Insular motor and error encoding supports self-correcting intracranial brain-computer interface

Error recognition is fundamental to adaptive behavior, enabling rapid compensatory action when outcomes deviate from expectations. Central to this function are neural circuits for performance monitoring, encoding cognitive signals that could support more reliable neural interfaces. Here, we recorded intracranial electroencephalography (iEEG) in epilepsy patients to enable a motor brain-computer interface (BCI) while sampling error-related activity across a distributed network.

Our work reveals high-frequency population dynamics emerging in the anterior insula and propagating to the prefrontal cortex as the interface fails to follow the user’s intention. We identify spatially organized insular responses to error processing and movement feedback, highlighting it as a heterogeneous hub linking action and outcome. Frontoinsular recording sites were found to preferentially encode error-related activity, while centroparietal responses were intermixed with compensatory motor signals, making the former a compelling target for real-time error correction.

Together, our findings demonstrate a human intracranial BCI harnessing insular brain activity, integrating cognitive processes directly into device control. We sincerely thank all patients and technicians at the Kempenhaeghe epilepsy monitoring unit for their valuable contributions to this study. Their willingness to support the study beyond the regular clinical schedule was essential to its successful completion.

P.W., M.V., P.K., and C.H. thank the INTENSE consortium for their funding (project number 17619 of the research programme NWO Crossover Programme, which is partially financed by the Dutch Research Council NWO). Department of Neurosurgery, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, The Netherlands Paul Weger, Sophia Gimple, Maxime Verwoert, Pieter Kubben & Christian Herff School of Engineering, Brown University, Providence, USA Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, USA Neurosciences Graduate Program, University of California San Diego, La Jolla, USA Academic Center for Epileptology, Kempenhaeghe/Maastricht University Medical Center, Heeze, The Netherlands Albert Colon, Louis Wagner & Johannes P. van Dijk Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands Correspondence to Paul Weger or Christian Herff.

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