Identifying brain-computer interface translational priorities with an outlook on the field in 2035

Brain–computer interfaces (BCIs) have advanced rapidly, particularly over the past few decades, evolving from experimental demonstrations to powerful research tools and early-stage clinical technologies. Invasive, semi-invasive, and non-invasive modalities now enable neural decoding, neuromodulation, and functional restoration across diverse neurological conditions. Yet, despite striking laboratory demonstrations and growing investment, few BCIs have become viable medical products, having only a limited impact. Here, we provide a quantitative analysis to identify crucial clinical applications on which BCI translational efforts should focus to achieve substantial clinical, societal, and economic impact. Using an urgency–importance–impact framework based on disability-adjusted life years analysis, we assessed 12 neurological conditions to provide insight into how to prioritize strategic BCI development efforts. Alzheimer’s disease, stroke, depression, and anxiety, with their combined high urgency, importance, and impact, emerge as strategic targets with the greatest societal and economic stakes. We further argue that BCIs today, particularly invasive modalities, function primarily as transformative scientific instruments, analogous to the astronomic telescope in the era preceding classical mechanics, and will shape future theoretical and clinical innovation. Realizing a sustainable BCI industry beyond 2035 will require aligning basic neuroscience, artificial intelligence-driven advances, scalable clinical validation, ethical safeguards, and coordinated strategic planning.