{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:13:03Z","timestamp":1780636383004,"version":"3.54.1"},"reference-count":124,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Hightech-Agenda Bayern"},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["32NE30_199436"],"award-info":[{"award-number":["32NE30_199436"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["32NE30_199436"],"award-info":[{"award-number":["32NE30_199436"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Closed-loop (CL) neurotechnology, which dynamically adapts to patients\u2019 neural states, offers new opportunities for treating neurological and psychiatric disorders. However, its real-time feedback mechanisms raise critical ethical challenges. This scoping review assesses whether and how clinical studies involving CL neurotechnologies address ethical concerns. We analyzed peer-reviewed research on human participants to evaluate both the presence and depth of ethical engagement. Despite the prominence of CL systems in neuroethical discourse, explicit ethical assessments remain rare. Ethical issues are typically addressed only implicitly, folded into technical or procedural discussions without structured analysis. Most notably, our findings reveal a persistent gap between regulatory compliance and meaningful ethical reflection. To address this, we propose empirically grounded, community-responsive recommendations to strengthen ethical oversight in this field. These recommendations aim to support governance frameworks that are context-sensitive, reflexive, and capable of addressing the complex ethical terrain introduced by adaptive neurotechnologies.<\/jats:p>","DOI":"10.1038\/s41746-025-01908-4","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T20:05:43Z","timestamp":1754683543000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Ethical gaps in closed-loop neurotechnology: a scoping review"],"prefix":"10.1038","volume":"8","author":[{"given":"Lea","family":"Haag","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7428-2619","authenticated-orcid":false,"given":"Georg","family":"Starke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7767-7170","authenticated-orcid":false,"given":"Markus","family":"Ploner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8835-5444","authenticated-orcid":false,"given":"Marcello","family":"Ienca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"1908_CR1","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1001\/jama.2016.11708","volume":"316","author":"RM Bergenstal","year":"2016","unstructured":"Bergenstal, R. M. et al. Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. JAMA 316, 1407\u20131408 (2016).","journal-title":"JAMA"},{"key":"1908_CR2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/S2213-8587(21)00289-8","volume":"10","author":"LM Wilson","year":"2022","unstructured":"Wilson, L. M., Jacobs, P. G., Riddell, M. C., Zaharieva, D. P. & Castle, J. R. Opportunities and challenges in closed-loop systems in type 1 diabetes. Lancet Diab. Endocrinol. 10, 6\u20138(2022).","journal-title":"Lancet Diab. Endocrinol."},{"key":"1908_CR3","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1001\/jamaneurol.2015.0608","volume":"72","author":"E Krook-Magnuson","year":"2015","unstructured":"Krook-Magnuson, E., Gelinas, J. N., Soltesz, I. & Buzs\u00e1ki, G. Neuroelectronics and biooptics: closed-loop technologies in neurological disorders. JAMA Neurol. 72, 823\u2013829 (2015).","journal-title":"JAMA Neurol."},{"key":"1908_CR4","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1038\/s41386-023-01631-2","volume":"49","author":"KK Sellers","year":"2024","unstructured":"Sellers, K. K. et al. Closed-loop neurostimulation for the treatment of psychiatric disorders. Neuropsychopharmacology 49, 163\u2013178 (2024).","journal-title":"Neuropsychopharmacology"},{"key":"1908_CR5","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.parkreldis.2016.03.020","volume":"28","author":"M Arlotti","year":"2016","unstructured":"Arlotti, M., Rosa, M., Marceglia, S., Barbieri, S. & Priori, A. The adaptive deep brain stimulation challenge. Parkinsonism Relat. Disord. 28, 12\u201317 (2016).","journal-title":"Parkinsonism Relat. Disord."},{"key":"1908_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurot.2023.e00308","volume":"21","author":"FV Gouveia","year":"2024","unstructured":"Gouveia, F. V., Warsi, N. M., Suresh, H., Matin, R. & Ibrahim, G. M. Neurostimulation treatments for epilepsy: deep brain stimulation, responsive neurostimulation and vagus nerve stimulation. Neurotherapeutics 21, e00308 (2024).","journal-title":"Neurotherapeutics"},{"key":"1908_CR7","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1038\/s41746-023-00779-x","volume":"6","author":"AS Chandrabhatla","year":"2023","unstructured":"Chandrabhatla, A. S., Pomeraniec, I. J., Horgan, T. M., Wat, E. K. & Ksendzovsky, A. Landscape and future directions of machine learning applications in closed-loop brain stimulation. npj Digit Med. 6, 79 (2023).","journal-title":"npj Digit Med."},{"key":"1908_CR8","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1212\/WNL.0000000000001280","volume":"84","author":"GK Bergey","year":"2015","unstructured":"Bergey, G. K. et al. Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology 84, 810\u2013817 (2015).","journal-title":"Neurology"},{"key":"1908_CR9","doi-asserted-by":"publisher","first-page":"016004","DOI":"10.1088\/1741-2552\/aae67f","volume":"16","author":"B Houston","year":"2019","unstructured":"Houston, B., Thompson, M., Ko, A. & Chizeck, H. A machine-learning approach to volitional control of a closed-loop deep brain stimulation system. J. Neural. Eng. 16, 016004 (2019).","journal-title":"J. Neural. Eng."},{"key":"1908_CR10","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1002\/ana.23951","volume":"74","author":"S Little","year":"2013","unstructured":"Little, S. et al. Adaptive deep brain stimulation in advanced Parkinson disease. Ann. Neurol. 74, 449\u2013457 (2013).","journal-title":"Ann. Neurol."},{"key":"1908_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneumeth.2021.109209","volume":"358","author":"RA Movahed","year":"2021","unstructured":"Movahed, R. A., Jahromi, G. P., Shahyad, S. & Meftahi, G. H. A major depressive disorder classification framework based on EEG signals using statistical, spectral, wavelet, functional connectivity, and nonlinear analysis. J. Neurosci. Methods 358, 109209 (2021).","journal-title":"J. Neurosci. Methods"},{"key":"1908_CR12","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1038\/mp.2014.2","volume":"19","author":"WJ Neumann","year":"2014","unstructured":"Neumann, W. J. et al. Different patterns of local field potentials from limbic DBS targets in patients with major depressive and obsessive compulsive disorder. Mol. Psychiatry 19, 1186\u20131192 (2014).","journal-title":"Mol. Psychiatry"},{"key":"1908_CR13","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-021-01669-0","volume":"11","author":"MSE Sendi","year":"2021","unstructured":"Sendi, M. S. E. et al. Intraoperative neural signals predict rapid antidepressant effects of deep brain stimulation. Transl. Psychiatry 11, 551 (2021).","journal-title":"Transl. Psychiatry"},{"key":"1908_CR14","doi-asserted-by":"publisher","first-page":"3934","DOI":"10.3390\/jcm9123934","volume":"9","author":"J-Y Kim","year":"2020","unstructured":"Kim, J.-Y., Lee, H. S. & Lee, S.-H. EEG source network for the diagnosis of schizophrenia and the identification of subtypes based on symptom severity\u2014a machine learning approach. J. Clin. Med. 9, 3934 (2020).","journal-title":"J. Clin. Med."},{"key":"1908_CR15","doi-asserted-by":"publisher","unstructured":"Widge, A. S., Malone, D. A. & Dougherty, D. D. Closing the loop on deep brain stimulation for treatment-resistant depression. Front. Neurosci. 12, https:\/\/doi.org\/10.3389\/fnins.2018.00175 (2018).","DOI":"10.3389\/fnins.2018.00175"},{"key":"1908_CR16","doi-asserted-by":"publisher","first-page":"1696","DOI":"10.1038\/s41591-021-01480-w","volume":"27","author":"KW Scangos","year":"2021","unstructured":"Scangos, K. W. et al. Closed-loop neuromodulation in an individual with treatment-resistant depression. Nat. Med. 27, 1696\u20131700 (2021).","journal-title":"Nat. Med."},{"key":"1908_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2024.101662","volume":"5","author":"J Wang","year":"2024","unstructured":"Wang, J. & Chen, Z. S. Closed-loop neural interfaces for pain: Where do we stand?. Cell Rep. Med 5, 101662 (2024).","journal-title":"Cell Rep. Med"},{"key":"1908_CR18","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1080\/2326263X.2016.1207497","volume":"3","author":"E Klein","year":"2016","unstructured":"Klein, E. et al. Brain-computer interface-based control of closed-loop brain stimulation: attitudes and ethical considerations. Brain Comput. Interfaces 3, 140\u2013148 (2016).","journal-title":"Brain Comput. Interfaces"},{"key":"1908_CR19","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1017\/S0963180116000359","volume":"25","author":"P Kellmeyer","year":"2016","unstructured":"Kellmeyer, P. et al. The effects of closed-loop medical devices on the autonomy and accountability of persons and systems. Camb. Q. Healthc. Ethics 25, 623\u2013633 (2016).","journal-title":"Camb. Q. Healthc. Ethics"},{"key":"1908_CR20","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jdbs.2023.11.001","volume":"3","author":"S Baker","year":"2023","unstructured":"Baker, S. et al. Ethical considerations in closed loop deep brain stimulation. Deep Brain Stimul. 3, 8\u201315 (2023).","journal-title":"Deep Brain Stimul."},{"key":"1908_CR21","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1080\/21507740.2015.1105880","volume":"6","author":"J Amadio","year":"2015","unstructured":"Amadio, J. & Boulis, N. M. Brain implants as closed-loop systems: risks and opportunities. AJOB Neurosci. 6, 14\u201315 (2015).","journal-title":"AJOB Neurosci."},{"key":"1908_CR22","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s11023-020-09518-7","volume":"30","author":"S Aggarwal","year":"2020","unstructured":"Aggarwal, S. & Chugh, N. Ethical implications of closed loop brain device: 10-year review. Minds Mach. 30, 145\u2013170 (2020).","journal-title":"Minds Mach."},{"key":"1908_CR23","doi-asserted-by":"publisher","first-page":"2869","DOI":"10.1038\/s41596-023-00873-0","volume":"18","author":"R Yuste","year":"2023","unstructured":"Yuste, R. Advocating for neurodata privacy and neurotechnology regulation. Nat. Protoc. 18, 2869\u20132875 (2023).","journal-title":"Nat. Protoc."},{"key":"1908_CR24","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-024-01087-z","volume":"25","author":"G Starke","year":"2024","unstructured":"Starke, G. et al. Qualitative studies involving users of clinical neurotechnology: a scoping review. BMC Med. Ethics 25, 89 (2024).","journal-title":"BMC Med. Ethics"},{"key":"1908_CR25","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1017\/S0963180117000640","volume":"27","author":"F Gilbert","year":"2018","unstructured":"Gilbert, F., O\u2019brien, T. & Cook, M. The effects of closed-loop brain implants on autonomy and deliberation: what are the risks of being kept in the loop?. Camb. Q. Healthc. Ethics 27, 316\u2013325 (2018).","journal-title":"Camb. Q. Healthc. Ethics"},{"key":"1908_CR26","unstructured":"Beauchamp, T. L., & Childress, J. F. Principles of Biomedical Ethics. Oxford: Oxford University Press (1979)."},{"key":"1908_CR27","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1016\/j.brs.2021.09.002","volume":"14","author":"S Cernera","year":"2021","unstructured":"Cernera, S. et al. Wearable sensor-driven responsive deep brain stimulation for essential tremor. Brain Stimul. 14, 1434\u20131443 (2021).","journal-title":"Brain Stimul."},{"key":"1908_CR28","doi-asserted-by":"publisher","first-page":"046006","DOI":"10.1088\/1741-2552\/aabc9b","volume":"15","author":"NC Swann","year":"2018","unstructured":"Swann, N. C. et al. Adaptive deep brain stimulation for Parkinson\u2019s disease using motor cortex sensing. J. Neural Eng. 15, 046006 (2018).","journal-title":"J. Neural Eng."},{"key":"1908_CR29","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.nbd.2018.09.014","volume":"121","author":"D Pi\u00f1a-Fuentes","year":"2019","unstructured":"Pi\u00f1a-Fuentes, D. et al. The characteristics of pallidal low-frequency and beta bursts could help implementing adaptive brain stimulation in the parkinsonian and dystonic internal globus pallidus. Neurobiol. Dis. 121, 47\u201357 (2019).","journal-title":"Neurobiol. Dis."},{"key":"1908_CR30","doi-asserted-by":"crossref","unstructured":"Houston, B. C., Thompson, M. C., Ojemann, J. G., Ko, A. L., Chizeck, H. J. eds. Classifier-based closed-loop deep brain stimulation for essential tremor. In 2017 8th International IEEE\/EMBS Conference on Neural Engineering (NER) (IEEE, 2017)","DOI":"10.1109\/NER.2017.8008354"},{"key":"1908_CR31","doi-asserted-by":"publisher","unstructured":"Molina, R. et al. Closed-Loop Deep Brain Stimulation to Treat Medication-Refractory Freezing of Gait in Parkinson\u2019s Disease. Front. Human Neurosci. 15, https:\/\/doi.org\/10.3389\/fnhum.2021.633655 (2021).","DOI":"10.3389\/fnhum.2021.633655"},{"key":"1908_CR32","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1111\/j.1525-1403.2012.00521.x","volume":"16","author":"T Yamamoto","year":"2013","unstructured":"Yamamoto, T. et al. On-demand control system for deep brain stimulation for treatment of intention tremor. Neuromodulation 16, 230\u2013235 (2013).","journal-title":"Neuromodulation"},{"key":"1908_CR33","doi-asserted-by":"publisher","first-page":"eaay7680","DOI":"10.1126\/scitranslmed.aay7680","volume":"12","author":"E Opri","year":"2020","unstructured":"Opri, E. et al. Chronic embedded cortico-thalamic closed-loop deep brain stimulation for the treatment of essential tremor. Sci. Transl. Med. 12, eaay7680 (2020).","journal-title":"Sci. Transl. Med."},{"key":"1908_CR34","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1002\/mds.28513","volume":"36","author":"S He","year":"2021","unstructured":"He, S. et al. Closed-loop deep brain stimulation for essential tremor based on thalamic local field potentials. Mov. Disord. 36, 863\u2013873 (2021).","journal-title":"Mov. Disord."},{"key":"1908_CR35","doi-asserted-by":"publisher","first-page":"107354","DOI":"10.1016\/j.yebeh.2020.107354","volume":"112","author":"DE Burdette","year":"2020","unstructured":"Burdette, D. E. et al. Brain-responsive corticothalamic stimulation in the centromedian nucleus for the treatment of regional neocortical epilepsy. Epilepsy Behav. 112, 107354 (2020).","journal-title":"Epilepsy Behav."},{"key":"1908_CR36","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1002\/epi4.12524","volume":"6","author":"D Burdette","year":"2021","unstructured":"Burdette, D., Mirro, E. A., Lawrence, M. & Patra, S. E. Brain-responsive corticothalamic stimulation in the pulvinar nucleus for the treatment of regional neocortical epilepsy: a case series. Epilepsia Open 6, 611\u2013617 (2021).","journal-title":"Epilepsia Open"},{"key":"1908_CR37","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1111\/epi.13740","volume":"58","author":"EB Geller","year":"2017","unstructured":"Geller, E. B. et al. Brain-responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia 58, 994\u20131004 (2017).","journal-title":"Epilepsia"},{"key":"1908_CR38","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1111\/epi.13739","volume":"58","author":"BC Jobst","year":"2017","unstructured":"Jobst, B. C. et al. Brain-responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia 58, 1005\u20131014 (2017).","journal-title":"Epilepsia"},{"key":"1908_CR39","doi-asserted-by":"publisher","first-page":"109207","DOI":"10.1016\/j.yebeh.2023.109207","volume":"142","author":"D Tager","year":"2023","unstructured":"Tager, D. et al. The effect of responsive neurostimulation (RNS) on neuropsychiatric and psychosocial outcomes in drug-resistant epilepsy. Epilepsy Behav. 142, 109207 (2023).","journal-title":"Epilepsy Behav."},{"key":"1908_CR40","doi-asserted-by":"publisher","first-page":"107868","DOI":"10.1016\/j.yebeh.2021.107868","volume":"117","author":"DW Loring","year":"2021","unstructured":"Loring, D. W. et al. Mood and quality of life in patients treated with brain-responsive neurostimulation: The value of earlier intervention. Epilepsy Behav. 117, 107868 (2021).","journal-title":"Epilepsy Behav."},{"key":"1908_CR41","doi-asserted-by":"publisher","first-page":"e1244","DOI":"10.1212\/WNL.0000000000010154","volume":"95","author":"DR Nair","year":"2020","unstructured":"Nair, D. R. et al. Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy. Neurology 95, e1244\u2013e1256 (2020).","journal-title":"Neurology"},{"key":"1908_CR42","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1212\/WNL.0b013e3182302056","volume":"77","author":"MJ Morrell","year":"2011","unstructured":"Morrell, M. J. Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology 77, 1295\u20131304 (2011).","journal-title":"Neurology"},{"key":"1908_CR43","doi-asserted-by":"publisher","first-page":"324","DOI":"10.3390\/brainsci13020324","volume":"13","author":"CM O\u2019Donnell","year":"2023","unstructured":"O\u2019Donnell, C. M. et al. Responsive neurostimulation of the anterior thalamic nuclei in refractory genetic generalized epilepsy: a case series. Brain Sci. 13, 324 (2023).","journal-title":"Brain Sci."},{"key":"1908_CR44","doi-asserted-by":"crossref","unstructured":"Nunna, R. S. et al. Responsive neurostimulation of the mesial temporal white matter in bilateral temporal lobe epilepsy. Neurosurgery 88, 261\u2013267 (2021).","DOI":"10.1093\/neuros\/nyaa381"},{"key":"1908_CR45","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1111\/epi.12534","volume":"55","author":"CN Heck","year":"2014","unstructured":"Heck, C. N. et al. Two-year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: final results of the RNS System Pivotal trial. Epilepsia 55, 432\u2013441 (2014).","journal-title":"Epilepsia"},{"key":"1908_CR46","doi-asserted-by":"publisher","first-page":"1836","DOI":"10.1111\/epi.13191","volume":"56","author":"DW Loring","year":"2015","unstructured":"Loring, D. W., Kapur, R., Meador, K. J. & Morrell, M. J. Differential neuropsychological outcomes following targeted responsive neurostimulation for partial-onset epilepsy. Epilepsia 56, 1836\u20131844 (2015).","journal-title":"Epilepsia"},{"key":"1908_CR47","doi-asserted-by":"publisher","first-page":"134636","DOI":"10.1016\/j.neulet.2019.134636","volume":"716","author":"H Kawaji","year":"2020","unstructured":"Kawaji, H. et al. Additional seizure reduction by replacement with Vagus Nerve Stimulation Model 106 (AspireSR). Neurosci. Lett. 716, 134636 (2020).","journal-title":"Neurosci. Lett."},{"key":"1908_CR48","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.yebeh.2016.06.016","volume":"62","author":"RL Verrier","year":"2016","unstructured":"Verrier, R. L., Nearing, B. D., Olin, B., Boon, P. & Schachter, S. C. Baseline elevation and reduction in cardiac electrical instability assessed by quantitative T-wave alternans in patients with drug-resistant epilepsy treated with vagus nerve stimulation in the AspireSR E-36 trial. Epilepsy Behav. 62, 85\u201389 (2016).","journal-title":"Epilepsy Behav."},{"key":"1908_CR49","doi-asserted-by":"publisher","first-page":"580","DOI":"10.3171\/2016.8.JNS16536","volume":"127","author":"JA Herron","year":"2017","unstructured":"Herron, J. A. et al. Chronic electrocorticography for sensing movement intention and closed-loop deep brain stimulation with wearable sensors in an essential tremor patient. J. Neurosurg. 127, 580\u2013587 (2017).","journal-title":"J. Neurosurg."},{"key":"1908_CR50","doi-asserted-by":"publisher","first-page":"107144","DOI":"10.1016\/j.yebeh.2020.107144","volume":"110","author":"T Kulju","year":"2020","unstructured":"Kulju, T. et al. Circadian distribution of autostimulations in rVNS therapy in patients with refractory focal epilepsy. Epilepsy Behav. 110, 107144 (2020).","journal-title":"Epilepsy Behav."},{"key":"1908_CR51","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.seizure.2019.07.006","volume":"71","author":"M Tzadok","year":"2019","unstructured":"Tzadok, M. et al. Clinical outcomes of closed-loop vagal nerve stimulation in patients with refractory epilepsy. Seizure 71, 140\u2013144 (2019).","journal-title":"Seizure"},{"key":"1908_CR52","doi-asserted-by":"publisher","first-page":"101003","DOI":"10.1016\/j.inat.2020.101003","volume":"23","author":"P Spindler","year":"2021","unstructured":"Spindler, P., Vajkoczy, P. & Schneider, U. C. Closed-loop vagus nerve stimulation. Patient-tailored therapy or undirected treatment?. Interdiscip. Neurosurg. 23, 101003 (2021).","journal-title":"Interdiscip. Neurosurg."},{"key":"1908_CR53","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1684\/epd.2016.0831","volume":"18","author":"R El Tahry","year":"2016","unstructured":"El Tahry, R. et al. Early experiences with tachycardia-triggered vagus nerve stimulation using the AspireSR stimulator. Epileptic Disord. 18, 155\u2013162 (2016).","journal-title":"Epileptic Disord."},{"key":"1908_CR54","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1111\/ner.13238","volume":"23","author":"T Kulju","year":"2020","unstructured":"Kulju, T. et al. Frequency of automatic stimulations in responsive vagal nerve stimulation in patients with refractory epilepsy. Neuromodulation23, 852\u2013858 (2020).","journal-title":"Neuromodulation"},{"key":"1908_CR55","doi-asserted-by":"publisher","first-page":"106431","DOI":"10.1016\/j.eplepsyres.2020.106431","volume":"167","author":"A Hadjinicolaou","year":"2020","unstructured":"Hadjinicolaou, A. et al. Generator replacement with cardiac-based VNS device in children with drug-resistant epilepsy: an observational study. Epilepsy Res. 167, 106431 (2020).","journal-title":"Epilepsy Res."},{"key":"1908_CR56","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1007\/s00701-015-2362-3","volume":"157","author":"UC Schneider","year":"2015","unstructured":"Schneider, U. C., Bohlmann, K., Vajkoczy, P. & Straub, H.-B. Implantation of a new Vagus Nerve Stimulation (VNS) Therapy\u00ae generator, AspireSR\u00ae: considerations and recommendations during implantation and replacement surgery\u2014comparison to a traditional system. Acta Neurochirurgica 157, 721\u2013728 (2015).","journal-title":"Acta Neurochirurgica"},{"key":"1908_CR57","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.eplepsyres.2017.04.008","volume":"133","author":"M Ravan","year":"2017","unstructured":"Ravan, M. Investigating the correlation between short-term effectiveness of VNS Therapy in reducing the severity of seizures and long-term responsiveness. Epilepsy Res. 133, 46\u201353 (2017).","journal-title":"Epilepsy Res."},{"key":"1908_CR58","doi-asserted-by":"publisher","first-page":"3301","DOI":"10.1109\/TBME.2019.2903987","volume":"66","author":"M Ravan","year":"2019","unstructured":"Ravan, M. & Begnaud, J. Investigating the effect of short term responsive VNS therapy on sleep quality using automatic sleep staging. IEEE Trans. Biomed. Eng. 66, 3301\u20133309 (2019).","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"1908_CR59","first-page":"e18698","volume":"13","author":"J Villarreal","year":"2021","unstructured":"Villarreal, J. et al. Neuromodulation in intractable epilepsy through responsive vagal nerve stimulation: a three-year retrospective study at the University of Texas Medical Branch, Galveston. Cureus 13, e18698 (2021).","journal-title":"Cureus"},{"key":"1908_CR60","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.yebeh.2010.10.017","volume":"20","author":"RE Elliott","year":"2011","unstructured":"Elliott, R. E. et al. Vagus nerve stimulation in 436 consecutive patients with treatment-resistant epilepsy: Long-term outcomes and predictors of response. Epilepsy Behav. 20, 57\u201363 (2011).","journal-title":"Epilepsy Behav."},{"key":"1908_CR61","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1142\/S0129065709001938","volume":"19","author":"A Shoeb","year":"2009","unstructured":"Shoeb, A., Pang, T., Guttag, J. & Schachter, S. Non-invasive computerized system for automatically initiating vagus nerve stimulation following patient-specific detection of seizures or epileptiform discharges. Int J. Neural Syst. 19, 157\u2013172 (2009).","journal-title":"Int J. Neural Syst."},{"key":"1908_CR62","doi-asserted-by":"publisher","unstructured":"Grimm, F. & Gharabaghi, A. Closed-loop neuroprosthesis for reach-to-grasp assistance: combining adaptive multi-channel neuromuscular stimulation with a multi-joint arm exoskeleton. Front. Neurosci. 10, https:\/\/doi.org\/10.3389\/fnins.2016.00284 (2016).","DOI":"10.3389\/fnins.2016.00284"},{"key":"1908_CR63","doi-asserted-by":"publisher","first-page":"54","DOI":"10.3167\/th.2010.5712504","volume":"57","author":"T Metz","year":"2010","unstructured":"Metz, T. For the sake of the friendship: relationality and relationship as grounds of beneficence. Theoria 57, 54\u201376 (2010).","journal-title":"Theoria"},{"key":"1908_CR64","doi-asserted-by":"publisher","first-page":"107327","DOI":"10.1016\/j.yebeh.2020.107327","volume":"112","author":"AM Hixon","year":"2020","unstructured":"Hixon, A. M. et al. RNS modifications to eliminate stimulation-triggered signs or symptoms (STS): case series and practical guide. Epilepsy Behav. 112, 107327 (2020).","journal-title":"Epilepsy Behav."},{"key":"1908_CR65","doi-asserted-by":"publisher","first-page":"e110","DOI":"10.1111\/epi.16933","volume":"62","author":"IH Quraishi","year":"2021","unstructured":"Quraishi, I. H. & Hirsch, L. J. Patient-detectable responsive neurostimulation as a seizure warning system. Epilepsia 62, e110\u2013e116 (2021).","journal-title":"Epilepsia"},{"key":"1908_CR66","doi-asserted-by":"publisher","first-page":"107280","DOI":"10.1016\/j.yebeh.2020.107280","volume":"111","author":"P Datta","year":"2020","unstructured":"Datta, P. et al. Vagus nerve stimulation with tachycardia detection provides additional seizure reduction compared to traditional vagus nerve stimulation. Epilepsy Behav. 111, 107280 (2020).","journal-title":"Epilepsy Behav."},{"key":"1908_CR67","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.seizure.2015.08.011","volume":"32","author":"P Boon","year":"2015","unstructured":"Boon, P. et al. A prospective, multicenter study of cardiac-based seizure detection to activate vagus nerve stimulation. Seizure 32, 52\u201361 (2015).","journal-title":"Seizure"},{"key":"1908_CR68","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.seizure.2015.02.004","volume":"26","author":"KG Hampel","year":"2015","unstructured":"Hampel, K. G., Vatter, H., Elger, C. E. & Surges, R. Cardiac-based vagus nerve stimulation reduced seizure duration in a patient with refractory epilepsy. Seizure 26, 81\u201385 (2015).","journal-title":"Seizure"},{"key":"1908_CR69","first-page":"490","volume":"6","author":"AC Mennen","year":"2021","unstructured":"Mennen, A. C. et al. Cloud-based functional magnetic resonance imaging neurofeedback to reduce the negative attentional bias in depression: a proof-of-concept study. Biol. Psychiatry Cogn. Neurosci. Neuroimaging 6, 490\u2013497 (2021).","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"1908_CR70","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1109\/TCYB.2015.2453402","volume":"46","author":"TH Cheng","year":"2016","unstructured":"Cheng, T. H. et al. Identification-based closed-loop NMES limb tracking with amplitude-modulated control input. IEEE Trans. Cybern. 46, 1679\u20131690 (2016).","journal-title":"IEEE Trans. Cybern."},{"key":"1908_CR71","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.jelekin.2012.09.004","volume":"23","author":"O Barzilay","year":"2013","unstructured":"Barzilay, O. & Wolf, A. Adaptive rehabilitation games. J. Electromyogr. Kinesiol 23, 182\u2013189 (2013).","journal-title":"J. Electromyogr. Kinesiol"},{"key":"1908_CR72","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.neuroimage.2016.03.016","volume":"134","author":"G Naros","year":"2016","unstructured":"Naros, G., Naros, I., Grimm, F., Ziemann, U. & Gharabaghi, A. Reinforcement learning of self-regulated sensorimotor \u03b2-oscillations improves motor performance. Neuroimage 134, 142\u2013152 (2016).","journal-title":"Neuroimage"},{"key":"1908_CR73","doi-asserted-by":"publisher","first-page":"5015","DOI":"10.1093\/brain\/awad233","volume":"146","author":"S He","year":"2023","unstructured":"He, S. et al. Beta-triggered adaptive deep brain stimulation during reaching movement in Parkinson\u2019s disease. Brain 146, 5015\u20135030 (2023).","journal-title":"Brain"},{"key":"1908_CR74","doi-asserted-by":"publisher","first-page":"056026","DOI":"10.1088\/1741-2552\/abb416","volume":"17","author":"BI Ferleger","year":"2020","unstructured":"Ferleger, B. I. et al. Fully implanted adaptive deep brain stimulation in freely moving essential tremor patients. J. Neural Eng. 17, 056026 (2020).","journal-title":"J. Neural Eng."},{"key":"1908_CR75","doi-asserted-by":"publisher","first-page":"541625","DOI":"10.3389\/fnhum.2020.541625","volume":"14","author":"S Castano-Candamil","year":"2020","unstructured":"Castano-Candamil, S. et al. A pilot study on data-driven adaptive deep brain stimulation in chronically implanted essential tremor patients. Front Hum. Neurosci. 14, 541625 (2020).","journal-title":"Front Hum. Neurosci."},{"key":"1908_CR76","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1109\/TAFFC.2021.3134183","volume":"14","author":"W Huang","year":"2023","unstructured":"Huang, W. et al. Neurofeedback training with an electroencephalogram-based brain-computer interface enhances emotion regulation. IEEE Trans. Affect. Comput. 14, 998\u20131011 (2023).","journal-title":"IEEE Trans. Affect. Comput."},{"key":"1908_CR77","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1136\/jnnp-2016-313518","volume":"87","author":"L Simon","year":"2016","unstructured":"Simon, L. et al. Adaptive deep brain stimulation for Parkinson\u2019s disease demonstrates reduced speech side effects compared to conventional stimulation in the acute setting. J. Neurol., Neurosurg. Psychiatry 87, 1388 (2016).","journal-title":"J. Neurol., Neurosurg. Psychiatry"},{"key":"1908_CR78","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1016\/j.brs.2019.02.020","volume":"12","author":"A Velisar","year":"2019","unstructured":"Velisar, A. et al. Dual threshold neural closed loop deep brain stimulation in Parkinson disease patients. Brain Stimul.12, 868\u2013876 (2019).","journal-title":"Brain Stimul."},{"key":"1908_CR79","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1093\/brain\/aww286","volume":"140","author":"H Cagnan","year":"2017","unstructured":"Cagnan, H. et al. Stimulating at the right time: phase-specific deep brain stimulation. Brain 140, 132\u2013145 (2017).","journal-title":"Brain"},{"key":"1908_CR80","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1111\/ner.13290","volume":"24","author":"A Cukiert","year":"2021","unstructured":"Cukiert, A., Cukiert, C. M., Mariani, P. P. & Burattini, J. A. Impact of cardiac-based vagus nerve stimulation closed-loop stimulation on the seizure outcome of patients with generalized epilepsy: a prospective, individual-control study. Neuromodulation 24, 1018\u20131023 (2021).","journal-title":"Neuromodulation"},{"key":"1908_CR81","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.pediatrneurol.2023.03.001","volume":"143","author":"RK Singh","year":"2023","unstructured":"Singh, R. K. et al. Responsive neurostimulation in drug-resistant pediatric epilepsy: findings from the epilepsy surgery subgroup of the pediatric epilepsy research consortium. Pediatr. Neurol. 143, 106\u2013112 (2023).","journal-title":"Pediatr. Neurol."},{"key":"1908_CR82","doi-asserted-by":"publisher","unstructured":"Arlotti, M. et al. A new implantable closed-loop clinical neural interface: first application in Parkinson\u2019s disease. Front. Neurosci. 15, https:\/\/doi.org\/10.3389\/fnins.2021.763235 (2021).","DOI":"10.3389\/fnins.2021.763235"},{"key":"1908_CR83","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1136\/jnnp-2015-310972","volume":"87","author":"L Simon","year":"2016","unstructured":"Simon, L. et al. Bilateral adaptive deep brain stimulation is effective in Parkinson\u2019s disease. J. Neurol. Neurosurg. Psychiatry 87, 717 (2016).","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"1908_CR84","doi-asserted-by":"crossref","unstructured":"Haneef, Z. et al. Brain stimulation using responsive neurostimulation improves verbal memory: a crossover case\u2013control study. Neurosurgery 90, 306\u2013312 (2022).","DOI":"10.1227\/NEU.0000000000001818"},{"key":"1908_CR85","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.seizure.2021.03.030","volume":"88","author":"GM Winston","year":"2021","unstructured":"Winston, G. M. et al. Closed-loop vagal nerve stimulation for intractable epilepsy: a single-center experience. Seizure 88, 95\u2013101 (2021).","journal-title":"Seizure"},{"key":"1908_CR86","doi-asserted-by":"publisher","DOI":"10.1186\/s40504-017-0050-1","volume":"13","author":"M Ienca","year":"2017","unstructured":"Ienca, M. & Andorno, R. Towards new human rights in the age of neuroscience and neurotechnology. Life Sci. Soc. Policy 13, 5 (2017).","journal-title":"Life Sci. Soc. Policy"},{"key":"1908_CR87","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s12152-023-09525-2","volume":"16","author":"H Zohny","year":"2023","unstructured":"Zohny, H., Lyreskog, D. M., Singh, I. & Savulescu, J. The mystery of mental integrity: clarifying its relevance to neurotechnologies. Neuroethics 16, 20 (2023).","journal-title":"Neuroethics"},{"key":"1908_CR88","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1684\/epd.2020.1224","volume":"22","author":"L Theroux","year":"2020","unstructured":"Theroux, L. et al. Improved seizure burden and cognitive performance in a child treated with responsive neurostimulation (RNS) following febrile infection related epilepsy syndrome (FIRES). Epileptic Disord. 22, 811\u2013816 (2020).","journal-title":"Epileptic Disord."},{"key":"1908_CR89","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1007\/s12152-023-09523-4","volume":"16","author":"JM Mu\u00f1oz","year":"2023","unstructured":"Mu\u00f1oz, J. M., Bern\u00e1cer, J. & G\u00fcell, F. A conceptual framework to safeguard the neuroright to personal autonomy. Neuroethics 16, 18 (2023).","journal-title":"Neuroethics"},{"key":"1908_CR90","unstructured":"Farahany, N. A. The battle for your brain: defending the right to think freely in the age of neurotechnology (St. Martin\u2019s Press; 2023)."},{"key":"1908_CR91","doi-asserted-by":"publisher","unstructured":"Vold, K. & Whittlestone, J. Privacy, Autonomy, and Personalised Targeting: rethinking how personal data is used. Apollo - University of Cambridge Repository. https:\/\/doi.org\/10.17863\/CAM.43129 (2019).","DOI":"10.17863\/CAM.43129"},{"key":"1908_CR92","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1038\/nbt.4240","volume":"36","author":"M Ienca","year":"2018","unstructured":"Ienca, M., Haselager, P. & Emanuel, E. J. Brain leaks and consumer neurotechnology. Nat. Biotechnol. 36, 805\u2013810 (2018).","journal-title":"Nat. Biotechnol."},{"key":"1908_CR93","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1093\/brain\/awx010","volume":"140","author":"G Tinkhauser","year":"2017","unstructured":"Tinkhauser, G. et al. The modulatory effect of adaptive deep brain stimulation on beta bursts in Parkinson\u2019s disease. Brain 140, 1053\u20131067 (2017).","journal-title":"Brain"},{"key":"1908_CR94","doi-asserted-by":"crossref","unstructured":"Paskett, M. D., Davis, T. S., Tully, T. N., Brinton, M. R. & Clark, G. A. eds. Portable system for home use enables closed-loop, continuous control of multi-degree-of-freedom bionic arm. In 2021 43rd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC) (IEEE, 2021).","DOI":"10.1109\/EMBC46164.2021.9631087"},{"key":"1908_CR95","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1007\/s11019-014-9560-2","volume":"17","author":"H Carel","year":"2014","unstructured":"Carel, H. & Kidd, I. J. Epistemic injustice in healthcare: a philosophial analysis. Med. Health Care Philos. 17, 529\u2013540 (2014).","journal-title":"Med. Health Care Philos."},{"key":"1908_CR96","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1111\/ner.12897","volume":"22","author":"T Kulju","year":"2019","unstructured":"Kulju, T., Haapasalo, J., Rainesalo, S., Lehtim\u00e4ki, K. & Peltola, J. Autostimulation in vagus nerve stimulator treatment: modulating neuromodulation. Neuromodulation22, 630\u2013637 (2019).","journal-title":"Neuromodulation"},{"key":"1908_CR97","doi-asserted-by":"publisher","unstructured":"Lavazza, A. Freedom of thought and mental integrity: the moral requirements for any neural prosthesis. Front. Neurosci. 12, https:\/\/doi.org\/10.3389\/fnins.2018.00082 (2018).","DOI":"10.3389\/fnins.2018.00082"},{"key":"1908_CR98","doi-asserted-by":"publisher","unstructured":"Chen, B. B. et al. Race-Ethnicity, rurality, and age in prospective preferences and concerns regarding closed-loop implanted neural devices. J. Neuropsychiatry Clin. Neurosci. https:\/\/doi.org\/10.1176\/appi.neuropsych.20230190 (2025).","DOI":"10.1176\/appi.neuropsych.20230190"},{"key":"1908_CR99","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1212\/WNL.0000000000011834","volume":"96","author":"M Hegde","year":"2021","unstructured":"Hegde, M., Chiong, W. & Rao, V. R. New ethical and clinical challenges in \u201cclosed-loop\u201d neuromodulation. Neurology 96, 799\u2013804 (2021).","journal-title":"Neurology"},{"key":"1908_CR100","doi-asserted-by":"publisher","unstructured":"D\u2019Imperio, A. & Ienca, M. Deep brain stimulation and suicide attempts in treatment-resistant patients: a case report and neuroethical analysis. Front. Psychiatry. 15, https:\/\/doi.org\/10.3389\/fpsyt.2024.1398777 (2024).","DOI":"10.3389\/fpsyt.2024.1398777"},{"key":"1908_CR101","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1038\/s41593-023-01369-6","volume":"26","author":"R M\u00fcller","year":"2023","unstructured":"M\u00fcller, R. et al. Next steps for global collaboration to minimize racial and ethnic bias in neuroscience. Nat. Neurosci. 26, 1132\u20131133 (2023).","journal-title":"Nat. Neurosci."},{"key":"1908_CR102","doi-asserted-by":"publisher","first-page":"1993","DOI":"10.1212\/WNL.0000000000202247","volume":"100","author":"A Dada","year":"2023","unstructured":"Dada, A. et al. Factors mediating public perceptions of therapeutic closed-loop brain implants for epilepsy and mood disorders (P6-9.002). Neurology 100, 1993 (2023).","journal-title":"Neurology"},{"key":"1908_CR103","first-page":"1","volume":"21","author":"P Henderson","year":"2020","unstructured":"Henderson, P. et al. Towards the systematic reporting of theenergy and carbon footprints of machine learning. J. Mach. Learn. Res. 21, 1\u201343 (2020).","journal-title":"J. Mach. Learn. Res."},{"key":"1908_CR104","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1080\/21507740.2020.1778121","volume":"11","author":"J Eberwine","year":"2020","unstructured":"Eberwine, J. & Kahn, J. The BRAIN initiative and neuroethics: enabling and enhancing neuroscience advances for society. AJOB Neurosci. 11, 135\u2013139 (2020).","journal-title":"AJOB Neurosci."},{"key":"1908_CR105","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1038\/s41586-024-08437-2","volume":"638","author":"J Illes","year":"2025","unstructured":"Illes, J. et al. Two-Eyed Seeing and other Indigenous perspectives for neuroscience. Nature 638, 58\u201368 (2025).","journal-title":"Nature"},{"key":"1908_CR106","doi-asserted-by":"publisher","DOI":"10.1186\/s40900-023-00433-6","volume":"9","author":"J Petkovic","year":"2023","unstructured":"Petkovic, J. et al. Key issues for stakeholder engagement in the development of health and healthcare guidelines. Res. Involv. Engagem. 9, 27 (2023).","journal-title":"Res. Involv. Engagem."},{"key":"1908_CR107","unstructured":"The National Health and Medical Research Council. Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research (The National Health and Medical Research Council, 2003)."},{"key":"1908_CR108","unstructured":"Hudson, M., Milne, M., Reynolds, P., Russell, K. & Smith, B. Te Ara Tika: Guidelines for M\u0101ori research ethics: A framework for researchers and ethics committee members (Auckland: Health Research Council of New Zealand, 2010)."},{"key":"1908_CR109","unstructured":"McDonald, M. The tri-council policy statement on ethical conduct for research involving humans. Canadian Bioethics Society Newsletter 3, 11\u201313 (1998)."},{"key":"1908_CR110","doi-asserted-by":"publisher","first-page":"m4435","DOI":"10.1136\/bmj.m4435","volume":"371","author":"B Gaglio","year":"2020","unstructured":"Gaglio, B. et al. Methodological standards for qualitative and mixed methods patient centered outcomes research. BMJ 371, m4435 (2020).","journal-title":"BMJ"},{"key":"1908_CR111","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/j.lpm.2012.02.049","volume":"41","author":"E Wager","year":"2012","unstructured":"Wager, E. The Committee on Publication Ethics (COPE): objectives and achievements 1997\u20132012. La Presse M\u00e9d.41, 861\u2013866 (2012).","journal-title":"La Presse M\u00e9d."},{"key":"1908_CR112","unstructured":"ICoMJ. Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals (ICMJE, 2024)."},{"key":"1908_CR113","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1080\/21507740.2019.1632966","volume":"10","author":"DZ Buchman","year":"2019","unstructured":"Buchman, D. Z. & Wadhawan, S. A global vision for neuroethics needs more social justice: brain imaging, chronic pain, and population health inequalities. AJOB Neurosci. 10, 130\u2013132 (2019).","journal-title":"AJOB Neurosci."},{"key":"1908_CR114","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1080\/21507740.2024.2326915","volume":"15","author":"WG Johnson","year":"2024","unstructured":"Johnson, W. G. Beyond substance: structural and political questions for neurotechnologies and human rights. AJOB Neurosci. 15, 134\u2013136 (2024).","journal-title":"AJOB Neurosci."},{"key":"1908_CR115","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1007\/s43681-021-00043-6","volume":"1","author":"A van Wynsberghe","year":"2021","unstructured":"van Wynsberghe, A. Sustainable AI: AI for sustainability and the sustainability of AI. AI Ethics 1, 213\u2013218 (2021).","journal-title":"AI Ethics"},{"key":"1908_CR116","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1001\/jama.2014.11100","volume":"312","author":"L Frank","year":"2014","unstructured":"Frank, L., Basch, E. & Selby, J. V. Institute FtP-COR. The PCORI perspective on patient-centered outcomes research. JAMA 312, 1513\u20131514 (2014).","journal-title":"JAMA"},{"key":"1908_CR117","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/1364557032000119616","volume":"8","author":"H Arksey","year":"2005","unstructured":"Arksey, H. & O\u2019Malley, L. Scoping studies: towards a methodological framework. Int. J. Soc. Res. Methodol. 8, 19\u201332 (2005).","journal-title":"Int. J. Soc. Res. Methodol."},{"key":"1908_CR118","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","volume":"169","author":"PRISMA Extension for Scoping Reviews (PRISMA-ScR","year":"2018","unstructured":"PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist and explanation. Ann. Intern. Med.169, 467\u2013473 (2018).","journal-title":"Ann. Intern. Med."},{"key":"1908_CR119","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","volume":"169","author":"AC Tricco","year":"2018","unstructured":"Tricco, A. C. et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann. Intern. Med. 169, 467\u2013473 (2018).","journal-title":"Ann. Intern. Med."},{"key":"1908_CR120","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1093\/jmp\/15.2.219","volume":"15","author":"KD Clouser","year":"1990","unstructured":"Clouser, K. D. & Gert, B. A critique of principlism. J. Med. Philos. 15, 219\u2013236 (1990).","journal-title":"J. Med. Philos."},{"key":"1908_CR121","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/j.1467-8519.2005.00424.x","volume":"19","author":"P Borry","year":"2005","unstructured":"Borry, P., Schotsmans, P. & Dierickx, K. The birth of the empirical turn in bioethics. Bioethics 19, 49\u201371 (2005).","journal-title":"Bioethics"},{"key":"1908_CR122","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1017\/S0963180101001098","volume":"10","author":"T Takala","year":"2001","unstructured":"Takala, T. What is wrong with global bioethics? On the limitations of the four principles approach. Camb. Q. Healthc. Ethics 10, 72\u201377 (2001).","journal-title":"Camb. Q. Healthc. Ethics"},{"key":"1908_CR123","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1080\/23294515.2019.1708515","volume":"11","author":"K Zeiler","year":"2020","unstructured":"Zeiler, K. & De Boer, M. The empirical and the philosophical in empirical bioethics: time for a conceptual turn. AJOB Empir. Bioeth. 11, 11\u201313 (2020).","journal-title":"AJOB Empir. Bioeth."},{"key":"1908_CR124","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1002\/mds.26241","volume":"30","author":"M Rosa","year":"2015","unstructured":"Rosa, M. et al. Adaptive deep brain stimulation in a freely moving parkinsonian patient. Mov. Disord. 30, 1003\u20131005 (2015).","journal-title":"Mov. Disord."}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01908-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01908-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01908-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T15:48:42Z","timestamp":1757346522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01908-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":124,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1908"],"URL":"https:\/\/doi.org\/10.1038\/s41746-025-01908-4","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]},"assertion":[{"value":"7 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.I. has been a policy advisor on neurotechnology to the OECD, the Council of Europe, the UN, and the EU Parliament. He receives book royalties from Cambridge University Press, Oxford University Press, Routledge, Springer Nature and Elsevier. He is a member of the ethics board of IDUN Technologies, a company producing EEG-earbuds. None of these interests can be construed as a conflict of interest. All other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"510"}}