Brain-controlled functional electrical stimulation restores bimanual object manipulation in chronic tetraplegia

Brain-controlled functional electrical stimulation restores bimanual object manipulation in chronic tetraplegia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Brain-controlled functional electrical stimulation restores bimanual object manipulation in chronic tetraplegia Lucas Struber, Jean Faber, Violaine Juillard, Félix Martel, Andres Carvallo-Pecci, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7598810/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted You are reading this latest preprint version Abstract Spinal cord injury causes paralysis, hindering daily activities, many of which require the coordinated use and interaction of both hands. Brain–computer interfaces (BCI) have previously enabled individuals with tetraplegia to regain voluntary movement, but applications were largely restricted to simple unimanual actions or sequential bimanual activation. Here, we present an intracranial neuroprosthesis combining chronic electrocorticography (ECoG) recordings from wireless 64-channel WIMAGINE implants with two surface functional electrical stimulators (sFES). This iBCI-sFES system enabled two participants to achieve real-time, concurrent bimanual asynchronous control of both hands, allowing simultaneous and independent movement to freely perform functional object manipulation in home-like environments. The neuroprosthesis features fast model calibration and is designed for stable long-term use, demonstrating feasibility for future deployment in real home settings. Moreover, we show that sFES enhances neural synchronization associated with motor intentions, promoting real-time afferent feedback to the sensorimotor cortex. Together, these results highlight the potential of iBCI-sFES not only to restore complex bimanual interactions in individuals with paralysis, but also to serve as a neurorehabilitation tool in long-term practice. Biological sciences/Biotechnology/Nanobiotechnology/Biosensors Physical sciences/Engineering/Biomedical engineering Physical sciences/Mathematics and computing/Computer science Full Text Additional Declarations There is NO Competing Interest. Supplementary Files Supplementaryfile3RealElbowFlexionv2.docx Supplementary file 3 - Combining motor imagery and sFES elicits naturalistic movements Supplementaryfile1Exclusionprocedurev5.docx Supplementary file 1 - Exclusion of sFES evoked potential period Supplementaryfile4Signalstabilityv3.docx Supplementary file 4 - Long-term stability of ECoG signals measured with WIMAGINE implant Supplementaryfile2Sensitivefeedbackv3.docx Supplementary file 2 - Sensitive feedback triggered by sFES and pencil touch clinatecbci2025videoX3v021080p.mp4 Restoring bimanual hand control for object manipulation with the iBCI-sFES neuroprosthesis clinatecbci2025videoX1v051080p.mp4 Concept and implementation of the iBCI-sFES neuroprosthesis for tetraplegic patients clinatecbci2025videoX2v021080p.mp4 Moving objects of different shapes, sizes and weights using the iBCI-sFES neuroprosthesis Cite Share Download PDF Status: Under Review Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7598810","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":514356794,"identity":"6fba7983-8fa5-4cab-93b4-0aaba600d411","order_by":0,"name":"Lucas Struber","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIiWNgGAWjYBACPgSTB4grQAzGB3i1sEFpCYiWMyA2swEJWhjbiNEikfzw4w+GujrzGbkHH1fOs5Pjb2Bm+4BfS5qxNA/DYQmZG3nJhme3JRtLHGBmnoFfSw6DNAPDAQkJiRwzycZtBxIbDvAfJuCwHOafQIeBtJj/bJxzoH4+0BZCWtgkeBiYwbYwNjYcSDAgqIXnmZk1j8FhyRk875IlG44lG248TEALP3vy45s/Kur4JdhzD35sqLGTlzvejF8LBKBEBDEaRsEoGAWjYBTgBwBkiTpXHPg3MgAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-3890-9100","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":true,"prefix":"","firstName":"Lucas","middleName":"","lastName":"Struber","suffix":""},{"id":514356795,"identity":"e637d3f4-b193-41e5-b025-6db6cbd2deeb","order_by":1,"name":"Jean Faber","email":"","orcid":"","institution":"Escola Paulista de Medicina, Federal University of São Paulo","correspondingAuthor":false,"prefix":"","firstName":"Jean","middleName":"","lastName":"Faber","suffix":""},{"id":514356796,"identity":"1ce8c774-6571-4ecf-bdec-bda5bae33bc7","order_by":2,"name":"Violaine Juillard","email":"","orcid":"","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Violaine","middleName":"","lastName":"Juillard","suffix":""},{"id":514356797,"identity":"ef1e3e2b-81bd-4716-879d-8e0ca3dda8c4","order_by":3,"name":"Félix Martel","email":"","orcid":"https://orcid.org/0000-0003-4877-1771","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Félix","middleName":"","lastName":"Martel","suffix":""},{"id":514356798,"identity":"0b7bf070-50ce-4ee6-9d25-24429645526f","order_by":4,"name":"Andres Carvallo-Pecci","email":"","orcid":"","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Andres","middleName":"","lastName":"Carvallo-Pecci","suffix":""},{"id":514356799,"identity":"e314398e-7a43-4165-b9a6-c5deba3fadec","order_by":5,"name":"Alexandre Bleuzé","email":"","orcid":"","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Alexandre","middleName":"","lastName":"Bleuzé","suffix":""},{"id":514356800,"identity":"7faa7ec5-90eb-4c95-ac8c-f23d56d33a25","order_by":6,"name":"Rémi Souriau","email":"","orcid":"","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Rémi","middleName":"","lastName":"Souriau","suffix":""},{"id":514356801,"identity":"ab653955-f190-4bcf-ad0c-3cd30d97bcc9","order_by":7,"name":"Serpil Karakas","email":"","orcid":"","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Serpil","middleName":"","lastName":"Karakas","suffix":""},{"id":514356802,"identity":"d60ed881-9a92-424a-833f-827a7da9ed78","order_by":8,"name":"Elodie Faure","email":"","orcid":"","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Elodie","middleName":"","lastName":"Faure","suffix":""},{"id":514356803,"identity":"e55a1ecf-e042-48db-94c6-5326825c3e2e","order_by":9,"name":"Ahmed Adham","email":"","orcid":"","institution":"CHU of St Etienne","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"","lastName":"Adham","suffix":""},{"id":514356804,"identity":"3371b5e1-77fb-4605-bbca-2348bbf88e1f","order_by":10,"name":"Fabien Sauter-Starace","email":"","orcid":"","institution":"University Grenoble Alpes, CEA, LETI, Clinatec","correspondingAuthor":false,"prefix":"","firstName":"Fabien","middleName":"","lastName":"Sauter-Starace","suffix":""},{"id":514356805,"identity":"e4b22f31-8440-44d4-991c-ae0c55d343ad","order_by":11,"name":"Stephan Chabardès","email":"","orcid":"","institution":"Univ. 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