Evidence map›Paper›PMID 41639858›Full record

ArticleJournal of neuroengineering and rehabilitation2026

Explainability in AI-enabled medical neurotechnology: a scoping review.

Laura Schopp, Georg Starke, Marcello Ienca

Abstract readScoping Review
In one paragraph

Article in Journal of neuroengineering and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Laura SchoppInstitute of History and Ethics in Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany. laura.schopp@tum.de.
Georg StarkeInstitute of History and Ethics in Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Marcello IencaInstitute of History and Ethics in Medicine, School of Medicine and Health, Technical University of Munich, Munich, Germany. marcello.ienca@tum.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Artificial Intelligence (AI) approaches, including Machine Learning (ML), and other complex algorithms, are driving progress in medical closed-loop neurotechnology, including neurostimulation systems and brain–computer interfaces (BCIs). These advances are transforming the treatment landscape for neurological and psychiatric conditions. However, the inherent opacity of many AI models raises clinical, epistemological and ethical challenges. Explainability is widely recognized as a critical requirement for addressing these challenges, yet its concrete application in neurotechnology remains insufficiently explored. Objective. This scoping review maps how Explainable AI (XAI) methods are implemented in AI-enabled closed-loop neurotechnologies and examines how explainability is conceptualized and operationalized in this domain. Approach. Following JBI guidance and PRISMA-ScR, we systematically searched five databases for original research on AI-enabled medical closed-loop neurotechnologies targeting neurological and psychiatric conditions. A total of 161 studies were included and analyzed using descriptive statistics and qualitative content analysis to identify the presence and framing of XAI methods. Main results. Explainable AI adoption in medical neurotechnology is limited: only 14 studies (9%) employed explicit XAI techniques. Thematic analysis of the full corpus identified three recurring barriers and focal points: (A) technical constraints and proposed workarounds, (B) challenges in explanation quality and system transparency, and (C) the relationship between explainability and user trust. Significance. Although closed-loop neurotechnologies are rapidly advancing, explainability is rarely implemented in practice, constraining transparency, accountability, and clinical usability. Our findings reveal key factors behind the explainability gap and provides a framework to guide future research and development. Addressing this shortfall is essential for fostering ethically sound, clinically effective, and patient-trusted neurotechnological applications.

Indexed as

Artificial IntelligenceBrain-Computer InterfacesNervous System DiseasesHumansIntelligent SystemsMental DisordersBrain-computer interfaceExplainable artificial intelligenceNeurological diseaseNeurorehabilitationNeurostimulationNeurotechnologyPsychiatric disorder

Identifiers

PMID41639858
PMCPMC12983565

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.