Brain Computing Interface

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INTRODUCTION: WHAT IS BCI? HOW DOES IT WORK?

Brain-computer interfaces (BCI) is an up-and-coming technology which has great potential to improve the quality of life of its users, particularly patients in healthcare. Ultimately, BCI is a communication system which allows the control of devices through brain signals [1].

It is an emergent technology which creates a direct communication pathway between the brain and external devices like computers, robots, artificial limbs and wheelchairs. They record, analyze, and translate brain signals into commands which are then relayed to output devices that carry out the desired action. For example, a communication system with global BCI technology allows disabled people to interact with external environments and communicate with other people without the need for muscular or peripheral neural activity.

BCIs operate by placing electrodes near neurons to detect action potential signals being transmitted between axon-dendrite synapses in the cortex. When these action potential molecules are transferred through the synapse, an electric current is briefly opened between the neuron membranes which is detectable by the electrode. This is facilitated by polarity changes in voltage-gated or ion gated molecular channels between the axon-dendrite synapse. By monitoring and recording these action potentials through thousands of neurons at once, scientists are able to decode and understand what these signals are telling the brain and body to do. This method can theoretically be performed in different areas of the brain to measure the senses of touch, smell, sight, sound, taste, and even thoughts [2].

The main goal of BCI is to assist patients of neuromuscular disorders in the restoration of effective functions [2]. BCIs are also useful for rehabilitation after stroke and for other disorders. In the future, there are hopes of BCI strengthening the performance of surgeons or other medical professionals. However as the technology continues to mature, application in different areas and industries are anticipated. The functioning of BCI can be explained in four components: component, type, technology, and application [3]. These will be discussed in the following sections.

Components

The component-based segments of BCI refer to the software and hardware [4].

Hardware is anything that eases the data gathering. For example, sensors that detect neuron signals, components that amplify and digitalize signals, and client hardware running the BCI software are all forms of hardware used in BCI.

Software is those that pertains to the analysis of the neuron signal data that is gathered by the hardware. Some examples of this are logical components that record, digitalize, and store neural signals, components that perform signal-analysis, output components that realize the analysis, and operating protocol that governs the operation. Note that signal analysis refers to the extraction of brain signals to determine the user’s intent and the translation of intentions into action, and operating protocol describes the guidelines that determine the configuration, parameterization, and timing of the operation.

Types

Non-Invasive BCI [5]

In addition to BCI components, there are also three main types of BCI: invasive, noninvasive, and partially invasive [6]. Non-Invasive BCIs are those in which sensors are placed on the scalp. The non-invasive BCI segment dominated the overall market size in 2019 and is expected to maintain dominance during the forecast period between 2019-2027 [7]. This technology is applied to products such as headsets, amplifiers, and gaming sticks. A large share for this segment is credited to the advantage of not requiring any insertion of a foreign device into the brain, and thus being the safest. In June 2019, Carnegie Mellon University developed the first mind-controlled robotic arm using BCI technology, which can track and follow a computer cursor [6].

Invasive BCIs are those in which micro-electrodes are placed in the cortex of the brain [6]. Invasive BCI is expected to witness lucrative growth over the forecast period owing to the ability of this BCI technology in providing functionality to paralyzed people through brain-controlled robotic prostheses [7].

Lastly, partially invasive BCIs are those in which electrodes are placed inside the skull but outside the brain. Partially invasive BCI is expected to register a significant growth rate over the forecast period due to tremendous technological advancement and easy adaptability [7]. In September 2019, Synchron Inc launched the trial of Stentrode, which is a minimally invasive neural brain-to-computer interface technology to wirelessly record brain activities [8].

Technology

In addition to the types and components of BCI, there are also six types of technology-based segmentation including near-infrared spectroscopy (NIRS), functional magnetic resonance imaging (fMRI), positron emission tomography (PET), magnetoencephalography (MEG), electroencephalography (EEG), and electrocorticography (ECoG)[9].

Near-infrared spectroscopy (NIRS) is a non-invasive optical imaging technique that scans the hemodynamic signals of the brain where blood oxygen level dependent (BOLD) signals. It measures changes in the hemoglobin concentration in the blood, which arise due to regional cerebral blood flow (CBF), during brain activity [9]. A standalone NIRS could not be used to image the regions of brain activity as it is not possible to measure the quantity of hemoglobin changes. This means that it cannot produce imaging of the hemoglobin changes on its own; however, there have been methods developed recently which are able to quantify the changes.

Next is functional magnetic resonance imaging (fMRI) which is the most widely used imaging modality for the brain, especially in the functional imaging of the brain. It depends on natural contrast from the BOLD signal. fMRI works on the basis of nuclear magnetic resonance, which is the base for all MRI modalities. The spatial resolution of the functional MRI is better than the temporal resolution, with a range of several millimeters in voxel size. This can be extremely beneficial in cognitive neuroimaging. However, the temporal resolution of functional MRI is weak due to the fact that blood circulation changes fast [9].

Positron emission tomography (PET) is another useful imaging tool which employs a radio tracer that transmits positron upon interaction with the electron. The radiotracer used for PET is fluorodeoxyglucose (FDG) in which deoxyglucose is linked to an F-18 radioisotope [9]. The basic concept of PET imaging relies on the process of glucose uptake by cells as an energy source. The cell uses the glucose in FDG which sets free the radio tracers, This then creates the production of gamma rays due to the interaction of the free positron with the electron. PET has wide applications in neuroimaging studies. It has a similar function as in fMRI where the regional blood flow changes can be measured and viewed. A PET study in subjects performing tasks ranging from low to highly demanding intellectual levels helped ensure the fact that the efficiency of processing by the brain decreases as the difficulty of tasks increases [9].

Electro-encephalography (EEG) is a non-invasive/invasive modality used to monitor the brain’s electrical signals associated with various cognitive processes. It consists of electrodes placed on the scalp to record the minute-intensity electrical signals passing through the neuronal network of the brain. The brain’s cortical signal associated with the hand movement has been used to control an artificial hand, by recording the EEG signal associated with the brain region during that movement task. This EEG signal is processed and translated into commands for an external robotic hand movement, which aids the recovery of post-traumatic injury patients in their rehabilitation [9].

Magnetoencephalography (MEG) is a non-invasive type of modality that monitors and records magnetic signals from the brain. These signals are produced in the form of magnetic flux because of flow of the postsynaptic electric current in the neurons of the brain. It does not contain electrodes attached to subjects, which reduces discomfort during recording. MEG has a good spatio-temporal resolution (data collected across time and space) when compared to EEG and the distortion of signals is very low in MEG as compared to EEG, as the magnetic flux can travel out of the skull without damping. MEG can distinguish the sensory-motor rhythm of each finger movements with a better spatial resolution [9].

Finally, there is electrocorticography (ECoG), which is a partially invasive technique of recording the brain’s electrical signal by placing a patch electrode on the surface of the brain. It is partially invasive as it requires a part of the skull to be removed to directly place the electrode on the surface of the brain. ECoG is efficient and has better spatial resolution than EEG [9].

By far, EEG is the most suitable modality of application because of its temporal resolution and relatively better ease of use compared to other modalities.

Business Applications

Brain Computer Interface [10]

The potential of BCI technology is immense. It can be applied across multiple industries due to the practicality of its main functions: communication and user state monitoring [11].

BCI enables communication through the decryption of biosignals, which is greatly beneficial to those who suffer health conditions that inhibit the individual from communication. For instance, BCI can assist disabled individuals to express their opinion through semantic categorization and silent speech communication [11]. It can also be used alongside the Internet of Things (IoT) to enable hands-free, non-verbal control of machines [11]. An example of such is the use of smart homes which will be further elaborated in the following sections.

The second functionality is allowing user state monitoring, which includes the assessment of stress, fatigue and attention levels. These can be applied to areas such as smart transportation, healthcare, smart homes, and education.

Overall, there are seven areas in which BCI can be applied: medical, neuroergonomics and smart environments, neuromarketing and advertising, education and self-regulation, games and entertainment, security and authentication [11], and military [7].

Medical

BCI in healthcare can be used for prevention, detection and diagnosis, and rehabilitation and restoration [11].

Prevention

Prevention refers to the ability to predict a potential loss of function and decreased alertness level resulting from smoking, alcoholism or motion sickness. Prediction is enabled by using BCI technology to analyze brain signals in order to analyze the user’s consciousness level. With this valuable information, authorities or third parties can intervene and prevent certain incidents from occurring. The ability to implement BCI technology in these instances can ultimately contribute to a decline in traffic accidents, which is considered the main cause for death or other serious injuries in many countries across the globe [12].

Detection and Diagnosis

BCI technology can also aid in the detection and diagnosis of health issues, such as abnormal brain structure, seizure disorder, sleep disorder and brain swelling [11]. Today’s research, with relation to BCI technology and abnormal brain structure, is most concerned with the development of detection systems that can recognize EEG abnormalities. For instance, a recent system that analyzes incoming EEG signals to identify discrepancies in order to detect brain tumours and epilepsy seizures was proposed by Sharanreddy and Kulkarni [13]. As BCI technology matures, it will become a more reliable and cost effective alternative to detecting brain tumours, in comparison to magnetic resonance imaging (MRI) and computerized tomography (CT) scans [11].

Moreover, BCI technology can also assist in predicting Parkinson’s disease by using EEG signals to identify idiopathic rapid eye-movement sleep behaviour disorder (iRBD), which has been concluded as a strong early predictor of the disease [14].

Rehabilitation and Restoration
VR-BCI based rehabilitation therapy [15]

BCI technology can also be applied to help patients restore lost functions, regain mobility, or adapt to disabilities [11]. Stroke and patients are two main types of patients who will benefit most in this regard. For stroke patients, increased use of BCI is able to trigger recovery in the brain thus allowing patients to witness improvements in motor functions [16], whereas disabled patients can take advantage of the integration of prosthetic limbs and BCI to improve their day-to-day activities [17].

BCI-based rehabilitation can also be further categorized into real, virtual and augmented rehabilitation approaches [11]. In real rehabilitation, patient recovery is achieved by modifying a patient’s thinking by feeding the brain with recorded brain signals of a healthy individual. Virtual rehabilitation represents the combination of BCIs and virtual reality (VR) to stimulate recovery by allowing patients to control their experiences in VR using only brain activity. This method of rehabilitation is often used in conjunction with conventional therapy. By utilizing VR, rehabilitation strategies can be simulated to account for the intensity, frequency and duration of therapy in a more cost-effective approach. Lastly is augmented rehabilitation, which mainly stems from the development of Mirror Box Therapy (MBT). MBT is a commonly used rehabilitation strategy that uses a mirror to “create a reflective illustration of an affected limb in order to trick the brain into thinking movement has occurred without pain, or to create positive visual feedback of a limb movement” [18]. An example of augmented rehabilitation is ViLimbs, which applies the principle of MBT to treat patients who are recovering from phantom limb pain, by using augmented reality (AR) and BCI [19]. The patient is first seated in front of a camera stream with a marker placed on the beginning of the missing limb. With AR, the patient is able to visualize him or herself with both limbs, and he or she is able to reposition the missing limb to a more comfortable position through BCI.

Neuroergonomics and Smart Environments

Neuroergonomics refers to “the study of the human brain in relation to performance at work and everyday settings” [20]. To elaborate, BCI can be applied in smart homes, smart workplace and smart transportation by cooperating with the Internet of Things (IoT).

Brain computer interface-based Smart Living Environmental Auto-adjustment Control System (BSLEAS) is a common topic in the realm of BCI and smart homes. The concept of BSLEAS is based on the receipt of brain signals from the host in order to adjust the environment according to a user’s cognitive state [21]. In fact, BSLEAS have been tested and verified in a demonstration that allows for the same techniques to be extended to other applications within home networking.

As well, BCI can be applied in the workplace to improve employee wellbeing. This is achieved through assessing employees’ cognitive state to determine the individual’s fatigue levels through the use of EEG signals [22]. While this application might not be practical in most situations, the success rate of a surgical operation may be increased through monitoring the neural state of surgeons during an operation.

Lastly is BCI application in smart transportation. In this field, BCI is focused on collecting data regarding the drivers’ fatigue detection and concentration levels in order to build predictive models that will help decrease the risk of traffic accidents [23].

Neuromarketing & Advertisement

NeuroSky's app store [24]

Advancements in marketing and advertisements will occur through integration of BCI technology. By reading EEG signals using BCI technology, marketers will have access to information regarding the audience’s attention level [25] and correspondingly, perform targeted advertising based on one’s emotional state to yield the best results [26].

NeuroSky, a manufacturer of consumer BCI technology, has developed numerous digital games to use along with their consumer BCI products. They also leverage these applications to gain additional revenue from in-game ads. Ads are shown to select users based on the individual’s cognitive and emotional state [27].

Education & Self-regulation

BCI applications in education mainly emphasize on utilizing the technology to monitor students’ attentive and stress levels. According to Abdulkader et al., BCI allows instructors to assess the level of clarity a student possesses towards a certain topic [11]. With this type of information, educators can adapt a more proactive approach to teaching by reaching out to confused students instead of relying on students to voice their concerns.

In Verkijika and De Wet’s academic paper, the authors claim that BCI educational games can also be used to reduce math anxiety [28]. This solution is more effective than today’s interventions, which focused more on what teachers can do to alleviate the stress from students.

BCI used for Gaming and Entertainment [29]

Games & Entertainment

There are two types of BCI-based games: recreational games and rehabilitative gamification [11].

Recreational games, in theory, represent the combination of current day digital games and brain controlling capabilities. However, due to the premature development of the technology, it has yet to be widely implemented. According to Rexwinkle, Lieberman & Jaswa [30], developing models pertaining to task-related activity, which is imperative to the successful creation of BCI games, requires large amounts of data that must be collected, processed and classified. Therefore, BCI gamification is expected to be presented to the consumer market at a later time.

Rehabilitative gamification, as the name suggests, is used to assist in patient recovery. An example is Synapse which is intended to treat Parkinson’s [31]. Developed by Nexeon MedSystems, Synapse is a device that is planted in the chest and connected with wires to the brain. Patient treatment is executed by sending electricity to specific parts of the brain when connected to a game.

Security & Authentication

BCI authentication represents the new era of security and authentication. Instead of relying on current methods of authentication, such as passwords, access cards and biometrics, authentication via biosignals can be achieved [32]. This method of authentication bypasses common issues such as password hacking, shoulder surfing, scanner issues for fingerprint biometrics, and inaccurate capturing of biometrics. In fact, BCI authentication enables individuals with extreme impairment conditions to authenticate themselves, which remains a challenge today. The technology for this application remains relatively premature. However, with additional data gathering and analysis, improvements in throughput and error rate can be expected [32]. Furthermore, some existing research has been dedicated towards applying EEG signal authentication to smart driving systems to replace car keys [11].

Military

Lastly is the integration of BCI to the military. The most notable progress in this field is “Silent Talk” which is developed by the Defense Advanced Research Projects Agency (DARPA) of the United States. It applies BCI technology to allow soldiers to give commands telepathically to mobile robots. With this application, soldiers are able to maintain a safe distance yet perform their duties. According to Grand View Research, the military segment is expected to witness lucrative growth during war activities [7].

EVOLUTION OF BCI

The concept of BCI was first documented in the 1930’s. The following section will provide a more detailed discussion about its development since then.

Timeline of major moments in BCI evolution.

1930’s

BCI technology has come a long way. Like most areas of bioscience and neural network technology, the rate of advancement has been on an exponential track since the conceptualization and first recording using an electroencephalograph, a machine used for EEG, by Hans Berger in 1929 [33]. The recording showed a 17-year-old boy while he was undergoing a neurosurgery [34]. A year later in 1930, Berger successfully recorded the first human ECoG during another brain surgery.

A lot of the early neural recordings were conducted at the Kaiser Wilhelm Society in Germany. Through the 1930’s, neurologists in England and the U.S. confirmed the findings of Berger’s EEG recording in experiments of their own. As well, the potential for clinical use on patients experiencing seizures and altered states of consciousness was recognized [35].

World War II

As the Nazis gained control of Germany, many scientists of all disciplines fled or were exiled to countries across the globe. By the end of the war in 1945, many research institutes in Germany were destroyed and the international community had hesitations regarding the unethical research methods found to be common during the Nazi rule [36]. Because of this, BCI development remained stagnant during and after the war globally.

1960-70’s

During the 60’s and 70’s, many EEG recording experiments were successful on animals including rats, dogs, cats, and monkeys. These recordings helped study the cortical potentials, otherwise known as brainwaves, detectable in the cortex of the brain. The EEG studies conducted on human brains during this time also began having greater precision at detecting neural signals other than cortical potential [33][35].

1980’s

In 1980, the first active BCI output was observed when an individual was able to change the strength of their cortical potential when given biofeedback sessions. They were able to move a rocket ship up and down on a monitor [37].

Another kind of event-related brain potential occurred in 1988 where individuals without any motor system control were able to communicate with a visual keyboard. The EEG-based device detected the neural signal that was triggered in the brain when the visual keyboard indicated the desired character or symbol the individual wanted to select [38]. The use of multi-dimensional control with a BCI is commonly done through iconic language. Iconic language leverages the human brain’s ability to correlate icons or gestures with letters of the alphabet or even simple words. Examples of iconic language include moving your hand in the shape of something, imitating the noise of something, or identifying a symbol to mean something. If you were trying to move a cursor to a letter, you might also associate it with where it is in the alphabet, or by the sound of the letter [39].

1990’s

In 1998, the first invasive BCI was implanted on a paralysed man’s motor cortex. The device was made out of microelectrodes in glass cones and placed two millimeters into the patient’s motor cortex. The glass cones were used for corrosion resistance. Signals were amplified and then transmitted by a radio device from under the scalp, on top of the skull. Given the device’s simplicity, the patient was empowered to move a cursor on a computer screen [33].

2000’s & Cyberkinetics

In 2001, Cyberkinetics was the first company to attract substantial investment capital for the purpose of developing a marketable BCI. Three bioscience investment funds – Oxford Bioscience Partners, NeuroVentures, and Global Life Science Ventures – invested a total of $9.3 million in Cyberkinetics [40]. By 2004, Cyberkinetics’s BrainGate microelectrode array was successfully implanted into a patient’s motor cortex and enabled the patient to operate prosthetics, operate a robotic arm, operate a TV, and open simulated emails [41].

MARKET SIZE AND GENERAL OUTLOOK

The growth and market value of BCI is optimistic, given the immense potential across varying industries. In this section, additional information will be provided regarding its market size, market drivers, limitations and potential for implementation.

Market Size

Healthcare is expected to dominate the BCI market [42]
The global brain computer interface market size in 2019 was valued at approximately $1.36 billion USD. The market is expected to reach $3.85 billion USD by 2027, rising at a 14.3% compound annual growth rate from 2020 to 2027 [7].

Furthermore, the healthcare sector has the highest share in the global BCI market in 2019 due to the high demand of the technology for severely disabled patients in order to resume basic communication capacities [7]. In accordance with geographies, North America accounted for the highest BCI market share the same year due to rising incidences of neurodegenerative disorders and virtual gaming prevalence which will facilitate the development of advanced BCI systems in the region [43].

Asia Pacific will have the highest growth rate over the forecast period, due to increasing disposable revenue and low-cost production sites. In May 2018 Compumedics collaborated with a China-based organization, Health 100, to improve its product portfolio in sleep technology. In March 2019, Integra received approval for DuraGen Dural Regeneration Matrix in Japan, which helped the company expand its presence. The growing healthcare infrastructure in developing economies like India is expected to provide huge opportunities for the growth of BCI tech in the region. As healthcare infrastructure improves innovative systems that improve the lives of the disabled are encouraged [7].

Market Drivers

The major factors driving the market are technological advances in human-machine sensing, application of BCI in entertainment, gaming, and communication & control, as well as the increased use of BCI in the healthcare sector [7].

Healthcare

Clinical studies, research institutes, and government agencies have assisted this industry's development through funds, grants, and acquisitions, which encouraged research efforts to improve the use of BCIs. The need for biocompatible materials will also expand the use of BCI in the near future.

In addition to the above, the growing prevalence of Alzheimer’s, Parkinson’s disease, and epilepsy are expected to boost the BCI market size. According to the World Health Organization, about 82 million people are estimated to be affected by dementia by 2030 and 152 million people by 2050. This trend indicates the potential demand for BCI in the years to come [7].

Overall, healthcare was the biggest revenue-generating category in 2019 based on demand. In fact, North America accounted for the largest BCI market share 42.3% due to increases in neurodegenerative disorders and cerebrovascular diseases. The key factor contributing to the growth of BCI market share in the healthcare system is the use of BCI technology to treat a wide range of disorders, including sleeping disorders, Alzheimer’s disease, and Parkinson’s disease [7].

Gaming

The rise in demand for immersive gaming is expected to lead to the development of technologies such as augmented BCI. There is stiff competition among companies for developing innovative products at affordable prices which comply with FDI regulations [7].

BCIs are also becoming more commonly used in both the smartphone and virtual gaming industries through integrating the technology with VR headsets. Digital gaming has opened a range of new possibilities for mind-controlled headsets and accessories [7].

Market Limitations

One limitation for the growth of this market is the lack of skilled technicians. There are not enough skilled workers to be able to manage these complex devices which can limit the growth of BCIs. Some additional limitations include the lack of awareness, poor information transfer rate of BCI, and technological challenges related to integration of BCI technology with other devices [11].

Market Potential of Implementation

Healthcare dominated the BCI market in 2019 due to the high applicability of BCI technology to treat sleep disorders and neurological diseases[7]. Moreover, BCI technology is increasingly used to treat paralytic patients, and for the continuous study of neuroscience.

Technological advancements and initiatives by key industry players are driving the market for BCI systems. In June 2018, Medtronic launched a new clinician programmer for deep brain stimulation therapy with Activa neurostimulator. In October 2018, Advanced Brain Monitoring Inc. received a grant to use brain activity biomarkets to prevent cognitive decline associated with aging and dementia. These initiatives contribute towards the wide application of BCI in healthcare applications.

KEY PLAYERS

The key companies operating in the global BCI market are Advanced Brain Monitoring Inc., Compumedics, Integra Livescience, Cadwell Industries Inc., OpenBCI, Cortech Solutions Inc., NeuroSky, Emotiv, G.tec medical engineering GmbH, Natus Medical, and Mind Solutions [7], and we will be discussing a few of these in more detail below.

Players in this market focus on strategies such as mergers, acquisitions, partnerships, and collaborations to increase their market share. In September 2018, Medtronic acquired Mazor Robotics to improve its robotic surgery portfolio. In October 2017, Natus Medical acquired the neurosurgery business assets of Integra Lifesciences to gain market share in the neurosurgery space [7].

Advanced Brain Monitoring Inc.

Advanced Brain Monitoring Inc is a neuro-diagnostics device company that is internationally recognized for its innovative technologies. They have pioneered the use of EEG-based awake and asleep assessment technologies for pharmaceutical, medical device and academic clinical trials.

In October 2018, Advanced Brain Monitoring Inc. received a grant to use brain activity biomarkets to prevent cognitive decline associated with aging and dementia [44]. To date, they have been awarded over forty research grants totalling over $37 million. These initiatives contribute towards the wide application of BCI in healthcare applications.

Compumedics

Compumedics designs and manufactures innovative technologies for the diagnosis of sleep disorders. It leads the sleep diagnostic market in Australia, with a market share of approximately 80%. Compudemics is also growing internationally, with a focus in the United States which is the world’s largest medical device market.

In May, 2018, Compumedics collaborated with a China-based organization, Health 100, to improve its product portfolio in sleep technology. They are recognized as the top sleep and neuro-diagnostics device supplier in Australia, China, and Japan, and the top three in the United States for neurological monitoring devices and sleep diagnostics solutions [45].

Integra LiveSciences

Integra is a leader in neurosurgery, offering a broad portfolio of implants, devices, instruments and systems that are applied in neurosurgery, neuromonitoring, neurotrauma, and related critical care. In the United States, Integra is a leading provider of surgical instruments to hospitals, surgery centers and alternate care sites, including physician and dental offices.

In March 2019, Integra received approval for DuraGen Dural Regeneration Matrix in Japan, which helped the company expand its global presence. Integra LifeSciences, a world leader in medical technology, is dedicated to limiting uncertainty for surgeons, so they can concentrate on providing the best patient care [46].

CONSUMER BCIs

NeuroSky MindWave [47]

There are a number of BCI products available to the general public that allow individuals to record their neural activity and analyze it using applications available on mobile or desktop platforms. Modern consumer BCI’s are all non-invasive or passive, meaning they are entirely removable, and the user does not receive any input feedback from the BCI system. EEG headsets are the technology of choice for consumer BCI’s because they are easy for anyone to use without imposing any risk to the user. The points of differentiation amongst competitors in the market consist of the number of electrode sensors, channel resolution, sampling rate, battery life, ergonomics and supported software.

The following section highlights key consumer BCIs by NeuroSky and Emotiv, however, there are other competitors in this market including Muse and Unicorn.

NeuroSky Mindwave

Released to the public as one of the first consumer BCI’s on the market in 2010, the MindWave was designed as both an educational and entertainment device that offered users the ability to track their neural activity at an affordable price point of $99 USD. With only one electrode and a comparatively low channel resolution, the MindWave is outperformed by other devices in areas of accuracy and detail of the recorded signals.

EPOC X [48]

The applications available for the MindWave include games, educational content, health and wellness, meditation and focus improvement. Since 2010, NeuroSky has developed a wide assortment of these genres of applications both in-house and through independent app developers who licence their application on the NeuroSky App Store. The MindWave device has gone through a number of updates to both the software and hardware since its initial release, which has resulted in some applications no longer being compatible with the new updates or models.

Emotiv Insight, EPOC X/+ and EPOC Flex

EPOC Flex [49]

Emotiv has developed a number of different EEG BCI headsets with a wide range of practical uses. Their devices come along a price range of $299 USD to $2,099 USD, with the number of electrodes and quality of signal resolution, frequency and sampling rate being the major upgrades across their product line.

The intended use of each product also differs slightly, with the $299 USD, 5 channel Emotiv Insight being best suited for meditation or neural activity mapping and visualization applications. The $849, 14 channel Emotiv EPOC X/+ offers greater granularity in the recording of neural signals in different areas of the brain. While still practical for the same uses as the Insight, the EPOC X/+ can also provide much more complex data for research and analysis in areas such as education, attention span and other personal measurements. The 2,099 USD Emotiv EPOC Flex is a 32 channel EEG cap with wired sensors connecting to a portable control unit, rather than an all-in-one headset. This product is meant to be used for both personal and clinical use, offering similar signal recording performance as clinically developed EEG caps, but with the convenience of portability. The EPOC Flex requires subscription to Emotiv PRO, a software developed by Emotiv for neuroscience research with their devices.

RISK AND BENEFIT ANALYSIS

IT is evident that BCI enables a wide range of benefits across different industries. However, there are notable risks associated with the adoption of this technology, especially with partially invasive BCI. In this section, an exploration of the potential benefits and challenges will be provided.

Potential Benefits

The benefits of BCI can be generalized under three categories, namely medical and psychological improvements as well as the ability to improve workplace performance.

Medical Benefits

BCIs can be used to help patients communicate with others. Communication is enabled through training paralyzed patients to be able to express their thoughts via the analysis of their EEG signals from a virtual keyboard acquired. Motor skill is another breakthrough for BCI. Neuroprosthetic devices provide motor restoration which will enable people with disabilities, such as spinal cord injuries, to form rudimentary tasks such as brushing one’s teeth [50]. Furthermore, BCI and locomotion will enable paralyzed individuals to regain a means of transportation such as a wheelchair without a caregiver's assistance. Although the control systems have little flexibility, current research is dedicated to improving the current experience by utilizing a laser-based control evaluator that inspects the surrounding environment and avoids obstacles [51].

Psychological Benefits

BCIs can track individuals’ emotions and mood states which allow the diagnosis of emotional disorders [52]. The University of Southern California scientists used machine learning to understand the brain signals that are associated with specific mood states [53]. Through their studies, mental health practitioners can detect patients’ mood states and determine their emotional disorders such as anxiety and depression. Furthermore, another group of scientists proved that a wireless affective BCI can notice depression and anxiety levels in women by studying hormonal imbalances that are caused by stress.

Improve the Future of Work

BCI can be used to improve employees’ performance in the workplace. This is achieved by using BCI technology as a training tool to analyze employees’ attention level at work. A Toronto-based startup called “Muse” has developed a brain-training headband [54]. This headband measures a variety of signals including brainwaves, body movements, heart rate and breathing. The device is intended for employees and meditators providing them with real-time feedback on their mental ability and bodily signals. Through these assistive solutions, individuals can increase their concentration levels, lower stress and improve engagement. Other headbands on the market also use proprietary sensors to track whether someone is focused or distracted and leverage machine learning algorithms to provide insights into the engagement levels of users/workers [55].

Potential Challenges

On the other hand, some potential challenges and risks pertaining to BCI adoption include security, privacy and controllability concerns, physical and psychological concerns, and regulatory challenges.

Security, Privacy and Controllability Concerns

While health-related BCIs are promising treatments for most patients, these treatments carry more associated risks stemming from surgery, infection, and glial scarring. More importantly, users become vulnerable to security breaches [56][57].

Hackers can gain control of the BCI device through its manufacturing vulnerabilities. Once they gain unauthorized access to the device, patients become targets of cyber attacks where they are subject to unauthorized tampering of the device resulting. Hackers can utilize the connection to control the patients, confiscate their freedom and command malicious and destructive actions. Moreover, neuro-criminals can access and remove neural information without user consent. Information such as financial details and personal locations can be stolen, which endangers the user’s privacy. In theory, attackers can also manipulate users to lose autonomy of themselves, including the inability to protect and control one’s actions.

Through the control of the user’s brain by exploiting vulnerabilities in BCI devices, hackers can also biohack different areas of the body. An increase in BCI will push biohackers who mostly use hazardous labs, which are prone to accidents with potentials of bacterial infection, to harm communities. In 2015, a Californian lab created a night vision of eye drop but couldn’t confirm its long-term chemical effects showing that these experiments are unstable and possibly life-threatening [58]. These labs are also suitable for bioterrorists who could develop bio-weapons causing epidemics.

Physical and Psychological Concerns

Although patients enjoy psychological benefits in theory, the effect of BCI treatment on individual patients remains uncertain. Some patients refer to the relationship with BCI technology as “radical symbiosis”, which is defined as the intimate co-existence of two parties for mutual advantage [59]. Other patients who have undergone BCI treatment for Parkinson’s disease have demonstrated other changes. Some became violent while others became hypersexual and apathetic [59]. While there are obvious benefits to BCI application, many patients experience a distorted perception of themselves for a prolonged period of time.

Regulatory Challenges

As consumer BCIs grow dramatically, regulation of EEG-based motor imagery BCIs is expected to be strictly implemented. This type of BCI uses a technique called transcranial direct stimulation (TDS) that can enhance physical movement and improve cognitive performance. However, scientists found that the scientific literature on the benefits of TDS is mixed [60]. A senior research scientist at the Health Ethics & Policy Lab of ETH Zurich in Switzerland, Marcello Lenca, warned that information about clinical trials must be realistic and unbiased, and if companies continue to exaggerate the benefits of invasive procedures, it can mislead participants when enrolling in clinical trials with unrealistic expectations, leading to potential consequences for the organization [61]. Before regulations are outlined and implemented, companies must remain transparent and ethical to the best of their abilities.

Currently, the US and UK governments are working with ethicists and regulators to develop guidance for BCI-related companies. The Royal Society, a UK scientific institution, has suggested that “allowing new BCI-related devices to be temporarily tested in a controlled environment can be used as a test case for new approaches to technology regulation,” and “participation from the public is also suggested to shape future regulations” [62].

CASE STUDY: NEURALINK

Neuralink was co-founded in 2016 by Elon Musk, CEO of Tesla Inc and SpaceX, with the mission to help cure neurological conditions and fuse humankind with AI [63].

Neuralink envisions the invasive placement of electrodes within the grey matter of the brain to monitor individual neurons. All these electrodes are connected on molecular-sized threads of film metals which lead to an implanted device called the “Link”, which processes, stimulates, and transmits neural signals [64]. The latest design has 1024 electrodes recording and transmitting neural stimuli throughout the primary motor cortex. Advanced material engineering is necessary to make the threads corrosion resistant and ensure the electrodes are sensitive enough to detect sufficient neuron activity. Once neural activity is detected, signal amplifiers are necessary for the chip in the “Link” to process and upload the information to a device [64]. Further, the sheer quantity of data that would be recorded necessitates very powerful chips in the “Link”, which are also extremely power efficient as to minimize power dissipation and ensure practical battery life.

The microscopic scale of the hardware requires the threads and link to be implanted through machine-assisted neurosurgery [64]. Neuralink has designed a specialized robot to conduct the surgery, which was first displayed by Elon Musk on August 28, 2020.

Neuralink Surgical Robot [65]

The wireless connection from the “Link” to a digital device such as a computer or phone would be facilitated with a user interface application with the use of Bluetooth. Being in control of the communication between the “Link” and the App would not be through any traditional input device like a trackpad or keyboard [64]. As such, user training will be necessary to become competent at using Neuralink. Users will need to train themselves to first just think of a simple gesture with their hand, and have that gesture imitated on the device they are using. For example, to scroll on a phone, users would begin by both thinking of the phone screen scrolling, while also thinking of moving their hand in an upwards or downwards motion. Next, they’d imagine moving their thumb in the swiping motion and scrolling your phone. Through repetition, and the assistance of algorithms, the neural signals produced by their brain when thinking of making that hand or thumb gesture would be correlated to the scrolling of the phone screen. Eventually, the “Link” would direct the phone to scroll simply by the thought of doing so.

Much like many other new and complex BCI’s, Neuralink was conceptualized to enable individuals with paralysis to control digital devices such as phones and computers. This would unlock their potential to communicate digitally, express themselves through photography or art, and even write code for an application. Currently, Neuralink wants to offer the technology to individuals with spinal cord injury as a means to attain digital device independence, beginning with simple actions such as moving a mouse on a screen. Mouse control has been achieved by other BCI’s in controlled medical and academic settings, so this is certainly an attainable goal. The advantage of Neuralink would be its preciseness, neural signal processing ability, and discrete design, enabling practical everyday usability.

“This technology has the potential to treat a wide range of neurological disorders, to restore sensory and movement function, and eventually to expand how we interact with each other, with the world, and with ourselves [66].” - Neuralink

Since the conception of Neuralink, commercial medical use scalability has become a central guiding point for design and development as the material science and algorithmic capability behind the design has progressed. With future advancement of algorithm complexity, increased user familiarity with the technology and the incorporation of machine learning and artificial intelligence in the decoding of neural signals, Neuralink may be able to complete more intricate tasks such as using a keyboard or game controller.

The application of Neuralink to browse the internet, play virtual video games, authenticate usernames and passwords, and even communicate with others through “the Link” are all high aspirations for the technology. However, Neuralink is only focused on making “medical devices” as of right now, and the proliferation of consumer BCI’s for healthy individuals is barely on the horizon, if at all.

FUTURE OF BCI

The future achievements of this technology depends on advances in 3 crucial areas. The first area would be in signal-acquisition hardware. The goal is to create hardware which is convenient, portable, safe, and able to function in all environments for maximized success. The second achievement would be the validation in long-term studies of real-world use by people with severe disabilities and implementation of effective/viable models for their widespread dissemination. Right now, BCIs are very uncertain as there is not much of a sample size of individuals who have had the opportunity of using partially invasive or invasive BCIs. An increased number of usage from the general public and studies of the results would be imperative to advance the growth of this industry. Finally, improvement in moment-to-moment reliability of BCI performance so that it approached the reliability of natural muscle-based function would be another key factor in advancing the success and achievements of BCI [11]. Given the potential of this technology, numerous research has been performed to study the social impact of BCI. Some key topics that many researchers anticipate include the loss of humanity, stigma and normality, and the role of media.

Loss of humanity

Loss of humanity refers to the issue of control over one’s thoughts and actions. BCI technology functions by detecting and analyzing biosignals. The design of this technology magnifies the possibility of expressing or acting on an inappropriate thought that others who are not under the influence of BCI may refrain from [67]. Under such circumstances, it is unclear which party should be held responsible for these actions - particularly with respect to cases involving legal governance.

The loss of humanity also impacts the validity of consent [67]. All individuals have the right to withdraw their participation in BCI-related activities. For individuals experiencing dramatic psychological effects, the validity of their consent is challenged especially if their independent thinking is compromised. In this case, it is uncertain whether the subject’s family members would have the ability to overrule the decision.

Stigma and normality

BCI is largely seen as assistive technology, particularly because of its ability to help patients regain independence and enjoy a better quality of life. However, researchers anticipate the decision of adopting BCI to be significantly impacted by the social stigma of disability [67]. While some may be eager to turn to BCI to recover communicative or mobile functions in order to give back to society, others may be hesitant. This behaviour may be explained by the increased stigma of disability.

Media

Awareness about BCI is largely due to the media. Moreover, media coverage about BCI remains positive and futuristic. However, BCI is not at all reliable as research and development remains in the early stages. In fact, current research suggests considerable side effects that are experienced by subjects. Ultimately, further research must be performed to explore the role that media should play in reporting BCI technology [67].

CONCLUSION

BCIs could be one of the most revolutionary technologies ever conceived in recent decades. The technology leverages the combined capabilities of the Internet, artificial reality and artificial intelligence to provide unprecedented benefits to users.

Given the power of this technology, it demonstrates immense potential to expand into the global market. The technology currently holds a large market share in North America across numerous fields, including health and psychology, neuromarketing, games and entertainment, and smart environments. As well, BCIs can be applied to retain, regain or enhance human capabilities; however, BCI use contains elements that challenge common experiences. For instance, the technology may at times stand in conflict with the affective side of BCI users [68].

As consumer-based BCIs continue to grow rapidly, collaboration between scientists, engineers, ethicists and regulators is critical to the development of more cost efficient, user-friendly and ethically committed BCIs [69]. Additionally, governments must also plan ahead and establish legislations to regulate BCIs and related companies. By the time a bi-directional BCI becomes commonplace, the way of life as we know it will undergo drastic change and the promise of BCI will finally be realized.

AUTHORS

Nicole Cheung Lewis Darling Tao Ge Prerna Kapoor
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada
Beedie School of Business
Simon Fraser University
Burnaby, BC, Canada

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