The emerging world of motor neuroprosthetics: A neurosurgical perspective

A MOTOR NEUROPROSTHETIC device, or brain computer interface, is a machine that can take some type of signal from the brain and convert that information into overt device control such that it reflects the intentions of the user's brain: In essence, these constructs can decode the electrophysiological signals representing motor intent. With the parallel evolution of neuroscience; engineering, and rapid computing the era of clinical neuroprosthetics is approaching as a practical reality for people with severe motor impairment. Patients with such diseases as spinal cord injury; stroke, limb loss, and neuromuscular disorders may benefit through the implantation of these brain computer interfaces that serve to augment their ability to communicate and interact with their environment: In the upcoming years, it will be important for the neurosurgeon to understand what a brain computer interface is, its fundamental principle of operation; and what the salient surgical issues are when considering implantation. We review the current state of the field of motor neuroprosthetics research; the early clinical applications, and the essential considerations from a neurosurgical perspective for the future.