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Toward expanding the population of potential BCI users to the many individuals with lateralized cortical stroke, here we examined whether the cortical hemisphere controlling ongoing movements of the contralateral limb can simultaneously generate signals to control a BCI. A monkey was trained to perform a simultaneous BCI and manual control task designed to test whether one hemisphere could effectively differentiate its output and provide independent control of two tasks. Pairs of well-isolated single units were used to control a BCI cursor in one dimension, while isometric wrist torque of the contralateral forelimb controlled the cursor in a second dimension. The monkey could independently modulate cortical units and contralateral wrist torque regardless of the strength of directional tuning of the units controlling the BCI. When the presented targets required explicit decoupling of unit activity and wrist torque, directionally tuned units exhibited significantly less efficient cursor trajectories compared to when unit activity and wrist torque could remain correlated. The results indicate that neural activity from a single hemisphere can be effectively decoupled to simultaneously control a BCI and ongoing limb movement, suggesting that BCIs may be a viable future treatment for individuals with lateralized cortical stroke.

There is a pressing clinical need for responsive neurostimulators, which sense a patient's brain activity and deliver targeted electrical stimulation to suppress unwanted symptoms. This is particularly true in psychiatric illness, where symptoms can fluctuate throughout the day. Affective BCIs, which decode emotional experience from neural activity, are a candidate control signal for responsive stimulators targeting the limbic circuit. Present affective decoders, however, cannot yet distinguish pathologic from healthy emotional extremes. Indiscriminate stimulus delivery would reduce quality of life and may be actively harmful. We argue that the key to overcoming this limitation is to specifically decode volition, in particular the patient's intention to experience emotional regulation. Those emotion-regulation signals already exist in prefrontal cortex (PFC), and could be extracted with relatively simple BCI algorithms. We describe preliminary data from an animal model of PFC-controlled limbic brain stimulation and discuss next steps for pre-clinical testing and possible translation.