Implications of shared motor and perceptual activations on the sensorimotor cortex for neuroprosthetic decoding

Neuroprostheses can restore communicative ability to people with paralysis by decoding intended speech movements from the sensorimotor cortex (SMC). However, overlapping neural populations in the SMC are also engaged in visual and auditory processing. The nature of these shared motor and perceptual activations and their potential to interfere with decoding are particularly relevant questions for speech neuroprostheses, as reading and listening are essential daily functions. In two participants with vocal-tract paralysis and anarthria (ClinicalTrials.gov; NCT03698149 ), we developed an online electrocorticography (ECoG) based speech-decoding system that maintained accuracy and specificity to intended speech, even during common daily tasks like reading and listening. Offline, we studied the spectrotemporal characteristics and spatial distribution of reading, listening, and attempted-speech responses across our participants' ECoG arrays. Across participants, the speech-decoding system had zero false-positive activations during 63.2 minutes of attempted speech and perceptual tasks, maintaining accuracy and specificity to volitional speech attempts. Offline, though we observed shared neural populations that responded to attempted speech, listening, and reading, we found they leveraged different neural representations with differentiable spectrotemporal responses. Shared populations localized to the middle precentral gyrus and may have a distinct role in speech-motor planning. Potential neuroprosthesis users strongly desire reliable systems that will retain specificity to volitional speech attempts during daily use. These results demonstrate a decoding framework for speech neuroprostheses that maintains this specificity and further our understanding of shared perceptual and motor activity on the SMC.