Clinical translation and accessibility of brain-computer interfaces: From technology development to clinical application

Brain-computer interface (BCI) technology establishes a direct communication pathway between neural activity and external devices. Driven by advances in neuroscience, artificial intelligence (AI), neural signal acquisition, decoding algorithms, and implantable system design, BCIs have progressed rapidly from experimental prototypes toward clinically relevant neurotechnologies. However, the translation of these technical advances into routine clinical practice and equitable real-world access remains substantially slower than technological innovation. This review summarizes the major technological pathways of BCIs and their clinical applications, and it then examines BCI development from the perspective of clinical translation and accessibility. We focus on key barriers across the translational chain, including long-term technical stability, quality of clinical evidence, evaluation standards, reimbursement mechanisms, health-economic evidence, and the feasibility of implementation in real-world healthcare settings. We argue that the central challenge in BCI development has shifted from improving technical performance alone to building the translational infrastructure required for safe, effective, affordable, and sustainable clinical integration.