A Wireless Peripheral-Cortical Interface for Real-Time Decoding of Motor Intent to Restore Assistive Control in Tetraplegia (AxonCtrl)

Spinal cord injury (SCI) often results in paralysis and the permanent loss of hand and arm function, severely limiting independence and quality of life. Existing assistive technologies, such as surface electromyography, nerve implants, or brain–computer interfaces, are either too inaccurate, too invasive, or too unstable for long-term clinical use. To address this, we have developed intramuscular microelectrode arrays (MEAs) that can be implanted percutaneously to record the discharges of spinal motor neurons, providing the first minimally invasive interface with individual neurons of the human spinal cord. In the ERC project NaturalBionicS, we demonstrated that even in individuals with complete clinical paralysis, residual motor neuron activity below the lesion can be accessed and voluntarily modulated, offering a new avenue for restoring motor control. This Proof of Concept project, AxonCtrl, will translate this breakthrough into a patient-ready system: the intramuscular Peripheral-Cortical Interface (iPCI). We will deliver two innovations. First, a miniaturised wireless circuit that connects to the implanted MEA, enabling stable, high-fidelity recordings without bulky laboratory equipment and giving users mobility in daily life. Second, a safe injector device that allows simple and reliable implantation of MEAs, eliminating the need for trained researchers in home use. By combining the performance of invasive neural implants with the safety and accessibility of a minimally invasive system, iPCI establishes a new class of scalable neural interfaces. The validated prototype developed in this project will empower people with SCI to regain high-functionality control of assistive devices such as wheelchairs and digital interfaces, reducing reliance on carers and healthcare systems. Beyond SCI, iPCI will provide new tools for neuroscience, rehabilitation, and neuromodulation, positioning it as the cornerstone for a new generation of neurotechnology.