Clinical Applications and Future Translation of Somatosensory Neuroprostheses.

Somatosensory neuroprostheses restore, replace, or enhance tactile and proprioceptive feedback for people with sensory impairments due to neurological disorders or injury. Somatosensory neuroprostheses typically couple sensor inputs from a wearable device, prosthesis, robotic device, or virtual reality system with electrical stimulation applied to the somatosensory nervous system via noninvasive or implanted interfaces. While prior research has mainly focused on technology development and proof-of-concept studies, recent acceleration of clinical studies in this area demonstrates the translational potential of somatosensory neuroprosthetic systems. In this review, we provide an overview of neurostimulation approaches currently undergoing human testing and summarize recent clinical findings on the perceptual, functional, and psychological impact of somatosensory neuroprostheses. We also cover current work toward the development of advanced stimulation paradigms to produce more natural and informative sensory feedback. Finally, we provide our perspective on the remaining challenges that need to be addressed prior to translation of somatosensory neuroprostheses.

Neurofeedback and epilepsy: Renaissance of an old self-regulation method?

Neurofeedback is a brain-computer interface tool enabling the user to self-regulate their neuronal activity, and ultimately, induce long-term brain plasticity, making it an interesting instrument to cure brain disorders. Although this method has been used successfully in the past as an adjunctive therapy in drug-resistant epilepsy, this approach remains under-explored and deserves more rigorous scientific inquiry. In this review, we present early neurofeedback protocols employed in epilepsy and provide a critical overview of the main clinical studies. We also describe the potential neurophysiological mechanisms through which neurofeedback may produce its therapeutic effects. Finally, we discuss how to innovate and standardize future neurofeedback clinical trials in epilepsy based on evidence from recent research studies.

[An emerging discipline: brain-computer interfaces medicine].

With the development of brain-computer interface (BCI) technology and its translational application in clinical medicine, BCI medicine has emerged, ushering in profound changes to the practice of medicine, while also bringing forth a series of ethical issues related to BCI medicine. BCI medicine is progressively emerging as a new disciplinary focus, yet to date, there has been limited literature discussing it. Therefore, this paper focuses on BCI medicine, firstly providing an overview of the main potential medical applications of BCI technology. It then defines the discipline, outlines its objectives, methodologies, potential efficacy, and associated translational medical research. Additionally, it discusses the ethics associated with BCI medicine, and introduces the standardized operational procedures for BCI medical applications and the methods for evaluating the efficacy of BCI medical applications. Finally, it anticipates the challenges and future directions of BCI medicine. In the future, BCI medicine may become a new academic discipline or major in higher education. In summary, this article is hoped to provide thoughts and references for the development of the discipline of BCI medicine.

Thought-based interaction: Same data, same methods, different results?

Restoration of communication in people with complete motor paralysis-a condition called complete locked-in state (CLIS)-is one of the greatest challenges of brain-computer interface (BCI) research. New findings have recently been presented that bring us one step closer to this goal. However, the validity of the evidence has been questioned: independent reanalysis of the same data yielded significantly different results. Reasons for the failure to replicate the findings must be of a methodological nature. What is the best practice to ensure that results are stringent and conclusive and analyses replicable? Confirmation bias and the counterintuitive nature of probability may lead to an overly optimistic interpretation of new evidence. Lack of detail complicates replicability.

Brain-computer interfaces for amyotrophic lateral sclerosis.

A brain-computer interface (BCI) is a device that detects signals from the brain and transforms them into useful commands. Researchers have developed BCIs that utilize different kinds of brain signals. These different BCI systems have differing characteristics, such as the amount of training required and the degree to which they are or are not invasive. Much of the research on BCIs to date has involved healthy individuals and evaluation of classification algorithms. Some BCIs have been shown to have potential benefit for users with minimal muscular function as a result of amyotrophic lateral sclerosis. However, there are still several challenges that need to be successfully addressed before BCIs can be clinically useful.

The future of upper extremity rehabilitation robotics: research and practice.

The loss of upper limb motor function can have a devastating effect on people's lives. To restore upper limb control and functionality, researchers and clinicians have developed interfaces to interact directly with the human body's motor system. In this invited review, we aim to provide details on the peripheral nerve interfaces and brain-machine interfaces that have been developed in the past 30 years for upper extremity control, and we highlight the challenges that still remain to transition the technology into the clinical market. The findings show that peripheral nerve interfaces and brain-machine interfaces have many similar characteristics that enable them to be concurrently developed. Decoding neural information from both interfaces may lead to novel physiological models that may one day fully restore upper limb motor function for a growing patient population.

Cognitive Enhancement and Brain-Computer Interfaces: Potential Boundaries and Risks.

Electroencephalography (EEG) systems and brain-computer interfaces (BCIs) are terms frequently involved in the field of neurological research. Under a technological point of view, BCI is considered to be a significant achievement within the frame of learning disabilities rehabilitation. Nevertheless, the specifications for efficient use for cognitive enhancement and its potential boundaries are under concern. Author's main objective is to discuss BCI concrete components and potential advances as well as depict potential limitations while using technological devices within the frame of the learning procedure. Within this context, requirements, advantages, possible addiction risks, and boundaries regarding the specifications for brain-computer interfaces and technology in order to serve long-term research and developmental learning goals are discussed.

Latent Factors and Dynamics in Motor Cortex and Their Application to Brain-Machine Interfaces.

In the 1960s, Evarts first recorded the activity of single neurons in motor cortex of behaving monkeys (Evarts, 1968). In the 50 years since, great effort has been devoted to understanding how single neuron activity relates to movement. Yet these single neurons exist within a vast network, the nature of which has been largely inaccessible. With advances in recording technologies, algorithms, and computational power, the ability to study these networks is increasing exponentially. Recent experimental results suggest that the dynamical properties of these networks are critical to movement planning and execution. Here we discuss this dynamical systems perspective and how it is reshaping our understanding of the motor cortices. Following an overview of key studies in motor cortex, we discuss techniques to uncover the "latent factors" underlying observed neural population activity. Finally, we discuss efforts to use these factors to improve the performance of brain-machine interfaces, promising to make these findings broadly relevant to neuroengineering as well as systems neuroscience.

Invasive Brain Machine Interface System.

Because of high spatial-temporal resolution of neural signals obtained by invasive recording, the invasive brain-machine interfaces (BMI) have achieved great progress in the past two decades. With success in animal research, BMI technology is transferring to clinical trials for helping paralyzed people to restore their lost motor functions. This chapter gives a brief review of BMI development from animal experiments to human clinical studies in the following aspects: (1) BMIs based on rodent animals; (2) BMI based on non-human primates; and (3) pilot BMIs studies in clinical trials. In the end, the chapter concludes with a summary of potential opportunities and future challenges in BMI technology.

Future of Neural Interfaces.

The technological ability to capture electrophysiological activity of populations of cortical neurons through chronic implantable devices has led to significant advancements in the field of brain-computer interfaces. Recent progress in the field has been driven by developments in integrated microelectronics, wireless communications, materials science, and computational neuroscience. Here, we review major device development landmarks in the arena of neural interfaces from FDA-approved clinical systems to prototype head-mounted and fully implantable wireless systems for multi-channel neural recording. Additionally, we provide an outlook toward next-generation, highly miniaturized technologies for minimally invasive, vastly parallel neural interfaces for naturalistic, closed-loop neuroprostheses.

An Experiential Learning-Based Approach to Neurofeedback Visualisation in Serious Games.

This study explores brain-computer interfacing, its possible use in serious or educational games and frameworks. Providing real-time feedback regarding cognitive states and behaviours can be a powerful tool for mental health education and games can offer unique and engaging environments for these neurofeedback experiences. We explore how EEG neurofeedback systems can be affordably created for further research and experimentation and suggest design choices that may assist in developing effective experiences of this nature.

Ethical aspects of brain computer interfaces: a scoping review.

BACKGROUND: Brain-Computer Interface (BCI) is a set of technologies that are of increasing interest to researchers. BCI has been proposed as assistive technology for individuals who are non-communicative or paralyzed, such as those with amyotrophic lateral sclerosis or spinal cord injury. The technology has also been suggested for enhancement and entertainment uses, and there are companies currently marketing BCI devices for those purposes (e.g., gaming) as well as health-related purposes (e.g., communication). The unprecedented direct connection created by BCI between human brains and computer hardware raises various ethical, social, and legal challenges that merit further examination and discussion. METHODS: To identify and characterize the key issues associated with BCI use, we performed a scoping review of biomedical ethics literature, analyzing the ethics concerns cited across multiple disciplines, including philosophy and medicine. RESULTS: Based on this investigation, we report that BCI research and its potential translation to therapeutic intervention generate significant ethical, legal, and social concerns, notably with regards to personhood, stigma, autonomy, privacy, research ethics, safety, responsibility, and justice. Our review of the literature determined, furthermore, that while these issues have been enumerated extensively, few concrete recommendations have been expressed. CONCLUSIONS: We conclude that future research should focus on remedying a lack of practical solutions to the ethical challenges of BCI, alongside the collection of empirical data on the perspectives of the public, BCI users, and BCI researchers.

Electroencephalographic Motor Imagery Brain Connectivity Analysis for BCI: A Review.

Recent research has reached a consensus on the feasibility of motor imagery brain-computer interface (MI-BCI) for different applications, especially in stroke rehabilitation. Most MI-BCI systems rely on temporal, spectral, and spatial features of single channels to distinguish different MI patterns. However, no successful communication has been established for a completely locked-in subject. To provide more useful and informative features, it has been recommended to take into account the relationships among electroencephalographic (EEG) sensor/source signals in the form of brain connectivity as an efficient tool of neuroscience. In this review, we briefly report the challenges and limitations of conventional MI-BCIs. Brain connectivity analysis, particularly functional and effective, has been described as one of the most promising approaches for improving MI-BCI performance. An extensive literature on EEG-based MI brain connectivity analysis of healthy subjects is reviewed. We subsequently discuss the brain connectomes during left and right hand, feet, and tongue MI movements. Moreover, key components involved in brain connectivity analysis that considerably affect the results are explained. Finally, possible technical shortcomings that may have influenced the results in previous research are addressed and suggestions are provided.

The Effects of Closed-Loop Medical Devices on the Autonomy and Accountability of Persons and Systems.

Closed-loop medical devices such as brain-computer interfaces are an emerging and rapidly advancing neurotechnology. The target patients for brain-computer interfaces (BCIs) are often severely paralyzed, and thus particularly vulnerable in terms of personal autonomy, decisionmaking capacity, and agency. Here we analyze the effects of closed-loop medical devices on the autonomy and accountability of both persons (as patients or research participants) and neurotechnological closed-loop medical systems. We show that although BCIs can strengthen patient autonomy by preserving or restoring communicative abilities and/or motor control, closed-loop devices may also create challenges for moral and legal accountability. We advocate the development of a comprehensive ethical and legal framework to address the challenges of emerging closed-loop neurotechnologies like BCIs and stress the centrality of informed consent and refusal as a means to foster accountability. We propose the creation of an international neuroethics task force with members from medical neuroscience, neuroengineering, computer science, medical law, and medical ethics, as well as representatives of patient advocacy groups and the public.