Intracortical BCI Performance is Robust to Changes in Attentional Load During Dual-Tasking.

High performance intracortical brain-computer interface (iBCI) control has been demonstrated in research settings, but performance can still vary within and between sessions. One potential source of this variability is the change in attentional load that comes from processing naturally occurring distractors such as thoughts, sounds, fatigue, or pain. To improve the consistency of iBCI performance in real-world environments where this sort of multi-tasking is inevitable, we must understand how shifts in attention can impact performance. Here we examined the effect of attentional load on iBCI performance and movement-related neural activity using a 2D cursor translation + click iBCI task paired with an N-Back working memory task to increase attentional load during dual-task performance. Two participants (P2 and P4) with tetraplegia completed the study while enrolled in a long-term clinical trial of an iBCI device (NCT1894802). Common neural correlates of attention (theta and alpha band power) were measured with simultaneously recorded scalp electroencephalography (EEG). While the EEG recordings and difficulty ratings suggested increased attentional load during dual tasking, iBCI performance was quite robust across the various dual tasking conditions. One participant, P2, experienced a small but significant increase in trial completion time and normalized path length during the mild attentional load condition. Signal quality differences between the two participants may have impacted the results, as P2 had lower signal quality and was therefore likely more vulnerable to attentional load. P4's higher signal quality likely allowed him to accommodate increased attentional load without a drop in performance. Overall, iBCI performance appears to be robust to attentional load, but the complex trends observed here reflect a need for continued investigation of BCI use under different cognitive states to elucidate potential challenges and compensatory mechanisms across participants.