The EU-funded LUMINOUS research project, led by the company Starlab in Barcelona, is working on a way to communicate with coma patients and those with completely locked-in syndrome by scanning their level of consciousness. The project coordinator of LUMINOUS, Dr.-Ing. Aureli Soria-Frisch from Starlab Barcelona, explains further.
Aureli, would you tell us more about what consciousness states are all about?
Some states of consciousness are natural, and some are unhealthily low. For instance, one can be awake like you and me, aware of what is going on around us and able to interact with the environment; or people can suffer from conditions that don't allow them to interact or in some cases even be aware of anything. These conditions include minimal consciousness syndrome (MCS), completely locked in syndrome, and coma. These are conditions of extremely low consciousness levels, even unconsciousness in some cases. On the other hand, there are people who struggle to naturally decrease their consciousness levels and fall asleep. Insomnia can also be a very troubling condition. We are trying to find a solution for that too.
We study all these states in a general framework, the healthy ones and the unhealthy ones, and try to come up with a way to analyse and improve them. In fact, even the state of normal consciousness of a healthy person can be increased by application of our technology. We are working with two devices: an electrical stimulation device and a brain monitoring device.
So how can your technology help patients suffering from a consciousness dysfunction?
First of all, our technology can be used to determine a patient’s consciousness level. To recognise the right level is very important for choosing the best treatment for the patient: for example, those suffering from MCS (minimal consciousness syndrome) can feel pain, which means they need anaesthetics. They are also more likely to recover their consciousness with time, and knowing that can give their loved ones very valuable hope. As a next step, our therapy based on the electrical stimulation of the brain can contribute to these patients' recovery of some of their minor motor functions, such as moving fingers or following their face in a mirror.
Brain scanning can also help, by offering a way to communicate without actually speaking. This form of communication can be applied even in more severe consciousness-related diseases, such as completely locked-in syndrome, a terrible disease that completely paralyses the patient while they remain conscious. Medicine has not yet found a cure, so all we can do is to try to find new ways for those who suffer from this syndrome to be connected to the world.
The process works by making use of the fact that brain activity is very different when a person is, for example, playing sports (using the motor complex) or going through the rooms of a house (orientation in different areas). Interestingly enough, a computer connected to a brain scanning device can distinguish between these two thinking processes. This setup can be used for establishing minimal communication with the patient. A minimally conscious state patient is asked a simple question and then instructed – if you want to answer yes, think of playing sports, if you wish to answer no, think about going through your house. What LUMINOUS is trying to do in these cases is to first improve this minimal communication through brain computer interfaces, and second to make it easier for the patient to use it.
Can coma patients also be helped in this way?
We don’t address this in terms of communication, but in terms of treatment, in which case the answer is yes. Coma is the most severe case of a consciousness-related disease, but the related minimal conscious states can be treated and helped by modifying brain activity, which is also one of the objectives of our project.
How does sleep fit into all this?
Some phases of sleep are actually low consciousness levels, just like anaesthesia. Moreover, insomnia can be a serious condition, as sleep is a very important body function. In the sleep lab of one of our partners we are researching new ways to facilitate sleep. So far we haven't observed any significant positive effects of our technology, but we are confident about future results – research is ongoing.
You mentioned anaesthesia. How can your technology be used in that area?
Anaesthesia is typically induced by drugs that lower one’s consciousness level to a state that is similar to sleep, although there are some differences. Unfortunately, the drugs used in this procedure have, in some cases, side effects causing cognitive impediments: in extreme cases, delirium (a temporary form of dementia). LUMINOUS is now exploring better techniques for monitoring a person’s state of consciousness during anaesthesia. However, our scientific dream is to find a way for anaesthetic drugs to be complemented with electrical stimulation of the brain to at least reduce the necessary dosage, and hence reduce undesirable side effects. Perhaps eventually it will be possible to induce anaesthesia without using any drugs. But that would be a matter of the next 10 years, if not more.
How else are you planning to make use of your technology?
Foetal monitoring can be considered an interesting “playground” for measuring consciousness. In theory, it would be possible to carry out screening to check if the development of a foetus' consciousness is going as it should, but also to learn new information about the development process and about the emergence of consciousness, and then use this information to help adults with their consciousness-related problems.
There is also another hypothetical way of how the technology we are working on can be used, although I do not have a consolidated opinion about this type of technology usage. I am talking about defence training, particularly in the military. We are committed not to work for the military and to apply all our technology in civilian contexts. However, according to American experiments that tested a technology similar to ours, our solutions could also work for the cognitive enhancement of soldiers. Apparently, electrical stimulation on the brain during 3D video game training can speed up soldiers' ability to detect cues indicating potential danger like a shadow. It seems that this therapy helped the soldiers to increase their level of attention, and consequently decrease their learning time by 50% (2 weeks instead of 4). Of course, the same principle can be applied to other types of training, such as the learning of mathematical skills.
How did you get into research on consciousness?
When I was 14 I saw Blade Runner, a movie where robots behave like humans and eventually become conscious of their state and their origin, and look to extend their lives. This put a question in my head that has occupied me for many years: is it possible for a machine to become conscious? I had no idea at the time that in the long run this very inquiry would bring me exactly where I am now.
Wondering about consciousness in robots motivated me to do my PhD in artificial intelligence, but for three semesters I studied philosophy. Once I discussed my questions with a professor and asked him about the principles of consciousness, and he advised me to read the work of French materialists, which then made me focus on bio-inspired artificial intelligence. My studies in AI made me wonder about the algorithms used by the brain to process all that information and make sense of the world. That all became material for my relationship to neuroscience. You never know where your career path will take you as a researcher.
What impressions do you have of FET after working with the programme for so long?
My experience started in 2009 with our project HIVE. In my opinion, FET is a wonderful programme that makes it possible to realise your scientific and technological dreams, visions, and ambitions. I appreciate its bottom-up strategy, which I find very democratic. I believe that the FET concept gives rise to a balance between exploring and implementing. I would like to congratulate the EU on supporting this type of programme and encourage its further development.