Deep brain stimulators appear to unfetter an otherwise intact voluntary motor control system from the aberrant activity of one or more nuclei of the basal ganglia in patients with Parkinson’s disease or dystonia, whereas cochlear implants bypass a dysfunctional organ of Corti to activate an intact vestibulocochlear nerve to re-instate audition. Medical devices seek to restore lost function and leverage remaining, intact aspects of the patient’s physiology. Non-invasive techniques under development include transcranial magnetic or direct current stimulation, and biofeedback delivered from quantitative electroencephalography (EEG) or functional magnetic resonance imaging (fMRI). Other types of neurotechnology devices improve health by modulating pre-existing systems: deep brain stimulators, for example, deliver targeted electrical stimulation to the basal ganglia to relieve the symptoms of Parkinson’s disease. Sensory devices inject signals into the nervous system, while motor prosthetics extract signals from the nervous system and send them to control devices such as robotic arms or stimulators to re-activate paralyzed muscles. Cochlear implants have restored hearing to thousands of people, while devices to restore sight and movement are progressing rapidly. While non-invasive approaches might strengthen a patient’s remaining intact cognitive abilities, neurocognitive prosthetics comprised of direct brain–computer interfaces could in theory physically reconstitute and augment the substrate of cognition itself.Ī range of medical devices to restore or augment human functions are becoming available with the swift engineering and biomedical advances in the new field of neurotechnology. In order to paint a vision for future device development, it is essential to first review what can be achieved using behavioral and external modulatory techniques. Like their neuromotor counterparts, neurocognitive prostheses might sense or modulate neural function in a non-invasive manner or by means of implanted electrodes. Recent findings about the neurophysiology of these conditions in humans coupled with progress in engineering devices to treat refractory neurological conditions imply that the time has arrived to consider the design and evaluation of a new class of devices. No medical devices are currently available to help restore these cognitive functions. Executive planning, the ability to direct and sustain attention, language and several types of memory may be compromised by conditions such as stroke, traumatic brain injury, cancer, autism, cerebral palsy and Alzheimer’s disease.
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