Pandarinath, ChethanNuyujukian, PaulBlabe, Christine HSorice, Brittany LSaab, JadWillett, Francis RHochberg, LeighShenoy, Krishna VHenderson, Jaimie M2017-03-282017Pandarinath, Chethan, Paul Nuyujukian, Christine H Blabe, Brittany L Sorice, Jad Saab, Francis R Willett, Leigh R Hochberg, Krishna V Shenoy, and Jaimie M Henderson. 2017. “High performance communication by people with paralysis using an intracortical brain-computer interface.” eLife 6 (1): e18554. doi:10.7554/eLife.18554. http://dx.doi.org/10.7554/eLife.18554.http://nrs.harvard.edu/urn-3:HUL.InstRepos:31731757Brain-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 DOI: http://dx.doi.org/10.7554/eLife.18554.001en-USbrain-machine interfaceALSneural prosthesisassistive technologyHumanJournal Article2017-03-2810.7554/eLife.18554