%0 Journal Article
%T Longevity of a Brain-Computer Interface for Amyotrophic Lateral Sclerosis.
%A Vansteensel MJ
%A Leinders S
%A Branco MP
%A Crone NE
%A Denison T
%A Freudenburg ZV
%A Geukes SH
%A Gosselaar PH
%A Raemaekers M
%A Schippers A
%A Verberne M
%A Aarnoutse EJ
%A Ramsey NF
%J N Engl J Med
%V 391
%N 7
%D 2024 Aug 15
%M 39141854
%F 176.079
%R 10.1056/NEJMoa2314598
%X The 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.).