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Miguel A. L. Nicolelis

Real-time direct interfaces between the brain and electronic and mechanical
devices could one day be used to restore sensory and motor functions lost
through injury or disease. Hybrid brain–machine interfaces also have the
potential to enhance our perceptual, motor and cognitive capabilities by
revolutionizing the way we use computers and interact with remote
environments.

After a clever throw in by Tostão, a simple flick of Rivelino’s magic left foot was enough to send artificially generated electrical signals to
the ball soaring into the thin air of the Azteca stadium in Mexico City. As the immaculate white stimulate brain tissue in order to transmit
object flew towards the middle of the penalty box on that hot afternoon, the colourful crowd that some particular type of sensory information
packed the stands slowly rose in anticipation. They roared, already celebrating, because they or to mimic a particular neurological func-
had seen that scene a thousand times before: the same graceful black man, dressed in blue shorts tion. The classic example of this application is
and a yellow jersey with the green 10 sewn in the back, defying logic, making fun of physics. The an auditory prosthesis. Future applications
early celebration was warranted. As expected, Pelé floated above all Italian defenders to aimed at restoring other sensory functions,
encounter the ball in mid air, and, with a gentle kiss of a forehead, changed its trajectory towards such as vision, by microstimulation of specif-
the net. Brazil had scored the first of its four goals in the final game of the 1970 World Cup and a ic brain areas would also belong to this group.
whole country was about to start dancing in the streets. In addition, type 1 HBMIs include methods
for direct stimulation of the brain to alleviate
pain, to control motor disorders such as
Brain–machine interfaces Parkinson’s disease5, and to reduce epileptic

T
he vast range of human abilities and
behaviour illustrated here, as well as the I propose that the introduction of new meth- activity by stimulation of cranial nerves6.
gift of remembering the multitude of ods for measuring large-scale brain activity, These last three applications rely on the
sensations associated with an instant of joy new techniques for microstimulating observation that direct microstimulation of
many decades ago, offer us a glimpse of the neuronal tissue, and emerging developments brain tissue can disrupt pathological patterns
awesome repertoire of tasks that the human in microchip design, computer science and of brain activity that underlie some
brain can accomplish. Through mechanisms robotics have the potential to coalesce into a neurological disorders. Type 2 HBMIs rely on
that still elude our comprehension, the new technology devoted to creating inter- the real-time sampling and processing of
electrical activity of millions of brain cells faces between the human brain and artificial large-scale brain activity to control artificial
(neurons) can be translated into precise devices. One day, it is conceivable that such devices. An example of this application
sequences of skilled movements. Coordinat- technology could allow patients to use brain would be the use of neural signals derived
ed neuronal activity also provides us with activity to control electronic, mechanical or from the motor cortex to control the
exquisite perceptual and sensorimotor capa- even virtual devices, leading to new
bilities, illustrated in this example by Pelé’s therapeutic alternatives for restoring lost
ability to track the ball’s trajectory and plan
the timing of his jump to hit it head on.
sensory, motor and even cognitive functions.
Although many fundamental neurobiological
Box 1 Cochlear implants:
But this is not all. Highly distributed patterns
of neuronal firing underlie our ability to
questions and technical difficulties need to be
solved, we can be optimistic about the feasibili-
the first HBMI
generate expectations about the outcome of a ty of implementing this concept in the next few
future event, learn the complex laws of nature decades. Indeed, one brain–machine interface Auditory prostheses work by converting features of
and create art. One could argue, therefore, — the auditory prosthesis known as the acoustic signals, such as speech, into patterns of
that hidden within the intricate principles cochlear implant — was introduced years ago electrical stimuli that are then delivered through
that govern the way brain circuits operate lies and has improved the quality of life of many an array of chronically implanted electrodes to
the key to understanding the very essence of deaf patients1,2 (see Box 1). auditory nerve fibres lying on the basilar
what it is to be human. Neuroscientists have long relished the membrane of the cochlea. As the basilar
Witnessing the relentless growth of possibility of using brain signals to control membrane contains a representation of sound
the disciplines that define modern neuro- artificial devices3. As a consequence, there frequencies, known as a tonotopic map, auditory
science, one cannot help wondering what are already many terms in the literature4 to prostheses deliver high-frequency information to
kind of insights, clinical applications and describe devices that could accomplish this the basal region of the cochlea, and low-frequency
technologies may emerge from brain goal (for example, brain-actuated technolo- signals to the apical region, to mimic normal
research in the future, and, more important, gy, neuroprostheses or neurorobots). Here I auditory processing. More than 30,000 deaf
how they will impact on our lives. Although will refer to these devices collectively as patients, ranging in age from 12 months to 80
many of the imagined possibilities may not ‘hybrid brain–machine interfaces (HBMIs)’. years, have had such devices successfully
be feasible at this time, recent work indicates The word ‘hybrid’ reflects the fact that these implanted2. Although results vary from case to
that some current ideas will come to fruition applications rely on continuous interactions case, even slight improvements in auditory
in the not-so-distant future. Here, I focus between living brain tissue and artificial performance have helped people to communicate
on one of these — the development of electronic or mechanical devices. better and to become more aware of their
direct interfaces between machines and My definition of HBMIs incorporates two surrounding environment.
the human brain. main types of application. Type 1 devices use
NATURE | VOL 409 | 18 JANUARY 2001 | www.nature.com © 2001 Macmillan Magazines Ltd 403
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movements of a prosthetic robotic arm in real a
time. Obviously, clinical applications that Technique for multichannel
require reciprocal interaction between the acquisition system b c
brain and artificial devices will combine both
Signal Real-time
type 1 and 2 HBMIs. processing analysis of
The design and implementation of brain
HBMIs will involve the combined efforts of
many areas of research, such as neuroscience, d
computer science, biomedical engineering, Real-time
very large scale integration (VLSI) design telemetry
and robotics. I have selected a few current interface
developments in these fields to illustrate
below some of the conceptual advances and
technologies that will be required to design
and implement useful HBMIs. I will then
describe two potential clinical applications
Telemetry
of such technology that should emerge in the receiver
near future: a system to monitor and treat
epileptic seizures and a device to control a Three-dimensional
e
artificial limb
robotic prosthetic arm. f Real-time
multichannel
Tactile and mechanical
Building a HBMI Visual
proprioceptive
feedback actuator
The first of the many challenges associated feedback
with the development of any HBMI is the need
to understand better the principles by which
neural ensembles encode sensory, motor and Figure 1 Schematic description of the general organization of a type 2 HBMI.
cognitive information. This is rapidly
becoming one of the main goals of modern
neuroscience, but our present knowledge is device we will need to sample the activity of 1940s and 50s with multichannel recordings
elementary at best. In the case of motor con- many neurons simultaneously and design of scalp electroencephalographic (EEG)
trol, for instance, the areas of the primate brain algorithms capable of extracting motor activity and of the general electrical activity
involved are well known, and considerable control signals from these ensembles. evoked by movement or sensory stimulation,
information is available on the physiological Moreover, it will be crucial to investigate how a variety of metabolic, optical and electro-
properties of individual neurons located in these neural ensembles interact under more physiological methods have been introduced
each of them. But we know little about how the complex and ‘real-world’ experimental con- for monitoring large-scale brain activity.
brain makes use of information from these ditions8 to generate different motor behav- Modern multichannel electrophysiological
neurons to generate movements. To design a iours. These data will be vital to answering recordings are made from arrays of micro-
type 2 HBMI that uses brain-derived signals to basic questions in regard to the development electrodes surgically implanted in the brain.
control a prosthetic robotic arm, we will need of type 2 HBMIs. For example, what is the They currently allow neurophysiologists to
to learn how to sample and decode the motor minimum neuronal sample required to gen- record simultaneously, with a resolution of
signals generated by neurons and how to feed erate reliable brain-derived control signals? milliseconds, the extracellular activity of up
them into an artificial device to mimic the Should these samples be obtained from one or to 100 individual neurons, distributed across
intended movement. multiple brain areas? Does the same popula- multiple brain structures, in animals carry-
tion of neurons code for single or multiple ing out some task or other12. Although future
Recording brain activity control parameters? Finally, how might improvements might allow long-term and
It is clear that neurobiological principles will neural encoding mechanisms change with non-invasive sampling of human neural
be central in devising a strategy to overcome time, experience and learning? activity with the same temporal resolution as
these hurdles. For example, classic experi- Figure 1 illustrates the general organiza- intracranial recordings, the first generation
ments in primates have demonstrated that tion of a type 2 HBMI and depicts some of of HBMIs will probably rely on improved
fundamental parameters of motor control the technological challenges involved in versions of electrophysiological methods,
emerge by the collective activation of large designing such devices. The first design step such as multichannel EEG or multielectrode
distributed populations of neurons in the pri- involves the selection of a technique (Fig. 1a) intracranial recordings. Indeed, preliminary
mary motor cortex (M1). Single M1 that yields reliable, stable and long-term studies in paralysed patients have shown that
neurons are broadly tuned to the direction of recordings of brain activity that can be used EEG signals can be used to trigger the move-
force required to generate a reaching arm as control signals to drive an artificial device. ment of computer cursors13 or offer a way for
movement7. In other words, even though From recent studies in animals9,10, clinical patients to communicate14.
these neurons fire maximally before the applications of HBMIs will probably require Unfortunately, less invasive electrophysi-
execution of a movement in one direction, sampling of large numbers of neurons (in the ological methods, such as scalp EEG record-
they also fire significantly before the onset of order of hundreds or thousands) with a ings that reflect the common electrical
arm movements in a broad range of other temporal resolution of 10–100 ms, depend- activity of millions of neurons in widespread
directions. Therefore, to compute a precise ing on the application. areas of the cortex, lack the resolution to
direction of arm movement, the brain may Although neuroscientists have long rec- provide the kind of time-varying motor
have to perform the equivalent of a neuronal ognized the need to investigate the properties signals needed to control a robotic arm in
‘vote’ or, in mathematical terms, a vector sum- of large neural ensembles11, it is very difficult real time4. Multichannel intracranial record-
mation of the activity of these broadly tuned to obtain reliable, long-term measurements ings of brain activity, obtained by surgical
neurons7. This implies that to obtain the of neural ensemble activity with high spatial implantation of arrays of microwires within
motor signals required to control an artificial and temporal resolution. Starting in the one or more cortical motor areas, will
404 © 2001 Macmillan Magazines Ltd NATURE | VOL 409 | 18 JANUARY 2001 | www.nature.com
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other factors, will certainly be important in
the design of HBMIs16.
Having selected a method for sampling and
conditioning brain signals, the next step — and
one of the most difficult challenges — is to
102amplifiers define a strategy for extracting meaningful
control information from neural ensemble
activity in real time. Currently, neuroscientists
rely on a variety of linear and nonlinear
Differential multivariate algorithms, such as discriminant
amplifiers analysis, multiple linear regression and artifi-
cial neural networks, to carry out real-time and
Bandpass
filters
off-line analysis of neural ensemble data.
Preliminary results from animal studies that
use these different methods are encouraging,
but considerably more experience is needed to
apply these techniques in clinical HBMIs. The
challenge is to produce algorithms that can
combine the activity of large numbers of
neurons, which convey different amounts of
information, and extract stable control signals,
Figure 2 A prototype of an instrumentation neurochip for processing brain-derived signals. This even when the firing patterns of these neurons
chip, containing a portion of the analog signal processing for 16 neural channels, was designed by change significantly across different timescales.
I. Obeid, H. Aurora, J. Morizio and P. Wolf in the Departments of Biomedical and Electrical & Research on areas ranging from automatic
Computer Engineering at the Pratt School of Engineering, Duke University. The mixed-signal sorting algorithms for unsupervised isolation
CMOS (complementary metal-oxide semiconductor) process used in the design supports digital of single neuron action potentials, to the design
signal processing modules which will be included in future generations of this device. of real-time pattern recognition algorithms
that can handle data from thousands of simul-
taneously recorded neurons will certainly be
therefore be required, with mathematical signals in real time. Currently, this requires required. In the same context, clinical applica-
analysis of the extracellular activity of small- specialized, sizeable and expensive electron- tions of HBMIs will require considerable
er populations (100–1,000) of neurons pro- ic equipment, which can amplify and filter computational resources.
viding the raw brain signals for use in most the original signal as well as perform analog- In the not too distant future, new develop-
HBMIs10. Despite some degree of recording to-digital conversion to facilitate further ments in the design of brain-inspired VLSI17,
degradation over time, present technology processing and storage of data. To make an exciting area of research aimed at modelling
allows simultaneous sampling of 50–100 HBMIs viable, new technologies for neuronal systems in silicon18, may provide the
neurons, distributed across multiple cortical portable, wireless-based, multichannel means for achieving the type of efficient real-
areas of small primates, to remain viable for neural signal instrumentation are needed. time neural signal analysis required for
several years10,12. Technological advances in The central issue of signal conditioning HBMIs. This technology may allow pattern
multielectrode array design and neural and instrumentation may be solved in the near recognition algorithms, such as artificial
signal instrumentation in the next decade future by the application of mixed-signal VLSI neural networks or realistic models of neural
alone are expected to increase the number of into the design of neurophysiological instru- circuits, to be implemented directly in silicon
neurons that can be recorded simultaneous- mentation chips. This technology allows circuits. Among many other technical hurdles,
ly by at least one order of magnitude. analog and digital signals to coexist in the same significant work will be required to make these
The precise placement of the electrode microchip, and has the potential to provide the silicon circuits adaptive, perhaps by incorpo-
arrays for intracranial recording may not be multichannel, programmable and low-noise rating learning rules derived from the study of
as critical to the ability to control an artificial package required for conditioning brain- biological neural circuits. This will allow
device as was first conjectured. As motor derived signals for clinical implementation of ‘training’ of algorithms as well as ensuring the
control signals emerge from the distributed HBMIs. Moreover, the resulting microchip robustness of the control system. From an
activation of large populations of neurons, would be small enough to be chronically implementation point of view, ‘analytical
and as cortical and subcortical neurons are implanted in patients and could be powered by neurochips’ are ideal as they could be inter-
capable of considerable plastic reorganiza- replaceable batteries. Such microchips could faced with the instrumentation neurochip and
tion during adulthood15, electrode arrays rely on wireless communication protocols be chronically implanted in the subject.
targeted to brain areas of interest may suffice based on a radio frequency link to broadcast The final component of the idealized
in most cases. As subjects learn to interact neural signals to other components of the HBMI (Fig. 1e–f) is a real-time control inter-
with artificial devices through HBMIs, it is HBMI (Fig. 1d–e). face which uses processed brain signals to
likely that sampled neurons that were not Prototypes of dedicated ‘instrumenta- control an artificial device. The types of
originally involved in the type of motor tion neurochips’ (Fig. 2) are currently being devices used are likely to vary considerably in
control to be mimicked may be recruited developed, although many complex issues each application, ranging from elaborate
into generating the signals required to must be solved before they can become electrical pattern generators to control mus-
control artificial devices. operational16. For instance, efficient solu- cles, to complex robotic and computational
tions will have to be found to provide enough devices designed to augment motor skills19.
Generating the output power for performing analog and digital
After selecting a method for acquiring the processing, while still ensuring that signals HBMIs for epilepsy control
necessary brain signals, the next challenge is can be transmitted by telemetry. Thus, Estimates indicate that about 0.5–2.0% of the
to design the instrumentation (Fig. 1b–d) battery technology, device packing and the population has epilepsy20. About 10–50% of
required for recording and processing these bandwidth of the neural signals, among these patients do not respond well to current
NATURE | VOL 409 | 18 JANUARY 2001 | www.nature.com © 2001 Macmillan Magazines Ltd 405
insight feature
antiepileptic medications and may not be
a Seizure activity without intervention:
candidates for surgery. Throughout this
century, neuroscientists have used multi-
channel recording from scalp, brain surface
and even chronically implanted intracranial
electrodes to investigate the electrophysio- Seizure activity terminated by automatic seizure detector:
logical activity that characterizes different
types of seizure in humans. By doing so, Neural
scientists have not only identified different signal
from
types of epilepsy, but they have also learned brain Nerve cuff electrode
that there are distinct patterns of neurophysi- for seizure-triggered
Impulse cranial nerve
ological activity associated with the initiation from nerve stimulation
and establishment of a seizure attack.
Several exciting new developments in
epilepsy research indicate that the develop-
ment of an unsupervised HBMI for monitor-
ing, detecting and treating seizure activity
may be possible in the next decade (Fig. 3a).
First, for certain types of seizure, there seems Implanted VLSI device for
monitoring neural activity Implanted stimulus Implanted mini-pump
to be a particular spatiotemporal pattern of and detecting seizure activity generator for seizure-triggered
cortical activity that appears seconds or even systemic drug delivery
minutes before the full epileptic attack b
starts21. Recently, a few laboratories have
Multichannel neural
introduced automatic seizure-prediction signal processing:
Transmission of Computation of
algorithms that can be applied to intracranial Instrumentation and
neural activity 3D movement
analysis neurochip
and scalp recordings to forecast the occur- via telemetry trajectory
Implanted
rence of a seizure21,22. These and future microelectrode
seizure-prediction algorithms might provide arrays
sufficient time (2–5 minutes) to warn the
patient of an imminent attack, and to trigger
automatic therapeutic intervention before Visual and
tactile feedback
convulsion or loss of consciousness.
But what kind of therapy could be
triggered that would work in patients who are
refractory to epilepsy medication? The
Real-time interface to control
answer may lie in another recent develop- a robotic prosthetic arm
ment in epilepsy research. Studies in both
Z
animals23 and human subjects6 have revealed
that electrical stimulation of peripheral X
cranial nerves, such as the vagus23 and
trigeminal24 nerves, can substantially reduce Y
cortical epileptic activity. Moreover, if this 3D arm trajectory
peripheral nerve stimulation is applied
before the initiation of seizure or during its
initial stages, significantly higher reduction
of seizure activity can be achieved. Figure 3 Schematic description of two potential applications of type 2 HBMIs. a, Design of a ‘brain
From this I believe that a device containing a pacemaker’ that monitors neural activity using a VLSI chip designed to detect seizure activity.
combination of both type 1 and 2 HBMIs could When seizure activity is detected, the VLSI chip sends a signal to an implanted stimulus generator
be designed to function somewhat like a that drives either a nerve cuff electrode or a mini-pump for drug delivery, either of which can stop
modern heart pacemaker (Fig. 3a). This ‘brain the seizure activity. b, HBMI for controlling a robotic prosthetic arm using brain-derived signals.
pacemaker’ would rely on arrays of chronically Multiple, chronically implanted, intracranial microelectrode arrays would be used to sample the
implanted electrodes to search continuously activity of large populations of single cortical neurons simultaneously. The combined activity of
for spatiotemporal patterns of cortical these neural ensembles would then be transformed by a mathematical algorithm into continuous
activity indicating an imminent epileptic three-dimensional arm-trajectory signals that would be used to control the movements of a
attack. Instrumentation neurochips would be robotic prosthetic arm. A closed control loop would be established by providing the subject with
responsible for all the basic signal-processing both visual and tactile feedback signals generated by movement of the robotic arm.
operations. They would also provide signals to
one or more seizure-prediction algorithms,
implemented into analytical neurochips, drugs directly into the blood stream. Recently, a restoring different aspects of motor function
which would carry out real-time analysis of simplified implementation of this concept has in patients with severe body paralysis, caused
cortical activity. Once pre-seizure activity pat- been used successfully in rats24, giving hope primarily by strokes, spinal cord lesions or
terns were detected, the analytical neurochip that a brain pacemaker for seizure monitoring peripheral degenerative disorders (Fig. 3b).
could trigger electrical stimulation of one or and control in humans may not be far ahead. Advances in this rapidly growing field of
multiple cranial nerves. In patients who research indicate that neural signals from
respond to pharmacological therapy, the same HBMIs to restore motor function healthy regions of the brain could be used to
stimulator could be used to activate a mini- Another clinical application of HBMIs that control the movements of artificial prosthet-
pump to deliver one or more anti-epileptic could emerge in the near future aims at ic devices, such as a robotic arm. Preliminary
406 © 2001 Macmillan Magazines Ltd NATURE | VOL 409 | 18 JANUARY 2001 | www.nature.com
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findings also demonstrate that paralysed without any muscle activity, and hence that research on HBMIs will yield powerful new
patients can learn to use brain signals paralysed patients might be capable of learn- tools to investigate hypotheses of how large
obtained from their motor cortex to interact ing to operate a robotic arm even though they populations of neurons process information
with computers25. cannot move their own limbs. and adapt according to changes in experience.
Extensive electrophysiological work in These observations also raise the intrigu- Some may argue that one could achieve this
primates and imaging studies in humans have ing hypothesis that, by establishing a closed goal just by building theoretical models and
shown that multiple interconnected cortical control loop with an artificial device (Fig. 3b), running computational simulations. Perhaps
areas in the frontal and parietal lobes are the brain could incorporate electronic, that is true. But as my good friend Idan Segev, a
involved in the selection of motor commands mechanical or even virtual objects into its leading computational neuroscientist, always
that control the production of voluntary arm somatic and motor representations, and tells me, there is a subtle but fundamental
movements26. Although each of these areas operate upon them as if they were simple difference between simulating reality and
has different degrees of functional specializa- extensions of our own bodies. The fact that the building it. Those of us who saw Pelé scoring
tion, in theory, each of them could be selected adult cortex is capable of significant functional that magic goal on that hot Mexican afternoon
as the source of brain signals for controlling reorganization (or plasticity) after peripheral in 1970 and dreamed about doing the same
the movements of an artificial device. Within and central injuries15, changes in sensory thing would certainly agree.
each of these cortical areas, different motor experience28 and learning of new motor skills29 Miguel A. L. Nicolelis is in the Departments of
parameters, such a force and direction of supports this possibility. Indeed, the notion Neurobiology, Experimental Psychology, and
movement, are coded by the distributed that adult plasticity can dynamically alter the Biomedical Engineering, Duke University, Durham,
activity of populations of neurons, each of perception of the limits of our own body is cor- North Carolina 27710, USA
which is typically broadly tuned to one (or roborated by studies on patients who have (e-mail: nicoleli@neuro.duke.edu)
more) of these parameters. This indicates that undergone limb amputations. Immediately 1. Merzenich, M. M., Schindler, D. N. & White, M. W.
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though the rats continued to exhibit the significant conceptual and technological Acknowledgements. I thank J. Chapin, F. Ebner, E. Fanselow,
patterns of cortical activity required to control obstacles, the possibility of developing clinical A. Ghazanfar, C. Henriquez, J. Kaas, J. Kralik, D. Krupa, S. Ribeiro,
the movements of the robotic arm, this motor applications of HBMIs is real and worth V. de Sa, I. Segev, M. Shuler, S. Simon, J. Wessberg and P. Wolf for
activity did not result in any significant limb pursuing, especially given the potential bene- comments and suggestions, and E. Fanselow, D. Krupa, P. Beck and
J. Wessberg for their help in creating the illustrations for this article.
movement. This indicates that motor control fits that they may bring to people afflicted by The author’s research on HBMI is funded by NIH, DARPA and
signals can be generated by cortical neurons neurological disorders. At the very least, ONR grants.

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