Brain-Computer Interfaces (BCIs)

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Indications

Primary Indications

Severe motor impairmentALS communicationLocked-in syndromeStroke motor rehabilitationAssistive device control

Mechanism

BCIs work by recording brain activity (via EEG, ECoG, or implanted electrodes), decoding neural signals, and translating them into commands for external devices or feedback systems. Closed-loop BCIs can deliver stimulation back to the brain, potentially modulating circuits relevant to mood, movement, or cognition.

Protocol

Preparation

Screening for medical eligibility, training in BCI use, surgical preparation if invasive.

Procedure

Recording of brain signals via electrodes or sensors
Signal processing and decoding
User training with device control or neurofeedback
Ongoing adjustments for performance optimization

Frequency: Varies by application: daily training in rehabilitation, continuous for communication implants

Duration: 30–180 minutes per session (non-invasive); ongoing for implantable BCIs

Total Treatment Time: Weeks to months of training and adaptation

Equipment

EEG or ECoG recording systems
Implantable electrode arrays (for invasive systems)
Signal decoding software
Assistive devices (computer cursor, robotic arm, text-to-speech system)

Session Structure

pre session: Calibration and baseline signal acquisition

training phase: User engages in BCI tasks (cursor control, spelling, robotic movement)

post session: Performance review, retraining, and adjustments

home practice: Daily training for adaptation where applicable

Expected Outcomes

Immediate

Basic control of cursor or device
Initial communication output

Short Term

Improved accuracy with practice
Enhanced user-device adaptation

Long Term

Restoration of meaningful communication
Improved independence
Potential cognitive/emotional modulation

Side Effects

common

Fatigue
Frustration from training
Skin irritation from electrodes

uncommon

Seizures during invasive recording
Headaches

rare

Infection or hemorrhage (invasive implants)
Device malfunction

Contraindications

absolute

Active infection (for invasive implants)
Unfit for neurosurgery

relative

Severe cognitive impairment limiting training ability
Uncontrolled seizure disorder

special considerations

Long-term device safety still under investigation
User motivation and support crucial for success

Patient Selection

ideal candidates

ALS patients with preserved cognition
Locked-in patients seeking communication channels
Stroke survivors with rehabilitation potential

screening required

Neurological exam
Neuroimaging (for implant planning)
Cognitive and motivation assessment

Training Requirements

practitioner

Neurosurgeons (for implants)
Neuroengineers and technicians
Rehabilitation therapists

facility

Clinical neurotechnology lab
Rehabilitation clinic
Hospital surgical suite (for invasive BCI)

Research Evidence

studies

Hochberg et al. (2012): Pioneering work with implanted BCI enabling paralyzed patients to control robotic arms.
Recent Synchron (Stentrode) trials show safe minimally invasive vascular-implanted BCI for communication.
Non-invasive BCIs widely studied in stroke motor rehabilitation.

limitations: Small samples, high technical complexity, lack of long-term safety and efficacy data.

Cost Considerations

typical session cost: Experimental only; currently research funded

total treatment cost: Projected high costs for invasive devices

insurance coverage: Not covered

cost effectiveness: Unknown; investigational only

ux display: undefined

collapsible: undefined

heading: undefined

Integration Support

concurrent therapies

Speech and language therapy
Occupational therapy
Neurorehabilitation programs

lifestyle recommendations

Consistent training
Caregiver and social support
Engagement in rehabilitation routines

Special Populations

👶Pregnancy

Not studied

Clinical Notes

Invasive BCIs require ongoing neurosurgical monitoring.
User training and motivation are critical for success.
Regulatory frameworks evolving rapidly; some devices have Breakthrough Device designation.
May overlap with neurostimulation devices in psychiatric research.

References

Hochberg et al. (2012), Nature Synchron BCI Clinical Trial Review on BCIs in rehabilitation

This treatment information is for educational purposes only. Treatment decisions should be made in consultation with qualified healthcare professionals based on individual circumstances, symptoms, and medical history. Do not attempt treatment without professional guidance.

Interested in this treatment?

This information is for educational purposes. Always consult with a qualified healthcare provider before starting any new treatment.

Locate Psychiatrists