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Locked-in SyndromeCortiComNCT06207591

Investigation on the Cortical Communication System

A study testing ECoG (electrocorticography) sensing in people with Locked-in Syndrome and Neuromuscular Diseases, run by UMC Utrecht at 1 site in Netherlands.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to demonstrate communication through a brain implant in people in locked-in state, i.e. people with severe paralysis and communication problems. Read more about this study

Who is it for?
Ages 18 to 70 years
What is being tested?
ECoG (electrocorticography) sensing
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2 participants
Where
1 siteNetherlands
Study dates
15 Dec 2023to Sep 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18-70 years
  • Clinical diagnosis of locked-in state state or likelihood of soon progressing into LIS (within an estimated 2 years), caused by traumatic brain injury, brainstem stroke, neurodegenerative disease, neuromuscular disease or another cause
  • • Current or imminent complete or incomplete tetraplegia (quadriplegia) or tetraparesis (quadriparesis)
  • • Current or imminent motor-related speech impairment (dysarthria or anarthria)
  • Either receiving tracheostomy invasive ventilation, or having a stable and adequate respiratory situation without respiratory support, allowing for safe intubation, mechanical ventilation and detubation during surgery according to the involved clinicians, and, if relevant (e.g., in case of a progressive condition), in combination with a confirmed desire to receive tracheostomy invasive ventilation when that becomes necessary
  • Meeting surgical safety criteria, including surgical clearance by the study physicians
Show all 12Show fewer
  • Meeting (neuro)psychological evaluation criteria
  • Ability to communicate reliably, such as through eye movement
  • Willingness and ability to provide informed consent
  • Lives within reasonable distance from University Medical Center Utrecht
  • Participant consents to the study and still wishes to participate at the time of the study
  • Vision and hearing largely intact

Who cannot join

  • Performance on formal neuropsychological testing that indicates a significant current or recent psychiatric disorder, cognitive or behavioral impairment, that would interfere with obtaining informed consent or fully participating in study activities
  • Medical conditions contraindicating surgery of a chronically implanted device or that could interfere with study participation (for example active infections, unexplained fever, existing scalp lesions or skin breakdown, osteomyelitis, hepatitis, any autoimmune disease/disorder, epilepsy, skin disorders causing excessive skin sloughing or poor wound healing, cranioplasty, significant cardiovascular, metabolic, or renal impairments, chronic oral or intravenous use of steroids or immunosuppressive 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 or a medical contraindication to stop anti-coagulant medications during surgery)
  • Presence of pre-surgical findings in anatomical, functional, and/or vascular neuroimaging that makes achieving implant locations too challenging or incompatible with desired risk levels
  • Inability to undergo MRI for pre-implantation evaluation, for example due to the presence of 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
  • Anticipated need for MRI after implantation of the CortiCom assembly

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Mariska J Vansteensel, PhD contact

+31887555121

neuroprothese@umcutrecht.nl

Erik J Aarnoutse, PhD contact

+31887555123

e.j.aarnoutse@umcutrecht.nl

Netherlands1 site, 1 recruiting
  • University Medical Center

    Utrecht, 3584CX

    Mariska J Vansteensel, PhD, +31887555121, neuroprothese@umcutrecht.nl

    Erik J Aarnoutse, PhD, +31887555123, e.j.aarnoutse@umcutrecht.nl

    Recruiting

Other trials in Netherlands

About this study

Official title: Investigation on the Cortical Communication (CortiCom) System

The goal of this clinical trial is to demonstrate communication through a brain implant in people in locked-in state, i.e. people with severe paralysis and communication problems.

The main questions it aims to answer are efficient and stable control of Brain-Computer interface (BCI) functions for communication with attempted hand movements and operation of a keyword-based speech BCI.

Read more

Participants will be implanted with four electrode grids, with in total 128 electrodes, on the surface of the brain and a connector on the skull. Participation includes visits of researchers for recording and training at home, 2-3 times per week for one year. Extension of participation after one year is possible.

If successful, the participant will be able to use the BCI at home independently, without the presence of a researcher.

Read the detailed description

Locked-In Syndrome (LIS) is a neurological condition in which communication is impossible, or profoundly impaired, due to loss of speech and other motor functions, while cognition is intact. The most distressing aspect of LIS is the inability to initiate and sustain communication. Existing assistive technologies (ATs) fall short of a remedy. An effective brain-computer interface (BCI) for communication would dramatically improve quality of life for people with LIS. Electrocorticography (ECoG) with non-penetrating subdural electrodes is a promising implantable approach for BCI. In this study, the "CortiCom system" (which stands for Cortical Communication) wil be used. This system combines an implantable assembly, consisting of four small high-density (HD) ECoG grids on the hand and speech areas of the motor cortex, totalling 128-channels, and a transcutaneous pedestal connector, with an external data acquisition system. With the CortiCom system the overall hypothesis will be tested that broader and more densely spaced ECoG electrodes can better tap into the spatial detail of the organization of the sensorimotor cortex in order to expand BCI function and restore meaningful communication in LIS. Specifically, the CortiCom system will substantially increase the number and density of electrodes recording from the brain to determine whether more sophisticated control and communication can be achieved with more comprehensive and detailed spatial sampling of representations for movements of the hand/arm and of speech articulators. Clinically meaningful outcomes for people with LIS include rapid reestablishment, and stable maintenance of communication, at minimum consisting of a caregiver call-button and menu selections.

Objective:

Primary Objective 1: Demonstrate efficient and stable control of essential BCI functions (initiate BCI, call caregiver, and menu selections). Primary Objective 2: Demonstrate efficient and stable operation of a keyword-based speech BCI.

Intervention:

Participants will be implanted with an assembly consisting of HD-ECoG electrode grids over the sensorimotor cortex and a transcutaneous pedestal connector. The assembly will be connected with an external data acquisition system during recordings. During recordings, feedback about the neural signals is given via a visual display and participants are trained to employ the neural signals for fast brain-based communication. Upon adequate performance, participants can independently (i.e., without researcher involvement) train with and use the system at home for validation of performance and usability. After implantation, participation has a duration of 1 year, with a possibility of extension.

Being tested
ECoG (electrocorticography) sensing
Keywords
Locked-in, Amyotrophic lateral sclerosis, Neurodegenerative disease
Medical subject headings
Locked-In Syndrome, Neuromuscular Diseases, Brain Stem Infarctions, Brain Injuries, Traumatic, Amyotrophic Lateral Sclerosis, Neurodegenerative Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ECoG (electrocorticography) sensingDevice

    Also called CortiCom-Utrecht assembly

    Implant electrodes and pedestal connector and use, through amplifier and decoding, for control of BCI

Study groups in NCT06207591
Study groupRoleWhat they receive
ECoG (electrocorticography) sensingExperimentalUse implantable ECoG-based Brain Computer interface to control assistive technology
Receives: Device: ECoG (electrocorticography) sensing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Usability of the BCI system - Accuracy

    Accuracy: >80% sensitivity (true positive rate) for 1-command control, and 90% sensitivity and 80% classification accuracy (distinguishing between the six classes) for 6-command control

    Measured: 1 year

  2. Usability of the BCI system - speed

    Speed characters or keywords per minute

    Measured: 1 year

  3. Usability of the BCI system - subjective workload Visual Analogue Scale (VAS)

    Subjective Workload: Visual Analogue Scale Continuous scale: Little to no effort (0) - Much effort (5). Lower numbers are better.

    Measured: 1 year

  4. Usability of the BCI system - subjective workload National Aeronautics and Space Administration-Task Load Index (NASA-TLX)

    Subjective Workload: National Aeronautics and Space Administration-Task Load Index Scale: 21 point Likert-type scale. Lower numbers are better.

    Measured: 1 year

  5. Usability of the BCI system - user satisfaction Psychosocial impact of assistive devices scale (PIADS)

    User Satisfaction: Psychosocial impact of assistive devices scale. Likert-type scale -3, -2, -1, 0, 1, 2, 3. 3 is best result.

    Measured: 1 year

  6. Usability of the BCI system - user satisfaction Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)

    User Satisfaction: Quebec User Evaluation of Satisfaction with assistive Technology version 2.0.

    Likert-type scale: Extremely dissatisfied - Dissatisfied - Slightly satisfied - Satisfied - Extremely satisfied. Extremely Satisfied is the best result.

    Measured: 1 year

  7. Usability of the BCI system - validation

    Validation: Questionnaire to evaluate user satisfaction and ease of use of the home use software.

    Likert-type scale: fully disagree - disagree - neither agree or disagree - agree - fully agree - not applicable. Fully agree is the best result.

    Measured: 1 year

  8. Degrees of Freedom of BCI Control.

    the number of different commands that are successfully decoded, or the size of the decoded vocabulary

    Measured: 1 year

Secondary outcomes (5)
  1. Stability of BCI performance (electrode-tissue interaction)

    Longitudinal data of the 24-hour cycle after implantation of the impedance (in Ω). The data are fitted to determine trends and variance, over weeks, to determine improvement or deterioration of electrode-tissue interaction.

    Measured: 2 years

  2. Stability of BCI performance (signal)

    Longitudinal data of the 24-hour cycle after implantation of the raw power (after wavelet transform, in arbitrary units). The data are fitted to determine trends and variance, both within 24 hrs to detect a possible circadian pattern and over weeks, to determine improvement or deterioration of signal amplitude.

    Measured: 2 years

  3. Stability of BCI performance (modulation)

    Longitudinal data of the 24-hour cycle after implantation of the task-related modulation in power (correlation in r2). The data are fitted to determine trends and variance, over weeks, to determine improvement or deterioration of modulation.

    Measured: 2 years

  4. Stability of BCI performance (performance)

    Longitudinal data of the 24-hour cycle after implantation of the BCI performance (task accuracy). The data are fitted to determine trends and variance, both within 24 hrs to detect a possible circadian pattern and over weeks, to see improvement or deterioration of accuracy.

    Measured: 2 years

  5. Independent use of BCI

    Longitudinal data of independent use per day. The best result is 24h use. The data are fitted to determine trends and variance, both within 24 hrs to detect a possible circadian pattern and over weeks, to see increase or decrease of the hours of independent use.

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jan 2024
  2. Study start15 Dec 2023
  3. Primary completionSep 2028 (estimated)
  4. Study completionSep 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
2 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06207591
Sponsor's protocol ID
UMCU 23-171
Other IDs
NL81205.041.23
Acronym
CortiCom
Status last verified
Sep 2025
First submitted
1 Dec 2023
Last updated
3 Oct 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: selected datasets will be available through a public repository after publication of results

Publications

  • Vansteensel MJ, Leinders S, Branco MP, Crone NE, Denison T, Freudenburg ZV, Geukes SH, Gosselaar PH, Raemaekers M, Schippers A, Verberne M, Aarnoutse EJ, Ramsey NF. Longevity of a Brain-Computer Interface for Amyotrophic Lateral Sclerosis. N Engl J Med. 2024 Aug 15;391(7):619-626. doi: 10.1056/NEJMoa2314598.

    PubMed 39141854
  • Vansteensel MJ, Pels EGM, Bleichner MG, Branco MP, Denison T, Freudenburg ZV, Gosselaar P, Leinders S, Ottens TH, Van Den Boom MA, Van Rijen PC, Aarnoutse EJ, Ramsey NF. Fully Implanted Brain-Computer Interface in a Locked-In Patient with ALS. N Engl J Med. 2016 Nov 24;375(21):2060-2066. doi: 10.1056/NEJMoa1608085. Epub 2016 Nov 12.

    PubMed 27959736
  • The neural representation of fine hand movements in an individual approaching locked-in syndrome (2025) S.H. Geukes, A. Bekius, M.P. Branco, M.S.W. Verberne, A. Schippers, Z.V. Freudenburg, E.J. Aarnoutse, M.J. Vansteensel, N.E. Crone, N.F. Ramsey. 11th International BCI Meeting, Banff, Canada, DOI: 10.3217/978-3-99161-050-2-085

Questions about this trial

What is this clinical trial studying?

A study testing ECoG (electrocorticography) sensing in people with Locked-in Syndrome and Neuromuscular Diseases, run by UMC Utrecht at 1 site in Netherlands.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 12 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 3 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mariska J Vansteensel, PhD (+31887555121, neuroprothese@umcutrecht.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Usability of the BCI system - Accuracy (time frame: 1 year). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06207591, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Oct 2025.

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