Locked In Connections

Brain-computer interfaces (BCI) are able to process neural activity to control a computer, with crucial applications in neuroscience and medicine.

Note: this a perfunctory post for the e-SPEAIT course.
The weekly prompt was: “if a person has control over any function, they can control a computer”.

Season five, episode nineteen of House MD speaks about a patient who, following a cycling accident, suffers from Locked-In Syndrome. It’s a neurological disease causing the paralysis of all voluntary muscles, except the ones moving the eyes. A person is thus only able to communicate with the outside world by blinking.

I apologise if I spoil the episode for anyone, but at some moment, the medical team messes up. The patient loses his blinking ability and the doctors can no longer determine if he is braindead or not. Their twisted solution? A BCI: Brain-Computer Interface.

In the episode, doctors tasked the patient with moving an arrow on a screen. Moving up meant “yes”, moving down meant “no”. It took a while, but eventually the patient pulled it off, showing thus that he was still mentally present.

While House MD is a TV series, medicine in the real world also uses BCIs. In fact, as early as 2002, a BCI was successfully used to get a patient suffering from the syndrome to answer yes / no questions, instead of the traditional “blink once for yes, twice for no” method. In 2006, the technology was already so advanced to allow someone to use a web browser using a BCI [1].

BCIs, of course, have more applications than just the locked-in syndrome.

Types of BCIs

There are three major types of BCIs — invasive, partially invasive and non-invasive — which can help patients with various neurological diseases.

Invasive BCIs comprise electrodes that get implanted into the brain itself, thus resulting in the highest quality signals but also the most potential complications as it involves brain surgery.

Partially invasive BCIs are still within the skull, but placed on the brain’s surface, not inside of it. Non invasive BCIs make use of external neuroimaging using various techniques, and therefore do not require surgery.


BCIs are highly complex, and this blog post doesn’t do them justice. The key takeaway from this topic, however, is that this technology has the potential to process and exploit even the faintest neurological signals to manipulate a computer.

We have come a long way, and the technologies keep developing thanks to heavy research in the field. We can only hope that in the future, neurological diseases that once isolated people from society can reintegrate them, if not physically, then at least mentally.

[1] Karim AA, Hinterberger T, Richter J, Mellinger J, Neumann N, Flor H, Kübler A, Birbaumer N. “Neural internet: Web surfing with brain potentials for the completely paralyzed”. Neurorehabilitation & Neural Repair. 40 (4): 508–515

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