Perception of Brain-Computer Interface Implantation Surgery for Motor, Sensory, and Autonomic Restoration in Spinal Cord Injury and Stroke

TL;DR

This study surveyed stroke and SCI patients to assess their willingness to undergo invasive BCI surgery, finding high interest regardless of functional recovery levels, which informs future BCI development and ethical considerations.

Contribution

It provides novel insights into patient receptiveness to invasive BCIs and highlights the disconnect between functional outcomes and willingness to undergo surgery.

Findings

High willingness to undergo BCI surgery for basic functions

No correlation between functional recovery level and willingness

Participants interested even with minimal function restoration

Abstract

(Abridged) Stroke and SCI are conditions that can significantly impact the QoL of survivors in both the physical and psychosocial domains. Both diseases often result in significant motor and sensory impairments that are not fully reversible despite current available therapies. Invasive BCIs have emerged as a promising means to bypass the site of injury and potentially restore motor and sensory function. However, to maximize the utility and participant satisfaction with such technology, participants' willingness to embrace BCIs must be assessed, and placed in context with functional goals and rehabilitative priorities. Hence, we conducted a survey of a cohort of stroke (n=33), SCI (n=37), and both (n=1) participants regarding their receptiveness to invasive ECoG-based BCIs as well as to assess their goals for functional rehabilitation. Overall, participants indicated a high level of willingness to undergo surgery to implant ECoG grids for BCI technology if basic motor functions, including upper extremity, gait, bowel/bladder, and sensory function were restored. There was no correlation between participant willingness to undergo a prospective BCI implantation and the level of functional recovery offered by the BCI. Similarly, there was no correlation between willingness to undergo surgery and the participants' perceived rehabilitative priorities and level of disability. These findings indicate that participants were interested in invasive BCI technology even if only basic functions can be restored, regardless of their level of disability and their rehabilitative priorities. Such observations imply that first generation commercial invasive BCIs may not need extensive functions to garner adoption. Conversely, it also raises a concern that participants from the stroke and SCI cohort may be overly enthusiastic about such technology, which poses potential risks for medical exploitation.