Long-term independent use of an intracortical brain–computer interface for speech and cursor control
8 affiliations
- 1Department of Neurological Surgery, University of California, Davis, Davis, CA, USA. [email protected]
- 2Department of Neurological Surgery, University of California, Davis, Davis, CA, USA
- 3Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
- 4Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- 5School of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA
- 6VA Center for Neurorestoration and Neurotechnology, Rehabilitation Research Development and Translation Service, Department of Veterans Affairs, Providence, RI, USA
- 7Department of Neurological Surgery, University of California, Davis, Davis, CA, USA. [email protected]
- 8Department of Neurological Surgery, University of California, Davis, Davis, CA, USA. [email protected]
Abstract
Brain-computer interfaces (BCIs) can provide naturalistic communication and digital access to people with severe paralysis by decoding neural activity associated with attempted speech and movement. Recent work has demonstrated highly accurate intracortical BCIs for speech and cursor control, but two critical capabilities needed for practical viability were unmet: independent at-home operation without researcher assistance and reliable long-term performance supporting accurate speech and cursor decoding. Here we demonstrate the independent and near-daily use of a multimodal BCI with novel brain-to-text speech and computer cursor decoders by a man with paralysis and severe dysarthria due to amyotrophic lateral sclerosis. Over nearly 2 years, the participant used the BCI for more than 3,800 h at home with no researchers present to maintain rich interpersonal communication with his family and friends, independently control his personal computer and sustain full-time employment-despite being paralyzed. He communicated 183,060 sentences-totaling 1,960,163 words-at an average rate of 56 words per minute. He labeled 92% of sentences as being decoded at least mostly correctly. In formal quantifications of performance where he was asked to say words presented on a screen, attempted speech was consistently decoded with more than 99% word accuracy (125,000 word vocabulary). The participant also used the speech BCI as keyboard input and the cursor BCI as mouse input to control his personal computer, enabling him to send text messages and emails and to browse the internet. These results demonstrate that intracortical BCIs have the potential to support independent use in the home, marking a critical step toward practical assistive technology for people with severe motor impairment.
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BibTeX
@article{card2026longterm,
title = {{Long-term independent use of an intracortical brain–computer interface for speech and cursor control}},
author = {Nicholas S. Card and Tyler S. Singer-Clark and Hamza Peracha and Carrina Iacobacci and Xianda Hou and Maitreyee Wairagkar and Zachery Fogg and Elena C Offenberg and Leigh R. Hochberg and Sergey D. Stavisky and David M. Brandman},
journal = {Nature Medicine},
year = {2026},
month = jun,
doi = {10.1038/s41591-026-04414-6},
url = {https://doi.org/10.1038/s41591-026-04414-6},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long-term independent use of an intracortical brain–computer interface for speech and cursor control
AU - Nicholas S. Card
AU - Tyler S. Singer-Clark
AU - Hamza Peracha
AU - Carrina Iacobacci
AU - Xianda Hou
AU - Maitreyee Wairagkar
AU - Zachery Fogg
AU - Elena C Offenberg
AU - Leigh R. Hochberg
AU - Sergey D. Stavisky
AU - David M. Brandman
PY - 2026
DA - 2026/06/15
JO - Nature Medicine
DO - 10.1038/s41591-026-04414-6
UR - https://doi.org/10.1038/s41591-026-04414-6
AB - Brain-computer interfaces (BCIs) can provide naturalistic communication and digital access to people with severe paralysis by decoding neural activity associated with attempted speech and movement. Recent work has demonstrated highly accurate intracortical BCIs for speech and cursor control, but two critical capabilities needed for practical viability were unmet: independent at-home operation without researcher assistance and reliable long-term performance supporting accurate speech and cursor decoding. Here we demonstrate the independent and near-daily use of a multimodal BCI with novel brain-to-text speech and computer cursor decoders by a man with paralysis and severe dysarthria due to amyotrophic lateral sclerosis. Over nearly 2 years, the participant used the BCI for more than 3,800 h at home with no researchers present to maintain rich interpersonal communication with his family and friends, independently control his personal computer and sustain full-time employment-despite being paralyzed. He communicated 183,060 sentences-totaling 1,960,163 words-at an average rate of 56 words per minute. He labeled 92% of sentences as being decoded at least mostly correctly. In formal quantifications of performance where he was asked to say words presented on a screen, attempted speech was consistently decoded with more than 99% word accuracy (125,000 word vocabulary). The participant also used the speech BCI as keyboard input and the cursor BCI as mouse input to control his personal computer, enabling him to send text messages and emails and to browse the internet. These results demonstrate that intracortical BCIs have the potential to support independent use in the home, marking a critical step toward practical assistive technology for people with severe motor impairment.
SN - 1078-8956
SN - 1546-170X
SN - 1744-7933
ER -