paper

Breaking the silence: Brain–computer interfaces (BCI) for communication and motor control

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📜 Abstract

Brain–computer interfaces (BCI) allow control of computers or external devices with regulation of brain activity alone. Invasive BCIs, almost exclusively investigated in animal models using implanted electrodes in brain tissue, and noninvasive BCIs using electrophysiological recordings in humans are described. Clinical applications were reserved with few exceptions for the noninvasive approach: communication with the completely paralyzed and locked-in syndrome with slow cortical potentials, sensorimotor rhythm and P300, and restoration of movement and cortical reorganization in high spinal cord lesions and chronic stroke. It was demonstrated that noninvasive EEG-based BCIs allow brain-derived communication in paralyzed and locked-in patients but not in completely locked-in patients. At present no firm conclusion about the clinical utility of BCI for the control of voluntary movement can be made. Invasive multielectrode BCIs in otherwise healthy animals allowed execution of reaching, grasping, and force variations based on spike patterns and extracellular field potentials. The newly developed fMRI-BCIs and NIRS-BCIs, like EEG BCIs, offer promise for the learned regulation of emotional disorders and also disorders of young children.

✨ Summary

Influence and subsequent use

This review helped consolidate the clinical framing of brain–computer interfaces around two major applications: communication for people with severe paralysis and restoration of movement. It distinguished invasive and noninvasive approaches, compared slow cortical potentials, sensorimotor rhythms, P300, fMRI, and NIRS signals, and emphasized the practical constraints of training time, accuracy, technical support, and patient acceptability. These themes were subsequently carried into clinical and translational BCI research.

  • A later review by Birbaumer and Cohen used the paper as a central reference while examining communication and movement restoration in paralysis, indicating continuity of its clinical framework. (pmc.ncbi.nlm.nih.gov)
  • The 2016 Nature Reviews Neurology review on BCI communication and rehabilitation cited it in its synthesis of assistive and rehabilitative BCI technologies, including communication in paralysis and motor recovery. (nature.com)
  • Subsequent systematic reviews of BCI-based rehabilitation and post-stroke applications continued to cite the paper as background for the development of EEG-based communication and motor-rehabilitation systems. (bmjopen.bmj.com)

The available evidence therefore shows sustained influence on later BCI reviews and clinical research, particularly in assistive communication, locked-in syndrome, amyotrophic lateral sclerosis, stroke rehabilitation, and the comparison of invasive with noninvasive control methods.