20716 Impact of artificial intelligence on neural implants

Impact of artificial intelligence on neural implants Definition of neural implantsImplanting medical devices inside the human body can replace missing biological structures, support damaged biological structures, modulate function of physiological systems or enhance existing biological structures and physiological systems, respectively.A "neural implant" is an implant that interacts with neurons.Since it needs electrical power for interaction, it is classified as "active implantable medical device" (AIMD) and covered by the medical device regulation in the EU (MDR, 745/20167EU).Because of their potential to interfere with cognition, emotions and the psyche, neural implants connected to the brain ("brain-machine-interfaces", "brain-computer interfaces" [1]) continue to raise both hope and ethical concerns.As of today, the most successful active implants are cardiac pacemakers.Interestingly, the hearts own neural pacemaker cells in conjunction with peripheral glia cells closely resemble anatomical brain architecture [2].However, when neural implants are discussed, we usually talk about direct connections to nerves and to the brain.Among those, cochlear implants (CI) are the most frequently employed devices.More than one million CIs have been implanted worldwide.They have changed the treatment of profound hearing loss bordering on deafness that cannot be adequately treated with other hearing aids.CI use electricity to stimulate the spiral ganglion cells of the auditory nerve to restore sensorineural hearing loss, bypassing the damaged hearing apparatus.A prerequisite is the presence of the cochlear nerve, a cranial nerve connecting to the brainstem with relatively preserved anatomy.If this is not the case, similar implants placed at specific sites of the hearing pathway in the brainstem can partially restore hearing function [3].The most relevant and successful direct brain implant is a pacemaker for neural cells that regulate movement and behavior related to Parkinson's disease (PD).The method has been termed "deep-brain stimulation" (DBS) [4] because targets are not on the surface of the brain.As of 2023, around 244.000 DBS systems have been implanted worldwide [5].While first developed to treat movement-related symptoms like tremor and akinesia, DBS was soon found to influence emotion and personality in patients, too, which in turn widened the medical indications for these implants and led to the discovery of other anatomical targets in the brain.FDA-approved stimulation targets are the globus pallidus internus (GPi) located in the basal ganglia on either side of the thalamus, the subthalamic nucleus (STN) situated in the basal ganglia above the substantia nigra for akinetic-rigid PD, and the anterior limb of the internal capsule for medically