Preoperative navigated TMS workflow for intracortical BCI implantation in post-stroke aphasia: a case report

Intracortical brain-computer interfaces (BCIs) are rapidly approaching clinical translation for restoring communication in people with severe speech impairment [1–4]. However, implantation is not only a decoding problem, but also a neurosurgical planning problem, particularly in patients with major structural injury, altered anatomy, and limited task compliance. This challenge is especially relevant in severe post-stroke aphasia, where dominant-hemisphere infarct cavities, gliosis, altered vasculature, and prior decompressive surgery may render conventional ipsilesional implantation technically difficult or infeasible.