Evolution of brain-computer interfaces: going beyond classic motor physiology

Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications

Brain-computer interfaces (BCIs), a remarkable technological advancement in neurology and neurosurgery, mark a significant leap since the inception of electroencephalography in 1924. These interfaces effectively convert central nervous system signals into commands for external devices, offering revolutionary benefits to patients with severe communication and motor impairments due to a myriad of neurological conditions like stroke, spinal cord injuries, and neurodegenerative disorders. BCIs enable these individuals to communicate and interact with their environment, using their brain signals to operate interfaces for communication and environmental control. This technology is especially crucial for those completely locked in, providing a communication lifeline where other methods fall short. The advantages of BCIs are profound, offering autonomy and an improved quality of life for patients with severe disabilities. They allow for direct interaction with various devices and prostheses, bypassing damaged or nonfunctional neural pathways. However, challenges persist, including the complexity of accurately interpreting brain signals, the need for individual calibration, and ensuring reliable, long-term use. Additionally, ethical considerations arise regarding autonomy, consent, and the potential for dependence on technology. Despite these challenges, BCIs represent a transformative development in neurotechnology, promising enhanced patient outcomes and a deeper understanding of brain-machine interfaces.

Boosting brain-computer interfaces with functional electrical stimulation: potential applications in people with locked-in syndrome

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 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.

Nine decades of electrocorticography: A comparison between epidural and subdural recordings

In recent years, electrocorticography (ECoG) has arisen as a neural signal recording tool in the development of clinically viable neural interfaces. ECoG electrodes are generally placed below the dura mater (subdural) but can also be placed on top of the dura (epidural). In deciding which of these modalities best suits long-term implants, complications and signal quality are important considerations. Conceptually, epidural placement may present a lower risk of complications as the dura is left intact but also a lower signal quality due to the dura acting as a signal attenuator. The extent to which complications and signal quality are affected by the dura, however, has been a matter of debate. To improve our understanding of the effects of the dura on complications and signal quality, we conducted a literature review. We inventorized the effect of the dura on signal quality, decodability and longevity of acute and chronic ECoG recordings in humans and non-human primates. Also, we compared the incidence and nature of serious complications in studies that employed epidural and subdural ECoG. Overall, we found that, even though epidural recordings exhibit attenuated signal amplitude over subdural recordings, particularly for high-density grids, the decodability of epidural recorded signals does not seem to be markedly affected. Additionally, we found that the nature of serious complications was comparable between epidural and subdural recordings. These results indicate that both epidural and subdural ECoG may be suited for long-term neural signal recordings, at least for current generations of clinical and high-density ECoG grids.

Continuous versus discrete robotic feedback for brain-computer interfaces aimed for neurorehabilitation

Introduction

Brain-Computer Interfaces (BCI) can allow control of external devices using motor imagery (MI) decoded from electroencephalography (EEG). Although BCI have a wide range of applications including neurorehabilitation, the low spatial resolution of EEG, coupled to the variability of cortical activations during MI, make control of BCI based on EEG a challenging task.

Methods

An assessment of BCI control with different feedback timing strategies was performed. Two different feedback timing strategies were compared, comprised by passive hand movement provided by a robotic hand orthosis. One of the timing strategies, the continuous, involved the partial movement of the robot immediately after the recognition of each time segment in which hand MI was performed. The other feedback, the discrete, was comprised by the entire movement of the robot after the processing of the complete MI period. Eighteen healthy participants performed two sessions of BCI training and testing, one with each feedback.

Results

Significantly higher BCI performance (65.4 ± 17.9% with the continuous and 62.1 ± 18.6% with the discrete feedback) and pronounced bilateral alpha and ipsilateral beta cortical activations were observed with the continuous feedback.

Discussion

It was hypothesized that these effects, although heterogenous across participants, were caused by the enhancement of attentional and closed-loop somatosensory processes. This is important, since a continuous feedback timing could increase the number of BCI users that can control a MI-based system or enhance cortical activations associated with neuroplasticity, important for neurorehabilitation applications.

Somatosensory ECoG-based brain-machine interface with electrical stimulation on medial forebrain bundle

Brain-machine interface (BMI) provides an alternative route for controlling an external device with one's intention. For individuals with motor-related disability, the BMI technologies can be used to replace or restore motor functions. Therefore, BMIs for movement restoration generally decode the neural activity from the motor-related brain regions. In this study, however, we designed a BMI system that uses sensory-related neural signals for BMI combined with electrical stimulation for reward. Four-channel electrocorticographic (ECoG) signals were recorded from the whisker-related somatosensory cortex of rats and converted to extract the BMI signals to control the one-dimensional movement of a dot on the screen. At the same time, we used operant conditioning with electrical stimulation on medial forebrain bundle (MFB), which provides a virtual reward to motivate the rat to move the dot towards the desired center region. The BMI task training was performed for 7 days with ECoG recording and MFB stimulation. Animals successfully learned to move the dot location to the desired position using S1BF neural activity. This study successfully demonstrated that it is feasible to utilize the neural signals from the whisker somatosensory cortex for BMI system. In addition, the MFB electrical stimulation is effective for rats to learn the behavioral task for BMI.

Optically-generated focused ultrasound for noninvasive brain stimulation with ultrahigh precision

High precision neuromodulation is a powerful tool to decipher neurocircuits and treat neurological diseases. Current non-invasive neuromodulation methods offer limited precision at the millimeter level. Here, we report optically-generated focused ultrasound (OFUS) for non-invasive brain stimulation with ultrahigh precision. OFUS is generated by a soft optoacoustic pad (SOAP) fabricated through embedding candle soot nanoparticles in a curved polydimethylsiloxane film. SOAP generates a transcranial ultrasound focus at 15 MHz with an ultrahigh lateral resolution of 83 µm, which is two orders of magnitude smaller than that of conventional transcranial-focused ultrasound (tFUS). Here, we show effective OFUS neurostimulation in vitro with a single ultrasound cycle. We demonstrate submillimeter transcranial stimulation of the mouse motor cortex in vivo. An acoustic energy of 0.6 mJ/cm², four orders of magnitude less than that of tFUS, is sufficient for successful OFUS neurostimulation. OFUS offers new capabilities for neuroscience studies and disease treatments by delivering a focus with ultrahigh precision non-invasively.

Flexural bending to approximate cortical forces exerted by electrocorticography (ECoG) arrays

Objective.The force that an electrocorticography (ECoG) array exerts on the brain manifests when it bends to match the curvature of the skull and cerebral cortex. This force can negatively impact both short-term and long-term patient outcomes. Here we provide a mechanical characterization of a novel liquid crystal polymer (LCP) ECoG array prototype to demonstrate that its thinner geometry reduces the force potentially applied to the cortex of the brain.Approach.We built a low-force flexural testing machine to measure ECoG array bending forces, calculate their effective flexural moduli, and approximate the maximum force they could exerted on the human brain.Main results.The LCP ECoG prototype was found to have a maximal force less than 20% that of any commercially available ECoG arrays that were tested. However, as a material, LCP was measured to be as much as 24× more rigid than silicone, which is traditionally used in ECoG arrays. This suggests that the lower maximal force resulted from the prototype's thinner profile (2.9×-3.25×).Significance.While decreasing material stiffness can lower the force an ECoG array exhibits, our LCP ECoG array prototype demonstrated that flexible circuit manufacturing techniques can also lower these forces by decreasing ECoG array thickness. Flexural tests of ECoG arrays are necessary to accurately assess these forces, as material properties for polymers and laminates are often scale dependent. As the polymers used are anisotropic, elastic modulus cannot be used to predict ECoG flexural behavior. Accounting for these factors, we used our four-point flexure testing procedure to quantify the forces exerted on the brain by ECoG array bending. With this experimental method, ECoG arrays can be designed to minimize force exerted on the brain, potentially improving both acute and chronic clinical utility.

Closed-loop neuromodulation for studying spontaneous activity and causality

Having established that spontaneous brain activity follows meaningful coactivation patterns and correlates with behavior, researchers have turned their attention to understanding its function and behavioral significance. We suggest closed-loop neuromodulation as a neural perturbation tool uniquely well suited for this task. Closed-loop neuromodulation has primarily been viewed as an interventionist tool to teach subjects to directly control their own brain activity. We examine an alternative operant conditioning model of closed-loop neuromodulation which, through implicit feedback, can manipulate spontaneous activity at the network level, without violating the spontaneous or endogenous nature of the signal, thereby providing a direct test of network causality.

The Influence of Frequency Bands and Brain Region on ECoG-Based BMI Learning Performance

Numerous brain–machine interface (BMI) studies have shown that various frequency bands (alpha, beta, and gamma bands) can be utilized in BMI experiments and modulated as neural information for machine control after several BMI learning trial sessions. In addition to frequency range as a neural feature, various areas of the brain, such as the motor cortex or parietal cortex, have been selected as BMI target brain regions. However, although the selection of target frequency and brain region appears to be crucial in obtaining optimal BMI performance, the direct comparison of BMI learning performance as it relates to various brain regions and frequency bands has not been examined in detail. In this study, ECoG-based BMI learning performances were compared using alpha, beta, and gamma bands, respectively, in a single rodent model. Brain area dependence of learning performance was also evaluated in the frontal cortex, the motor cortex, and the parietal cortex. The findings indicated that BMI learning performance was best in the case of the gamma frequency band and worst in the alpha band (one-way ANOVA, F = 4.41, p < 0.05). In brain area dependence experiments, better BMI learning performance appears to be shown in the primary motor cortex (one-way ANOVA, F = 4.36, p < 0.05). In the frontal cortex, two out of four animals failed to learn the feeding tube control even after a maximum of 10 sessions. In conclusion, the findings reported in this study suggest that the selection of target frequency and brain region should be carefully considered when planning BMI protocols and for performing optimized BMI.

Flexible, high-resolution thin-film electrodes for human and animal neural research

Objective.Brain functions such as perception, motor control, learning, and memory arise from the coordinated activity of neuronal assemblies distributed across multiple brain regions. While major progress has been made in understanding the function of individual neurons, circuit interactions remain poorly understood. A fundamental obstacle to deciphering circuit interactions is the limited availability of research tools to observe and manipulate the activity of large, distributed neuronal populations in humans. Here we describe the development, validation, and dissemination of flexible, high-resolution, thin-film (TF) electrodes for recording neural activity in animals and humans.Approach.We leveraged standard flexible printed-circuit manufacturing processes to build high-resolution TF electrode arrays. We used biocompatible materials to form the substrate (liquid crystal polymer; LCP), metals (Au, PtIr, and Pd), molding (medical-grade silicone), and 3D-printed housing (nylon). We designed a custom, miniaturized, digitizing headstage to reduce the number of cables required to connect to the acquisition system and reduce the distance between the electrodes and the amplifiers. A custom mechanical system enabled the electrodes and headstages to be pre-assembled prior to sterilization, minimizing the setup time required in the operating room. PtIr electrode coatings lowered impedance and enabled stimulation. High-volume, commercial manufacturing enables cost-effective production of LCP-TF electrodes in large quantities.Main Results. Our LCP-TF arrays achieve 25× higher electrode density, 20× higher channel count, and 11× reduced stiffness than conventional clinical electrodes. We validated our LCP-TF electrodes in multiple human intraoperative recording sessions and have disseminated this technology to >10 research groups. Using these arrays, we have observed high-frequency neural activity with sub-millimeter resolution.Significance.Our LCP-TF electrodes will advance human neuroscience research and improve clinical care by enabling broad access to transformative, high-resolution electrode arrays.

Brain-Computer Interfaces in Neurorecovery and Neurorehabilitation

Recent advances in brain-computer interface technology to restore and rehabilitate neurologic function aim to enable persons with disabling neurologic conditions to communicate, interact with the environment, and achieve other key activities of daily living and personal goals. Here we evaluate the principles, benefits, challenges, and future directions of brain-computer interfaces in the context of neurorehabilitation. We then explore the clinical translation of these technologies and propose an approach to facilitate implementation of brain-computer interfaces for persons with neurologic disease.

Representation Learning for Motor Imagery Recognition with Deep Neural Network

This study describes a method for classifying electrocorticograms (ECoGs) based on motor imagery (MI) on the brain–computer interface (BCI) system. This method is different from the traditional feature extraction and classification method. In this paper, the proposed method employs the deep learning algorithm for extracting features and the traditional algorithm for classification. Specifically, we mainly use the convolution neural network (CNN) to extract the features from the training data and then classify those features by combing with the gradient boosting (GB) algorithm. The comprehensive study with CNN and GB algorithms will profoundly help us to obtain more feature information from brain activities, enabling us to obtain the classification results from human body actions. The performance of the proposed framework has been evaluated on the dataset I of BCI Competition III. Furthermore, the combination of deep learning and traditional algorithms provides some ideas for future research with the BCI systems.

From Seizure Detection to Smart and Fully Embedded Seizure Prediction Engine: A Review

Recent review papers have investigated seizure prediction, creating the possibility of preempting epileptic seizures. Correct seizure prediction can significantly improve the standard of living for the majority of epileptic patients, as the unpredictability of seizures is a major concern for them. Today, the development of algorithms, particularly in the field of machine learning, enables reliable and accurate seizure prediction using desktop computers. However, despite extensive research effort being devoted to developing seizure detection integrated circuits (ICs), dedicated seizure prediction ICs have not been developed yet. We believe that interdisciplinary study of system architecture, analog and digital ICs, and machine learning algorithms can promote the translation of scientific theory to a more realistic intelligent, integrated, and low-power system that can truly improve the standard of living for epileptic patients. This review explores topics ranging from signal acquisition analog circuits to classification algorithms and dedicated digital signal processing circuits for detection and prediction purposes, to provide a comprehensive and useful guideline for the construction, implementation and optimization of wearable and integrated smart seizure prediction systems.

Adding wisdom to 'smart' bioelectronic systems: a design framework for physiologic control including practical examples

This perspective provides an overview of how risk can be effectively considered in physiological control loops that strive for semi-to-fully automated operation. The perspective first introduces the motivation, user needs and framework for the design of a physiological closed-loop controller. Then, we discuss specific risk areas and use examples from historical medical devices to illustrate the key concepts. Finally, we provide a design overview of an adaptive bidirectional brain–machine interface, currently undergoing human clinical studies, to synthesize the design principles in an exemplar application.

Long-term recording reliability of liquid crystal polymer µECoG arrays

OBJECTIVE

The clinical use of microsignals recorded over broad cortical regions is largely limited by the chronic reliability of the implanted interfaces.

APPROACH

We evaluated the chronic reliability of novel 61-channel micro-electrocorticographic (µECoG) arrays in rats chronically implanted for over one year and using accelerated aging. Devices were encapsulated with polyimide (PI) or liquid crystal polymer (LCP), and fabricated using commercial manufacturing processes. In vitro failure modes and predicted lifetimes were determined from accelerated soak testing. Successful designs were implanted epidurally over the rodent auditory cortex. Trends in baseline signal level, evoked responses and decoding performance were reported for over one year of implantation.

MAIN RESULTS

Devices fabricated with LCP consistently had longer in vitro lifetimes than PI encapsulation. Our accelerated aging results predicted device integrity beyond 3.4 years. Five implanted arrays showed stable performance over the entire implantation period (247-435 d). Our regression analysis showed that impedance predicted signal quality and information content only in the first 31 d of recordings and had little predictive value in the chronic phase (>31 d). In the chronic phase, site impedances slightly decreased yet decoding performance became statistically uncorrelated with impedance. We also employed an improved statistical model of spatial variation to measure sensitivity to locally varying fields, which is typically concealed in standard signal power calculations.

SIGNIFICANCE

These findings show that µECoG arrays can reliably perform in chronic applications in vivo for over one year, which facilitates the development of a high-density, clinically viable interface.

Dissociable functional activities of cortical theta and beta oscillations in the lateral prefrontal cortex during intertemporal choice

The lateral prefrontal cortex (LPFC) plays an important role in the neural networks involved in intertemporal choice. However, little is known about how the neural oscillation of LPFC functions during intertemporal choice, owing to the technical limitations of functional magnetic resonance imaging and event-related brain potential recordings. Electrocorticography (ECoG) is a novel neuroimaging technique that has high spatial and temporal resolution. In this study, we used ECoG and projected the ECoG data onto individual brain spaces to investigate human intracranial cortex activity and how neural oscillations of the LPFC impact intertemporal choice. We found that neural activity of theta oscillation was significantly higher during impulsive decisions, while beta oscillation activity was significantly higher during non-impulsive ones. Our findings suggest a functional dissociation between cortical theta and beta oscillations during decision-making processes involved in intertemporal choice, and that decision outcomes may be determined by LPFC modulation, which involves neural oscillations at different frequencies.

State-Dependent Decoding Algorithms Improve the Performance of a Bidirectional BMI in Anesthetized Rats

Brain-machine interfaces (BMIs) promise to improve the quality of life of patients suffering from sensory and motor disabilities by creating a direct communication channel between the brain and the external world. Yet, their performance is currently limited by the relatively small amount of information that can be decoded from neural activity recorded form the brain. We have recently proposed that such decoding performance may be improved when using state-dependent decoding algorithms that predict and discount the large component of the trial-to-trial variability of neural activity which is due to the dependence of neural responses on the network's current internal state. Here we tested this idea by using a bidirectional BMI to investigate the gain in performance arising from using a state-dependent decoding algorithm. This BMI, implemented in anesthetized rats, controlled the movement of a dynamical system using neural activity decoded from motor cortex and fed back to the brain the dynamical system's position by electrically microstimulating somatosensory cortex. We found that using state-dependent algorithms that tracked the dynamics of ongoing activity led to an increase in the amount of information extracted form neural activity by 22%, with a consequently increase in all of the indices measuring the BMI's performance in controlling the dynamical system. This suggests that state-dependent decoding algorithms may be used to enhance BMIs at moderate computational cost.

Current Challenges Facing the Translation of Brain Computer Interfaces from Preclinical Trials to Use in Human Patients

Current research in brain computer interface (BCI) technology is advancing beyond preclinical studies, with trials beginning in human patients. To date, these trials have been carried out with several different types of recording interfaces. The success of these devices has varied widely, but different factors such as the level of invasiveness, timescale of recorded information, and ability to maintain stable functionality of the device over a long period of time all must be considered in addition to accuracy in decoding intent when assessing the most practical type of device moving forward. Here, we discuss various approaches to BCIs, distinguishing between devices focusing on control of operations extrinsic to the subject (e.g., prosthetic limbs, computer cursors) and those focusing on control of operations intrinsic to the brain (e.g., using stimulation or external feedback), including closed-loop or adaptive devices. In this discussion, we consider the current challenges facing the translation of various types of BCI technology to eventual human application.

Brain-computer interfaces and disability: extending embodiment, reducing stigma?

Brain-Computer Interfaces (BCIs) now enable an individual without limb function to "move" a detached mechanical arm to perform simple actions, such as feeding herself. This technology may eventually offer almost everyone a way to move objects at a distance, by exercising cognitive control of a mechanical device. At that point, BCIs may be seen less as an assistive technology for disabled people, and more as a tool, like the internet, which can benefit all users. We will argue that BCIs will have a significant but uncertain impact on attitudes toward disabilities and on norms of bodily form and function. It may be liberating, oppressive, or both. Its impact, we argue, will depend - though not in any simple way - on whether BCIs come to be seen as parts of the body itself or as external tools.

The Evolution of Neuroprosthetic Interfaces

The ideal neuroprosthetic interface permits high-quality neural recording and stimulation of the nervous system while reliably providing clinical benefits over chronic periods. Although current technologies have made notable strides in this direction, significant improvements must be made to better achieve these design goals and satisfy clinical needs. This article provides an overview of the state of neuroprosthetic interfaces, starting with the design and placement of these interfaces before exploring the stimulation and recording platforms yielded from contemporary research. Finally, we outline emerging research trends in an effort to explore the potential next generation of neuroprosthetic interfaces.

Optimizing the Detection of Wakeful and Sleep-Like States for Future Electrocorticographic Brain Computer Interface Applications

Previous studies suggest stable and robust control of a brain-computer interface (BCI) can be achieved using electrocorticography (ECoG). Translation of this technology from the laboratory to the real world requires additional methods that allow users operate their ECoG-based BCI autonomously. In such an environment, users must be able to perform all tasks currently performed by the experimenter, including manually switching the BCI system on/off. Although a simple task, it can be challenging for target users (e.g., individuals with tetraplegia) due to severe motor disability. In this study, we present an automated and practical strategy to switch a BCI system on or off based on the cognitive state of the user. Using a logistic regression, we built probabilistic models that utilized sub-dural ECoG signals from humans to estimate in pseudo real-time whether a person is awake or in a sleep-like state, and subsequently, whether to turn a BCI system on or off. Furthermore, we constrained these models to identify the optimal anatomical and spectral parameters for delineating states. Other methods exist to differentiate wake and sleep states using ECoG, but none account for practical requirements of BCI application, such as minimizing the size of an ECoG implant and predicting states in real time. Our results demonstrate that, across 4 individuals, wakeful and sleep-like states can be classified with over 80% accuracy (up to 92%) in pseudo real-time using high gamma (70-110 Hz) band limited power from only 5 electrodes (platinum discs with a diameter of 2.3 mm) located above the precentral and posterior superior temporal gyrus.

A Randomized Controlled Trial of EEG-Based Motor Imagery Brain-Computer Interface Robotic Rehabilitation for Stroke

Electroencephalography (EEG)-based motor imagery (MI) brain-computer interface (BCI) technology has the potential to restore motor function by inducing activity-dependent brain plasticity. The purpose of this study was to investigate the efficacy of an EEG-based MI BCI system coupled with MIT-Manus shoulder-elbow robotic feedback (BCI-Manus) for subjects with chronic stroke with upper-limb hemiparesis. In this single-blind, randomized trial, 26 hemiplegic subjects (Fugl-Meyer Assessment of Motor Recovery After Stroke [FMMA] score, 4-40; 16 men; mean age, 51.4 years; mean stroke duration, 297.4 days), prescreened with the ability to use the MI BCI, were randomly allocated to BCI-Manus or Manus therapy, lasting 18 hours over 4 weeks. Efficacy was measured using upper-extremity FMMA scores at weeks 0, 2, 4 and 12. ElEG data from subjects allocated to BCI-Manus were quantified using the revised brain symmetry index (rBSI) and analyzed for correlation with the improvements in FMMA score. Eleven and 15 subjects underwent BCI-Manus and Manus therapy, respectively. One subject in the Manus group dropped out. Mean total FMMA scores at weeks 0, 2, 4, and 12 weeks improved for both groups: 26.3±10.3, 27.4±12.0, 30.8±13.8, and 31.5±13.5 for BCI-Manus and 26.6±18.9, 29.9±20.6, 32.9±21.4, and 33.9±20.2 for Manus, with no intergroup differences (P=.51). More subjects attained further gains in FMMA scores at week 12 from BCI-Manus (7 of 11 [63.6%]) than Manus (5 of 14 [35.7%]). A negative correlation was found between the rBSI and FMMA score improvement (P=.044). BCI-Manus therapy was well tolerated and not associated with adverse events. In conclusion, BCI-Manus therapy is effective and safe for arm rehabilitation after severe poststroke hemiparesis. Motor gains were comparable to those attained with intensive robotic therapy (1,040 repetitions/session) despite reduced arm exercise repetitions using EEG-based MI-triggered robotic feedback (136 repetitions/session). The correlation of rBSI with motor improvements suggests that the rBSI can be used as a prognostic measure for BCI-based stroke rehabilitation.

Learned self-regulation of the lesioned brain with epidural electrocorticography

Introduction: Different techniques for neurofeedback of voluntary brain activations are currently being explored for clinical application in brain disorders. One of the most frequently used approaches is the self-regulation of oscillatory signals recorded with electroencephalography (EEG). Many patients are, however, unable to achieve sufficient voluntary control of brain activity. This could be due to the specific anatomical and physiological changes of the patient’s brain after the lesion, as well as to methodological issues related to the technique chosen for recording brain signals.

Methods: A patient with an extended ischemic lesion of the cortex did not gain volitional control of sensorimotor oscillations when using a standard EEG-based approach. We provided him with neurofeedback of his brain activity from the epidural space by electrocorticography (ECoG).

Results: Ipsilesional epidural recordings of field potentials facilitated self-regulation of brain oscillations in an online closed-loop paradigm and allowed reliable neurofeedback training for a period of 4 weeks.

Conclusion: Epidural implants may decode and train brain activity even when the cortical physiology is distorted following severe brain injury. Such practice would allow for reinforcement learning of preserved neural networks and may well provide restorative tools for those patients who are severely afflicted.

Brain-Machine Interfaces for Motor Control: A Guide for Neuroscience Clinicians

With the growing interdependence between medicine and technology, the prospect of connecting machines to the human brain is rapidly being realized. The field of neuroprosthetics is transitioning from the proof of concept stage to the development of advanced clinical treatments. In one area of brain-machine interfaces (BMIs) related to the motor system, also termed ‘motor neuroprosthetics’, research successes with implanted microelectrodes in animals have demonstrated immense potential for restoring motor deficits. Early human trials have also begun, with some success but also highlighting several technical challenges. Here we review the concepts and anatomy underlying motor BMI designs, review their early use in clinical applications, and offer a framework to evaluate these technologies in order to predict their eventual clinical utility. Ultimately, we hope to help neuroscience clinicians understand and participate in this burgeoning field.

Grasping with the Press of a Button: Grasp-selective Responses in the Human Anterior Intraparietal Sulcus Depend on Nonarbitrary Causal Relationships between Hand Movements and End-effector Actions

Evidence implicates ventral parieto-premotor cortices in representing the goal of grasping independent of the movements or effectors involved [Umilta, M. A., Escola, L., Intskirveli, I., Grammont, F., Rochat, M., Caruana, F., et al. When pliers become fingers in the monkey motor system. Proceedings of the National Academy of Sciences, U.S.A., 105, 2209-2213, 2008; Tunik, E., Frey, S. H., & Grafton, S. T. Virtual lesions of the anterior intraparietal area disrupt goal-dependent on-line adjustments of grasp. Nature Neuroscience, 8, 505-511, 2005]. Modern technologies that enable arbitrary causal relationships between hand movements and tool actions provide a strong test of this hypothesis. We capitalized on this unique opportunity by recording activity with fMRI during tasks in which healthy adults performed goal-directed reach and grasp actions manually or by depressing buttons to initiate these same behaviors in a remotely located robotic arm (arbitrary causal relationship). As shown previously [Binkofski, F., Dohle, C., Posse, S., Stephan, K. M., Hefter, H., Seitz, R. J., et al. Human anterior intraparietal area subserves prehension: A combined lesion and functional MRI activation study. Neurology, 50, 1253-1259, 1998], we detected greater activity in the vicinity of the anterior intraparietal sulcus (aIPS) during manual grasp versus reach. In contrast to prior studies involving tools controlled by nonarbitrarily related hand movements [Gallivan, J. P., McLean, D. A., Valyear, K. F., & Culham, J. C. Decoding the neural mechanisms of human tool use. Elife, 2, e00425, 2013; Jacobs, S., Danielmeier, C., & Frey, S. H. Human anterior intraparietal and ventral premotor cortices support representations of grasping with the hand or a novel tool. Journal of Cognitive Neuroscience, 22, 2594-2608, 2010], however, responses within the aIPS and premotor cortex exhibited no evidence of selectivity for grasp when participants employed the robot. Instead, these regions showed comparable increases in activity during both the reach and grasp conditions. Despite equivalent sensorimotor demands, the right cerebellar hemisphere displayed greater activity when participants initiated the robot's actions versus when they pressed a button known to be nonfunctional and watched the very same actions undertaken autonomously. This supports the hypothesis that the cerebellum predicts the forthcoming sensory consequences of volitional actions [Blakemore, S. J., Frith, C. D., & Wolpert, D. M. The cerebellum is involved in predicting the sensory consequences of action. NeuroReport, 12, 1879-1884, 2001]. We conclude that grasp-selective responses in the human aIPS and premotor cortex depend on the existence of nonarbitrary causal relationships between hand movements and end-effector actions.

Brain-machine interface for eye movements

A number of studies in tetraplegic humans and healthy nonhuman primates (NHPs) have shown that neuronal activity from reach-related cortical areas can be used to predict reach intentions using brain-machine interfaces (BMIs) and therefore assist tetraplegic patients by controlling external devices (e.g., robotic limbs and computer cursors). However, to our knowledge, there have been no studies that have applied BMIs to eye movement areas to decode intended eye movements. In this study, we recorded the activity from populations of neurons from the lateral intraparietal area (LIP), a cortical node in the NHP saccade system. Eye movement plans were predicted in real time using Bayesian inference from small ensembles of LIP neurons without the animal making an eye movement. Learning, defined as an increase in the prediction accuracy, occurred at the level of neuronal ensembles, particularly for difficult predictions. Population learning had two components: an update of the parameters of the BMI based on its history and a change in the responses of individual neurons. These results provide strong evidence that the responses of neuronal ensembles can be shaped with respect to a cost function, here the prediction accuracy of the BMI. Furthermore, eye movement plans could be decoded without the animals emitting any actual eye movements and could be used to control the position of a cursor on a computer screen. These findings show that BMIs for eye movements are promising aids for assisting paralyzed patients.

Epidural electrocorticography of phantom hand movement following long-term upper-limb amputation

INTRODUCTION

Prostheses for upper-limb amputees are currently controlled by either myoelectric or peripheral neural signals. Performance and dexterity of these devices is still limited, particularly when it comes to controlling hand function. Movement-related brain activity might serve as a complementary bio-signal for motor control of hand prosthesis.

METHODS

We introduced a methodology to implant a cortical interface without direct exposure of the brain surface in an upper-limb amputee. This bi-directional interface enabled us to explore the cortical physiology following long-term transhumeral amputation. In addition, we investigated neurofeedback of electrocorticographic brain activity related to the patient's motor imagery to open his missing hand, i.e., phantom hand movement, for real-time control of a virtual hand prosthesis.

RESULTS

Both event-related brain activity and cortical stimulation revealed mutually overlapping cortical representations of the phantom hand. Phantom hand movements could be robustly classified and the patient required only three training sessions to gain reliable control of the virtual hand prosthesis in an online closed-loop paradigm that discriminated between hand opening and rest.

CONCLUSION

Epidural implants may constitute a powerful and safe alternative communication pathway between the brain and external devices for upper-limb amputees, thereby facilitating the integrated use of different signal sources for more intuitive and specific control of multi-functional devices in clinical use.

Assessing attention and cognitive function in completely locked-in state with event-related brain potentials and epidural electrocorticography

OBJECTIVE

Patients in the completely locked-in state (CLIS), due to, for example, amyotrophic lateral sclerosis (ALS), no longer possess voluntary muscle control. Assessing attention and cognitive function in these patients during the course of the disease is a challenging but essential task for both nursing staff and physicians.

APPROACH

An electrophysiological cognition test battery, including auditory and semantic stimuli, was applied in a late-stage ALS patient at four different time points during a six-month epidural electrocorticography (ECoG) recording period. Event-related cortical potentials (ERP), together with changes in the ECoG signal spectrum, were recorded via 128 channels that partially covered the left frontal, temporal and parietal cortex.

MAIN RESULTS

Auditory but not semantic stimuli induced significant and reproducible ERP projecting to specific temporal and parietal cortical areas. N1/P2 responses could be detected throughout the whole study period. The highest P3 ERP was measured immediately after the patient's last communication through voluntary muscle control, which was paralleled by low theta and high gamma spectral power. Three months after the patient's last communication, i.e., in the CLIS, P3 responses could no longer be detected. At the same time, increased activity in low-frequency bands and a sharp drop of gamma spectral power were recorded.

SIGNIFICANCE

Cortical electrophysiological measures indicate at least partially intact attention and cognitive function during sparse volitional motor control for communication. Although the P3 ERP and frequency-specific changes in the ECoG spectrum may serve as indicators for CLIS, a close-meshed monitoring will be required to define the exact time point of the transition.

Seizures in low-grade gliomas: natural history, pathogenesis, and outcome after treatments

Seizures represent a common symptom in low-grade gliomas; when uncontrolled, they significantly contribute to patient morbidity and negatively impact quality of life. Tumor location and histology influence the risk for epilepsy. The pathogenesis of tumor-related epilepsy is multifactorial and may differ among tumor histologies (glioneuronal tumors vs diffuse grade II gliomas). Gross total resection is the strongest predictor of seizure freedom in addition to clinical factors, such as preoperative seizure duration, type, and control with antiepileptic drugs (AEDs). Epilepsy surgery may improve seizure control. Radiotherapy and chemotherapy with alkylating agents (procarbazine + CCNU+ vincristine, temozolomide) are effective in reducing the frequency of seizures in patients with pharmacoresistant epilepsy. Newer AEDs (levetiracetam, topiramate, lacosamide) seem to be better tolerated than the old AEDs (phenobarbital, phenytoin, carbamazepine), but there is lack of evidence regarding their superiority in terms of efficacy.

Neurosurgery and the dawning age of Brain-Machine Interfaces

Brain–machine interfaces (BMIs) are on the horizon for clinical neurosurgery. Electrocorticography-based platforms are less invasive than implanted microelectrodes, however, the latter are unmatched in their ability to achieve fine motor control of a robotic prosthesis capable of natural human behaviors. These technologies will be crucial to restoring neural function to a large population of patients with severe neurologic impairment – including those with spinal cord injury, stroke, limb amputation, and disabling neuromuscular disorders such as amyotrophic lateral sclerosis. On the opposite end of the spectrum are neural enhancement technologies for specialized applications such as combat. An ongoing ethical dialogue is imminent as we prepare for BMI platforms to enter the neurosurgical realm of clinical management.

Design of optimal stimulation patterns for neuronal ensembles based on Volterra-type hierarchical modeling

This paper presents a general methodology for the optimal design of stimulation patterns applied to neuronal ensembles in order to elicit a desired effect. The methodology follows a variant of the hierarchical Volterra modeling approach that utilizes input-output data to construct predictive models that describe the effects of interactions among multiple input events in an ascending order of interaction complexity. The illustrative example presented in this paper concerns the multi-unit activity of CA1 neurons in the hippocampus of a rodent performing a learned delayed-nonmatch-to-sample (DNMS) task. The multi-unit activity of the hippocampal CA1 neurons is recorded via chronically implanted multi-electrode arrays during this task. The obtained model quantifies the likelihood of having correct performance of the specific task for a given multi-unit (spatiotemporal) activity pattern of a CA1 neuronal ensemble during the 'sample presentation' phase of the DNMS task. The model can be used to determine computationally (off-line) the 'optimal' multi-unit stimulation pattern that maximizes the likelihood of inducing the correct performance of the DNMS task. Our working hypothesis is that application of this optimal stimulation pattern will enhance performance of the DNMS task due to enhancement of memory formation and storage during the 'sample presentation' phase of the task.

Navigation of a telepresence robot via covert visuospatial attention and real-time fMRI

Brain-computer interfaces (BCIs) allow people with severe neurological impairment and without ability to control their muscles to regain some control over their environment. The BCI user performs a mental task to regulate brain activity, which is measured and translated into commands controlling some external device. We here show that healthy participants are capable of navigating a robot by covertly shifting their visuospatial attention. Covert Visuospatial Attention (COVISA) constitutes a very intuitive brain function for spatial navigation and does not depend on presented stimuli or on eye movements. Our robot is equipped with motors and a camera that sends visual feedback to the user who can navigate it from a remote location. We used an ultrahigh field MRI scanner (7 Tesla) to obtain fMRI signals that were decoded in real time using a support vector machine. Four healthy subjects with virtually no training succeeded in navigating the robot to at least three of four target locations. Our results thus show that with COVISA BCI, realtime robot navigation can be achieved. Since the magnitude of the fMRI signal has been shown to correlate well with the magnitude of spectral power changes in the gamma frequency band in signals measured by intracranial electrodes, the COVISA concept may in future translate to intracranial application in severely paralyzed people.

The use of P300-based BCIs in amyotrophic lateral sclerosis: from augmentative and alternative communication to cognitive assessment

The use of augmentative and alternative communication (AAC) tools in patients with amyotrophic lateral sclerosis (ALS), as effective means to compensate for the progressive loss of verbal and gestural communication, has been deeply investigated in the recent literature. The development of advanced AAC systems, such as eye-tracking (ET) and brain-computer interface (BCI) devices, allowed to bypass the important motor difficulties present in ALS patients. In particular, BCIs could be used in moderate to severe stages of the disease, since they do not require preserved ocular-motor ability, which is necessary for ET applications. Furthermore, some studies have proved the reliability of BCIs, regardless of the severity of the disease and the level of physical decline. However, the use of BCI in ALS patients still shows some limitations, related to both technical and neuropsychological issues. In particular, a range of cognitive deficits in most ALS patients have been observed. At the moment, no effective verbal-motor free measures are available for the evaluation of ALS patients' cognitive integrity; BCIs could offer a new possibility to administer cognitive tasks without the need of verbal or motor responses, as highlighted by preliminary studies in this field. In this review, we outline the essential features of BCIs systems, considering advantages and challenges of these tools with regard to ALS patients and the main applications developed in this field. We then outline the main findings with regard to cognitive deficits observed in ALS and some preliminary attempts to evaluate them by means of BCIs. The definition of specific cognitive profiles could help to draw flexible approaches tailored on patients' needs. It could improve BCIs efficacy and reduce patients' efforts. Finally, we handle the open question, represented by the use of BCIs with totally locked in patients, who seem unable to reliably learn to use such tool.

An EEG-based study of discrete isometric and isotonic human lower limb muscle contractions

Background

Electroencephalography (EEG) combined with independent component analysis enables functional neuroimaging in dynamic environments including during human locomotion. This type of functional neuroimaging could be a powerful tool for neurological rehabilitation. It could enable clinicians to monitor changes in motor control related cortical dynamics associated with a therapeutic intervention, and it could facilitate noninvasive electrocortical control of devices for assisting limb movement to stimulate activity dependent plasticity. Understanding the relationship between electrocortical dynamics and muscle activity will be helpful for incorporating EEG-based functional neuroimaging into clinical practice. The goal of this study was to use independent component analysis of high-density EEG to test whether we could relate electrocortical dynamics to lower limb muscle activation in a constrained motor task. A secondary goal was to assess the trial-by-trial consistency of the electrocortical dynamics by decoding the type of muscle action.

Methods

We recorded 264-channel EEG while 8 neurologically intact subjects performed isometric and isotonic, knee and ankle exercises at two different effort levels. Adaptive mixture independent component analysis (AMICA) parsed EEG into models of underlying source signals. We generated spectrograms for all electrocortical source signals and used a naïve Bayesian classifier to decode exercise type from trial-by-trial time-frequency data.

Results

AMICA captured different electrocortical source distributions for ankle and knee tasks. The fit of single-trial EEG to these models distinguished knee from ankle tasks with 80% accuracy. Electrocortical spectral modulations in the supplementary motor area were significantly different for isometric and isotonic tasks (p < 0.05). Isometric contractions elicited an event related desynchronization (ERD) in the α-band (8–12 Hz) and β-band (12–30 Hz) at joint torque onset and offset. Isotonic contractions elicited a sustained α- and β-band ERD throughout the trial. Classifiers based on supplementary motor area sources achieved a 4-way classification accuracy of 69% while classifiers based on electrocortical sources in multiple brain regions achieved a 4-way classification accuracy of 87%.

Conclusions

Independent component analysis of EEG reveals unique spatial and spectro-temporal electrocortical properties for different lower limb motor tasks. Using a broad distribution of electrocortical signals may improve classification of human lower limb movements from single-trial EEG.

On the decoding of intracranial data using sparse orthonormalized partial least squares

It has recently been shown that robust decoding of motor output from electrocorticogram signals in monkeys over prolonged periods of time has become feasible (Chao et al 2010 Front. Neuroeng. 3 1-10). In order to achieve these results, multivariate partial least-squares (PLS) regression was used. PLS uses a set of latent variables, referred to as components, to model the relationship between the input and the output data and is known to handle high-dimensional and possibly strongly correlated inputs and outputs well. We developed a new decoding method called sparse orthonormalized partial least squares (SOPLS) which was tested on a subset of the data used in Chao et al (2010) (freely obtainable from neurotycho.org (Nagasaka et al 2011 PLoS ONE 6 e22561)). We show that SOPLS reaches the same decoding performance as PLS using just two sparse components which can each be interpreted as encoding particular combinations of motor parameters. Furthermore, the sparse solution afforded by the SOPLS model allowed us to show the functional involvement of beta and gamma band responses in premotor and motor cortex for predicting the first component. Based on the literature, we conjecture that this first component is involved in the encoding of movement direction. Hence, the sparse and compact representation afforded by the SOPLS model facilitates interpretation of which spectral, spatial and temporal components are involved in successful decoding. These advantages make the proposed decoding method an important new tool in neuroprosthetics.

Brain-computer interfaces in medicine

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.

Theories and control models and motor learning: clinical applications in neuro-rehabilitation

INTRODUCTION

In recent decades there has been a special interest in theories that could explain the regulation of motor control, and their applications. These theories are often based on models of brain function, philosophically reflecting different criteria on how movement is controlled by the brain, each being emphasised in different neural components of the movement. The concept of motor learning, regarded as the set of internal processes associated with practice and experience that produce relatively permanent changes in the ability to produce motor activities through a specific skill, is also relevant in the context of neuroscience. Thus, both motor control and learning are seen as key fields of study for health professionals in the field of neuro-rehabilitation.

DEVELOPMENT

The major theories of motor control are described, which include, motor programming theory, systems theory, the theory of dynamic action, and the theory of parallel distributed processing, as well as the factors that influence motor learning and its applications in neuro-rehabilitation.

CONCLUSIONS

At present there is no consensus on which theory or model defines the regulations to explain motor control. Theories of motor learning should be the basis for motor rehabilitation. The new research should apply the knowledge generated in the fields of control and motor learning in neuro-rehabilitation.

Sensing with the motor cortex

The primary motor cortex is a critical node in the network of brain regions responsible for voluntary motor behavior. It has been less appreciated, however, that the motor cortex exhibits sensory responses in a variety of modalities including vision and somatosensation. We review current work that emphasizes the heterogeneity in sensorimotor responses in the motor cortex and focus on its implications for cortical control of movement as well as for brain-machine interface development.

Decoding motor signals from the pediatric cortex: implications for brain-computer interfaces in children

OBJECTIVE

To demonstrate the decodable nature of pediatric brain signals for the purpose of neuroprosthetic control. We hypothesized that children would achieve levels of brain-derived computer control comparable to performance previously reported for adults.

PATIENTS AND METHODS

Six pediatric patients with intractable epilepsy who were invasively monitored underwent screening for electrocortical control signals associated with specific motor or phoneme articulation tasks. Subsequently, patients received visual feedback as they used these associated electrocortical signals to direct one dimensional cursor movement to a target on a screen.

RESULTS

All patients achieved accuracies between 70% and 99% within 9 minutes of training using the same screened motor and articulation tasks. Two subjects went on to achieve maximum accuracies of 73% and 100% using imagined actions alone. Average mean and maximum performance for the 6 pediatric patients was comparable to that of 5 adults. The mean accuracy of the pediatric group was 81% (95% confidence interval [CI]: 71.5-90.5) over a mean training time of 11.6 minutes, whereas the adult group had a mean accuracy of 72% (95% CI: 61.2-84.3) over a mean training time of 12.5 minutes. Maximum performance was also similar between the pediatric and adult groups (89.6% [95% CI: 83-96.3] and 88.5% [95% CI: 77.1-99.8], respectively).

CONCLUSIONS

Similarly to adult brain signals, pediatric brain signals can be decoded and used for BCI operation. Therefore, BCI systems developed for adults likely hold similar promise for children with motor disabilities.

A cortical neural prosthesis for restoring and enhancing memory

A primary objective in developing a neural prosthesis is to replace neural circuitry in the brain that no longer functions appropriately. Such a goal requires artificial reconstruction of neuron-to-neuron connections in a way that can be recognized by the remaining normal circuitry, and that promotes appropriate interaction. In this study, the application of a specially designed neural prosthesis using a multi-input/multi-output (MIMO) nonlinear model is demonstrated by using trains of electrical stimulation pulses to substitute for MIMO model derived ensemble firing patterns. Ensembles of CA3 and CA1 hippocampal neurons, recorded from rats performing a delayed-nonmatch-to-sample (DNMS) memory task, exhibited successful encoding of trial-specific sample lever information in the form of different spatiotemporal firing patterns. MIMO patterns, identified online and in real-time, were employed within a closed-loop behavioral paradigm. Results showed that the model was able to predict successful performance on the same trial. Also, MIMO model-derived patterns, delivered as electrical stimulation to the same electrodes, improved performance under normal testing conditions and, more importantly, were capable of recovering performance when delivered to animals with ensemble hippocampal activity compromised by pharmacologic blockade of synaptic transmission. These integrated experimental-modeling studies show for the first time that, with sufficient information about the neural coding of memories, a neural prosthesis capable of real-time diagnosis and manipulation of the encoding process can restore and even enhance cognitive, mnemonic processes.

Brain-computer interface based on generation of visual images

This paper examines the task of recognizing EEG patterns that correspond to performing three mental tasks: relaxation and imagining of two types of pictures: faces and houses. The experiments were performed using two EEG headsets: BrainProducts ActiCap and Emotiv EPOC. The Emotiv headset becomes widely used in consumer BCI application allowing for conducting large-scale EEG experiments in the future. Since classification accuracy significantly exceeded the level of random classification during the first three days of the experiment with EPOC headset, a control experiment was performed on the fourth day using ActiCap. The control experiment has shown that utilization of high-quality research equipment can enhance classification accuracy (up to 68% in some subjects) and that the accuracy is independent of the presence of EEG artifacts related to blinking and eye movement. This study also shows that computationally-inexpensive bayesian classifier based on covariance matrix analysis yields similar classification accuracy in this problem as a more sophisticated Multi-class Common Spatial Patterns (MCSP) classifier.

Closing the loop in cortically-coupled computer vision: a brain-computer interface for searching image databases

We describe a closed-loop brain-computer interface that re-ranks an image database by iterating between user generated 'interest' scores and computer vision generated visual similarity measures. The interest scores are based on decoding the electroencephalographic (EEG) correlates of target detection, attentional shifts and self-monitoring processes, which result from the user paying attention to target images interspersed in rapid serial visual presentation (RSVP) sequences. The highest scored images are passed to a semi-supervised computer vision system that reorganizes the image database accordingly, using a graph-based representation that captures visual similarity between images. The system can either query the user for more information, by adaptively resampling the database to create additional RSVP sequences, or it can converge to a 'done' state. The done state includes a final ranking of the image database and also a 'guess' of the user's chosen category of interest. We find that the closed-loop system's re-rankings can substantially expedite database searches for target image categories chosen by the subjects. Furthermore, better reorganizations are achieved than by relying on EEG interest rankings alone, or if the system were simply run in an open loop format without adaptive resampling.

Using the electrocorticographic speech network to control a brain-computer interface in humans

Electrocorticography (ECoG) has emerged as a new signal platform for brain-computer interface (BCI) systems. Classically, the cortical physiology that has been commonly investigated and utilized for device control in humans has been brain signals from the sensorimotor cortex. Hence, it was unknown whether other neurophysiological substrates, such as the speech network, could be used to further improve on or complement existing motor-based control paradigms. We demonstrate here for the first time that ECoG signals associated with different overt and imagined phoneme articulation can enable invasively monitored human patients to control a one-dimensional computer cursor rapidly and accurately. This phonetic content was distinguishable within higher gamma frequency oscillations and enabled users to achieve final target accuracies between 68% and 91% within 15 min. Additionally, one of the patients achieved robust control using recordings from a microarray consisting of 1 mm spaced microwires. These findings suggest that the cortical network associated with speech could provide an additional cognitive and physiologic substrate for BCI operation and that these signals can be acquired from a cortical array that is small and minimally invasive.

Challenges and opportunities for next-generation intracortically based neural prostheses

Neural prosthetic systems aim to help disabled patients by translating neural signals from the brain into control signals for guiding computer cursors, prosthetic arms, and other assistive devices. Intracortical electrode arrays measure action potentials and local field potentials from individual neurons, or small populations of neurons, in the motor cortices and can provide considerable information for controlling prostheses. Despite several compelling proof-of-concept laboratory animal experiments and an initial human clinical trial, at least three key challenges remain which, if left unaddressed, may hamper the translation of these systems into widespread clinical use. We review these challenges: achieving able-bodied levels of performance across tasks and across environments, achieving robustness across multiple decades, and restoring able-bodied quality proprioception and somatosensation. We also describe some emerging opportunities for meeting these challenges. If these challenges can be largely or fully met, intracortically based neural prostheses may achieve true clinical viability and help increasing numbers of disabled patients.