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Neural Eng."],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background.<\/jats:italic>\n                    Implantable brain\u2013computer interfaces (iBCIs) decode neural signals to generate command signals for effector devices to restore lost functions, such as movement or speech. However, maintaining device performance over time requires recalibration of decoding algorithms due to inherent instability in neural signals.\n                    <jats:italic>Objective.<\/jats:italic>\n                    To systematically review recalibration procedures in iBCIs for patients with motor impairments, focusing on the clinical implications of recalibration requirements and strategies which can enable long-term, independent use.\n                    <jats:italic>Approach.<\/jats:italic>\n                    A systematic search was conducted across EMBASE, MEDLINE, and CINAHL databases to identify studies involving recalibration of iBCIs. Data on recalibration frequency, duration, staff requirements, and location were extracted and analyzed.\n                    <jats:italic>Main results.<\/jats:italic>\n                    Recalibration practices varied widely amongst studies and were typically performed according to predetermined study protocols, rather than practical need following deteriorating device performance. Common practices include manual recalibration requiring a specialist research team, semi-automatic recalibration which could be performed by a non-specialist caregiver, and automatic recalibration methods whereby patients did not require assistance. Devices utilizing electrocorticography (ECoG) recording arrays generally required less frequent recalibration compared to those using microelectrode arrays (MEAs). Extended independent use was more frequently reported with ECoG-based iBCIs.\n                    <jats:italic>Significance.<\/jats:italic>\n                    Reducing recalibration frequency or complexity can improve patient autonomy, which is crucial for enhancing long-term independent iBCI use in home and clinical settings. ECoG iBCIs typically have a low recalibration burden due to inherent signal stability. Conversely, MEA iBCIs typically involve a higher recalibration burden, though recent studies have reduced this by incorporating spectral data and continuously updating models. Despite this progress, recalibration procedures are often not fully defined in iBCI studies, and where they are, they usually relate to the study protocol rather than the clinically meaningful recalibration requirement due to worsening device performance. Future studies should continue to develop user-friendly recalibration procedures and outline the clinically relevant recalibration requirements where possible.\n                  <\/jats:p>","DOI":"10.1088\/1741-2552\/ae7694","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T22:59:17Z","timestamp":1780441157000},"page":"031004","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Recalibration of implantable brain\u2013computer interfaces to enable long-term independent use\u2013a systematic review"],"prefix":"10.1088","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8003-6750","authenticated-orcid":true,"given":"Eleanor","family":"Swanson","sequence":"first","affiliation":[{"name":"University Medical Centre Utrecht"},{"name":"Institute of Neurology, University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5385-2026","authenticated-orcid":false,"given":"Esmee","family":"Dohle","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-2491","authenticated-orcid":true,"given":"Luke","family":"Bashford","sequence":"additional","affiliation":[{"name":"Newcastle University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7848-5325","authenticated-orcid":false,"given":"Hugo Layard","family":"Horsfall","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery"},{"name":"Institute of Neurology, University College London"},{"name":"The Francis Crick Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9726-2594","authenticated-orcid":false,"given":"Luka","family":"Jovanovic","sequence":"additional","affiliation":[{"name":"East and North Hertfordshire NHS Trust, Lister Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7163-0120","authenticated-orcid":false,"given":"William R","family":"Muirhead","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery"},{"name":"Institute of Neurology, University College London"},{"name":"The Francis Crick Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1697-403X","authenticated-orcid":true,"given":"Jamie F M","family":"Brannigan","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"jneae7694bib1","doi-asserted-by":"publisher","first-page":"43","DOI":"10.3390\/brainsci11010043","type":"journal-article","article-title":"Summary of over fifty years with brain-computer interfaces\u2014a review","volume":"11","author":"Kawala-Sterniuk","year":"2021","journal-title":"Brain Sci."},{"key":"jneae7694bib2","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1038\/nature11076","type":"journal-article","article-title":"Reach and grasp by people with tetraplegia using a neurally controlled robotic arm","volume":"485","author":"Hochberg","year":"2012","journal-title":"Nature"},{"key":"jneae7694bib3","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1177\/1545968314554624","type":"journal-article","article-title":"Neural point-and-click communication by a person with incomplete locked-in syndrome","volume":"29","author":"Bacher","year":"2015","journal-title":"Neurorehabil. 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