ORIGINAL RESEARCH article

Front. Neurosci.

Sec. Neuroprosthetics

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

  • 1. Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, United States

  • 2. University of California Los Angeles David Geffen School of Medicine, Los Angeles, United States

  • 3. Department of Neurology, University of California, Irvine, Irvine, CA, United States

  • 4. Independent Researcher (formerly at University of California, Irvine), Irvine, CA, United States

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Abstract

Stroke and spinal cord injury (SCI) are neurological injuries that can significantly impact the quality of life 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 Brain-computer interface (BCI) technology has 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 BCI technology must be assessed, and placed in context with functional goals and rehabilitative priorities. To this end, we conducted a survey of a cohort (n=71) of stroke (n=33), SCI (n=37), and both stroke and SCI (n=1) participants regarding their receptiveness to invasive ECoG-based BCI technology as well as to assess their goals for functional rehabilitation. Overall, participants indicated a high level of willingness to undergo surgery to implant electrocorticography (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 suggest that participants expressed interest in invasive BCI technology even if only basic functions can be restored, regardless of their level of disability and their rehabilitative priorities. Such observations suggest that first generation commercial invasive BCIs may find receptive users even with limited functionality, although interest expressed in this study may not directly translate to informed consent when facing actual surgical decisions. This level of interest also raises important ethical considerations, as participants from the stroke and SCI cohort may be susceptible to overly optimistic portrayals of emerging neurotechnology, underscoring the need for robust consent frameworks as BCIs approach clinical deployment.

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Keywords

brain-computer interface (BCI), electrocorticography (ECoG), Functional restoration, Neuroethics, Patient perception, spinal cord injury (SCI), stroke rehabilitation, SurgicalWillingness

Received

02 August 2025

Accepted

21 January 2026

Copyright

© 2026 Lin, Tran, Thaploo, Matias, Pixley, Nenadic and Do. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Derrick Lin; An H. Do

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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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