Interface

Life in the Trial, with Ian Burkhart

Ian Burkhart lived for seven years as part of a brain-computer interface trial, operating a neural bypass between his brain and his hand. Then it came out. He has since moved to the other side of the table in an effort to accelerate the time to approval for such devices.

By Claire White, Oseh Mathias·Jul 30, 2026·8 min

In the summer of 2010 Ian Burkhart had just finished his freshman year of college and was on holiday at the Outer Banks in North Carolina. He dove into an oncoming wave, which drove him headfirst into a sandbar, breaking two of his vertebrae.

Ian came to rest face down on the seafloor and could not move. His friends reached him and pulled him out. He had lost consciousness and was carried into a helicopter that airlifted him to a trauma hospital in Virginia, where surgeons spent close to nine hours stabilising his spine with two rods.

Today the injury presents as complete C5 AIS A with a zone of partial preservation to C6. In practice that means shoulders and biceps. He can flex his elbows and move his arms freely, but can't move his wrist or fingers, or feel sensation in them.

After came the rehabilitation, and with it, all of the learning about how one's own body works.

"I really didn't know a whole lot about neurotechnology at all until after I had my spinal cord injury 16 years ago. And at that point, I started really diving into it, because I went through traditional rehabilitation and wasn't super pleased with the outcomes and advancements that I had made with my condition," Ian told me. "And so I was just looking for what else I could do to improve my quality of life."

What he found was a clinical trial at Ohio State.

The trial

The study was registered as NCT01997125, officially titled "Reanimation in Tetraplegia", run out of the Center for Neuromodulation at the Ohio State University Wexner Medical Center under sponsor-investigator Marcia Bockbrader. The technology was Battelle's NeuroLife neural bypass.

On 22 April 2014, surgeons placed a 96-channel Utah microelectrode array into the hand region of his left primary motor cortex, with a Blackrock Neurotech NeuroPort pedestal through the scalp to carry the signal out. The other end of the system was a flexible sleeve of 130 electrodes wrapped around his right forearm, sitting on hydrogel disks against the skin. The array read his intention to move. The sleeve drove the muscles that his spinal cord could no longer reach. And it worked wonders.

"We used that to control a muscle stimulation system on my forearm to restore hand function," Ian explained. "With this system, I would think about moving individual fingers, or think about moving my wrist in flexion, extension, or radial deviation, and the stimulation system would activate the muscles in my forearm to make those movements happen."

About six weeks after surgery, in June 2014, he closed his hand around a spoon by thinking about it. That result became the 2016 Nature paper, Restoring cortical control of functional movement in a human with quadriplegia, which reported six wrist and hand motions and full grasp, manipulate and release tasks.

The results kept coming for years afterwards, because Ian kept coming back, two or three times a week, three or four hours a session. A 2019 paper in Archives of Physical Medicine and Rehabilitation documented gains across 1,341 days of follow-up, including a 2.9 kilogram increase in grip strength and a functional motor level that assessed at C7 to T1 rather than C5 to C6 while he was using the system. A 2020 Cell paper found residual touch signals still arriving in his motor cortex below the threshold of his own perception, pulled them apart from his movement intention, and fed them back to him as haptic vibration. His ability to detect that an object was in his hand was almost fully restored.

"I was able to take the technology that I was using and use it in a way that was essentially extra therapy for myself. I was able to restore some coordination in my shoulder and do a little bit more in my day-to-day, as well as really push the science forward."

Why it never left the lab

He used the system in the laboratory for seven years.

But part of the reason the device never made it home with him was because of financial and regulatory hurdles. "Some bureaucratic and approval factors, of needing to make sure that we had IRB approval and FDA approval to use the device outside of the lab."

Part of it is that the thing was never built to leave.

"It was really just designed as a proof of concept. It was set up to just see if it works. It wasn't set up to be very portable, and it wasn't set up to be something that we could really use easily without having a team of engineers around."

And part of it is that nobody planned for the study to run as long as it did.

"Our study was originally supposed to be 12 to 18 months, and it ballooned into seven years, which is wild. But at the same time, once we hit that two year mark, we really were just running by what we could think of, versus a preset plan."

Feeling it go away

The implant came out in August 2021, after about seven years and four months. An infection had developed where the percutaneous connector passed through his scalp, and the funding for the study had ended.

He had prepared for this, deliberately and from the beginning.

"I knew when I signed up for the clinical trial that it was something that I wasn't going to have forever. And since I was only using it in the lab, I really tried to compartmentalise using the technology in the lab versus using it at home. And I think that was beneficial, because when it came time to have the device removed and the trial stopped, it made it much easier for me to process that."

The compartmentalising helped, but it did not make it painless.

"However, it still was a challenge to have this restoration of function and then have it be taken away again. That was a big challenge."

He has put it more bluntly elsewhere, telling IEEE Spectrum that it was "a little bit of a tease where I got to see the capability of the restoration of function", and that he is now "just back to where I was".

What he wants understood is that a demonstrated benefit creates an obligation.

"To some degree I fully understand that translation takes a lot of time, and it's really hard to get something from the bench to the bedside. But if you can prove that something is possible, and that it can really impact and benefit people's quality of lives, it should be something that you figure out somehow, what to do and how to make that happen for folks."

The work now

The gap Ian has set out to close now is a structural one. Implanted BCI trials are tiny. Most are an n of one, like his, or an n in the single digits. That is fine for science and terrible for representation, because it means the field's entire understanding of what users want can rest on a handful of people who happened to live near a research hospital.

"We wanted to do what we can to pull together more perspectives of everyone that's involved, so we're designing devices that aren't going to be used just for the few people in the research group, that can work for the entirety of people that they're designed to help."

He founded the BCI Pioneers Coalition, which brings together the people who have actually had these devices implanted, alongside Jan Scheuermann, Nathan Copeland and Nancy Smith. It sets ethics, guidelines and best practice for participants, clinicians and companies, and exists so that a company can hear a consensus view rather than one participant's preference.

You certainly don't want people to have a technology and then have that taken away from them, and in particular to have it taken away from them with no other options.

The work also took him to the regulator. He sits on the US Food and Drug Administration's Patient Engagement Advisory Committee, the CDRH committee made up entirely of patients, carers and patient advocates, with a term running to April 2027.

He has also served as president of the North American Spinal Cord Injury Consortium, worked with Unite2Fight Paralysis to secure six million dollars of Ohio state spinal cord injury research funding, and co-authored a 2025 review in Nature Reviews Bioengineering on the state of clinical trials of implantable BCIs, covering 67 implanted participants across 21 research groups. In 2025 MIT Technology Review named him to its Innovators Under 35 list.

Ian is a force to be reckoned with!

Get involved with Ian Burkhart

Ian founded the Ian Burkhart Foundation in April 2017. It is a registered 501(c)(3), and makes grants to people with spinal cord injuries for the equipment insurance will not cover, funds spinal cord injury research, and advocates for the community. Ian has been doing this personally since he became a Christopher and Dana Reeve Foundation certified peer mentor in 2015.

If you build BCIs, the most useful thing you can do is bring people like Ian into the room while the device is still a decision rather than a product. He's seen it all, he's lived it, and he's sat on every side of the table, giving him a unique perspective on designing for patient outcomes.

If you want to help the people who are living with these injuries right now, you can donate to the foundation at ianburkhartfoundation.org.

References

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CompanyBlackrock NeurotechPersonIan Burkhart

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