Currently accepted at: JMIR Neurotechnology
Date Submitted: Aug 10, 2025
Date Accepted: May 1, 2026
(closed for review but you can still tweet)
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/82142
The final accepted version (not copyedited yet) is in this tab.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Understanding Patient Preferences for Implantable Brain-Computer Interfaces in Motor Neuron Disease: A Cross-Sectional Survey
ABSTRACT
Background:
Motor neuron disease (MND) causes progressive paralysis with preserved cognition. Implantable brain–computer interfaces (iBCIs) may help restore function, but patient priorities and tolerance for associated burdens remain poorly understood.
Objective:
To assess the preferences of people with MND for iBCI functions, performance characteristics, and acceptable surgical and training demands.
Methods:
A cross-sectional online survey was disseminated by the MND Association (30 September–15 December 2024). Thirty-nine adults responded, with 32 completing the survey, reporting demographic and clinical information, iBCI awareness, desired device functions, and tolerable surgical risks and training demands.
Results:
Among participants, 66.7% (n=26) used digital devices during every waking hour, yet 30.8% (n=12) were unable to control them with their hands. Familiarity with BCIs was generally low. Most (80%, n=28) would accept surgical implantation if it offered meaningful benefits, though only 60% (n=21) would do so if its function lasted just one year. Participants tolerated a median of 12 home-based training sessions (versus five if clinic-based), and nearly half preferred sessions under two hours. Mobility, communication, and upper limb function were the most desired iBCI functions. Among digital-specific applications, communication, employment, and leisure emerged as the top three preferences. When considering iBCI implantation, accuracy, ease of use, and long-term reliability were prioritised over speed. More than 90% emphasised the need for ongoing technical support to reduce the risk of device abandonment.
Conclusions:
These findings highlight a strong willingness among people with MND to undergo iBCI surgery if it provides lasting functional improvements with minimal training burden. Enhanced patient education and guaranteed long-term support may be critical for maximising adoption and real-world impact.
Citation
