About the Study

About the Technology

Function Near Infared Imaging

Near infrared spectroscopy (NIRS) is a spectroscopic method which uses the near infrared region of the electromagnetic spectrum (from about 800 nm to 2500 nm). Typical applications include pharmaceutical, medical diagnostics (including blood sugar and oximetry), food and agrochemical quality control, as well as combustion research.

About Brain-Computer Interface

A brain-computer interface (BCI), sometimes called a direct neural interface or a brain-machine interface, is a direct communication pathway between a brain and an external device. BCIs were aimed at assisting, augmenting or repairing human cognitive or sensory-motor functions.

Research on BCIs began in the 1970s at the University of California Los Angeles (UCLA) under a grant from the National Science Foundation followed by a contract from DARPA. These papers also mark the first appearance of the expression "Brain Computer Interface" in the scientific literature.

The field has since blossomed spectacularly, mostly toward neuroprosthetics applications that aim at restoring damaged hearing, sight and movement. Thanks to the remarkable cortical plasticity of the brain, signals from implanted prostheses can, after adaptation, be handled by the brain like natural sensor or effector channels. Following years of animal experimentation, the first neuroprosthetic devices implanted in humans appeared in the mid-nineties.

Objective of the Study

The objective of this study is to evaluate the safety and effectiveness of a device developed by Hitachi Japan called the “Kokoro Gatari”, which means “Teller of Hearts” in Japanese.  The Kokoro Gatari is a direct brain interface, which is a class of systems that detect small changes in brain activity to allow people with severe disabilities to communicate and control their environment.  The Kokoro Gatari is based on a technology called functional near infrared (fNIR) imaging.  fNIR imaging is a technique that uses infrared light to detect brain activity. We plan to test the Kokoro Gatari, to see how well it works as a communication device for people with ALS. 

Study Design

1. Subjects
Forty people with ALS will participate in this study over the course of a year. All participants will be at least 18 years old and will have normal or corrected to normal hearing. In order to participate in the study, each person or their family will need to get a verbal approval from their primary care doctor.  Each person who wishes to participate in the study must be able to hear and understand questions that investigators or caregivers will ask during the study sessions.  All participants must have a way of saying at least “yes” and “no” by some means, such as blinking or moving their eyes, or using a communication device.  This allows us to make sure that participants can tell us if they experience any discomfort.

            There are some conditions that will prevent us from accepting a person into the study.  These include hypertension (high blood pressure), peripheral circulation insufficiency, or cerebro-vascular disease.  If potential participants have questions about any of these conditions, they should contact their primary care doctor.

2. Procedures

Setting up the Kokoro Gatari
In the first part of this study, investigators will set up the Kokoro Gatari device and collect data that will allow them to customize the device for each participant.  Investigators or caregivers will place a headband with a flat, smooth sensor onto the participant’s forehead with the sensor just above the left eyebrow.   The investigators will then ask the participant to perform a series of mental tasks, such as silently repeating a nonsense syllable such as “la, la, la” or silently singing a song.

After the initial data has been collected, the investigators will adjust the device to respond to the participant’s brain activity as closely as possible.  At that point, investigators will ask the participant to try to say “yes” or “no” three times each, in random order.  Investigators will record the participant’s brain activity data and calculate their accuracy.  If the accuracy is not high enough, investigators may adjust the device again.

Each session should last no longer than 60 minutes. Participants will be given a brief rest break every 10-15 minutes during each session.  The participant may end the session at any time, for any reason.

The investigators will teach the participant’s caregivers to set up and operate the device and make sure they understand how it works.  Participants are asked to practice with the Kokoro Gatari at least twice a week. After one month, investigators will collect all of the data for the month and calculate the participant’s accuracy.  If the average accuracy of responses during this period is high enough, the participant may be given the opportunity to continue using the machine for an additional 3 months.

Trial Period
The overall study of all 40 people with ALS will take up to one year. Investigators will check with participants three months after the initial screening to see if all requirements for participation in the study are still met.

3. Risks
There are minimal risks to health or safety that result from using the Kokoro Gatari device. The sensors in the device used to record brain activity are electrically isolated so there is not possibility of shock in the unlikely event of an electrical fault in the equipment. Some people experience minor discomfort as a result of wearing the headband for long periods of time.  Patients may also experience rash or itching from the using the headband. 

The Kokoro Gatari sensor emits some heat through the LED. This amount is very small and the risk of low-temperature burn is extremely low. However, if participants have a fever, they should not use the device until their skin temperature returns to normal.

Finally, some participants may experience headache and fatigue that result from repeated brain activation. No one should use this device for longer than the recommended time interval (one hour) during any single session.