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Updated: May 6, 2026

A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
A high-performance neuroprosthesis for speech decoding and avatar control
Sean L Metzger1,2,3, Kaylo T Littlejohn1,2,4, Alexander B Silva1,2,3
1Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
None:
Speech neuroprostheses have the potential to restore communication to people living with paralysis, but naturalistic speed and expressivity are elusive1. Here we use high-density surface recordings of the speech cortex in a clinical-trial participant with severe limb and vocal paralysis to achieve high-performance real-time decoding across three complementary speech-related output modalities: text, speech audio and facial-avatar animation. We trained and evaluated deep-learning models using neural data collected as the participant attempted to silently speak sentences. For text, we demonstrate accurate and rapid large-vocabulary decoding with a median rate of 78 words per minute and median word error rate of 25%. For speech audio, we demonstrate intelligible and rapid speech synthesis and personalization to the participant's pre-injury voice. For facial-avatar animation, we demonstrate the control of virtual orofacial movements for speech and non-speech communicative gestures. The decoders reached high performance with less than two weeks of training. Our findings introduce a multimodal speech-neuroprosthetic approach that has substantial promise to restore full, embodied communication to people living with severe paralysis.
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