Brain-computer interface-based control of closed-loop brain stimulation: attitudes and ethical considerations

Eran Klein, Sara Goering, Josh Gagne, Conor V. Shea, Rachel Franklin, Samuel Zorowitz, Darin D. Dougherty, Alik S. Widge

Research output: Contribution to journalArticlepeer-review

82 Scopus citations


Patients who have undergone deep brain stimulation (DBS) for emerging indications have unique perspectives on ethical challenges that may shape trial design and identify key design features for BCI-driven DBS systems. DBS research in cognitive and emotional disorders has generated significant ethical interest. Much of this work has focused on developing ethical guidelines and recommendations for open-loop DBS systems. While early trials of open-loop DBS for depression gave disappointing results, research is moving toward clinical trials with closed-loop or patient-controllable DBS systems that may modulate aspects of personality and emotion. Though user-centered design is an increasingly important principle in neurotechnology, the perspectives of implanted individuals on ethical issues raised by DBS are poorly understood. We solicited those perspectives through a focus group and set of qualitative interviews of participants in trials of DBS for depression and obsessive-compulsive disorder. We identified four major themes: control over device function, authentic self, relationship effects, and meaningful consent. Each has implications for the design of closed-loop systems for non-motor disorders.

Original languageEnglish (US)
Pages (from-to)140-148
Number of pages9
JournalBrain-Computer Interfaces
Issue number3
StatePublished - Jul 2 2016
Externally publishedYes

Bibliographical note

Funding Information:
The work of Dr. Klein and Dr. Goering was supported by Award Number EEC-1028725 from the National Science Foundation. Dr. Widge gratefully acknowledges research support from the MGH-MIT Strategic Initiative, Brain & Behavior Research Foundation, and Harvard Brain Institute Bipolar Disorder Seed Fund.

Publisher Copyright:
© 2016, © 2016 Informa UK Limited, trading as Taylor & Francis Group.


  • closed-loop
  • deep brain stimulation
  • end-user perspectives
  • ethics
  • patient-controlled


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