Brain-computer interface in paralysis

Curr Opin Neurol. 2008 Dec;21(6):634-8. doi: 10.1097/WCO.0b013e328315ee2d.


Purpose of review: Communication with patients suffering from locked-in syndrome and other forms of paralysis is an unsolved challenge. Movement restoration for patients with chronic stroke or other brain damage also remains a therapeutic problem and available treatments do not offer significant improvements. This review considers recent research in brain-computer interfaces (BCIs) as promising solutions to these challenges.

Recent findings: Experimentation with nonhuman primates suggests that intentional goal directed movements of the upper limbs can be reconstructed and transmitted to external manipulandum or robotic devices controlled from a relatively small number of microelectrodes implanted into movement-relevant brain areas after some training, opening the door for the development of BCI or brain-machine interfaces in humans. Although noninvasive BCIs using electroencephalographic recordings or event-related-brain-potentials in healthy individuals and patients with amyotrophic lateral sclerosis or stroke can transmit up to 80 bits/min of information, the use of BCIs - invasive or noninvasive - in severely or totally paralyzed patients has met some unforeseen difficulties.

Summary: Invasive and noninvasive BCIs using recordings from nerve cells, large neuronal pools such as electrocorticogram and electroencephalography, or blood flow based measures such as functional magnetic resonance imaging and near-infrared spectroscopy show potential for communication in locked-in syndrome and movement restoration in chronic stroke, but controlled phase III clinical trials with larger populations of severely disturbed patients are urgently needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / physiology*
  • Communication Aids for Disabled*
  • Humans
  • Paralysis / psychology
  • Paralysis / rehabilitation*
  • User-Computer Interface*