Intracortical Microstimulation in Brain-Computer Interfaces: Evoking Perception and Plasticity.

Intracortical microstimulation (ICMS), the activation of specific neuronal populations via microelectrodes implanted in the cortex, has emerged as a key technology for invasive brain-computer interfaces (BCIs). This article reviews the technical foundations and functional applications of ICMS within the BCI field, highlighting its diverse capabilities in both perception construction and targeted neuromodulation, while emphasizing the interface and parameter constraints that shape its long-term use. At the technical level, we analyze the evolution of ICMS microelectrode interfaces from rigid arrays to flexible, biomimetic, and biohybrid strategies, alongside key pulse-train parameters relevant to neural recruitment and application safety. Functionally, we discuss how biomimetic and spatiotemporally patterned ICMS generates high-resolution artificial tactile and visual perception, and how ICMS can serve as learnable information channels to guide behavior. We further consider temporally contingent and closed-loop ICMS as plasticity-based approaches for modulating cortical functional connectivity and pathological network activity in selected experimental models, while noting translational challenges related to stability, scalability, safety, and patient variability. Finally, we extend the discussion to novel biohybrid neural interfaces, including cell-seeded interface modifications, axon-guidance strategies, and stem-cell- and brain-organoid-integrated platforms, which provide a theoretical reference for next-generation biointegrated neuromodulation technologies in BCIs. Together, this review evaluates ICMS in BCIs along 2 central lines: evoking artificial perception and engaging plasticity-based modulation, while highlighting that long-term translation will require coordinated advances in interface reliability, stimulation encoding, closed-loop calibration, safety evaluation, and biohybrid integration.