Home Use of a Percutaneous Wireless Intracortical Brain-Computer Interface by Individuals With Tetraplegia
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Abstract
OBJECTIVE: Individuals with neurological disease or injury such as amyotrophic lateral sclerosis, spinal cord injury or stroke may become tetraplegic, unable to speak or even locked-in. For people with these conditions, current assistive technologies are often ineffective. Brain-computer interfaces are being developed to enhance independence and restore communication in the absence of physical movement. Over the past decade, individuals with tetraplegia have achieved rapid on-screen typing and point-and-click control of tablet apps using intracortical brain-computer interfaces (iBCIs) that decode intended arm and hand movements from neural signals recorded by implanted microelectrode arrays. However, cables used to convey neural signals from the brain tether participants to amplifiers and decoding computers and require expert oversight, severely limiting when and where iBCIs could be available for use. Here, we demonstrate the first human use of a wireless broadband iBCI. METHODS: Based on a prototype system previously used in pre-clinical research, we replaced the external cables of a 192-electrode iBCI with wireless transmitters and achieved high-resolution recording and decoding of broadband field potentials and spiking activity from people with paralysis. Two participants in an ongoing pilot clinical trial completed on-screen item selection tasks to assess iBCI-enabled cursor control. RESULTS: Communication bitrates were equivalent between cabled and wireless configurations. Participants also used the wireless iBCI to control a standard commercial tablet computer to browse the web and use several mobile applications. Within-day comparison of cabled and wireless interfaces evaluated bit error rate, packet loss, and the recovery of spike rates and spike waveforms from the recorded neural signals. In a representative use case, the wireless system recorded intracortical signals from two arrays in one participant continuously through a 24-hour period at home. SIGNIFICANCE: Wireless multi-electrode recording of broadband neural signals over extended periods introduces a valuable tool for human neuroscience research and is an important step toward practical deployment of iBCI technology for independent use by individuals with paralysis. On-demand access to high-performance iBCI technology in the home promises to enhance independence and restore communication and mobility for individuals with severe motor impairment.
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Several studies indicate that UEAs retain their functionality in humans for more than 1000 days.
“and several studies indicate that UEAs retain their functionality in humans for more than 1000 days (29, 31).”
From Visual percepts evoked with an intracortical 96-channel microelectrode array inserted in human occipital cortex (2021) · cites this paper as [31]
The Results section (page unavailable) shows that implanted intracortical arrays supported computer use in two people with tetraplegia, including T5 on trial day 588. The References section cites a study reporting cursor control 1000 days after array implantation, but this paper does not report functionality for more than 1000 days. (LLM, conf=0.85)
Experimental — accuracy not yet measuredWireless versions of the UEA and other systems have been developed, but these prototype systems are not yet sufficiently robust for clinical use.
“A clinical cortical visual prosthesis would be expected to use wireless actuation of the electrode arrays, and although wireless versions of the UEA and other systems have been developed (31, 50, 51), these prototype systems are not yet sufficiently robust for clinical use.”
From Visual percepts evoked with an intracortical 96-channel microelectrode array inserted in human occipital cortex (2021) · cites this paper as [31]
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Tchoe, Y., Bourhis, A. M., Cleary, D. R., Stedelin, B., Lee, J., Tonsfeldt, K. J., Brown, E. C., Siler, D. A., Paulk, A. C., Yang, J. C., et al. (2022) · Science Translational Medicine · doi:10.1126/scitranslmed.abj1441 · Cited by 135 · see citing works
Interim Safety Profile From the Feasibility Study of the BrainGate Neural Interface System
Rubin, D. B., Ajiboye, A. B., Barefoot, L., Bowker, M., Cash, S. S., Chen, D., Donoghue, J. P., Eskandar, E. N., Friehs, G., Grant, C., et al. (2023) · Neurology · doi:10.1212/wnl.0000000000201707 · Cited by 81 · see citing works
Self-citationChallenges for Large-Scale Cortical Interfaces
Nurmikko, A. (2020) · Neuron · doi:10.1016/j.neuron.2020.10.015 · Cited by 68 · see citing works
Self-citationLearned motor patterns are replayed in human motor cortex during sleep
Rubin, D. B., Hosman, T., Kelemen, J. N., Kapitonava, A., Willett, F. R., Coughlin, B. F., Halgren, E., Kimchi, E. Y., Williams, Z. M., Simeral, J. D., et al. (2022) · The Journal of Neuroscience · doi:10.1523/jneurosci.2074-21.2022 · Cited by 57 · see citing works
Self-citationBRAND: a platform for closed-loop experiments with deep network models
Ali, Y. H., Bodkin, K., Rigotti-Thompson, M., Patel, K., Card, N. S., Bhaduri, B., Nason-Tomaszewski, S. R., Mifsud, D. M., Hou, X., Nicolas, C., et al. (2024) · Journal of Neural Engineering · doi:10.1088/1741-2552/ad3b3a · Cited by 32 · see citing works
Self-citation
- Authors
- Simeral, J. D., Hosman, T., Saab, J., Flesher, S. N., Vilela, M., Franco, B., Kelemen, J. N., Brandman, D. M., Ciancibello, J. G., Rezaii, P. G., Eskandar, E. N., Rosler, D. M., Shenoy, K. V., Henderson, J. M., Nurmikko, A. V., & Hochberg, L. R.
- Affiliations
- Brown University (US)
- Howard Hughes Medical Institute (US)
- Massachusetts General Hospital (US)
- Emory University (US)
- Feinstein Institute for Medical Research (US)
- Tulane University (US)
- Albert Einstein College of Medicine (US)
- Stanford University (US)
- Harvard University (US)
- Corresponding author
- Simeral, John D.
- ORCID
- Venue
- IEEE Transactions on Biomedical Engineering
- Published
- 2021-07
- Volume
- 68
- Issue
- 7
- Pages
- 2313-2325
- ISSN
- 0018-9294 (ISSN-L)
- 1558-2531
- PMC
- PMC8218873
- OpenAlex
- W3144365080
- Cited by
- 165
- References
- 69
- Citations by year
- 2026: 22 · 2025: 28 · 2024: 29 · 2023: 39 · 2022: 26 · 2021: 19 · 2020: 2
- FWCI
- 14.86
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- IEEE Transactions on Biomedical Engineering (publishedVersion, cc-by-nc-nd)
- medRxiv (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- NIH-NINDS (UH2NS095548)
- Office of Research and Development, Rehabilitation R&D Service, Department of Veterans Affairs (N9228C, N2864C, A2295R, B6453R, P1155R)
- NIH-NIDCD (R01DC009899, R01DC014034)
- NIH-NIBIB (R01EB007401)
- Executive Committee on Research
- Stanford University
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › EEG and Brain-Computer Interfaces
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Keywords
- intracortical brain-computer interfaces, wireless neural recording, tetraplegia, paralysis, augmentative and alternative communication, microelectrode arrays, long-term neural recording, locked-in state
- MeSH terms
- Brain, Hand, Humans, Microelectrodes, Quadriplegia, Brain-Computer Interfaces
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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