Neurosurgical Considerations for the Brain Computer Interface

Brain Computer Interface (BCI) devices are being developed to restore or improve the function of people suffering with neurological disabilities such as limb paralysis, sensory loss, blindness, deafness, movement disorders, memory loss, loss of speech and epilepsy. BCI technology is advancing rapidly but major challenges remain, such as biocompatibility, developing micro-electrodes which function effectively for many years, maintenance of device hermeticity, improved wireless functionality and the ability to simultaneously stimulate and record from a neural network of thousands or millions of neurons. Non-invasive devices are attractive but are far less capable compared with the spatial or functional resolution of implanted devices. Engineers need to collaborate with neurosurgeons to develop devices that significantly benefit the patient, are practical to implant with low and acceptable surgical risks, have a record of long-term safety, and can be safely explanted. Neurosurgeons should be involved in the preclinical (animal) testing of prototype devices and they need to understand the technical capability of the BCI and its experimental results to be able to discuss the BCI with the potential recipients and their families so that they can give informed consent. This chapter describes the neurosurgery/engineering collaboration necessary to successfully develop test and commercialize BCIs and also presents the full range of BCI applications. The ethical considerations concerning the development and application of BCIs will also be presented.