Lim Mervyn Jun Rui, Lo Jack Yu Tung, Tan Yong Yi, Lin Hong-Yi, Wang Yuhang, Tan Dewei, Wang Eugene, Naing Ma Yin Yin, Wei Ng Joel Jia, Jefree Ryan Ashraf, Tseng Tsai Yeo
Division of Neurosurgery, Department of Surgery, National University Hospital, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
J Neural Eng. 2025 Mar 12;22(2). doi: 10.1088/1741-2552/adb88e.
Invasive brain-computer interfaces (iBCIs) have evolved significantly since the first neurotrophic electrode was implanted in a human subject three decades ago. Since then, both hardware and software advances have increased the iBCI performance to enable tasks such as decoding conversations in real-time and manipulating external limb prostheses with haptic feedback. In this systematic review, we aim to evaluate the advances in iBCI hardware, software and functionality and describe challenges and opportunities in the iBCI field.Medline, EMBASE, PubMed and Cochrane databases were searched from inception until 13 April 2024. Primary studies reporting the use of iBCI in human subjects to restore function were included. Endpoints extracted include iBCI electrode type, iBCI implantation, decoder algorithm, iBCI effector, testing and training methodology and functional outcomes. Narrative synthesis of outcomes was done with a focus on hardware and software development trends over time. Individual patient data (IPD) was also collected and an IPD meta-analysis was done to identify factors significant to iBCI performance.93 studies involving 214 patients were included in this systematic review. The median task performance accuracy for cursor control tasks was 76.00% (Interquartile range [IQR] = 21.2), for motor tasks was 80.00% (IQR = 23.3), and for communication tasks was 93.27% (IQR = 15.3). Current advances in iBCI software include use of recurrent neural network architectures as decoders, while hardware advances such as intravascular stentrodes provide a less invasive alternative for neural recording. Challenges include the lack of standardized testing paradigms for specific functional outcomes and issues with portability and chronicity limiting iBCI usage to laboratory settings.Our systematic review demonstrated the exponential rate at which iBCIs have evolved over the past two decades. Yet, more work is needed for widespread clinical adoption and translation to long-term home-use.
自30年前首个神经营养电极植入人体以来，侵入式脑机接口（iBCI）有了显著发展。从那时起，硬件和软件的进步都提高了iBCI的性能，使其能够完成诸如实时解码对话以及通过触觉反馈操控外部肢体假肢等任务。在本系统评价中，我们旨在评估iBCI在硬件、软件和功能方面的进展，并描述iBCI领域的挑战与机遇。对Medline、EMBASE、PubMed和Cochrane数据库从创建至2024年4月13日进行了检索。纳入了报告在人体中使用iBCI来恢复功能的原始研究。提取的终点指标包括iBCI电极类型、iBCI植入情况、解码器算法、iBCI效应器、测试和训练方法以及功能结局。对结局进行了叙述性综合分析，重点关注硬件和软件开发随时间的趋势。还收集了个体患者数据（IPD），并进行了IPD荟萃分析以确定对iBCI性能有显著影响的因素。本系统评价纳入了93项涉及214例患者的研究。光标控制任务的中位任务性能准确率为76.00%（四分位间距[IQR]=21.2），运动任务为80.00%（IQR=23.3），通信任务为93.27%（IQR=15.3）。iBCI软件目前的进展包括使用循环神经网络架构作为解码器，而诸如血管内支架电极等硬件进展为神经记录提供了侵入性较小的替代方案。挑战包括缺乏针对特定功能结局的标准化测试范式，以及便携性和长期性方面的问题限制了iBCI仅能在实验室环境中使用。我们的系统评价表明，在过去二十年中iBCI呈指数级发展。然而，要实现广泛的临床应用并转化为长期家庭使用，还需要开展更多工作。
