Community perspectives regarding brain-computer interfaces: A cross-sectional study of community-dwelling adults in the UK.

Background: Brain-computer interfaces (BCIs) represent a ground-breaking advancement in neuroscience, facilitating direct communication between the brain and external devices. This technology has the potential to significantly improve the lives of individuals with neurological disorders by providing innovative solutions for rehabilitation, communication and personal autonomy. However, despite the rapid progress in BCI technology and social media discussions around Neuralink, public perceptions and ethical considerations concerning BCIs-particularly within community settings in the UK-have not been thoroughly investigated.

Objective: The primary aim of this study was to investigate public knowledge, attitudes and perceptions regarding BCIs including ethical considerations. The study also explored whether demographic factors were related to beliefs about BCIs increasing inequalities, support for strict regulations, and perceptions of appropriate fields for BCI design, testing and utilization in healthcare.

Methods: This cross-sectional study was conducted between 1 December 2023 and 8 March 2024. The survey included 29 structured questions covering demographics, awareness of BCIs, ethical considerations and willingness to use BCIs for various applications. The survey was distributed via the Imperial College Qualtrics platform. Participants were recruited primarily through Prolific Academic's panel and personal networks. Data analysis involved summarizing responses using frequencies and percentages, with chi-squared tests to compare groups. All data were securely stored and pseudo-anonymized to ensure confidentiality.

Results: Of the 950 invited respondents, 846 participated and 806 completed the survey. The demographic profile was diverse, with most respondents aged 36-45 years (26%) balanced in gender (52% female), and predominantly identifying as White (86%). Most respondents (98%) had never used BCIs, and 65% were unaware of them prior to the survey. Preferences for BCI types varied by condition. Ethical concerns were prevalent, particularly regarding implantation risks (98%) and costs (92%). Significant associations were observed between demographic variables and perceptions of BCIs regarding inequalities, regulation and their application in healthcare. Conclusion: Despite strong interest in BCIs, particularly for medical applications, ethical concerns, safety and privacy issues remain significant highlighting the need for clear regulatory frameworks and ethical guidelines, as well as educational initiatives to improve public understanding and trust. Promoting public discourse and involving stakeholders including potential users, ethicists and technologists in the design process through co-design principles can help align technological development with public concerns whilst also helping developers to proactively address ethical dilemmas.