In groundbreaking clinical trials in Shanghai, brain implants have allowed two epilepsy patients to control language and movement using only their thoughts. The breakthrough marks a major step toward brain-computer interfaces (BCIs) that can translate human brain activity into complex language and actions, opening new possibilities for millions with speech and motor impairments.

While a 43-year-old patient successfully decoded and synthesized Mandarin syllables — one of the world’s most complex languages — a 21-year-old patient used similar technology to play games and operate smart devices.

According to Shanghai news outlet The Paper, the trials were conducted by Shanghai-based NeuroXess at Huashan Hospital, affiliated with Fudan University, using the company’s self-developed high-throughput BCI.

Mandarin, with its over 400 syllables, four tones, and reliance on graphic comprehension, engages multiple brain regions during communication — posing a significant challenge for neural decoding systems.

In the language-focused trial, a 43-year-old patient with epilepsy underwent surgery to implant electrodes in the brain’s language center, targeting a lesion linked to their condition. The procedure, which lasted only a few minutes, successfully located the lesion, placed the electrodes, and preserved critical brain functions. Two days after surgery, the patient began training and, within a week, achieved a 71% accuracy rate in decoding 142 common Mandarin syllables.

Using real-time brain decoding, the patient could synthesize Mandarin syllables through thought alone, interact with large language models, and perform other advanced tasks. Brain signals were translated into language and converted into commands to control dexterous robotic hands, enabling seamless human-machine interaction.

In the separate motor-focused trial, the 21-year-old epilepsy patient underwent a similar procedure. Electrodes were implanted to monitor a lesion in their brain’s motor center and preserve critical motor functions. Two days after surgery, the patient began training and successfully performed tasks like playing table tennis and controlling a video game using only their thoughts.

After two weeks of training, the patient could operate common apps such as messaging platforms and online shopping tools, as well as control smart home devices and a motorized wheelchair. The trial demonstrated the potential of brain-computer interfaces to restore independence and improve daily life for individuals with motor impairments.

Despite these advances, the current BCI systems still require external equipment. Patients must wear headgear and remain connected to power and data lines — referred to as “braids” — to relay brain activity to processing devices. NeuroXess plans to address these limitations with its next-generation devices, expected later this year, which aim to enable wireless data transmission and charging.

While companies like Elon Musk’s Neuralink have achieved real-time motor decoding, NeuroXess, founded in 2021, is among the only invasive BCI companies to combine real-time motor and language decoding in human trials.

“Neuralink’s strategy requires implantation into the cerebral cortex, which can cause damage to brain tissue,” said Tao Hu, founder and chief scientist of NeuroXess, according to the state-run China Daily. “Our approach involves the cerebral cortex, which can effectively avoid potential damage to brain tissue.”

Editor: Apurva.

(Header image: Left: A 43-year-old epilepsy patient successfully decodes and synthesizes Mandarin syllables; right: A 21-year-old epilepsy patient uses similar technology to play games and operate smart devices at Huashan Hospital in Shanghai, December 2024. From The Paper)