Brainstem stroke and amyotrophic lateral sclerosis can lead to devastating disability, resulting in part from communication impairment and immobility. In the most severe cases, patients become locked-in - awake and alert, but unable to move, control their environment, or ask for help. In these disorders, as well as other neurologic diseases and injuries, the desire or intention to move remains fully intact, but the motor centers of the brain are "disconnected" from their targets in the brainstem or spinal cord, resulting in paralysis. The development and testing of a technology that enables someone with severe paralysis or locked-in syndrome to communicate independently and reliably would revolutionize the fields of assistive technology and neuroengineering, and would be critical steps toward re-enabling limb movement after paralyzing disease or injury. Based on encouraging preliminary findings from participants with tetraplegia and limited communication, this proposed translational research will seek to further develop a neural interface system that can record brain signals and permit persons with paralysis to control communication software, simply by imagining the movement of their own paralyzed arm or hand. Up to five participants with brainstem stroke or ALS will receive a 96-microelectrode array (4x4 mm) which will record the individual and summed activities of ensembles of neurons in the motor cortex. In addition to further assessing the safety of this implanted medical device, this research will support the development of reliable neural decoding algorithms that permit persons with paralysis to use their natural movement-related cortical signals to drive a communication device for speech synthesis and improved environmental control.

Public Health Relevance

People with brainstem stroke or ALS are sometimes unable to talk or communicate, despite being fully awake. This research aims to test and develop a neural interface system that could restore the ability to type words, just imagining the movement of one's own hand.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZDC1-SRB-L (44))
Program Officer
Miller, Roger
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Massachusetts General Hospital
United States
Zip Code
Bacher, Daniel; Jarosiewicz, Beata; Masse, Nicolas Y et al. (2015) Neural Point-and-Click Communication by a Person With Incomplete Locked-In Syndrome. Neurorehabil Neural Repair 29:462-71
Homer, Mark L; Perge, Janos A; Black, Michael J et al. (2014) Adaptive offset correction for intracortical brain-computer interfaces. IEEE Trans Neural Syst Rehabil Eng 22:239-48
Masse, Nicolas Y; Jarosiewicz, Beata; Simeral, John D et al. (2014) Non-causal spike filtering improves decoding of movement intention for intracortical BCIs. J Neurosci Methods 236:58-67
Hochberg, Leigh R; Cudkowicz, Merit E (2014) Locked in, but not out? Neurology 82:1852-3
Perge, János A; Zhang, Shaomin; Malik, Wasim Q et al. (2014) Reliability of directional information in unsorted spikes and local field potentials recorded in human motor cortex. J Neural Eng 11:046007
Jarosiewicz, Beata; Masse, Nicolas Y; Bacher, Daniel et al. (2013) Advantages of closed-loop calibration in intracortical brain-computer interfaces for people with tetraplegia. J Neural Eng 10:046012
Perge, Janos A; Homer, Mark L; Malik, Wasim Q et al. (2013) Intra-day signal instabilities affect decoding performance in an intracortical neural interface system. J Neural Eng 10:036004
Homer, Mark L; Nurmikko, Arto V; Donoghue, John P et al. (2013) Sensors and decoding for intracortical brain computer interfaces. Annu Rev Biomed Eng 15:383-405
Shaikhouni, Ammar; Donoghue, John P; Hochberg, Leigh R (2013) Somatosensory responses in a human motor cortex. J Neurophysiol 109:2192-204
Chadwick, E K; Blana, D; Simeral, J D et al. (2011) Continuous neuronal ensemble control of simulated arm reaching by a human with tetraplegia. J Neural Eng 8:034003

Showing the most recent 10 out of 16 publications