Evidence map›Paper›PMID 41361599›Full record

ArticleNature biomedical engineering2026

Long-term unsupervised recalibration of cursor-based intracortical brain-computer interfaces using a hidden Markov model.

Guy H Wilson, Elias A Stein, Foram Kamdar, Donald T Avansino, Tsam Kiu Pun, Ronnie Gross, Tommy Hosman, Tyler Singer-Clark, Anastasia Kapitonava, Leigh R Hochberg and 5 more

Abstract read
In one paragraph

Article in Nature biomedical engineering, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. On the horizon in biomedical engineering.Nature biomedical engineering · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Guy H WilsonNeurosciences Graduate Program, Stanford University, Stanford, CA, USA.ORCID http://orcid.org/0000-0003-0961-1994
Elias A SteinDepartment of Electrical Engineering, Stanford University, Stanford, CA, USA.
Foram KamdarDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.ORCID http://orcid.org/0009-0000-2734-3247
Donald T AvansinoDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.
Tsam Kiu PunSchool of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA.
Ronnie GrossSchool of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA.
Tommy HosmanSchool of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA.
Tyler Singer-ClarkSchool of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA.ORCID http://orcid.org/0000-0001-8636-5075
Anastasia KapitonavaCenter for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Leigh R HochbergSchool of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA.ORCID http://orcid.org/0000-0003-0261-2273
John D SimeralSchool of Engineering and Carney Institute for Brain Science, Brown University, Providence, RI, USA.ORCID http://orcid.org/0000-0002-6855-1963
Krishna V ShenoyDepartment of Electrical Engineering, Stanford University, Stanford, CA, USA.
Shaul DruckmannDepartment of Electrical Engineering, Stanford University, Stanford, CA, USA.
Jaimie M HendersonDepartment of Neurosurgery, Stanford University, Stanford, CA, USA.ORCID http://orcid.org/0000-0002-3276-2267
Francis R WillettDepartment of Neurosurgery, Stanford University, Stanford, CA, USA. fwillett@stanford.edu.

Funding

Engaging new cognitive and motor signals to improve communication prosthesesR01DC014034 · NIDCD · STANFORD UNIVERSITY · PI JAIMIE M HENDERSON · 2015 to 2026
$8.2M
Understanding the Neural Basis of Volitional State through Continuous Recordings in HumansU01NS098968 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI CASH, SYDNEY S · 2016 to 2018
$4.7M
Intuitive, complete neural control of tablet computers for communicationU01DC017844 · NIDCD · BROWN UNIVERSITY · PI HOCHBERG, LEIGH R · 2019 to 2025
$4.3M
Dissecting distributed representations by advanced population activity analysis methods and modelingR01EB028171 · NIBIB · STANFORD UNIVERSITY · PI DRUCKMANN, SHAUL · 2019 to 2019
$1.1M
NIBIB NIH HHS R01 EB028171NIDCD NIH HHS R01 DC014034NIDCD NIH HHS U01 DC017844NINDS NIH HHS U01 NS098968RRD VA I01 RX002295RRD VA I01 RX002827RRD VA I01 RX003803Simons Foundation 542969U.S. Department of Health & Human Services | NIH | National Institute of Biomedical Imaging and Bioengineering (NIBIB) R01-EB028171U.S. Department of Health & Human Services | NIH | National Institute of Neurological Disorders and Stroke (NINDS) U01-NS098968U.S. Department of Health & Human Services | NIH | National Institute on Deafness and Other Communication Disorders (NIDCD) U01DC017844
6 · The paper itself

Abstract

Intracortical brain-computer interfaces (iBCIs) require frequent recalibration to maintain robust performance due to changes in neural activity that accumulate over time, which result in periods when users cannot use their device. Here we introduce a hidden Markov model to infer which targets users are moving towards during iBCI use and we retrain the system using these inferred targets, enabling unsupervised adaptation to changing neural activity. Our approach outperforms distribution alignment methods in large-scale, closed-loop simulations over two months, as well as in a closed loop with a human iBCI user over one month. Leveraging an offline dataset spanning five years of iBCI recordings, we show how target inference recalibration methods appear capable of long-term unsupervised recalibration, whereas recently proposed data-distribution-matching approaches appear to accumulate compounding errors over time. We show offline that our approach performs well on freeform datasets of a person using a home computer with an iBCI. Our results demonstrate the use of task structure to bootstrap a noisy decoder into a highly performant one, thereby overcoming one of the major barriers to clinically translating BCIs.

Indexed as

Brain-Computer InterfacesAlgorithmsCalibrationComputer SimulationHidden Markov ModelsHumansMarkov Chains

Identifiers

PMID41361599
PMCPMC13375652

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.