralyzed loved one go ahead and face a jury.

What about EEG?

[atticus9]

It's an interesting approach but it seems like an EEG, that monitors brainwaves and allows control through that would be better, the article touches on that briefly and rules it out as too expensinve/time intensive to setup. But modern EEG's don't really take that much setup and are cheap (you can buy one from NeuroSky for $79 that has one sensor that goes across your forehead and connects through wireless usb for example) I'd much rather see research going on there than pupil dilation.

Re:What about EEG?

[Gravis Zero]

mod parent up. proven BCIs like Emotiv's are already out and your programs can talk to it using a lib. it's already been used to help quadriplegics, so it's not some dive into the unknown.

Re:What about EEG?

[dpidcoe]

I have an Emotive unit, and it's pretty terrible at brainwave detection. What it is slightly better at is detecting the movements of facial muscles. If you use the gyroscope output and then couple that with monitoring something like eyeblinks, you can have a pretty decent hands free headmouse (though it's annoying to have to close your eyes in order to click things). Most of the ~~awesome~~ demos that you see of it on youtube are based on detecting a combination of the gyroscope and facial movements, not actual mental state.

Re:What about EEG?

[Gravis Zero]

i'll take it off your hands if you dont want it. :)

Re:The first question I want them to ask me...

[Hsien-Ko]

O_O

prior art:

[Black Parrot]

I've *always* answered hard questions with a glazed look in my eyes.

Sounds like fun

[Hoi Polloi]

Message #1: "Scratch my nose"
Message #2: "Shoot me"

Question #1

[BlueMikey]

Dilate for "yes" if you are not wanting us to not kill you. Oh, you have more to say? We'll come back in 4 hours after you binary out a message.

Pupils?

[wcrowe]

I must be old. My first reaction was, "Why would paralyzed patients have pupils? What are they teaching?"

One name that shows lack of invention

[poofmeisterp]

There's a difference between a "spin-off" and an "invention".

One name: Stephen Hawking.