Invasive Brain–Computer Interface for Communication: A Scoping Review

Background: The rapid expansion of the brain–computer interface for patients with neurological deficits has garnered significant interest, and for patients, it provides an additional route where conventional rehabilitation has its limits. This has particularly been the case for patients who lose the...

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Bibliographic Details
Main Authors: Shujhat Khan, Leonie Kallis, Harry Mee, Salim El Hadwe, Damiano Barone, Peter Hutchinson, Angelos Kolias
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/4/336
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Summary:Background: The rapid expansion of the brain–computer interface for patients with neurological deficits has garnered significant interest, and for patients, it provides an additional route where conventional rehabilitation has its limits. This has particularly been the case for patients who lose the ability to communicate. Circumventing neural injuries by recording from the intact cortex and subcortex has the potential to allow patients to communicate and restore self-expression. Discoveries over the last 10–15 years have been possible through advancements in technology, neuroscience, and computing. By examining studies involving intracranial brain–computer interfaces that aim to restore communication, we aimed to explore the advances made and explore where the technology is heading. Methods: For this scoping review, we systematically searched PubMed and OVID Embase. After processing the articles, the search yielded 41 articles that we included in this review. Results: The articles predominantly assessed patients who had either suffered from amyotrophic lateral sclerosis, cervical cord injury, or brainstem stroke, resulting in tetraplegia and, in some cases, difficulty speaking. Of the intracranial implants, ten had ALS, six had brainstem stroke, and thirteen had a spinal cord injury. Stereoelectroencephalography was also used, but the results, whilst promising, are still in their infancy. Studies involving patients who were moving cursors on a screen could improve the speed of movement by optimising the interface and utilising better decoding methods. In recent years, intracortical devices have been successfully used for accurate speech-to-text and speech-to-audio decoding in patients who are unable to speak. Conclusions: Here, we summarise the progress made by BCIs used for communication. Speech decoding directly from the cortex can provide a novel therapeutic method to restore full, embodied communication to patients suffering from tetraplegia who otherwise cannot communicate.
ISSN:2076-3425