1. Department of Neurology, Massachusetts General Hospital, Brigham and Women's Hospital, and Spaulding Rehabilitation Hospital, Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA
2. Department of Neuroscience and Brain Science Program, and
3. Department of Engineering, Brown University, PO Box 1953, Providence, Rhode Island 02912, USA
4. Center for Restorative and Regenerative Medicine, Rehabilitation Research and Development Service, Department of Veterans Affairs, Veterans Health Administration, 830 Chalkstone Avenue, Providence, Rhode Island 02908, USA
5. Department of Clinical Neurosciences (Neurosurgery), Brown University, and
6. Department of Neurosurgery, Rhode Island Hospital, 120 Dudley Street, Suite 103, Providence, Rhode Island 02905, USA
7. Department of Rehabilitation Medicine, Brown University, 593 Eddy Street, Providence, Rhode Island 02903, USA
8. Sargent Rehabilitation Center, 800 Quaker Lane, Warwick, Rhode Island 02818, USA
9. Cyberkinetics Neurotechnology Systems, Inc., 100 Foxborough Boulevard–Suite 240, Foxborough, Massachusetts 02035, USA
10. Cyberkinetics Neurotechnology Systems, Inc., 391 Chipeta Way, Suite G, Salt Lake City, Utah 84108, USA
11. Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, 345 E. Superior Street, 1146, Chicago, Illinois 60611, USA
12. Department of Neurosurgery, University of Chicago Hospitals, 5841 S. Maryland Avenue, MC3026, Chicago, Illinois 60637, USA
13. †Present address: Graduate Program in Computational Neuroscience, University of Chicago, Chicago, Illinois 60637, USA

Correspondence to: John P. Donoghue^2,9 Correspondence and requests for materials should be addressed to J.P.D. (Email: john_donoghue@brown.edu).

Abstract

Neuromotor prostheses (NMPs) aim to replace or restore lost motor functions in paralysed humans by routeing movement-related signals from the brain, around damaged parts of the nervous system, to external effectors. To translate preclinical results from intact animals to a clinically useful NMP, movement signals must persist in cortex after spinal cord injury and be engaged by movement intent when sensory inputs and limb movement are long absent. Furthermore, NMPs would require that intention-driven neuronal activity be converted into a control signal that enables useful tasks. Here we show initial results for a tetraplegic human (MN) using a pilot NMP. Neuronal ensemble activity recorded through a 96-microelectrode array implanted in primary motor cortex demonstrated that intended hand motion modulates cortical spiking patterns three years after spinal cord injury. Decoders were created, providing a 'neural cursor' with which MN opened simulated e-mail and operated devices such as a television, even while conversing. Furthermore, MN used neural control to open and close a prosthetic hand, and perform rudimentary actions with a multi-jointed robotic arm. These early results suggest that NMPs based upon intracortical neuronal ensemble spiking activity could provide a valuable new neurotechnology to restore independence for humans with paralysis.

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