{ "id": "AIBD-0118", "title": "Double neural bypass restores arm movement and touch for Keith Thomas, paralyzed since a 2020 diving accident", "summary": "Keith Thomas, paralyzed since 2020, regained arm movement and touch after a 15-hour brain-implant operation in Manhasset, New York.", "date_observed": "2023-07-28", "date_basis": "source publication", "date_precision": "day", "benefit_status": null, "source_collection": null, "source_entry": null, "account": "On 9 March 2023, surgeons led by Ashesh Mehta and Netanel Ben-Shalom implanted five microelectrode arrays in the brain of Keith Thomas, 45. The 15-hour operation was at North Shore University Hospital. A diving accident on 18 July 2020 had paralyzed him from the chest down. The Feinstein Institutes' double neural bypass decodes his movement intentions with recurrent neural networks and reinforcement learning. It pairs them with patterned spinal cord stimulation and restores touch by cortical microstimulation. By 28 July 2023 he could move his arms at will and feel his sister's hand. The Feinstein release of 16 July 2026 on the Nature Medicine paper reports 86% and 62% arm-strength gains, self-feeding and gains persisting beyond two years. The original paper distinguishes the earlier arm-strength gains from the AI-controlled hand tasks. Its grasp-force comparison reports 87% success with reinforcement learning and 27% without it.", "category": "benefit created", "unexpected": false, "purpose": "ClinicalTrials.gov NCT03680872 describes an early feasibility trial of the Bidirectional Neural Bypass System. It is meant to restore movement and sensation in the hand and wrist of up to seven people with tetraplegia. This benefit is that purpose.", "system": "Double neural bypass (Bidirectional Neural Bypass System): intracortical brain-computer interface with an LSTM decoder and deep reinforcement-learning agent, patterned spinal cord stimulation and intracortical microstimulation", "model_version": null, "developer": "Feinstein Institutes for Medical Research, Northwell Health (Institute of Bioelectronic Medicine, Chad Bouton)", "deployer": "Northwell Health, North Shore University Hospital", "location": "Manhasset, United States", "domain": "Healthcare (neuroprosthetics and spinal cord injury)", "segment": "Complete cervical spinal cord injury (C4 sensory/C5 motor tetraplegia)", "benefit_type": "Improved Physical Health", "taxonomy_note": null, "registry_ids": { "oecd_aim": "2023-07-28-1c4b" }, "ratings": [ { "group": "personal", "depth": 3, "reason": "In the laboratory, Thomas used AI-decoded intent to control grasping, including self-feeding, alongside spinal stimulation and sensory feedback. This restored meaningful abilities in one person. The study does not isolate every component’s contribution." } ], "ai_role": { "status": "assessed", "statement": "The decoder turns motor-cortex activity into intended hand movements. A reinforcement-learning agent regulates grasp force: figure 4c of the original paper reports 87% task success with the agent and 27% without it. The separate 86% and 62% arm-strength gains occurred during spinal stimulation and activity-based training before the hand neuroprosthesis. The full system combines AI with surgery, stimulation, an orthosis, and rehabilitation. The paper anonymizes its participant; Northwell identifies him as Keith Thomas." }, "evidence": [ { "kind": "peer-reviewed study", "citation": "Chandrasekaran S, Wandelt SK, Jangam A, et al. (2026). A neuroprosthesis for restoring hand movement and sensation in a person with complete tetraplegia. Nature Medicine 32(7):2591–2601. Figure 4c reports the comparison with and without reinforcement learning; figure 2 concerns earlier spinal stimulation and training.", "title": "A neuroprosthesis for restoring hand movement and sensation in a person with complete tetraplegia", "url": "https://doi.org/10.1038/s41591-026-04498-0", "date": "2026-07-16", "written_by": "makers", "quote": "87% success with RL and 27% success without RL" }, { "kind": "news report", "citation": "Barmash J. / Patch Massapequa (2023). Inspirational Quadraplegic Massapequa Man In 'Amazing' Clinical Trial. Patch.", "title": "Inspirational Quadraplegic Massapequa Man In 'Amazing' Clinical Trial", "url": "https://patch.com/new-york/massapequa/inspirational-quadraplegic-massapequa-man-amazing-clinical-trial", "date": "2023-08-09", "written_by": "independent", "quote": "Mobility in my right arm has increased by 110% compared to my baseline that I started with" }, { "kind": "press release", "citation": "Feinstein Institutes for Medical Research / Northwell Health (August 2024). Double Neural Bypass Update: Bites Transcript. Institutional interview transcript, pp. 1–2.", "title": "Double Neural Bypass Update: Bites Transcript", "url": "https://msnewsroommedia.s3.amazonaws.com/mcp/northwell/neuralbypass/03-2024/3-Soundbites_Script%20%28New_Aug._2024%29/Double%20Neural%20Bypass%20Update%20-%20Bites%20Transcript.pdf", "date": null, "written_by": "makers", "quote": null }, { "kind": "press release", "citation": "Libassi M. / Feinstein Institutes for Medical Research (2023). Feinstein Institutes researchers first to use double neural bypass to restore feeling, movement in man living with quadriplegia. Northwell Health news release.", "title": "Feinstein Institutes researchers first to use double neural bypass to restore feeling, movement in man living with quadriplegia", "url": "https://msnewsroommedia.s3.amazonaws.com/mcp/northwell/neuralbypass/02-2023/2023_Press_Release/DoubleNeuralBypass_Release.pdf", "date": "2023-07-28", "written_by": "makers", "quote": "Paralyzed from the chest down, Keith Thomas, 45, of Massapequa, NY, is the first human to use the technology." }, { "kind": "press release", "citation": "Libassi M. / Feinstein Institutes for Medical Research (2026). Feinstein Institutes technology that restores movement and sensation after paralysis featured in Nature Medicine. Northwell Health news release.", "title": "Feinstein Institutes technology that restores movement and sensation after paralysis featured in Nature Medicine", "url": "https://northwell.multimedia-newsroom.com/index.php/2026/07/16/paralyzed-man-has-feeling-lasting-movement-restored-in-hand/", "date": "2026-07-16", "written_by": "makers", "quote": "Over 35 weeks of this intervention, Mr. Thomas achieved statistically significant increases of 86% in right arm strength and 62% in left arm strength." }, { "kind": "dataset", "citation": "Bouton C / Northwell Health. Restoring Motor and Sensory Hand Function in Tetraplegia Using a Neural Bypass System. ClinicalTrials.gov NCT03680872, first posted September 21, 2018, updated March 11, 2026. Sponsor-submitted registration; not a regulatory finding of benefit.", "title": "Restoring Motor and Sensory Hand Function in Tetraplegia Using a Neural Bypass System", "url": "https://clinicaltrials.gov/study/NCT03680872", "date": "2018-09-21", "written_by": "makers", "quote": "an investigational device called the Bidirectional Neural Bypass System can lead to the restoration of movement and sensation in the hand and wrist of up to seven individuals with tetraplegia" } ], "replication": { "produced_by": [ "Chronic complete cervical spinal cord injury (C4 sensory/C5 motor) with movement intentions still readable from motor cortex", "Five microelectrode arrays placed in motor and somatosensory cortex during a 15-hour mapped operation with the participant partly awake", "An LSTM plus deep reinforcement-learning decoder paired with patterned spinal cord stimulation and intracortical microstimulation", "Thirty-five weeks of supervised laboratory sessions inside an approved early-feasibility trial (NCT03680872)" ], "must_hold": [ "Decoder accuracy sustained over months (84.6% over five months) so intended movements reliably trigger stimulation", "Neurosurgical, engineering and rehabilitation teams present throughout. The gains were measured in the laboratory", "Follow-up with the system switched off to confirm that strength and sensation gains persist" ], "echoes": [] }, "paired_incident": null, "headline": "Double neural bypass restores Keith Thomas's movement and touch", "metric": "87% vs 27% successful grasp-force control with and without reinforcement learning", "comparator": { "against": "Grasp-force control with the reinforcement-learning agent switched off, in the same participant", "before": "27% successful force control without the reinforcement-learning agent", "after": "87% successful force control with the reinforcement-learning agent", "basis": "measured", "quote": "87% success with RL and 27% success without RL", "url": "https://doi.org/10.1038/s41591-026-04498-0" }, "later": { "status": "persisted", "date": "2026-07-16", "note": "The Feinstein Institutes' July 2026 release on the Nature Medicine paper reports that the strength and sensation gains were still present at a follow-up more than two years later.", "quote": "“Remarkably, in a recent follow up, it was found these gains were still present after more than two years. This is incredibly encouraging,” said Dr. Bouton.", "url": "https://northwell.multimedia-newsroom.com/index.php/2026/07/16/paralyzed-man-has-feeling-lasting-movement-restored-in-hand/" }, "value": null, "developer_country": "United States", "deployer_country": "United States", "unrated_because": null, "brief_notes": null, "brief": null, "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the OECD Monitor entry and the cited sources.", "source": "https://oecd.ai/en/incidents/2023-07-28-1c4b", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Accessibility among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Added what the benefit is measured against, what happened since from the cited sources.", "source": "https://doi.org/10.1038/s41591-026-04498-0; https://feinstein.northwell.edu/news/the-latest/double-neural-bypass-technology-featured-on-cover-of-nature-medicine", "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/Feinstein_Institutes_for_Medical_Research; https://en.wikipedia.org/wiki/Northwell_Health", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the replication conditions, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "source": null, "editor": "AIBD" }, { "date": "2026-10-24", "change": "Read the original paper, extended data, supplementary information, reporting summary, sponsor registration, original releases and firsthand interviews. Separated spinal-stimulation strength gains from the direct AI grasp-control comparison. Corrected the sponsor-submitted registry from independent regulatory evidence to a maker-authored dataset. Replaced the derivative one-year news account with the original institutional interview transcript. Retained Patch’s separate patient/researcher interviews. The original 2023 publication date remains unchanged.", "source": "https://doi.org/10.1038/s41591-026-04498-0", "editor": "AIBD" } ], "confidence": "reported", "shade": "medium", "claim_status": "Independently reported", "claim_basis": "Sources: one independent news report, the makers' peer-reviewed study, the makers' dataset and three press releases from the makers. 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Peer review is not an independent replication." }, { "source_refs": [ "AIBD-0118-source-0002" ], "url": "https://patch.com/new-york/massapequa/inspirational-quadraplegic-massapequa-man-amazing-clinical-trial", "relationship": "Original 2023 interviews with Thomas and investigator Chandrasekaran add firsthand experience. The patient’s 110% statement is not the paper’s later clinical metric." }, { "source_refs": [ "AIBD-0118-source-0003" ], "url": "https://msnewsroommedia.s3.amazonaws.com/mcp/northwell/neuralbypass/03-2024/3-Soundbites_Script%20%28New_Aug._2024%29/Double%20Neural%20Bypass%20Update%20-%20Bites%20Transcript.pdf", "relationship": "Original institutional interview transcript for the 2024 follow-up. Read from the media kit linked by Northwell’s 2026 page." }, { "source_refs": [ "AIBD-0118-source-0004" ], "url": "https://msnewsroommedia.s3.amazonaws.com/mcp/northwell/neuralbypass/02-2023/2023_Press_Release/DoubleNeuralBypass_Release.pdf", "relationship": "Original July 28, 2023 release PDF, recovered from the institutional media kit. Establishes the named participant, accident and surgery dates, and original announcement." }, { "source_refs": [ "AIBD-0118-source-0005" ], "url": "https://northwell.multimedia-newsroom.com/index.php/2026/07/16/paralyzed-man-has-feeling-lasting-movement-restored-in-hand/", "relationship": "Original institutional 2026 report identifies the anonymized paper participant and adds the investigator’s report of persistence beyond two years." }, { "source_refs": [ "AIBD-0118-source-0006" ], "url": "https://clinicaltrials.gov/study/NCT03680872", "relationship": "Sponsor-investigator registration accessed through the ClinicalTrials.gov API. Establishes protocol and planned enrollment, not regulatory confirmation or independent benefit evidence." } ], "excluded_republications": [ { "url": "https://www.foxnews.com/health/man-paralyzed-diving-mishap-medical-miracle-year-after-ai-powered-brain-implant", "relationship": "The material one-year follow-up claims are available in the original Northwell interview transcript. This report does not independently test the clinical result." } ], "embedded_material_reviewed": [ { "url": "https://media.springernature.com/original/springer-static/esm/art%3A10.1038%2Fs41591-026-04498-0/MediaObjects/41591_2026_4498_MOESM1_ESM.pdf", "extent": "Supplementary table 1 and video descriptions read; the videos themselves were not reviewed." }, { "url": "https://media.springernature.com/original/springer-static/esm/art%3A10.1038%2Fs41591-026-04498-0/MediaObjects/41591_2026_4498_MOESM2_ESM.pdf", "extent": "Reporting summary pp. 2–3 visually reviewed: one participant, no randomization, no investigator blinding, data collection 2021–2025." }, { "url": "https://clinicaltrials.gov/api/v2/studies/NCT03680872", "extent": "Protocol and sponsor identity read." }, { "url": "https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2023.1210328/full", "extent": "Reference 16 checked: earlier spinal-stimulation method study with two different participants, not independent corroboration of Thomas’s AI-assisted tasks." } ], "limitations": [ "One participant, with repeated sessions rather than independent replication.", "Data and code require author access; this review does not independently reproduce the analysis.", "The paper’s text and figure 4c caption differ on whether the reported t-test was paired. No resolution is inferred.", "Two-year persistence is an investigator report, not an independent long-term evaluation." ], "ordering_basis": "Original clinical analysis first, followed by distinct firsthand accounts and the sponsor protocol.", "lead_source_ref": "AIBD-0118-source-0001", "retained_source_order": [ "AIBD-0118-source-0001", "AIBD-0118-source-0002", "AIBD-0118-source-0003", "AIBD-0118-source-0004", "AIBD-0118-source-0005", "AIBD-0118-source-0006" ] } }, "provenance": { "kind": "source_review", "basis": "Reviewed the original source, embedded references, supplements and related firsthand accounts to the extent documented in the access notes.", "record_fields": [ "evidence" ], "source_refs": [ "AIBD-0118-source-0001", "AIBD-0118-source-0002", "AIBD-0118-source-0003", "AIBD-0118-source-0004", "AIBD-0118-source-0005", "AIBD-0118-source-0006" ], "reviewed_on": "2026-10-24" }, "review_state": "reviewed", "coverage": "complete", "display": { "answer": "The study follows one participant across repeated sessions. Data and code require author access. The text and figure 4c caption disagree on whether the t-test was paired, and the investigators’ report of two-year persistence has no independent evaluation.", "editor_note": "" } }, "strategic_assessments[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "family": "strategic assessments" }, "summary": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "summary": "Keith Thomas, paralyzed since 2020, regained arm movement and touch after a 15-hour brain-implant operation in Manhasset, New York.", "account": "On 9 March 2023, surgeons led by Ashesh Mehta and Netanel Ben-Shalom implanted five microelectrode arrays in the brain of Keith Thomas, 45. The 15-hour operation was at North Shore University Hospital. A diving accident on 18 July 2020 had paralyzed him from the chest down. The Feinstein Institutes' double neural bypass decodes his movement intentions with recurrent neural networks and reinforcement learning. It pairs them with patterned spinal cord stimulation and restores touch by cortical microstimulation. By 28 July 2023 he could move his arms at will and feel his sister's hand. The Feinstein release of 16 July 2026 on the Nature Medicine paper reports 86% and 62% arm-strength gains, self-feeding and gains persisting beyond two years. The original paper distinguishes the earlier arm-strength gains from the AI-controlled hand tasks. Its grasp-force comparison reports 87% success with reinforcement learning and 27% without it." } }, "provenance": { "kind": "source_review", "basis": "Updated the affected fields after reading the original evidence and its source lineage. Other field assessments are preserved.", "record_fields": [ "account" ], "source_refs": [ "AIBD-0118-source-0001", "AIBD-0118-source-0002", "AIBD-0118-source-0003", "AIBD-0118-source-0004", "AIBD-0118-source-0005", "AIBD-0118-source-0006" ], "reviewed_on": "2026-10-24" }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].autonomy_permissions": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].component_role": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].deployment_configuration": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].inputs_outputs": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].model_name": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].model_version": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].product_name": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "system": "Double neural bypass (Bidirectional Neural Bypass System): intracortical brain-computer interface with an LSTM decoder and deep reinforcement-learning agent, patterned spinal cord stimulation and intracortical microstimulation" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "system" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].provider": { "state": "value_present", "value": { "kind": "structured", "data": { "application_developer": "Feinstein Institutes for Medical Research, Northwell Health (Institute of Bioelectronic Medicine, Chad Bouton)" } }, "provenance": { "kind": "legacy_record", "basis": "Mapped from the existing case description without a new external source review.", "record_fields": [ "developer" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "taxonomy_crosswalks[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "title": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "title": "Double neural bypass restores arm movement and touch for Keith Thomas, paralyzed since a 2020 diving accident", "headline": "Double neural bypass restores Keith Thomas's movement and touch" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "title", "headline" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "version": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "0e65c8e90f1a2cb021bc98811b6fa50aaa89cf4801bb2c5f5676c66e38ecc9e8" ], "role": "SHA-256 of normalized original case data" }, "provenance": { "kind": "curatorial", "basis": "Deterministic content version assigned by the local migration.", "record_fields": [], "source_refs": [] }, "review_state": "record_mapped", "coverage": "complete" }, "workflow": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "account": "On 9 March 2023, surgeons led by Ashesh Mehta and Netanel Ben-Shalom implanted five microelectrode arrays in the brain of Keith Thomas, 45. The 15-hour operation was at North Shore University Hospital. A diving accident on 18 July 2020 had paralyzed him from the chest down. The Feinstein Institutes' double neural bypass decodes his movement intentions with recurrent neural networks and reinforcement learning. It pairs them with patterned spinal cord stimulation and restores touch by cortical microstimulation. By 28 July 2023 he could move his arms at will and feel his sister's hand. The Feinstein release of 16 July 2026 on the Nature Medicine paper reports 86% and 62% arm-strength gains, self-feeding and gains persisting beyond two years. The original paper distinguishes the earlier arm-strength gains from the AI-controlled hand tasks. Its grasp-force comparison reports 87% success with reinforcement learning and 27% without it.", "replication": { "produced_by": [ "Chronic complete cervical spinal cord injury (C4 sensory/C5 motor) with movement intentions still readable from motor cortex", "Five microelectrode arrays placed in motor and somatosensory cortex during a 15-hour mapped operation with the participant partly awake", "An LSTM plus deep reinforcement-learning decoder paired with patterned spinal cord stimulation and intracortical microstimulation", "Thirty-five weeks of supervised laboratory sessions inside an approved early-feasibility trial (NCT03680872)" ], "must_hold": [ "Decoder accuracy sustained over months (84.6% over five months) so intended movements reliably trigger stimulation", "Neurosurgical, engineering and rehabilitation teams present throughout. The gains were measured in the laboratory", "Follow-up with the system switched off to confirm that strength and sensation gains persist" ], "echoes": [] } } }, "provenance": { "kind": "source_review", "basis": "Updated the affected fields after reading the original evidence and its source lineage. Other field assessments are preserved.", "record_fields": [ "account" ], "source_refs": [ "AIBD-0118-source-0001", "AIBD-0118-source-0002", "AIBD-0118-source-0003", "AIBD-0118-source-0004", "AIBD-0118-source-0005", "AIBD-0118-source-0006" ], "reviewed_on": "2026-10-24" }, "review_state": "record_mapped", "coverage": "partial" } }, "summary": { "total": 91, "addressed": 91, "known": 30, "reviewed": 2, "record_mapped": 28, "not_assessed": 61, "complete": false, "by_state": { "value_present": 30, "not_reported": 0, "unresolved": 0, "not_assessed": 61, "not_applicable": 0, "withheld": 0, "source_unavailable": 0 } } } }