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Many within the general population rely on social media and massively multiplayer video games to address these needs. We developed a high-performance, finger-based brain\u2013computer-interface system allowing continuous control of three independent finger groups, of which the thumb can be controlled in two dimensions, yielding a total of four degrees of freedom. The system was tested in a human research participant with tetraplegia due to spinal cord injury over sequential trials requiring fingers to reach and hold on targets, with an average acquisition rate of 76 targets per minute and completion time of 1.58\u2009\u00b1\u20090.06\u2009seconds\u2014comparing favorably to prior animal studies despite a twofold increase in the decoded degrees of freedom. More importantly, finger positions were then used to control a virtual quadcopter\u2014the number-one restorative priority for the participant\u2014using a brain-to-finger-to-computer interface to allow dexterous navigation around fixed- and random-ringed obstacle courses. The participant expressed or demonstrated a sense of enablement, recreation and social connectedness that addresses many of the unmet needs of people with paralysis.<\/jats:p>","DOI":"10.1038\/s41591-024-03341-8","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T11:02:20Z","timestamp":1737370940000},"page":"96-104","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["A high-performance brain\u2013computer interface for finger decoding and quadcopter game control in an individual with paralysis"],"prefix":"10.1038","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2093-7733","authenticated-orcid":false,"given":"Matthew S.","family":"Willsey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishal P.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald T.","family":"Avansino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1663-2018","authenticated-orcid":false,"given":"Nick V.","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3119-7788","authenticated-orcid":false,"given":"Ryan M.","family":"Jamiolkowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2734-3247","authenticated-orcid":false,"given":"Foram B.","family":"Kamdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0261-2273","authenticated-orcid":false,"given":"Leigh R.","family":"Hochberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis R.","family":"Willett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3276-2267","authenticated-orcid":false,"given":"Jaimie M.","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"3341_CR1","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.2105\/AJPH.2016.303270","volume":"106","author":"BS Armour","year":"2016","unstructured":"Armour, B. 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L.R.H. is a co-investigator on a US National Institutes of Health Small Business Innovation Research grant with Paradromics, and is a non-compensated member of the board of directors of a nonprofit assistive communication device technology foundation (Speak Your Mind Foundation). Mass General Brigham is convening the Implantable Brain\u2013Computer Interface Collaborative Community (iBCI-CC); charitable gift agreements to Mass General Brigham, including those received so far from Paradromics, Synchron, Precision Neuro, Neuralink and Blackrock Neurotech, support the iBCI-CC, for which L.R.H. provides effort. J.M.H. is a consultant for Neuralink, Enspire DBS and Paradromics; holds equity (stock options) in MapLight Therapeutics; and is co-founder and shareholder in Re-EmergeDBS. J.M.H. and F.R.W. are inventors of intellectual property licensed by Stanford University to Blackrock Neurotech and Neuralink (\u2018Systems and methods for decoding intended symbols from neural activity\u2019. K.V. Shenoy, J.M. Henderson, F.R. Willett - US Patent 12,026,311, 2024). The other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}