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Article History

Received: 27 May 2025

Accepted: 16 March 2026

First Online: 15 April 2026

Competing interests

: I.D.E. Caution Statement: CAUTION: Investigational Device. Limited by Federal Law to Investigational Use. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Department of Veterans Affairs, or the United States Government. The Translational Research Center at Massachusetts General Hospital (MGH) has a clinical research support agreement (CRSA) with Axoft, Neuralink, Neurobionics, Precision Neuro, Synchron, and Reach Neuro, for which L.R.H. provides consultative input. L.R.H. is a co-investigator on an NIH SBIR 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 (MGB) is convening the Implantable Brain-Computer Interface Collaborative Community (iBCI-CC); charitable gift agreements to MGB, including those received to date from Paradromics, Synchron, Precision Neuro, Neuralink, and Blackrock Neurotech, support the iBCI-CC, for which L.R.H. provides effort. M.W., S.D.S., and D.M.B. have patent applications related to speech BCI owned by the Regents of the University of California (US patent application no. 63/461,507 and 63/450,317) including intellectual property which has been licensed to a neurotechnology startup. S.D.S. is an inventor on intellectual property owned by Stanford University (US patent no. 12008987) that has been licensed to Blackrock Neurotech and Neuralink Corp. He is an advisor to Sonera and a consultant to Neuralink. D.M.B. is an ad-hoc consultant for Globus Medical Inc. and was an ad-hoc consultant for Paradromics Inc. during the period of data collection for this manuscript, but not at the time of manuscript submission. The remaining authors declare no competing interests.