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

摘要

Article Figures and data Abstract eLife digest Introduction Results Discussion Materials and methods References Decision letter Author response Article and author information Metrics 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 https://doi.org/10.7554/eLife.18554.001 eLife digest People with various forms paralysis not only have difficulties getting around, but also are less able to use many communication technologies including computers. In particular, strokes, neurological injuries, or diseases such as ALS can lead to severe paralysis and make it very difficult to communicate. In rare instances, these disorders can result in a condition called locked-in syndrome, in which the affected person is aware but completely unable to move or speak. Several researchers are looking to help people with severe paralysis to communicate again, via a system called a brain-computer interface. These devices record activity in the brain either from the surface of the scalp or directly using a sensor that is surgically implanted. Computers then interpret this activity via algorithms to generate signals that can control various tools, including robotic limbs, powered wheelchairs or computer cursors. Such tools would be invaluable for many people with paralysis. Pandarinath, Nuyujukian et al. set out to study the performance of an implanted brain-computer interface in three people with varying forms of paralysis and focused specifically on a typing task. Each participant used a brain-computer interface known as “BrainGate” to move a cursor on a computer screen displaying the letters of the alphabet. The participants were asked to “point and click” on letters – similar to using a normal computer mouse – to type specific sentences, and their typing rate in words per minute was measured. With recently developed computer algorithms, the participants typed faster using the brain-computer interface than anyone with paralysis has ever managed before. Indeed, the highest performing participant could, on average, type nearly 8 words per minute. The next steps are to adapt the system so that brain-computer interfaces can control commercial computers, phones and tablets. These devices are widely available, and would allow paralyzed users to take advantage of a range of applications