脳とコンピューターのインターフェースが、反応のない集中治療患者の意思伝達を可能にする可能性(A Brain-Computer Interface May Give Unresponsive ICU Patients a Voice)

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2026-10-22 コロンビア大学

米国のコロンビア大学アービング医療センターなどの研究チームは、急性脳損傷によって反応できない集中治療室(ICU)の患者が、脳波を利用してコンピューターを操作する非侵襲型ブレイン・コンピューター・インターフェース(BCI)を開発した。研究では、入院後数日以内の重症患者41人を対象に、頭皮に装着した脳波(EEG)電極で脳活動を測定し、患者が手を開閉しようと意図した際の信号をコンピューターでリアルタイムに解析した。患者は、思考によって音の高さを上げ下げする課題に取り組み、約3分の1が操作に成功した。別の検査で認知運動解離(CMD)が確認された患者は、全員が操作できた。CMDは、意識や認知機能が保たれていても、身体の反応として意思を示せない状態を指す。本技術は、日常的にICUで使われる脳波計測を活用するため、脳への電極埋め込みを必要としない。今後、痛みや空腹などの訴えや、患者の希望を医療従事者や家族に伝える手段として発展することが期待される。

脳とコンピューターのインターフェースが、反応のない集中治療患者の意思伝達を可能にする可能性(A Brain-Computer Interface May Give Unresponsive ICU Patients a Voice)
A new study by Columbia researchers could pave the way for noninvasive brain-computer interfaces that allow patients with hidden consciousness to communicate with family members and physicians. The study shows that unresponsive ICU patients with brain injuries—when connected to a noninvasive brain-computer interface designed by Columbia researchers—were able to control the frequency of a beeping tone with their minds. Lead researcher Jan Claassen (white coat) demonstrates the interface with colleagues Sandy Song (left), Ami Camy (sitting), and Angela Velazquez (right). Photo by Rudy Diaz/Columbia University Irving Medical Center.

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急性脳損傷で臨床的に反応しない患者が脳コンピューターインターフェースを起動する Clinically unresponsive patients with acute brain injury activate a brain-computer interface

Qi Shen, Andrey Eliseyev, Vedant Kansara, Joel Neves Briard, You Lim Song, Jerina Carmona, Ian Jerome Gonzales, Angela Velazquez, Alex J Klein, Sachin Agarwal,…
Blain  Published:22 October 2026
DOI:https://doi.org/10.1093/brain/awag210

Abstract

Brain activation to verbal commands can be detected by EEG in clinically unresponsive patients. These patients with cognitive motor dissociation (CMD) are unable to communicate with the environment despite preserved consciousness. Advanced brain-computer interfaces (BCI) are promising to support motor function in patients with motor neuron disease or spinal cord injury. Our primary objective was to determine if clinically unresponsive patients can control a self-paced, one-way BCI early after acute brain injury. Secondarily, we assessed the association of BCI control with short- and long-term outcomes.

We conducted a prospective single-centre cohort study in 41 clinically unresponsive, critically ill and acutely brain injured patients, as well as in a convenience sample of 8 healthy volunteers and 22 conscious critically ill patients. The self-paced BCI analysed EEG in real time and modulated frequency and pitch of a tone that patients controlled by attempting a motor task: patients were provided with instructions ‘to make the beep sound faster, keep opening and closing your right hand’ alternating with ‘to make the beep sound slower, stop opening and closing your right hand’. CMD was detected by applying machine learning to EEG recorded while patients listened to motor commands. Clinical outcomes were recovery of consciousness by hospital discharge, assessed with the Coma Recovery Scale–Revised, and recovery of functional independence at 12 months, defined as a Glasgow Outcome Scale–Extended score of 4 or higher (denoting the ability to function independently for 8 h or more). Additionally, we invited conscious patients as well as family members of conscious and clinically unresponsive patients to complete a survey on perceived utility and challenges associated with the BCI.

In this study, 13 clinically unresponsive patients (32%) achieved BCI control and 8 of 41 (20%) were CMD-positive. All healthy volunteers and nine conscious patients (41%) were able to control the BCI. Median signal delay for BCI control was 49.8 [interquartile range (IQR) 39.9–75.6] seconds for clinically unresponsive patients, 17.1 (IQR 7.8–19.9) for conscious patients and 15.5 (IQR 12.9–21.2) for healthy volunteers. In the group of 41 clinically unresponsive patients, 4 of 13 patients with (31%) and 1 of 28 without BCI control (4%) recovered clinical consciousness at hospital discharge [odds ratio (OR) 21.2; 95% confidence interval (CI) 2.3–930.7]. At 12 months, 6 of 13 patients with (46%) and 2 of 28 without BCI control (7%) recovered functional independence (OR 9.9; 95% CI 1.8–81.6). None of the patients that were unable to control the BCI and were CMD-negative recovered. Patients with BCI control had shorter times to recovery of functional independence by 12 months than those who did not (hazards ratio 6.0; 95% CI 1.2–30.6). All respondents of the BCI survey (n = 37) expressed strong support for the potential future use of BCI devices.

These results suggest that BCI control is a strong predictor of outcomes following acute brain injury and provide initial evidence that a bedside, EEG-based BCI system might permit bidirectional communication in critically ill unresponsive patients.

医療・健康
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