Abstract
Amyotrophic lateral sclerosis (ALS) can result in the locked-in state (LIS), characterized by paralysis, and eventual respiratory failure, compensated by artificial ventilation,(1) or the completely LIS (CLIS), with additional total paralysis of eye muscles. Brain–computer interfaces (BCIs) have been used to allow paralyzed people to regain basic communication,(2) although current EEG-based BCIs have not succeeded with CLIS patients.(3) We present Class IV case evidence to establish that communication in the CLIS is possible with a metabolic BCI based on near-infrared spectroscopy (NIRS).