The Effect of Visual Impairment on the Controllability of a Brain-Computer Interface Using Visual Spatial Attention

The primary goal of a brain-computer interface (BCI) is to enable interactions with the environment by generating control signals directly from brain activity, independent of physical movement including gaze shifts. Attentional selection of peripheral objects has been used to control a BCI but requires sufficient visual acuity to reliably recognize the target stimulus. Here, we systematically investigated the effect of different stages of visual impairment on event-related potentials (ERPs) and BCI performance while healthy participants directed covert attention to peripheral visual stimuli. We hypothesized that the effect of visual impairments such as blurred or monocular vision might alter attention-related visual ERPs, but has only minor or no impact at all on BCI performance when color is the target feature. Early attention sensitive visual components were altered in monocular vision compared to binocular vision. Simulated vision degradation resulted in reduction of ERPs in the P300 range. The differences in ERPs across vision conditions did not affect the decoding accuracy of the BCI. The study not only revealed differences of visual ERPs in different viewing conditions but primarily demonstrated that a BCI can be reliably controlled by focusing attention on a visual stimulus whose distinguishing features such as color, can be recognized even with visual impairments. This provides a promising approach to enable paralyzed persons to communicate using a non-invasive, gaze-independent BCI.