• Mariska J Vansteensel, Sacha Leinders, Mariana P Branco, Nathan E Crone, Timothy Denison, Zachary V Freudenburg, Simon H Geukes, Peter H Gosselaar, Mathijs Raemaekers, Anouck Schippers, Malinda Verberne, Erik J Aarnoutse, and Nick F Ramsey.
• From the Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands (M.J.V., S.L., M.P.B., Z.V.F., S.H.G., P.H.G., M.R., A.S., M.V., E.J.A., N.F.R.); the Department of Neurology, Johns Hopkins University School of Medicine, Baltimore (N.E.C.); and the Institute of Biomedical Engineering and the Department of Engineering Science, University of Oxford, Oxford, United Kingdom (T.D.).
• N. Engl. J. Med. 2024 Aug 15; 391 (7): 619626619-626.

AbstractThe durability of communication with the use of brain-computer interfaces in persons with progressive neurodegenerative disease has not been extensively examined. We report on 7 years of independent at-home use of an implanted brain-computer interface for communication by a person with advanced amyotrophic lateral sclerosis (ALS), the inception of which was reported in 2016. The frequency of at-home use increased over time to compensate for gradual loss of control of an eye-gaze-tracking device, followed by a progressive decrease in use starting 6 years after implantation. At-home use ended when control of the brain-computer interface became unreliable. No signs of technical malfunction were found. Instead, the amplitude of neural signals declined, and computed tomographic imaging revealed progressive atrophy, which suggested that ALS-related neurodegeneration ultimately rendered the brain-computer interface ineffective after years of successful use, although alternative explanations are plausible. (Funded by the National Institute on Deafness and Other Communication Disorders and others; ClinicalTrials.gov number, NCT02224469.).Copyright © 2024 Massachusetts Medical Society.

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