| Sumario: | Purpose: For non-verbal individuals, brain-computer interfaces (BCIs) are a potential means of communication. Near-infrared spectroscopy (NIRS) is a brain-monitoring modality that has been considered for BCIs. To date, limited NIRS-BCI testing has involved online classification, particularly with individuals with severe motor impairments. Materials and methods: We tested an online NIRS-BCI developed for a non-verbal individual with severe congenital motor impairments. The binary BCI differentiated categorical verbal fluency task (VFT) performance and rest using prefrontal measurements. The participant attended five sessions, the last two of which were online with classification feedback. Results: An online classification accuracy of 63.33% was achieved using a linear discriminant classifier trained on a four-dimensional feature set. An offline, cross-validation analysis of all data yielded an optimal adjusted classification accuracy of 66.6 ± 9.11%. Inconsistent functional responses, contradictory effects of feedback, participant fatigue and motion artefacts were identified as challenges to online classification specific to this participant. Conclusions: Results suggest potential in using an NIRS-BCI controlled by the VFT in instances of severe congenital impairments. Further testing with users with severe disabilities is necessary. Implications for Rehabilitation: Brain-computer interfaces (BCIs) can provide a non-motor based means of communication for individuals with severe motor impairments. Near-infrared spectroscopy (NIRS) is a haemodynamic-based brain-imaging modality used in BCIs. To date, NIRS-BCIs have not been thoroughly tested with potential target users. This case study shows that NIRS-BCIs may offer a means of practical communication for individuals with severe congenital impairments and continued exploration is advisable.
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