ClinicalTrials.gg
RecruitingNCT03567213CortiComUpdated Aug 21, 2026

Investigation on the Cortical Communication (CortiCom) System

An interventional study of Surgical implantation of CortiCom system in Tetraplegia, Locked-in Syndrome and Brainstem Stroke, sponsored by Johns Hopkins University. Recruiting at 1 site in United States. Open to participants aged 22 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-08-21.

Primary conditionLocked-In SyndromeRegistry: QuadriplegiaReclassifiedWhy we changed it
Registry
Quadriplegia — the first condition term the registry derived for this study.
ClinicalTrials.gg
Locked-In Syndrome
Why
  1. The study's listed conditions name Locked-In Syndrome, a narrower term within Quadriplegia.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Johns Hopkins University · Not applicable, Interventional, and Device feasibility

From the registry’s dates

  • Started Dec 2021; still recruiting 4 years 10 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
3
Allocation
Not applicable
Ages
22 Years to 70 Years
Sex
All
01

Study summary

The CortiCom system consists of 510(k)-cleared components: platinum PMT subdural cortical electrode grids, a Blackrock Microsystems patient pedestal, and an external NeuroPort Neural Signal Processor. Up to two grids will be implanted in the brain, for a total channel count of up to 128 channels, for six months. In each participant, the grid(s) will be implanted over areas of cortex that encode speech and upper extremity movement.

Read the detailed description

The successful adoption of brain-computer interfaces (BCIs) as assistive technologies (ATs) for disabled populations depends on the ability to elicit rapid, intuitive, and reliable control signals. To date, it is not known which sources of neural information provide the most natural and efficient means of control. This study will directly assess the efficacy of two sources of neural control signals, speech and motor cortex, for BCI control of software and devices using investigators' Cortical Communication (CortiCom) system.

The CortiCom system consists of 510(k)-cleared components: platinum PMT subdural cortical electrode grids, a Blackrock Microsystems patient pedestal, and an external NeuroPort Neural Signal Processor. Up to two grids will be implanted in the brain, for a total channel count of up to 128 channels, for six months. In each participant, the grid(s) will be implanted over areas of cortex that encode speech and upper extremity movement.

Investigators' study will be the first to investigate the efficiency and intuitiveness of two contrasting neural control strategies for BCI: Motor imagery and speech. As the first study to chronically and simultaneously record from human speech and motor regions, this study seeks to achieve the following:

  • demonstrate the ability to decode intended upper extremity movements using information decoded from primary motor cortex arm/hand area;
  • demonstrate the ability to decode intended speech from articulatory speech cortex; and
  • determine the most effective and intuitive user strategies (e.g. imagined speech or imagined movement) and optimal neural sources for brain-computer interactions,

The patient populations targeted in this study are amyotrophic lateral sclerosis (ALS), brainstem stroke, locked-in syndrome (LIS), and tetraplegia. Individuals within these populations may have normal cortical function and cognition while suffering from motor or combined speech and motor deficits.

Based on research by colleagues, as well as investigators' own experience working with participants affected by epilepsy implanted with high density electrocorticographic grids, investigators hypothesize that long-term recording of neural activity from the targeted cortical areas may provide a new communication channel for these clinical populations. The utilization of high-channel-count (up to 128 channel) ECoG grids, in combination with simultaneous coverage of speech and motor cortex, will enable investigations into the performance of speech-mediated and motor-mediated control efficacy as applied to a variety of end effectors, such as computers, tablets, headsets for virtual or augmented reality, smart lights, televisions, and assistive technologies. Additionally, eye-tracking may be utilized in combination with neural commands to improve target selection performance and ease.

Through this study, investigators will assess the performance of speech- and motor-mediated control using chronic, high-channel count ECoG grid neural implants in pursuit of a high-performing, clinically beneficial BCI assistive technology.

02

Conditions studied

  • Tetraplegia
  • Locked-in Syndrome
  • Brainstem Stroke
  • Amyotrophic Lateral Sclerosis

Keywords

  • Tetraplegia
  • ALS
  • Locked-in Syndrome
  • Brainstem stroke
  • Brain Computer Interface
  • Rehabilitation
  • Stroke
  • Hopkins
03

In context

Locked-In Syndrome Reclassified

20 studies on the registry are indexed under Locked-In Syndrome; 12 are open to participants now.

This study's planned enrollment of 3 is below the median of 7 across 17 interventional studies indexed under Locked-In Syndrome.

Browse Locked-In Syndrome studies →

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,815 studies on the registry; 315 are open to participants now.

Of its 208 completed or terminated interventional studies of FDA-regulated products, 144 (69%) have results posted.

Compared within Locked-In Syndrome, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Quadriplegia. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
22 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Clinical diagnosis of tetraplegia (quadriplegia), brainstem stroke , amyotrophic lateral sclerosis (ALS) or Locked-in Syndrome (LIS)
  • Tetraplegia diagnosis, ALS diagnosis, stroke, or LIS etiology onset occurred at least one year prior to enrollment
  • Complete or incomplete tetraplegia (quadriplegia), tetraparesis (quadriparesis), or severe ataxia. In addition, these motor impairments may be combined with severe motor-related speech impairment (dysarthria or anarthria), as in LIS.
  • 22-70 years
  • Meeting surgical safety criteria, including surgical clearance by the participant's primary healthcare provider, study physicians, and any necessary consultants
  • Ability to communicate reliably, such as through eye movement
  • Willingness and ability to provide
  • Screened by rehabilitation psychologist with a result showing that the participant has a stable psychosocial support system with caregiver capable of monitoring participant throughout the study
  • Ability and willingness to travel up to 100 miles to study location up to three days per week for the duration of the study
  • Ability to understand and comply with study session instructions
  • Participant consents to the study and still wishes to participate at the time of the study

Exclusion criteria

Exclusion Criteria:

  • Performance on formal neuropsychological testing that indicates significant psychiatric conditions or cognitive impairments that would interfere with obtaining or fully participating in study activities.
  • Suicide attempt or persistent suicidal ideation within the past 12 months.
  • Implanted devices that are incompatible with MRI, which may include pacemakers, cardiac defibrillators, spinal cord or vagal nerve stimulators, deep brain stimulators, and cochlear implants.
  • History of substance abuse, narcotic dependence, or alcohol dependence in past 24 months
  • Medical conditions contraindicating surgery of a chronically implanted device (e.g. osteomyelitis, diabetes, hepatitis, any disease/disorder, epilepsy, skin disorders causing excessive skin sloughing or poor wound healing, blood or cardiac disorder requiring chronic anti-coagulation)
  • Other chronic, unstable medical conditions that could interfere with subject participation.
  • Presence of pre-surgical findings in anatomical, functional, and/or vascular neuroimaging that makes achieving implant locations within desired risk levels too challenging (to be decided by neurological and neurosurgical team)
  • Prior cranioplasty
  • Inability to undergo MRI or anticipated need for an MRI during the study period
  • Participants with active infections or unexplained fever
  • Participants with other morbid conditions making the implantation of the recording elements unsafe; not limited to: significant pulmonary, cardiovascular, metabolic, or renal impairments making the surgical procedure unsafe
  • Pregnancy (confirmation through blood test)
  • Nursing an infant, planning to become pregnant, or not using adequate
  • Corrected vision poorer than 20/100
  • or AIDS infection
  • Existing scalp lesions or skin breakdown
  • Chronic oral or intravenous use of or therapy
  • Active cancer within the past year or requires chemotherapy
  • Uncontrolled autonomic dysreflexia within the past 3 months
  • Hydrocephalus with or without an implanted ventricular shunt
  • Participants in whom it is medically to stop anti-coagulant medications during surgery
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Device feasibility
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
3 participants (estimated)

Study arms

  • Experimental
    Surgical implantation of the CortiCom system

    Device: Surgical implantation of CortiCom system

Interventions

  • DeviceSurgical implantation of CortiCom system

    Implantation of Cortical communication system, consisting of one or two Electrocorticography (ECoG) grids connected to a transcutaneous patient pedestal.

06

What researchers measure

Primary outcomes

  1. Time to device explantation

    This study outcome will be considered successful if the device is not explanted during the 26-week period of the study. Explantation of the device prior to the completion of the 26-week period implies that the device is putting the subject at risk (e.g. through a serious infection at the implantation site) and therefore must be removed.

    Time frame: 26 weeks

Secondary outcomes

  1. Success rate in controlling the brain computer interface, i.e. ratio of successful trials to total trials.

    One or more participants demonstrates successful use of the CortiCom system in which motor and/or speech neural signals can be decoded to provide control signals for software and devices. Efficacy is assessed in terms of accuracy, i.e. how often the participant is able to select a desired target.

    Time frame: 26 weeks

  2. Speed of brain-computer interface control, i.e. time to complete successful trials (in seconds).

    One or more participants demonstrates successful use of the CortiCom system in which motor and/or speech neural signals can be decoded to provide control signals for software and devices. Efficacy is therefore also assessed in terms of how long it takes to select the target.

    Time frame: 26 weeks

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Ouyang Z, Walmsley K, Luo S, Tippett D, Wyse-Sookoo K, Fifer M, Vansteensel MJ, Angrick M, Ramsey N, Crone NE. Stable speech BCI performance during slow progression of ALS: A longitudinal ECoG study. Res Sq [Preprint]. 2026 Mar 25:rs.3.rs-9156039. doi: 10.21203/rs.3.rs-9156039/v1. PubMed 41928799 ↗
  • Candrea DN, Angrick M, Luo S, Ganji R, Coogan C, Milsap GW, Rosenblatt KR, Uchil A, Clawson L, Maragakis NJ, Vansteensel MJ, Tenore FV, Ramsey NF, Fifer MS, Crone NE. Longitudinal study of gesture decoding in a clinical trial participant with ALS. medRxiv [Preprint]. 2025 Oct 3:2025.09.26.25335804. doi: 10.1101/2025.09.26.25335804. PubMed 41256173 ↗
  • Angrick M, Luo S, Rabbani Q, Joshi S, Candrea DN, Milsap GW, Gordon CR, Rosenblatt K, Clawson L, Maragakis N, Tenore FV, Fifer MS, Ramsey NF, Crone NE. Real-time detection of spoken speech from unlabeled ECoG signals: a pilot study with an ALS participant. J Neural Eng. 2025 Oct 6;22(5):056023. doi: 10.1088/1741-2552/ae0965. PubMed 40972658 ↗
  • Candrea DN, Shah S, Luo S, Angrick M, Rabbani Q, Coogan C, Milsap GW, Nathan KC, Wester BA, Anderson WS, Rosenblatt KR, Uchil A, Clawson L, Maragakis NJ, Vansteensel MJ, Tenore FV, Ramsey NF, Fifer MS, Crone NE. A click-based electrocorticographic brain-computer interface enables long-term high-performance switch scan spelling. Commun Med (Lond). 2024 Oct 22;4(1):207. doi: 10.1038/s43856-024-00635-3. PubMed 39433597 ↗
  • Angrick M, Luo S, Rabbani Q, Joshi S, Candrea DN, Milsap GW, Gordon CR, Rosenblatt K, Clawson L, Maragakis N, Tenore FV, Fifer MS, Ramsey NF, Crone NE. Real-time detection of spoken speech from unlabeled ECoG signals: A pilot study with an ALS participant. medRxiv [Preprint]. 2024 Sep 22:2024.09.18.24313755. doi: 10.1101/2024.09.18.24313755. PubMed 39371161 ↗
  • Wyse-Sookoo K, Luo S, Candrea D, Schippers A, Tippett DC, Wester B, Fifer M, Vansteensel MJ, Ramsey NF, Crone NE. Stability of ECoG high gamma signals during speech and implications for a speech BCI system in an individual with ALS: a year-long longitudinal study. J Neural Eng. 2024 Jul 12;21(4):10.1088/1741-2552/ad5c02. doi: 10.1088/1741-2552/ad5c02. PubMed 38925110 ↗
  • Angrick M, Luo S, Rabbani Q, Candrea DN, Shah S, Milsap GW, Anderson WS, Gordon CR, Rosenblatt KR, Clawson L, Tippett DC, Maragakis N, Tenore FV, Fifer MS, Hermansky H, Ramsey NF, Crone NE. Online speech synthesis using a chronically implanted brain-computer interface in an individual with ALS. Sci Rep. 2024 Apr 26;14(1):9617. doi: 10.1038/s41598-024-60277-2. PubMed 38671062 ↗
  • Crone N, Candrea D, Shah S, Luo S, Angrick M, Rabbani Q, Coogan C, Milsap G, Nathan K, Wester B, Anderson W, Rosenblatt K, Clawson L, Maragakis N, Vansteensel M, Tenore F, Ramsey N, Fifer M, Uchil A. A click-based electrocorticographic brain-computer interface enables long-term high-performance switch-scan spelling. Res Sq [Preprint]. 2023 Sep 25:rs.3.rs-3158792. doi: 10.21203/rs.3.rs-3158792/v1. PubMed 37841873 ↗
  • Angrick M, Luo S, Rabbani Q, Candrea DN, Shah S, Milsap GW, Anderson WS, Gordon CR, Rosenblatt KR, Clawson L, Maragakis N, Tenore FV, Fifer MS, Hermansky H, Ramsey NF, Crone NE. Online speech synthesis using a chronically implanted brain-computer interface in an individual with ALS. medRxiv [Preprint]. 2023 Jul 1:2023.06.30.23291352. doi: 10.1101/2023.06.30.23291352. PubMed 37425721 ↗

Individual participant data

Plan to share: Yes — IPD from published results will be made available upon reasonable request to corresponding authors and/or will be uploaded to a data archive for the BRAIN Initiative in compliance with its data sharing consortium.

Supporting information: Analytic code

Time frame: IPD and associated analytic code will be made available upon publication of research results and will remain available for the duration of the funded project.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 21, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03567213
Responsible party
Sponsor
First posted
Jun 25, 2018
Start date
Dec 14, 2021
Primary completion
Dec 31, 2028 (estimated)
Completion
Dec 31, 2030 (estimated)
Last update
Aug 21, 2026

Study contacts

Nathan E Crone, MD
Contact
ncrone@jhmi.edu
410-955-6772
Nathan E Crone, MD
principal investigator · Professor of Neurology

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion