• Ariel Tankus, Einat Stern, Guy Klein, Nufar Kaptzon, Lilac Nash, Tal Marziano, Omer Shamia, Guy Gurevitch, Lottem Bergman, Lilach Goldstein, Firas Fahoum, and Ido Strauss.
• Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
• Neurosurgery. 2024 Jun 27.

Background And ObjectivesLoss of speech due to injury or disease is devastating. Here, we report a novel speech neuroprosthesis that artificially articulates building blocks of speech based on high-frequency activity in brain areas never harnessed for a neuroprosthesis before: anterior cingulate and orbitofrontal cortices, and hippocampus.MethodsA 37-year-old male neurosurgical epilepsy patient with intact speech, implanted with depth electrodes for clinical reasons only, silently controlled the neuroprosthesis almost immediately and in a natural way to voluntarily produce 2 vowel sounds.ResultsDuring the first set of trials, the participant made the neuroprosthesis produce the different vowel sounds artificially with 85% accuracy. In the following trials, performance improved consistently, which may be attributed to neuroplasticity. We show that a neuroprosthesis trained on overt speech data may be controlled silently.ConclusionThis may open the way for a novel strategy of neuroprosthesis implantation at earlier disease stages (eg, amyotrophic lateral sclerosis), while speech is intact, for improved training that still allows silent control at later stages. The results demonstrate clinical feasibility of direct decoding of high-frequency activity that includes spiking activity in the aforementioned areas for silent production of phonemes that may serve as a part of a neuroprosthesis for replacing lost speech control pathways.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.

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