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Author Notes:

Email: shenoy@stanford.edu Email: henderj@stanford.edu

CP, Responsible for study design, research infrastructure development, algorithm design, data collection, analysis, and manuscript preparation.

PN, Responsible for study design, research infrastructure development, algorithm design, data collection, analysis, and manuscript preparation.

CHB, Contributed to study design and data collection for participants T6 and T5.

BLS, Contributed to study design and data collection from participant T7.

JS, Contributed to technical development.

FRW, Contributed to algorithm design.

LRH, Contributed to study design and is the sponsor-investigator of the multi-site pilot clinical trial.

KVS, Was involved in all aspects of the study.

JMH, Was responsible for surgical implantation for study participants T6 and T5 and was involved in all aspects of the study.

The authors would like to thank participants T6, T5, T7, and their families and caregivers; EN Eskandar for T7 implantation surgery; B Davis, B Pedrick, E Casteneda, M Coburn, S Patnaik, P Rezaii, B Travers, and D Rosler for administrative support; SI Ryu for surgical assistance; L Barefoot, S Cash, J Menon, and S Mernoff for clinical assistance; A Sarma, and N Schmansky for technical assistance; V Gilja, JD Simeral, JA Perge and B Jarosiewicz for technical assistance and helpful scientific discussions; JP Donoghue for helpful scientific discussions.

The authors declare that no competing interests exist.


Research Funding:

This work was supported by: Stanford Office of Postdoctoral Affairs; Craig H Neilsen Foundation; Stanford Medical Scientist Training Program; Stanford BioX-NeuroVentures, Stanford Institute for Neuro-Innovation and Translational Neuroscience; Larry and Pamela Garlick; Samuel and Betsy Reeves; NIH-NIDCD R01DC014034; NIH-NINDS R01NS066311; NIH-NIDCD R01DC009899; NIH-NICHD-NCMRR (N01HD53403 and N01HD10018); Rehabilitation Research and Development Service, Department of Veterans Affairs (B6453R); MGH-Deane Institute for Integrated Research on Atrial Fibrillation and Stroke; Executive Committee on Research, Massachusetts General Hospital.


  • ALS
  • assistive technology
  • brain-machine interface
  • human
  • human biology
  • medicine
  • neural prosthesis
  • neuroscience

High performance communication by people with paralysis using an intracortical brain-computer interface


Journal Title:



Volume 6


, Pages e18554-e18554

Type of Work:

Article | Final Publisher PDF


Brain-computer interfaces (BCIs) have the potential to restore communication for people with tetraplegia and anarthria by translating neural activity into control signals for assistive communication devices. While previous pre-clinical and clinical studies have demonstrated promising proofs-of-concept (Serruya et al., 2002; Simeral et al., 2011; Bacher et al., 2015; Nuyujukian et al., 2015; Aflalo et al., 2015; Gilja et al., 2015; Jarosiewicz et al., 2015; Wolpaw et al., 1998; Hwang et al., 2012; Spüler et al., 2012; Leuthardt et al., 2004; Taylor et al., 2002; Schalk et al., 2008; Moran, 2010; Brunner et al., 2011; Wang et al., 2013; Townsend and Platsko, 2016; Vansteensel et al., 2016; Nuyujukian et al., 2016; Carmena et al., 2003; Musallam et al., 2004; Santhanam et al., 2006; Hochberg et al., 2006; Ganguly et al., 2011; O’Doherty et al., 2011; Gilja et al., 2012), the performance of human clinical BCI systems is not yet high enough to support widespread adoption by people with physical limitations of speech. Here we report a high-performance intracortical BCI (iBCI) for communication, which was tested by three clinical trial participants with paralysis. The system leveraged advances in decoder design developed in prior pre-clinical and clinical studies (Gilja et al., 2015; Kao et al., 2016; Gilja et al., 2012). For all three participants, performance exceeded previous iBCIs (Bacher et al., 2015; Jarosiewicz et al., 2015) as measured by typing rate (by a factor of 1.4–4.2) and information throughput (by a factor of 2.2– 4.0). This high level of performance demonstrates the potential utility of iBCIs as powerful assistive communication devices for people with limited motor function.

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