ECoG BMI for Motor and Speech Control

ECoG is a type of electrophysiological monitoring that uses electrodes placed directly on the
exposed surface of the brain to record electrical activity. With this ECoG-based neural
interface, study patients will undergo training and assessment of their ability to control a
wearable hand robotic exoskeleton and determine if ECoG brain signals can be used to produce
speech.

Inclusion Criteria:

1. Age > 21

2. Limited ability to use upper limbs, based on neurological examination, due to stroke,
amyotrophic lateral sclerosis (ALS), multiple sclerosis, cervical spinal cord injury,
brainstem stroke, muscular dystrophy, myopathy or severe neuropathy.

3. Disability, defined by a 4 or greater score on the Modified Rankin Scale, must be
severe enough to cause loss of independence and inability to perform activities of
daily living.

4. If stroke or spinal cord injury, at least 1 year has passed since onset of symptoms

5. Must live within a two-hour drive of UCSF

Exclusion Criteria:

1. Pregnancy or breastfeeding

2. Inability to understand and/or read English

3. Inability to give consent

4. Dementia, based on history, physical exam, and MMSE

5. Active depression (BDI > 20) or other psychiatric illness (active general anxiety
disorder, schizophrenia, bipolar disorder, obsessive-compulsive disorder (OCD), or
personality disorders (e.g. multiple personality disorder, borderline personality
disorder, etc.)

6. History of suicide attempt or suicidal ideation

7. History of substance abuse

8. Co-morbidities including ongoing anticoagulation, uncontrolled hypertension, cancer,
or major organ system failure

9. Inability to comply with study follow-up visits

10. Any prior intracranial surgery

11. History of seizures

12. Immunocompromised

13. Has an active infection

14. Has a CSF drainage system or an active CSF leak

15. Requires diathermy, electroconvulsive therapy (ECT), or transcranial magnetic
stimulation (TMS) to treat a chronic condition

16. Has an implanted electronic device such as a neurostimulator, cardiac
pacemaker/defibrillator or medication pump, or presence of any head or neck metallic
foreign bodies

17. Allergies or known hypersensitivity to materials in the Blackrock NeuroPort Array
(i.e. silicone, titanium) or the PMT Subdural Cortical Electrode (silicone, platinum
iridium, nichrome)