  Individuals with a locked-in state live with severe whole-body paralysis that
limits their ability to communicate with family and loved ones. Recent advances
in the brain-computer interface (BCI) technology have presented a potential
alternative for these people to communicate by detecting neural activity
associated with attempted hand or speech movements and translating the decoded
intended movements to a control signal for a computer. A technique that could
potentially enrich the communication capacity of BCIs is functional electrical
stimulation (FES) of paralyzed limbs and face to restore body and facial
movements of paralyzed individuals, allowing to add body language and facial
expression to communication BCI utterances. Here, we review the current state
of the art of existing BCI and FES work in people with paralysis of body and
face and propose that a combined BCI-FES approach, which has already proved
successful in several applications in stroke and spinal cord injury, can
provide a novel promising mode of communication for locked-in individuals.
