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They function by (1) recording neural activity, (2) decoding the neural signal occurring in response to volitional motor intentions, and (3) generating digital control signals that may be used to control external devices. While brain-computer interface technology has the potential to revolutionize neurological care, clinical translation has been limited. Endovascular arrays present a novel form of minimally invasive brain-computer interface devices that have been deployed in human subjects during early feasibility studies. This article provides an overview of endovascular brain-computer interface devices and critically evaluates the patient with stroke as an implant candidate. Future opportunities are mapped, along with the challenges arising when decoding neural activity following infarction. Limitations arise when considering intracerebral hemorrhage and motor cortex lesions; however, future directions are outlined that aim to address these challenges.<\/jats:p>","DOI":"10.1161\/strokeaha.123.037719","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T08:00:37Z","timestamp":1701244837000},"page":"474-483","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Endovascular Brain-Computer Interfaces in Poststroke Paralysis"],"prefix":"10.1161","volume":"55","author":[{"given":"Jamie F.M.","family":"Brannigan","sequence":"first","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (J.F.M.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Fry","sequence":"additional","affiliation":[{"name":"Synchron, Inc, New York, NY (A.F., N.L.O., T.J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas L.","family":"Opie","sequence":"additional","affiliation":[{"name":"Synchron, Inc, New York, NY (A.F., N.L.O., T.J.O.)."},{"name":"Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Victoria, Australia (N.L.O., T.J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3632-9433","authenticated-orcid":true,"given":"Bruce C.V.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Neurology (B.C.V.C.), The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia."},{"name":"Melbourne Brain Centre (B.C.V.C.), The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8337-7529","authenticated-orcid":true,"given":"Peter J.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Radiology (P.J.M.), The Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5569-3612","authenticated-orcid":true,"given":"Thomas J.","family":"Oxley","sequence":"additional","affiliation":[{"name":"Synchron, Inc, New York, NY (A.F., N.L.O., T.J.O.)."},{"name":"Vascular Bionics Laboratory, Department of Medicine, The University of Melbourne, Victoria, Australia (N.L.O., T.J.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303270"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2019.116643"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1987.tb03543.x"},{"key":"e_1_3_2_5_2","first-page":"491","article-title":"Incidence and types of speech disorders in stroke patients.","volume":"50","author":"Vidovi\u0107 M","year":"2011","unstructured":"Vidovi\u0107, M, Sinanovi\u0107, O, Sabaski\u0107, L, Hatici\u0107, A, Brki\u0107, E. 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