Brain-Computer Interfaces Transform Neurosurgical Practice and Neurorehabilitation

Brain-computer interface technology is establishing direct communication between the brain and external devices, moving from science fiction to clinical reality. This technology is reshaping neurosurgical practices and neurorehabilitation by decoding brain signals to restore motor, sensory, and language functions. The implications extend to individuals affected by paralysis, aphasia, and neurodegenerative diseases, offering new therapeutic possibilities while raising significant ethical questions about autonomy, identity, and mental privacy.

A comprehensive review published in March 2025 in the Medical Journal of Peking Union Medical College Hospital explores how BCI technologies are transforming brain-related care. The study, led by Professor Zhao Jizong of Beijing Tiantan Hospital, synthesizes advancements in invasive and non-invasive BCIs, clinical applications, and integration with artificial intelligence. The research reveals BCIs are emerging not only as therapeutic tools but as platforms for decoding cognition and enabling intelligent, brain-directed interventions. The full review is available at https://dx.doi.org/10.12290/xhyxzz.2025-0152.

BCI systems function by detecting neural signals and translating them into commands that control external devices, essentially bypassing damaged pathways to restore function. These systems range from non-invasive headsets to fully implantable microelectrode arrays, each with varying precision and risks. In clinical settings, BCI devices have enabled paralyzed individuals to regain movement and aphasia patients to communicate through decoded speech intentions. Cutting-edge hardware, including graphene-based chips and flexible cortical films, enhances signal resolution while minimizing immune response.

In neurosurgery, BCIs have transformed intraoperative brain mapping, allowing real-time navigation that preserves critical cognitive and motor regions during tumor resections. Closed-loop systems show exceptional promise in managing Parkinson's disease and epilepsy, adjusting neural stimulation based on live brain activity. Emerging applications include using BCIs to detect consciousness in non-responsive patients, assist in psychiatric treatment, and potentially boost memory in those with Alzheimer's disease. As AI integration improves decoding speed and accuracy, BCIs are evolving from assistive devices into precision tools for intelligent brain modulation.

Professor Zhao Jizong, the study's corresponding author, emphasized that BCI technology represents one of the most exciting frontiers in neuroscience and clinical medicine. Its ability to restore lost functions and interface directly with the brain invites reconsideration of the boundaries of medicine, ethics, and human identity. The professor noted that multidisciplinary collaboration and ethical frameworks will be critical in ensuring this technology is harnessed responsibly and equitably.

The horizon for BCI applications continues to expand. In clinical practice, they promise more personalized and effective treatments for stroke recovery, spinal cord injury, and neurodegeneration. Beyond hospitals, BCIs could redefine human-computer interaction, enabling cognition-based communication, virtual control, and even mental augmentation. However, widespread deployment depends on overcoming technical hurdles such as long-term device stability and regulatory approval, as well as societal concerns over mental privacy and equity. With continued innovation and cross-sector coordination, BCIs could soon move from experimental trials to transformative tools in intelligent healthcare and neuro-enhancement.