{
  "id": "AIBD-0003",
  "title": "ECoG speech neuroprosthesis with avatar restores 78-words-per-minute communication after brainstem stroke (UCSF)",
  "summary": "253-electrode ECoG and deep-learning decoder let Ann Johnson, mute since a 2005 stroke, produce text, synthesized speech and an avatar",
  "date_observed": "2022-09-01",
  "date_basis": "unassessed",
  "date_precision": "unassessed",
  "benefit_status": null,
  "source_collection": null,
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  "account": "At UCSF Medical Center, a 47-year-old woman with quadriplegia and anarthria from a pontine infarct in 2005 was in the BRAVO trial (NCT03698149). News reports name her Ann Johnson. A 253-channel electrocorticography (ECoG) array was implanted over speech cortical areas in September 2022. Deep-learning recurrent neural networks trained on her attempted silent speech decoded text at a median 78 words per minute. Median word error rate was 25% over a 1,024-word vocabulary. They synthesized speech personalized to her pre-injury voice and animated a facial avatar (Metzger et al., Nature, 23 August 2023). She had earlier communicated by letterboard. The paper ties the text-decoding result to 14 days of data collection shortly after the September 2022 implant and gives no calendar session dates. So the implant month (1 September 2022) is the observation date.",
  "category": "benefit created",
  "unexpected": false,
  "purpose": "Built to restore communication by decoding attempted speech from cortical surface recordings into text, synthesized speech and avatar animation. That was the intended benefit and is what occurred.",
  "system": "UCSF multimodal speech neuroprosthesis (BRAVO trial)",
  "model_version": "253-channel high-density ECoG array; bidirectional RNN decoders with CTC loss producing text, synthesized speech and avatar gestures; 1,024-word vocabulary",
  "developer": "UCSF Chang Lab with UC Berkeley",
  "deployer": "UCSF Medical Center",
  "location": "San Francisco, United States",
  "domain": "Healthcare / assistive communication",
  "segment": "Post-stroke anarthria",
  "benefit_type": "Improved Accessibility",
  "taxonomy_note": null,
  "registry_ids": {},
  "ratings": [
    {
      "group": "personal",
      "depth": 2,
      "reason": "Material benefit to one identifiable person: fast text, synthesized voice and avatar communication demonstrated in research sessions (run at her residence). The paper reports no independent use outside those sessions."
    }
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  "ai_role": {
    "status": "assessed",
    "statement": "Deep-learning decoders are the mechanism. They map cortical activity during attempted speech to phonemes, speech units and articulatory gestures, and every output (text, voice, avatar) depends on them."
  },
  "evidence": [
    {
      "kind": "peer-reviewed study",
      "citation": "Metzger SL, Littlejohn KT, Silva AB, et al. (2023). A high-performance neuroprosthesis for speech decoding and avatar control. Nature.",
      "title": "A high-performance neuroprosthesis for speech decoding and avatar control",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10826467/",
      "date": "2023-08-23",
      "written_by": "makers",
      "quote": "median rate of 78 words per minute and median word error rate of 25%"
    },
    {
      "kind": "news report",
      "citation": "Bendix A (2023). Woman with paralysis speaks through an avatar 18 years after a stroke, thanks to a brain implant. NBC News (via Yahoo News).",
      "title": "Woman with paralysis speaks through an avatar 18 years after a stroke, thanks to a brain implant",
      "url": "https://www.yahoo.com/news/woman-paralysis-speaks-avatar-18-004307945.html",
      "date": "2023-08-24",
      "written_by": "independent",
      "quote": "In 2005, Ann Johnson suffered a stroke that left her severely paralyzed and unable to speak. She was 30."
    },
    {
      "kind": "news report",
      "citation": "Hamilton J (2023). These experimental brain implants can restore speech to paralyzed patients. NPR (via BPR).",
      "title": "These experimental brain implants can restore speech to paralyzed patients",
      "url": "https://www.bpr.org/2023-08-23/these-experimental-brain-implants-can-restore-speech-to-paralyzed-patients",
      "date": "2023-08-23",
      "written_by": "independent",
      "quote": "There is this aspect to it that is, to some degree, restoring identity and personhood."
    },
    {
      "kind": "press release",
      "citation": "Ellery M. Brain-to-voice neuroprosthesis restores naturalistic speech. Berkeley Engineering, 31 March 2025.",
      "title": "Brain-to-voice neuroprosthesis restores naturalistic speech",
      "url": "https://engineering.berkeley.edu/news/2025/03/brain-to-voice-neuroprosthesis-restores-naturalistic-speech/",
      "date": "2025-03-31",
      "written_by": "makers",
      "quote": null
    }
  ],
  "replication": {
    "produced_by": [
      "Preserved articulatory representations in speech sensorimotor cortex 18 years after paralysis",
      "High-density ECoG coverage of speech cortex",
      "Deep-learning decoders trained on the participant's attempted speech in under two weeks"
    ],
    "must_hold": [
      "Participant can attempt speech and retains cortical speech representations",
      "Array remains stable with adequate signal quality",
      "Research infrastructure available for training and real-time decoding"
    ],
    "echoes": [
      {
        "date": "2024-05-20",
        "setting": "UCSF, a different participant (a 36-year-old Spanish-English bilingual with anarthria and severe spastic quadriparesis after a bilateral pontine stroke, 128-electrode ECoG array, BRAVO trial NCT03698149; verified against the full text at PMC11554235): sentences decoded in either language",
        "model_version": "ECoG with deep-learning and bilingual natural-language models",
        "outcome": "recurred",
        "source": "Silva AB, Liu JR, Metzger SL, et al. (2024). A bilingual speech neuroprosthesis driven by cortical articulatory representations shared between languages. Nature Biomedical Engineering. doi:10.1038/s41551-024-01207-5"
      },
      {
        "date": "2025-03-31",
        "setting": "UCSF, a clinical trial participant with severe paralysis and anarthria (the accessible abstract does not say whether this is the same participant and the full text is behind a login wall, so the identity is unverified): continuously streaming speech synthesis personalized to the participant's pre-injury voice in 80 ms increments",
        "model_version": "Deep-learning recurrent neural network transducer models",
        "outcome": "recurred",
        "source": "Littlejohn KT, Cho CJ, Liu JR, et al. (2025). A streaming brain-to-voice neuroprosthesis to restore naturalistic communication. Nature Neuroscience. doi:10.1038/s41593-025-01905-6"
      }
    ]
  },
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    "database": "AI Incident Database",
    "identifier": "732",
    "title": "Whisper Speech-to-Text AI Reportedly Found to Create Violent Hallucinations",
    "url": "https://incidentdatabase.ai/cite/732",
    "severity": null,
    "group": "personal",
    "basis": "Both decode speech for people with impaired speech; Whisper fabricated words and violent phrases when transcribing impaired speech."
  },
  "headline": "UCSF neuroprosthesis lets Ann Johnson speak through an avatar",
  "metric": "decoded text at a median 78 words per minute with 25% median word error rate",
  "comparator": null,
  "later": {
    "status": "persisted",
    "date": "2025-03-31",
    "note": "The same participant went on to use a streaming synthesis approach, reported in Nature Neuroscience, that cut the decoding delay from about eight seconds per sentence to under a second.",
    "quote": "Ann, who also participated in the 2023 study, shared with researchers how her experience with the new streaming synthesis approach compared to the earlier study's text-to-speech decoding method.",
    "url": "https://engineering.berkeley.edu/news/2025/03/brain-to-voice-neuroprosthesis-restores-naturalistic-speech/"
  },
  "value": null,
  "developer_country": "United States",
  "deployer_country": "United States",
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  "revisions": [
    {
      "date": "2026-10-20",
      "change": "Record drafted from the cited sources.",
      "source": null,
      "editor": "AIBD"
    },
    {
      "date": "2026-10-20",
      "change": "Paired with AI Incident Database incident 732 (medium confidence); severity not given by the source.",
      "source": "https://incidentdatabase.ai/cite/732",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-20",
      "change": "Moved the date observed from the publication date to the September 2022 implant month to which the paper anchors its 14-day data-collection results, noted that the sessions ran at the participant's residence, added a taxonomy note on why a research-session demonstration is filed as a benefit created or restored, verified the Silva 2024 echo participant as a different person against the PMC full text, and marked the Littlejohn 2025 echo participant as unverified.",
      "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10826467/; https://pmc.ncbi.nlm.nih.gov/articles/PMC11554235/",
      "editor": "AIBD"
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    {
      "date": "2026-10-21",
      "change": "Added what happened since from the cited sources.",
      "source": "https://engineering.berkeley.edu/news/2025/03/brain-to-voice-neuroprosthesis-restores-naturalistic-speech/",
      "editor": "AIBD"
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    {
      "date": "2026-10-21",
      "change": "Country of the developer and the deployer added from the organization's own site or a registry.",
      "source": "https://changlab.ucsf.edu/; https://en.wikipedia.org/wiki/UCSF_Medical_Center",
      "editor": "AIBD"
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    {
      "date": "2026-10-21",
      "change": "Prose pass: a rating reason, account, purpose, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
      "source": null,
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  "confidence": "reported",
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  "claim_status": "Independently reported",
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        "value": {
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        },
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          }
        },
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        },
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            "title": "ECoG speech neuroprosthesis with avatar restores 78-words-per-minute communication after brainstem stroke (UCSF)",
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        },
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            "account": "At UCSF Medical Center, a 47-year-old woman with quadriplegia and anarthria from a pontine infarct in 2005 was in the BRAVO trial (NCT03698149). News reports name her Ann Johnson. A 253-channel electrocorticography (ECoG) array was implanted over speech cortical areas in September 2022. Deep-learning recurrent neural networks trained on her attempted silent speech decoded text at a median 78 words per minute. Median word error rate was 25% over a 1,024-word vocabulary. They synthesized speech personalized to her pre-injury voice and animated a facial avatar (Metzger et al., Nature, 23 August 2023). She had earlier communicated by letterboard. The paper ties the text-decoding result to 14 days of data collection shortly after the September 2022 implant and gives no calendar session dates. So the implant month (1 September 2022) is the observation date.",
            "replication": {
              "produced_by": [
                "Preserved articulatory representations in speech sensorimotor cortex 18 years after paralysis",
                "High-density ECoG coverage of speech cortex",
                "Deep-learning decoders trained on the participant's attempted speech in under two weeks"
              ],
              "must_hold": [
                "Participant can attempt speech and retains cortical speech representations",
                "Array remains stable with adequate signal quality",
                "Research infrastructure available for training and real-time decoding"
              ],
              "echoes": [
                {
                  "date": "2024-05-20",
                  "setting": "UCSF, a different participant (a 36-year-old Spanish-English bilingual with anarthria and severe spastic quadriparesis after a bilateral pontine stroke, 128-electrode ECoG array, BRAVO trial NCT03698149; verified against the full text at PMC11554235): sentences decoded in either language",
                  "model_version": "ECoG with deep-learning and bilingual natural-language models",
                  "outcome": "recurred",
                  "source": "Silva AB, Liu JR, Metzger SL, et al. (2024). A bilingual speech neuroprosthesis driven by cortical articulatory representations shared between languages. Nature Biomedical Engineering. doi:10.1038/s41551-024-01207-5"
                },
                {
                  "date": "2025-03-31",
                  "setting": "UCSF, a clinical trial participant with severe paralysis and anarthria (the accessible abstract does not say whether this is the same participant and the full text is behind a login wall, so the identity is unverified): continuously streaming speech synthesis personalized to the participant's pre-injury voice in 80 ms increments",
                  "model_version": "Deep-learning recurrent neural network transducer models",
                  "outcome": "recurred",
                  "source": "Littlejohn KT, Cho CJ, Liu JR, et al. (2025). A streaming brain-to-voice neuroprosthesis to restore naturalistic communication. Nature Neuroscience. doi:10.1038/s41593-025-01905-6"
                }
              ]
            }
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      }
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}