Brain-machine interfaces and transcranial stimulation: future implications for directing functional movement and improving function after spinal injury in humans

Since its origins, the primary goal of transforming thought into action and sensation into perception has been to improve the quality of life for the physically impaired. Brain-machine interfaces (BMI) aim to improve the quality of life for large numbers of neurological patients. In particular, this novel technology is meant to play a major role in the near future as a serious contribution to spinal cord rehabilitation. During the last decade we have witnessed a dramatic increase in BMI research with impressive demonstrations of rodents, nonhuman primates, and humans controlling robots, wheelchairs, and graphical cursors in real time through signals collected from the brain. In this chapter we first review the different techniques used in the field of BMI, including electroencephalography (EEG), electrocorticography (ECoG), magnetoencephalography (MEG), and chronic multielectrode recordings. In addition we review the use of transcranial magnetic stimulation (TMS) for noninvasive modulation of excitability in relatively focal cortical areas. The chapter concludes with a discussion on the future implications of BMIs for directing functional movement and improving function after spinal injury in humans.