Brain-Computer Interfaces in Medicine

Abstract

Brain-computer interfaces (BCIs) acquire brain signals, analyze them, and translate them into commands that are relayed to output devices that carry out desired actions. BCIs do not use normal neuromuscular output pathways. The main goal of BCI is to replace or restore useful function to people disabled by neuromuscular disorders such as amyotrophic lateral sclerosis, cerebral palsy, stroke, or spinal cord injury. From initial demonstrations of electroencephalography-based spelling and single-neuron-based device control, researchers have gone on to use electroencephalographic, intracortical, electrocorticographic, and other brain signals for increasingly complex control of cursors, robotic arms, prostheses, wheelchairs, and other devices. Brain-computer interfaces may also prove useful for rehabilitation after stroke and for other disorders. In the future, they might augment the performance of surgeons or other medical professionals. Brain-computer interface technology is the focus of a rapidly growing research and development enterprise that is greatly exciting scientists, engineers, clinicians, and the public in general. Its future achievements will depend on advances in 3 crucial areas. Brain-computer interfaces need signal-acquisition hardware that is convenient, portable, safe, and able to function in all environments. Brain-computer interface systems need to be validated in long-term studies of real-world use by people with severe disabilities, and effective and viable models for their widespread dissemination must be implemented. Finally, the day-to-day and moment-to-moment reliability of BCI performance must be improved so that it approaches the reliability of natural muscle-based function. U ntil recently, the dream of being able to control one's environment through thoughts had been in the realm of science fiction. However, the advance of technology has brought a new reality: Today, humans can use the electrical signals from brain activity to interact with, influence, or change their environments. The emerging field of brain-computer interface (BCI) technology may allow individuals unable to speak and/or use their limbs to once again communicate or operate assistive devices for walking and manipulating objects. Brain-computer interface research is an area of high public awareness. Videos on YouTube as well as news reports in the lay media indicate intense curiosity and interest in a field that hopefully one day soon will dramatically improve the lives of many disabled persons affected by a number of different disease processes.This review seeks to provide the general medical community with an introduction to BCIs. We define BCI and then review some of the seminal discoveries in this rapidly emerging field, the brain signals used by BCIs, the essential components of a BCI system, current BCI systems, and the key issues now engaging researchers. Challenges are inherent in translating any new technology to practical and useful clinical applications, and BCIs are no exception. We discuss the potent...

Dreaming of the future of stroke: translation of bench to bed

“…Because BCI can substitute physical impairments such as motor and language functions, it enables patients with stroke who exhibit motor impairments to control the electrical device, which could be a computer cursor and a wheelchair [42]. Furthermore, BCI has been applied for motor neuromodulation purposes to induce real-time feedback to patients with stroke and to reward consistent production of neural features concordant with the motor function [41,43].…”

Development of a Non-invasive Brain Computer Interface for Neurorehabilitation

“…There is growing interest and curiosity, not only restricted to the scientific community, but the public in general that soon this technology may improve the lives of many disabled people all over the world [50]. The primary goal of BCI technology is to establish a direct communication pathway between the brain and external devices, thereby enabling faster and more intuitive communication and control for individuals with motor disabilities caused by neurological disorders, namely stroke [51].…”

“…In this sense, a micro-ECoG has the capability to decode hand movements in order to provide control signals for prosthetic hands or functional electrical stimulator to restore function of impaired limbs, enabling a user to easily perform basic daily tasks, that were difficult, or even impossible, before [51]. For BCIs that serve more as rehabilitation tools than assistive devices, portability is not so crucial, but they should be non-invasive and practical [50], [51], [66].…”

“…The main principle behind the use of BCI as a rehabilitation tool is that it can induce cortical plasticity by training through feedback [50], [51], [67]. When subjects are trained to operate a BCI system, visual or other sensory feedback is presented to subjects in real-time.…”

Brain–computer interface targeting non-motor functions after spinal cord injury: a case report

“…1 BCIs do not depend on the central nervous systems normal output pathways that have been compromised following injury. Instead, participants overtly manipulate their brain activity as compared with using motor movements to produce signals that can be used to control devices and/or virtual environments.…”