Pike's injuries and the nature of his chair crop up every so often and some interesting ideas get tossed around the threads. Someone suggested this chair was something of a "stop gap" to stabilize his condition before more sophisticated devices could be employed, like a more refined communications interface. Unfortunately, the way McCoy talks, there's no way to tie more directly into Pike's brain to allow that.
I wonder if Roger Korby's android technology would be able to not only give Pike a new body, but completely allow full control (speech, etc.). The "am i real or not?" questions would pop up, but if a Korby body has the full range of senses, where the human brain would not know the difference, Pike would have enjoyed a second life to do whatever he desired.