title: High performance communication by people with paralysis using an intracortical brain-computer interface.
abstract: 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.Clinical Trial No: NCT00912041.
authors.affiliation: Department of Neurosurgery, Stanford University, Stanford, United States.|Electrical Engineering, Stanford University, Stanford, United States.|Stanford Neurosciences Institute, Stanford University, Stanford, United States.|Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, United States.|Department of Neurosurgery, Emory University, Atlanta, United States.
authors.forename: Chethan
authors.identifier: 0000-0003-1241-1432
authors.initials: C
authors.lastname: Pandarinath
authors.affiliation: Department of Neurosurgery, Stanford University, Stanford, United States.|Stanford Neurosciences Institute, Stanford University, Stanford, United States.|Department of Bioengineering, Stanford University, Stanford, United States.|School of Medicine, Stanford University, Stanford, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Nuyujukian
authors.affiliation: Department of Neurosurgery, Stanford University, Stanford, United States.
authors.forename: Christine H
authors.initials: CH
authors.lastname: Blabe
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, United States.
authors.forename: Brittany L
authors.initials: BL
authors.lastname: Sorice
authors.affiliation: School of Engineering, Brown University, Providence, United States.|Brown Institute for Brain Science, Brown University, Providence, United States.|Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Department of VA Medical Center, Providence, United States.
authors.forename: Jad
authors.initials: J
authors.lastname: Saab
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, United States.|Cleveland Functional Electrical Stimulation (FES) Center of Excellence, Louis Stokes VA Medical Center, Cleveland, United States.
authors.forename: Francis R
authors.initials: FR
authors.lastname: Willett
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, United States.|School of Engineering, Brown University, Providence, United States.|Brown Institute for Brain Science, Brown University, Providence, United States.|Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Department of VA Medical Center, Providence, United States.|Department of Neurology, Harvard Medical School, Boston, United States.
authors.forename: Leigh R
authors.identifier: 0000-0003-0261-2273
authors.initials: LR
authors.lastname: Hochberg
authors.affiliation: Electrical Engineering, Stanford University, Stanford, United States.|Stanford Neurosciences Institute, Stanford University, Stanford, United States.|Department of Bioengineering, Stanford University, Stanford, United States.|Neurosciences Program, Stanford University, Stanford, United States.|Department of Neurobiology, Stanford University, Stanford, United States.|Howard Hughes Medical Institute, Stanford University, Stanford, United States.
authors.forename: Krishna V
authors.initials: KV
authors.lastname: Shenoy
authors.affiliation: Department of Neurosurgery, Stanford University, Stanford, United States.|Stanford Neurosciences Institute, Stanford University, Stanford, United States.
authors.forename: Jaimie M
authors.identifier: 0000-0002-3276-2267
authors.initials: JM
authors.lastname: Henderson
mesh_terms: D062207:Brain-Computer Interfaces; D003142:Communication; D006801:Humans; D010243:Paralysis; D016896:Treatment Outcome
keywords: ALS; assistive technology; brain-machine interface; human; human biology; medicine; neural prosthesis; neuroscience