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Implanted brain-computer interface functionality during nighttime in late-stage amyotrophic lateral sclerosis
Sacha Leinders1, Erik J Aarnoutse1, Mariana P Branco1
1Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center, Utrecht, the Netherlands.
Scientific Reports
|March 19, 2026
Summary
Nocturnal use of brain-computer interfaces (BCIs) is feasible with a specialized nightmode. This system addresses signal changes during sleep, enabling reliable 24/7 assistive communication for individuals with paralysis.
Area of Science:
- Neuroscience
- Biomedical Engineering
- Assistive Technology
Background:
- Brain-computer interfaces (BCIs) offer communication solutions for individuals with severe paralysis.
- Current BCIs are primarily designed for daytime use, with nocturnal feasibility unexplored.
- Continuous 24/7 BCI availability is crucial for users with conditions like amyotrophic lateral sclerosis.
Purpose of the Study:
- To investigate the feasibility of nocturnal brain-computer interface (BCI) use.
- To analyze nocturnal changes in neural signal features relevant to BCI control.
- To evaluate the performance of a specifically developed BCI nightmode functionality.
Main Methods:
- Utilized electrocorticography (ECoG) data from a single user with amyotrophic lateral sclerosis.
- Analyzed nocturnal dynamics of neural signal power in low and high frequency bands.
- Assessed the performance of a daytime-trained decoder on nocturnal data and a newly developed nightmode.
Main Results:
- Significant increases in mean and variance of low and high frequency band power were observed during nighttime.
- Daytime decoders resulted in frequent unintentional BCI activations (245 clicks/13 calls per hour) during nocturnal use.
- The developed nightmode demonstrated high reliability, functioning error-free in 79% of nights over 1.5 years.
Conclusions:
- Reliable 24/7 BCI operation necessitates adaptive strategies for circadian and sleep-related neural signal variations.
- A specialized nightmode significantly improves BCI reliability during sleep.
- This study highlights the importance of developing 24/7 functional BCIs for individuals with severe paralysis.
