{
  "id": "AIBD-0053",
  "title": "Tetraplegic man controls a four-limb exoskeleton and avatar through an adaptive epidural ECoG decoder at Clinatec, Grenoble",
  "summary": "A 28-year-old with C4-C5 tetraplegia cortically controlled simulated walking and 8-DoF arm movements over 24 months (Lancet Neurology 2019).",
  "date_observed": "2017-06-12",
  "date_basis": "unassessed",
  "date_precision": "unassessed",
  "benefit_status": null,
  "source_collection": null,
  "source_entry": null,
  "account": "A 28-year-old man with tetraplegia after a C4-C5 spinal cord injury received two wireless epidural recorders of 64 electrodes each over the sensorimotor cortex. He was implanted at the Clinatec research center of the French Alternative Energies and Atomic Energy Commission (CEA), associated with Grenoble University Hospital. Epidural electrocorticographic signals were processed online by an adaptive decoding algorithm. It sent commands to a virtual avatar or a four-limb exoskeleton. Between 12 June 2017 and 21 July 2019 he cortically controlled a walking simulation and bimanual upper-limb movements with eight degrees of freedom. Success was 64.0% using the avatar at home and 70.9% with the exoskeleton in the laboratory. Decoding models were reusable for about seven weeks without recalibration (Lancet Neurology, 2019).",
  "category": "benefit created",
  "unexpected": false,
  "purpose": "Restore mobility to people with tetraplegia by decoding brain signals to drive an exoskeleton",
  "system": "Clinatec epidural wireless brain-machine interface with adaptive decoder driving a four-limb exoskeleton and virtual avatar",
  "model_version": null,
  "developer": "CEA-Clinatec (public research institute, not a company) with Grenoble University Hospital",
  "deployer": "Clinatec research center / Grenoble University Hospital clinical trial",
  "location": "Grenoble, France",
  "domain": "Neurotechnology / mobility rehabilitation",
  "segment": "People with tetraplegia",
  "benefit_type": "Improved Accessibility",
  "taxonomy_note": "The gain is brain-controlled exoskeleton and avatar movement for a man with tetraplegia in a proof-of-concept setting, not everyday use.",
  "registry_ids": {},
  "ratings": [
    {
      "group": "personal",
      "depth": 2,
      "reason": "One identifiable participant gained brain-controlled walking simulation and eight-degree-of-freedom arm control, exercised at home with an avatar and in the lab with the exoskeleton. It did not yet provide everyday mobility."
    },
    {
      "group": "societal",
      "depth": 1,
      "reason": "Single-patient proof of concept for semi-invasive long-term BCI. No population effect."
    }
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    "status": "assessed",
    "statement": "The adaptive decoding algorithm converts epidural ECoG into effector commands. The same group later described it as a recursive exponentially weighted Markov-switching multilinear mixture-of-experts model. Without it the implants record only. The exoskeleton itself was ceiling-suspended in the laboratory."
  },
  "evidence": [
    {
      "kind": "peer-reviewed study",
      "citation": "Benabid AL, Costecalde T, Eliseyev A, et al. (2019). An exoskeleton controlled by an epidural wireless brain-machine interface in a tetraplegic patient: a proof-of-concept demonstration. Lancet Neurology 18(12):1112-1122.",
      "title": "An exoskeleton controlled by an epidural wireless brain-machine interface in a tetraplegic patient: a proof-of-concept demonstration",
      "url": "https://europepmc.org/abstract/MED/31587955",
      "date": "2019-10-03",
      "written_by": "makers",
      "quote": "Epidural electrocorticographic (ECoG) signals were processed online by an adaptive decoding algorithm to send commands to effectors (virtual avatar or exoskeleton)."
    },
    {
      "kind": "peer-reviewed study",
      "citation": "Benabid AL, et al. (2019). Lancet Neurology 18(12):1112-1122 (findings).",
      "title": "An exoskeleton controlled by an epidural wireless brain-machine interface in a tetraplegic patient (findings)",
      "url": "https://europepmc.org/abstract/MED/31587955",
      "date": "2019-10-03",
      "written_by": "makers",
      "quote": "the patient cortically controlled a programme that simulated walking and made bimanual, multi-joint, upper-limb movements with eight degrees of freedom during various reach-and-touch tasks"
    },
    {
      "kind": "peer-reviewed study",
      "citation": "Moly A, Costecalde T, Martel F, et al. (2022). An adaptive closed-loop ECoG decoder for long-term and stable bimanual control of an exoskeleton by a tetraplegic. Journal of Neural Engineering 19(2).",
      "title": "An adaptive closed-loop ECoG decoder for long-term and stable bimanual control of an exoskeleton by a tetraplegic",
      "url": "https://europepmc.org/abstract/MED/35234665",
      "date": "2022-03-30",
      "written_by": "makers",
      "quote": "The stable over a period of six months (without decoder recalibration) eight-dimensional alternative bimanual control of the exoskeleton and its virtual avatar is demonstrated."
    }
  ],
  "replication": {
    "produced_by": [
      "Chronic bilateral epidural ECoG recorders with wireless transmission",
      "Adaptive, incrementally trained decoder with idle-state support",
      "Progressive training on mental tasks over 24 months"
    ],
    "must_hold": [
      "Stable epidural signal quality over years",
      "Decoder recalibration roughly every seven weeks",
      "Laboratory suspension system for safe exoskeleton walking"
    ],
    "echoes": [
      {
        "date": "2022-03-30",
        "setting": "Same patient, more than 36 months after implantation, asynchronous bimanual exoskeleton control",
        "model_version": "REW-MSLM adaptive decoder",
        "outcome": "recurred",
        "source": "Moly et al. (2022) J Neural Eng, PMID 35234665"
      }
    ]
  },
  "paired_incident": null,
  "headline": "Clinatec's ECoG decoder drives a four-limb exoskeleton",
  "metric": "64.0% success using the avatar at home and 70.9% with the exoskeleton in the laboratory",
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    "status": "persisted",
    "date": "2022-03-30",
    "note": "The same patient was still controlling the exoskeleton bimanually more than three years after implantation, with a decoder stable for six months without recalibration.",
    "quote": "The stable over a period of six months (without decoder recalibration) eight-dimensional alternative bimanual control of the exoskeleton and its virtual avatar is demonstrated.",
    "url": "https://europepmc.org/abstract/MED/35234665"
  },
  "value": null,
  "developer_country": "France",
  "deployer_country": "France",
  "unrated_because": null,
  "brief_notes": null,
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  "revisions": [
    {
      "date": "2026-10-20",
      "change": "Record drafted from the cited sources.",
      "source": null,
      "editor": "AIBD"
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    {
      "date": "2026-10-21",
      "change": "Added what happened since from the cited sources.",
      "source": "https://europepmc.org/abstract/MED/35234665",
      "editor": "AIBD"
    },
    {
      "date": "2026-10-21",
      "change": "Country of the developer and the deployer added from the organization's own site or a registry.",
      "source": "https://en.wikipedia.org/wiki/Clinatec; https://en.wikipedia.org/wiki/Clinatec",
      "editor": "AIBD"
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      "date": "2026-10-21",
      "change": "Prose pass: a rating reason, account, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.",
      "source": null,
      "editor": "AIBD"
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  "confidence": "claimed",
  "shade": "low",
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}