Search

Prior work has shown that transcranial alternating current stimulation (tACS) of parietooccipital alpha oscillations (8–14 Hz) can modulate working memory (WM) performance as a function of the phase lag to endogenous oscillations. However, leveraging this effect using real-time phase-tuned tACS has not been feasible so far due to stimulation artifacts preventing continuous phase tracking. We aimed to develop a system that tracks and adapts the phase lag between tACS and ongoing parietooccipital alpha oscillations in real-time. We hypothesized that such real-time phase-tuned tACS enhances working memory performance, depending on the phase lag. We developed real-time phase-tuned closed-loop amplitude-modulated tACS (CLAM-tACS) targeting parietooccipital alpha oscillations. CLAM-tACS was applied at six different phase lags relative to ongoing alpha oscillations while participants (N = 21) performed a working memory task. To exclude that behavioral effects of CLAM-tACS were mediated by other factors such as sensory co-stimulation, a second group of participants (N = 25) received equivalent stimulation of the forehead. WM accuracy improved in a phase lag dependent manner (p = 0.0350) in the group receiving parietooccipital stimulation, with the strongest enhancement observed at 330° phase lag between tACS and ongoing alpha oscillations (p = 0.00273, d = 0.976). Moreover, across participants, modulation of frontoparietal alpha oscillations correlated both in amplitude (p = 0.0248) and phase (p = 0.0270) with the modulation of WM accuracy. No such effects were observed in the control group receiving frontal stimulation. Our results demonstrate the feasibility and efficacy of real-time phase-tuned CLAM-tACS in modulating both brain activity and behavior, thereby paving the way for further investigation into brain-behavior relationships and the exploration of innovative therapeutic applications. • TACS is phase-tuned to alpha oscillations in real-time during stimulation. • TACS enhances working memory performance. • Working memory effects are associated with frontoparietal alpha synchrony. • No phase-dependent modulation in active control condition. [ABSTRACT FROM AUTHOR]

Educational chatbots have been shown to be useful assistants in computer-supported learning settings. However, how does feedback of an educational chatbot impact on the learner's attention? Thus, this paper proposes a study to measure changes in human attention when learning by using an educational chatbot Liza that is intended to improve human reasoning ability. In total, 18 participants participated in the study and had a conversation with Liza. During the interaction with Liza, the attention of the study participants was measured using a mobile electroencephalogram (EEG) device. Three findings have been determined based on statistics methods. First, it was found that there was a significant attention effect occurring in 54% of the times, after the educational chatbot showed feedback and the attention measurement took place over the length of a task. Second, when differentiating the type of feedback, positive feedback had a significant effect in 71 of these 137 cases (51.82%) and negative feedback had a significant effect in 66 of the 137 cases (48.18%). Third, statistical results showed that there was no significant difference in attention at the significant level of 0.05 during the 10 seconds before, and 10 seconds after positive feedback is received. Similar is the case for negative feedback. [ABSTRACT FROM AUTHOR]

With higher availability of WES, the diagnosis in our patient could have been established already at the time of onset of psychiatric symptoms or even earlier at the time of orthopaedic management of bone cysts with characteristics of internal fatty tissue indicative for NHD. In our opinion, clinical judgement in such cases cannot substitute genetic testing, as some diseases are rare and established red flags, such as positive family history, disease-specific MRI changes or "typical" symptoms are often absent or appear late in the disease course. Electroencephalography (EEG) revealed no epileptiform abnormalities but an asymmetric frontotemporal dysrhythmia during rest, with a pathological slowing of the dominant alpha frequency towards the theta band, and increased delta and beta power (Fig. Appendix EEG recording EEG recordings were analyzed using custom-written code in Python. [Extracted from the article]

Working memory (WM) is essential for reasoning, decision-making, and problem solving. Recently, there has been an increasing effort in improving WM through noninvasive brain stimulation (NIBS), especially transcranial direct and alternating current stimulation (tDCS/tACS). Studies suggest that tDCS and tACS can modulate WM performance, but large variability in research approaches hinders the identification of optimal stimulation protocols and interpretation of study results. Moreover, it is unclear whether tDCS and tACS differentially affect WM. Here, we summarize and compare studies examining the effects of tDCS and tACS on WM performance in healthy adults. Following PRISMA-selection criteria, our systematic review resulted in 43 studies (29 tDCS, 11 tACS, 3 both) with a total of 1826 adult participants. For tDCS, only 4 out of 23 single-session studies reported effects on WM, while 7 out of 9 multi-session experiments showed positive effects on WM training. For tACS, 10 out of 14 studies demonstrated effects on WM, which were frequency dependent and robust for frontoparietal stimulation. Our review revealed no reliable effect of single-session tDCS on WM but moderate effects of multi-session tDCS and single-session tACS. We discuss the implications of these findings and future directions in the emerging research field of NIBS and WM. [ABSTRACT FROM AUTHOR]

Background: Hallucinogen persisting perception disorder (HPPD) is characterized by spontaneous recurrence of visual hallucinations or disturbances after previous consumption of hallucinogens, such as lysergic acid diethylamide (LSD). The underlying physiological mechanisms are unknown and there is no standardized treatment strategy available. Case Presentation: A 33-year-old male patient presented with persistent visual distortions (halos around objects, intensified colors, positive after images, and trails following moving objects) that developed after repeated use of hallucinogenic drugs at the age of 18. Symptoms developed gradually and worsened several months later, resulting in various pharmacological and psychosocial treatment attempts that remained unsuccessful, however. At presentation, 32-channel electroencephalography (EEG) showed increased delta activity over the occipital brain regions, reminiscent of occipital intermittent rhythmic delta activity (OIRDA) usually seen in children. Two sessions of cathodal (inhibitory) transcranial direct current stimulation (tDCS) over 30 min attenuated visual hallucinations and occipital delta activity by approximately 60%. The response persisted for over four weeks. Conclusion: Pathological delta activity over occipital brain regions may play an important role in the development and perpetuation of HPPD and can be attenuated by non-invasive brain stimulation. [ABSTRACT FROM AUTHOR]

Severe upper limb paresis can represent an immense burden for stroke survivors. Given the rising prevalence of stroke, restoration of severe upper limb motor impairment remains a major challenge for rehabilitation medicine because effective treatment strategies are lacking. Commonly applied interventions in Germany, such as mirror therapy and impairment-oriented training, are limited in efficacy, demanding for new strategies to be found. By translating brain signals into control commands of external devices, brain-computer interfaces (BCIs) and brain-machine interfaces (BMIs) represent promising, neurotechnology-based alternatives for stroke patients with highly restricted arm and hand function. In this mini-review, we outline perspectives on how BCI-based therapy can be integrated into the different stages of neurorehabilitation in Germany to meet a long-term treatment approach: We found that it is most appropriate to start therapy with BCI-based neurofeedback immediately after early rehabilitation. BCI-driven functional electrical stimulation (FES) and BMI robotic therapy are well suited for subsequent post hospital curative treatment in the subacute stage. BCI-based hand exoskeleton training can be continued within outpatient occupational therapy to further improve hand function and address motivational issues in chronic stroke patients. Once the rehabilitation potential is exhausted, BCI technology can be used to drive assistive devices to compensate for impaired function. However, there are several challenges yet to overcome before such long-term treatment strategies can be implemented within broad clinical application: 1. developing reliable BCI systems with better usability; 2. conducting more research to improve BCI training paradigms and 3. establishing reliable methods to identify suitable patients. [ABSTRACT FROM AUTHOR]

The EU AI Act, the first comprehensive regulation of AI, came into effect in August. Here, we provide an overview of the provisions that apply to the field of neurotechnology with respect to research and development and neuroscience practice and discuss some implications for the future. The EU AI Act, the first comprehensive regulation of AI, came into effect in August. Here, Bublitz et al. provide an overview of the provisions that apply to the field of neurotechnology with respect to research and development and neuroscience practice and discuss some implications for the future. [ABSTRACT FROM AUTHOR]

Brain-computer interfaces (BCIs) provide a unique technological solution to circumvent the damaged motor system. For neurorehabilitation, the BCI can be used to translate neural signals associated with movement intentions into tangible feedback for the patient, when they are unable to generate functional movement themselves. Clinical interest in BCI is growing rapidly, as it would facilitate rehabilitation to commence earlier following brain damage and provides options for patients who are unable to partake in traditional physical therapy. However, substantial challenges with existing BCI implementations have prevented its widespread adoption. Recent advances in knowledge and technology provide opportunities to facilitate a change, provided that researchers and clinicians using BCI agree on standardisation of guidelines for protocols and shared efforts to uncover mechanisms. We propose that addressing the speed and effectiveness of learning BCI control are priorities for the field, which may be improved by multimodal or multi-stage approaches harnessing more sensitive neuroimaging technologies in the early learning stages, before transitioning to more practical, mobile implementations. Clarification of the neural mechanisms that give rise to improvement in motor function is an essential next step towards justifying clinical use of BCI. In particular, quantifying the unknown contribution of non-motor mechanisms to motor recovery calls for more stringent control conditions in experimental work. Here we provide a contemporary viewpoint on the factors impeding the scalability of BCI. Further, we provide a future outlook for optimal design of the technology to best exploit its unique potential, and best practices for research and reporting of findings. [ABSTRACT FROM AUTHOR]

Cervical spinal cord injuries (SCIs) often lead to loss of motor function in both hands and legs, limiting autonomy and quality of life. While it was shown that unilateral hand function can be restored after SCI using a hybrid electroencephalography/electrooculography (EEG/EOG) brain/neural hand exoskeleton (B/NHE), it remained unclear whether such hybrid paradigm also could be used for operating two hand exoskeletons, e.g., in the context of bimanual tasks such as eating with fork and knife. To test whether EEG/EOG signals allow for fluent and reliable as well as safe and user-friendly bilateral B/NHE control, eight healthy participants (six females, mean age 24.1 ± 3.2 years) as well as four chronic tetraplegics (four males, mean age 51.8 ± 15.2 years) performed a complex sequence of EEG-controlled bilateral grasping and EOG-controlled releasing motions of two exoskeletons visually presented on a screen. A novel EOG command performed by prolonged horizontal eye movements (>1 s) to the left or right was introduced as a reliable switch to activate either the left or right exoskeleton. Fluent EEG control was defined as average "time to initialize" (TTI) grasping motions below 3 s. Reliable EEG control was assumed when classification accuracy exceeded 80%. Safety was defined as "time to stop" (TTS) all unintended grasping motions within 2 s. After the experiment, tetraplegics were asked to rate the user-friendliness of bilateral B/NHE control using Likert scales. Average TTI and accuracy of EEG-controlled operations ranged at 2.14 ± 0.66 s and 85.89 ± 15.81% across healthy participants and at 1.90 ± 0.97 s and 81.25 ± 16.99% across tetraplegics. Except for one tetraplegic, all participants met the safety requirements. With 88 ± 11% of the maximum achievable score, tetraplegics rated the control paradigm as user-friendly and reliable. These results suggest that hybrid EEG/EOG B/NHE control of two assistive devices is feasible and safe, paving the way to test this paradigm in larger clinical trials performing bimanual tasks in everyday life environments. [ABSTRACT FROM AUTHOR]

Neurofeedback has begun to attract the attention and scrutiny of the scientific and medical mainstream. Here, neurofeedback researchers present a consensus-derived checklist that aims to improve the reporting and experimental design standards in the field. [ABSTRACT FROM AUTHOR]

Repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) is an effective treatment for major depressive disorder (MDD), but response rates are low and effect sizes small. Synchronizing TMS pulses with instantaneous brain oscillations can reduce variability and increase efficacy of TMS-induced plasticity. To study whether brain oscillation-synchronized rTMS is feasible, safe and has neuromodulatory effects when targeting the DLPFC of patients with MDD. Using real-time EEG-triggered TMS we conducted a pseudo-randomized controlled single-session crossover trial of brain oscillation-synchronized rTMS of left DLPFC in 17 adult patients with antidepressant-resistant MDD. Stimulation conditions in separate sessions were: (1) rTMS triggered at the negative EEG peak of instantaneous alpha oscillations (alpha-synchronized rTMS), (2) a variation of intermittent theta-burst stimulation (modified iTBS), and (3) a random alpha phase control condition. Triggering TMS at the negative peak of instantaneous alpha oscillations by real-time analysis of the electrode F5 EEG signal was successful in 15 subjects. Two subjects reported mild transient discomfort at the site of stimulation during stimulation; no serious adverse events were reported. Alpha-synchronized rTMS, but not modified iTBS or the random alpha phase control condition, reduced resting-state alpha activity in left DLPFC and increased TMS-induced beta oscillations over frontocentral channels. Alpha-synchronized rTMS of left DLPFC is feasible, safe and has specific single-session neuromodulatory effects in patients with antidepressant-resistant MDD. Future studies need to further elucidate the mechanisms, optimize the parameters and investigate the therapeutic potential and efficacy of brain oscillation-synchronized rTMS in MDD. • Proof-of-concept study of real-time EEG-triggered rTMS of left DLPFC in MDD. • TMS pulses were given phase-locked to instantaneous alpha oscillations in DLPFC. • Alpha-synchronized rTMS was feasible and safe in patients with MDD. • Alpha-synchronized rTMS modulated resting-state and induced oscillatory activity. • Clinical studies are needed to test its potential and efficacy in treatment of MDD. [ABSTRACT FROM AUTHOR]

Modulation of sensorimotor rhythm (SMR) power, a rhythmic brain oscillation physiologically linked to motor imagery, is a popular Brain–Machine Interface (BMI) paradigm, but its interplay with slower cortical rhythms, also involved in movement preparation and cognitive processing, is not entirely understood. In this study, we evaluated the changes in phase and power of slow cortical activity in delta and theta bands, during a motor imagery task controlled by an SMR-based BMI system. In Experiment I, EEG of 20 right-handed healthy volunteers was recorded performing a motor-imagery task using an SMR-based BMI controlling a visual animation, and during task-free intervals. In Experiment II, 10 subjects were evaluated along five daily sessions, while BMI-controlling same visual animation, a buzzer, and a robotic hand exoskeleton. In both experiments, feedback received from the controlled device was proportional to SMR power (11–14 Hz) detected by a real-time EEG-based system. Synchronization of slow EEG frequencies along the trials was evaluated using inter-trial-phase coherence (ITPC). Results: cortical oscillations of EEG in delta and theta frequencies synchronized at the onset and at the end of both active and task-free trials; ITPC was significantly modulated by feedback sensory modality received during the tasks; and ITPC synchronization progressively increased along the training. These findings suggest that phase-locking of slow rhythms and resetting by sensory afferences might be a functionally relevant mechanism in cortical control of motor function. We propose that analysis of phase synchronization of slow cortical rhythms might also improve identification of temporal edges in BMI tasks and might help to develop physiological markers for identification of context task switching and practice-related changes in brain function, with potentially important implications for design and monitoring of motor imagery-based BMI systems, an emerging tool in neurorehabilitation of stroke. [ABSTRACT FROM AUTHOR]

Brain-computer interfaces (BCIs) based on motor imagery have been gaining attention as tools to facilitate recovery from movement disorders resulting from stroke or other causes. These BCIs can detect imagined movements that are typically required within conventional rehabilitation therapy. This information about the timing, intensity, and location of imagined movements can help assess compliance and control feedback mechanisms such as functional electrical stimulation (FES) and virtual avatars. Here, we review work from eight groups that each presented recent results with BCI-based rehabilitation at a workshop during the 6th International Brain-Computer Interface Meeting. We also present major directions and challenges for future research. [ABSTRACT FROM AUTHOR]

Abstract: Brain‐computer interfaces (BCIs) can provide sensory feedback of ongoing brain oscillations, enabling stroke survivors to modulate their sensorimotor rhythms purposefully. A number of recent clinical studies indicate that repeated use of such BCIs might trigger neurological recovery and hence improvement in motor function. Here, we provide a first meta‐analysis evaluating the clinical effectiveness of BCI‐based post‐stroke motor rehabilitation. Trials were identified using MEDLINE, CENTRAL, PEDro and by inspection of references in several review articles. We selected randomized controlled trials that used BCIs for post‐stroke motor rehabilitation and provided motor impairment scores before and after the intervention. A random‐effects inverse variance method was used to calculate the summary effect size. We initially identified 524 articles and, after removing duplicates, we screened titles and abstracts of 473 articles. We found 26 articles corresponding to BCI clinical trials, of these, there were nine studies that involved a total of 235 post‐stroke survivors that fulfilled the inclusion criterion (randomized controlled trials that examined motor performance as an outcome measure) for the meta‐analysis. Motor improvements, mostly quantified by the upper limb Fugl‐Meyer Assessment (FMA‐UE), exceeded the minimal clinically important difference (MCID=5.25) in six BCI studies, while such improvement was reached only in three control groups. Overall, the BCI training was associated with a standardized mean difference of 0.79 (95% CI: 0.37 to 1.20) in FMA‐UE compared to control conditions, which is in the range of medium to large summary effect size. In addition, several studies indicated BCI‐induced functional and structural neuroplasticity at a subclinical level. This suggests that BCI technology could be an effective intervention for post‐stroke upper limb rehabilitation. However, more studies with larger sample size are required to increase the reliability of these results. [ABSTRACT FROM AUTHOR]

Brain–computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS. [ABSTRACT FROM PUBLISHER]

Transcranial alternating current stimulation (tACS) has been repeatedly demonstrated to modulate endogenous brain oscillations in a frequency specific manner. Thus, it is a promising tool to uncover causal relationships between brain oscillations and behavior or perception. While tACS has been shown to elicit a physiological aftereffect for up to 70 min, it remains unclear whether the effect can still be elicited if subjects perform a complex task interacting with the stimulated frequency band. In addition, it has not yet been investigated whether the aftereffect is behaviorally relevant. In the current experiment, participants performed a Shepard-like mental rotation task for 80 min. After 10 min of baseline measurement, participants received either 20 min of tACS at their individual alpha frequency (IAF) or sham stimulation (30 s tACS in the beginning of the stimulation period). Afterwards another 50 min of post-stimulation EEG were recorded. Task performance and EEG were acquired during the whole experiment. While there were no effects of tACS on reaction times or event-relatedpotentials (ERPs), results revealed an increase in mental rotation performance in the stimulation group as compared to sham both during and after stimulation. This was accompanied by increased ongoing alpha power and coherence as well as eventrelated-desynchronization (ERD) in the alpha band in the stimulation group. The current study demonstrates a behavioral and physiological aftereffect of tACS in parallel. This indicates that it is possible to elicit aftereffects of tACS during tasks interacting with the alpha band. Therefore, the tACS aftereffect is suitable to achieve an experimental manipulation. [ABSTRACT FROM AUTHOR]

Background: Frontal midline theta (FMT) oscillations (4-8 Hz) are strongly related to cognitive and executive control during mental tasks such as memory processing, arithmetic problem solving or sustained attention. While maintenance of temporal order information during a working memory (WM) task was recently linked to FMT phase, a positive correlation between FMT power, WM demand and WM performance was shown. However, the relationship between these measures is not well understood, and it is unknown whether purposeful FMT phase manipulation during a WM task impacts FMT power and WM performance. Here we present evidence that FMT phase manipulation mediated by transcranial alternating current stimulation (tACS) can block WM demand-related FMT power increase (FMTΔpower) and disrupt normal WM performance. Methods: Twenty healthy volunteers were assigned to one of two groups (group A, group B) and performed a 2-back task across a baseline block (block 1) and an intervention block (block 2) while 275-sensor magnetoencephalography (MEG) was recorded. After no stimulation was applied during block 1, participants in group A received tACS oscillating at their individual FMT frequency over the prefrontal cortex (PFC) while group B received sham stimulation during block 2. After assessing and mapping phase locking values (PLV) between the tACS signal and brain oscillatory activity across the whole brain, FMT power and WM performance were assessed and compared between blocks and groups. Results: During block 2 of group A but not B, FMT oscillations showed increased PLV across task-related cortical areas underneath the frontal tACS electrode. While WM task-related FMTΔpower and WM performance were comparable across groups in block 1, tACS resulted in lower FMTΔpower and WM performance compared to sham stimulation in block 2. Conclusion: tACS-related manipulation of FMT phase can disrupt WM performance and influence WM task-related FMTΔpower. This finding may have important implications for the treatment of brain disorders such as depression and attention deficit disorder associated with abnormal regulation of FMT activity or disorders characterized by dysfunctional coupling of brain activity, e.g., epilepsy, Alzheimer's or Parkinson's disease (AD/PD). [ABSTRACT FROM AUTHOR]

Stroke is among the leading causes of long-term disabilities leaving an increasing number of people with cognitive, affective and motor impairments depending on assistance in their daily life. While function after stroke can significantly improve in the first weeks and months, further recovery is often slow or non-existent in the more severe cases encompassing 30–50% of all stroke victims. The neurobiological mechanisms underlying recovery in those patients are incompletely understood. However, recent studies demonstrated the brain's remarkable capacity for functional and structural plasticity and recovery even in severe chronic stroke. As all established rehabilitation strategies require some remaining motor function, there is currently no standardized and accepted treatment for patients with complete chronic muscle paralysis. The development of brain–machine interfaces (BMIs) that translate brain activity into control signals of computers or external devices provides two new strategies to overcome stroke-related motor paralysis. First, BMIs can establish continuous high-dimensional brain-control of robotic devices or functional electric stimulation (FES) to assist in daily life activities ( assistive BMI). Second, BMIs could facilitate neuroplasticity, thus enhancing motor learning and motor recovery ( rehabilitative BMI). Advances in sensor technology, development of non-invasive and implantable wireless BMI-systems and their combination with brain stimulation, along with evidence for BMI systems' clinical efficacy suggest that BMI-related strategies will play an increasing role in neurorehabilitation of stroke. [ABSTRACT FROM AUTHOR]

This paper presents a novel mechatronics master–slave setup for hand telerehabilitation. The system consists of a sensorized glove acting as a remote master and a powered hand exoskeleton acting as a slave. The proposed architecture presents three main innovative solutions. First, it provides the therapist with an intuitive interface (a sensorized wearable glove) for conducting the rehabilitation exercises. Second, the patient can benefit from a robot-aided physical rehabilitation in which the slave hand robotic exoskeleton can provide an effective treatment outside the clinical environment without the physical presence of the therapist. Third, the mechatronics setup is integrated with a sensorized object, which allows for the execution of manipulation exercises and the recording of patient's improvements. In this paper, we also present the results of the experimental characterization carried out to verify the system usability of the proposed architecture with healthy volunteers. [ABSTRACT FROM PUBLISHER]

Current state-of-the-art diagnostic measures of Alzheimer's disease (AD) are invasive (cerebrospinal fluid analysis), expensive (neuroimaging) and time-consuming (neuropsychological assessment) and thus have limited accessibility as frontline screening and diagnostic tools for AD. Thus, there is an increasing need for additional noninvasive and/or cost-effective tools, allowing identification of subjects in the preclinical or early clinical stages of AD who could be suitable for further cognitive evaluation and dementia diagnostics. Implementation of such tests may facilitate early and potentially more effective therapeutic and preventative strategies for AD. Before applying them in clinical practice, these tools should be examined in ongoing large clinical trials. This review will summarize and highlight the most promising screening tools including neuropsychometric, clinical, blood, and neurophysiological tests. [ABSTRACT FROM AUTHOR]

Background Brain-machine interfaces (BMIs) allow direct translation of electric, magnetic or metabolic brain signals into control commands of external devices such as robots, prostheses or exoskeletons. However, non-stationarity of brain signals and susceptibility to biological or environmental artifacts impede reliable control and safety of BMIs, particularly in daily life environments. Here we introduce and tested a novel hybrid brain-neural computer interaction (BNCI) system fusing electroencephalography (EEG) and electrooculography (EOG) to enhance reliability and safety of continuous hand exoskeleton-driven grasping motions. Findings 12 healthy volunteers (8 male, mean age 28.1 ± 3.63y) used EEG (condition #1) and hybrid EEG/EOG (condition #2) signals to control a hand exoskeleton. Motor imagery-related brain activity was translated into exoskeleton-driven hand closing motions. Unintended motions could be interrupted by eye movement-related EOG signals. In order to evaluate BNCI control and safety, participants were instructed to follow a visual cue indicating either to move or not to move the hand exoskeleton in a random order. Movements exceeding 25% of a full grasping motion when the device was not supposed to be moved were defined as safety violation. While participants reached comparable control under both conditions, safety was frequently violated under condition #1 (EEG), but not under condition #2 (EEG/EOG). Conclusion EEG/EOG biosignal fusion can substantially enhance safety of assistive BNCI systems improving their applicability in daily life environments. [ABSTRACT FROM AUTHOR]