A Multifaceted Approach to Covert Attention Brain-Computer Interfaces

Over the last years, brain-computer interfaces (BCIs) have shown their value for assistive technology and neurorehabilitation. Recently, a BCI-approach for the rehabilitation of hemispatial neglect has been proposed on the basis of covert visuospatial attention (CVSA). CVSA is an internal action which can be described as shifting one's attention to the visual periphery without moving the actual point of gaze. Such attention shifts induce a lateralization in parietooccipital blood flow and oscillations in the so-called alpha band (8-14 Hz), which can be detected via electroencephalography (EEG), magnetoencephalography (MEG) or functional magnetic resonance imaging (fMRI). Previous studies have proven the technical feasibility of using CVSA as a control signal for BCIs, but unfortunately, these BCIs could not provide every subject with sufficient control. The aim of this thesis was to investigate the possibility of amplifying the weak lateralization patterns in the alpha band - the main reason behind insufficient CVSA BCI performance. To this end, I have explored three different approaches that could lead to better performing and more inclusive CVSA BCI systems. The first approach illuminated the changes in the behavior and brain patterns by closing the loop between subject and system with continuous real-time feedback at the instructed locus of attention. I could observe that even short (20 minutes) stretches of real-time feedback have an effect on behavioral correlates of attention, even when the changes observed in the EEG remained less conclusive. The second approach attempted to complement the information extracted fromthe EEG signal with another sensing modality that could provide additional information about the state of CVSA. For this reason, I firstly combined functional functional near-infrared spectroscopy (fNIRS) with EEG measurements. The results showed that, while the EEG was able to pick up the expected lateralization in the alpha band, the fNIRS was not able to reliably image changes in blood circulation in the parietooccipital cortex. Secondly, I successfully combined data from the EEG with measures of pupil size changes, induced by a high illumination contrast between the covertly attended target regions, which resulted in an improved BCI decoding performance. The third approach examined the option of using noninvasive electrical brain stimulation to boost the power of the alpha band oscillations and therefore render the lateralization pattern in the alpha band more visible compared to the background activity. However, I could not observe any impact of the stimulation on the ongoing alpha band power, and thus results of the subsequent effect on the lateralization remain inconclusive. Overall, these studies helped to further understand CVSA and lay out a useful basis for further exploration of the connection between behavior and alpha power oscillations in CVSA tasks, as well as for potential directions to improve CVSA-based BCIs.