User-Centered Design of an Aural Intracortical BCI Communication Interface for a Person with Complete Locked-in SyndromedissertationsNicolas, ClairecreatorSimeral, JohnAdvisorGray, MarissaReaderMernoff, StephenReaderBrown University. Biology and Medicine: Biomedical Engineeringsponsor2026vii, 63 p.born digitalThesis (Sc. M.)--Brown University, 2026thesesObjective: This research aims to create a new communication system for a person with complete Locked-In Syndrome using an intracortical brain-computer interface. We sought a robust method for BrainGate participant T17, who uses an intracortical BCI to answer yes/no questions. Methods: We used the Stanford Biodesign methodology as a guiding framework for developing a value-based solution. To best understand the communication needs of our participant we conducted a literature review and observations. We engaged the participant frequently throughout the system design by having them use various minimally viable interface designs and control paradigms, using Wizard-of-Oz testing and usability surveys. Results: We generated 91 potential solutions in a brainstorming session and narrowed them down to a final Sliding Scale solution that allowed the end-user to select up to 6 targets. By working with T17, we confirmed that the Sliding Scale interface with a scanner-like control paradigm was the most effective method. The new communication interface enabled participant T17 to independently request help with both essential and non-essential activities of daily living. Conclusions: We successfully tested and implemented a new communication interface for a person with complete Locked-In Syndrome, while documenting one of the first Wizard-of-Oz implementations in the BCI field. We also developed and used unique methods to collect user feedback from people with complex communication needs. These new methods and solutions ultimately enabled the advancement of high-tech, independent communication interfaces with minimal signal acuity.Brain-Computer InterfaceAmyotrophic lateral sclerosisNeuroengineeringCommunicationUser-centered system designLocked-In SyndromePeople with disabilities--Means of communicationCommunication devices for people with disabilitiesEnglishRPB20260516