The field of neuroprosthetics today is in its infancy. Currently, research is only beginning to crack the electrical information encoding the information in a human's thoughts. Despite the field's youth, early advances have already demonstrated that these platforms can be utilized to significantly enhance an impaired user's ability to interact with his/her environment. Each of the reviewed signal platforms has the potential to substantively improve the manner in which patients with spinal cord injury, stroke, cerebral palsy, and neuromuscular disorders communicate with their world. Each platform also has distinctive barriers that it will need to overcome. For the population signal platforms of EEG and ECoG, increasing the complexity of control is critical; while for single-unit platforms, demonstrating chronic implant durability is of central concern. Given the rapid progression of these technologies over the past five to seven years and the concomitant swift ascent of computer processing speeds, signal analysis techniques, and emerging ideas for novel biomaterials, these issues should not be viewed as obstacles, but rather as milestones that will be achieved. The order in which these milestones will be accomplished remains to be seen. As research in this field begins to transition from basic research to one of clinical application, it will herald in a new era of restorative neurosurgery. Through neurosurgical intervention, the ability will exist to restore function that today is unrecoverable. In the future, a neurosurgeon's capabilities will go beyond the ability to remove offending agents such as aneurysms, tumors, and hematomas to prevent the decrement of function. Rather, he or she will also have the skills and technologies in their clinical armamentarium to engage the nervous system to restore abilities that have already been lost.
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