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

Abstract

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.

CRMP2-binding compound, edonerpic maleate, accelerates motor function recovery from brain damage

“…The efficacy of edonerpic maleate in humans should be evaluated in clinical trials because safety profiles of this compound have already been well established in clinical phase I studies. For stroke recovery, engineering technologies for rehabilitation, such as brain machine interface and robotics, are expected to be promising tools (45,46). Other biological technologies, such as cell transplantation, may also be potential therapeutic alternatives, with distinct mechanisms from edonerpic maleate (47).…”

Brain–machine interfaces for rehabilitation of poststroke hemiplegia

“…Currently, two main approaches promise to improve BMI efficacy in neurorehabilitation: either the full implantation of a wireless BMI system capable of bridging weakened or nonexistent corticospinal pathways (for review, Murphy et al, 2016), or refining existent noninvasive systems by improving BMI paradigms toward increased efficacy in strengthening the thalamocortical sensorimotor circuit, including combination with tools improving BMI learning such as, eg, brain stimulation (Ang et al, 2015b;Kasashima-Shindo et al, 2015;Soekadar et al, 2015b). Yet, many questions related to BMI training in stroke neurorehabilitation remain unanswered; for instance, dose-response relationships, or the influence of BMI training on other brain functions, eg, the cognitive domain (Soekadar et al, 2015c).…”

“…Whereas microelectrode arrays and electrocorticography offer high temporal and spatial resolution in signal recordings resulting in high information transfer rates (Murphy et al, 2016), the invasiveness of such recordings represents a mental and physical burden for BMI users. Besides issues related to the implantation of the electrodes, there are several other challenges that relate to the long-term application of such devices, particularly related to biocompatibility, risk of infections, maintenance Basic principles and role of brain-machine interface (BMI) motor rehabilitation training in restoration of movements in poststroke hemiplegia.…”

Workshops of the Sixth International Brain–Computer Interface Meeting: brain–computer interfaces past, present, and future

“…This workshop promoted collaborative communication among investigators spanning traditionally disparate BCI domains to share best practices for clinical translational research, strategies for improving BCI performance, understanding user needs and expectations, and effective design and deployment of unattended in-home BCI systems for individuals with severe motor disability. Despite actual and inferred differences among BCI technologies and methods, investigators share common motivation and challenges in translation from investigational BCI systems to independent home use [ 243 ].…”