On March 20th, local time, Neuralink, a neurotechnology company founded by Elon Musk, live-streamed the latest situation of its first patient with brain implants on the social platform X: less than two months after the brain-machine interface implantation, the man who had been paralyzed from the neck down for eight years due to a diving accident was able to control a computer mouse and play games and chess online through his thoughts.
As a bridge between the human brain and computers, the emergence of brain-computer interfaces has opened up vast possibilities for treating neurological disorders that traditional methods struggle to cure. With the latest progress in Neuralink’s clinical trials, does this mean that such treatment methods will soon become widespread? What kind of miracles will the sci-fi-like brain-computer interfaces bring? Latest interviewed industry experts on this matter.
The Significant Clinical Outcome of the First Case is Remarkable
“The clinical achievements of the first case are remarkable!” praised Hong Bo, a professor at Tsinghua University School of Medicine, regarding Neuralink’s progress. In October and December 2023, Hong Bo’s team collaborated with Xuanwu Hospital of Capital Medical University and Beijing Temple of Heaven Hospital to implant the wireless minimally invasive semi-invasive brain-machine interface (NEO) into two high-level paraplegic patients’ skulls. The former achieved autonomous brain-controlled drinking, while the latter successfully controlled a computer cursor’s movement using brain electrical activity.
He said that the patient in the Neuralink video, named Nolan Albo, had a spinal cord injury at the fourth and fifth cervical vertebrae, similar to his two patients. “Compared with our NEO at Tsinghua, Neuralink’s approach is more aggressive, with varying results, but equally impressive.”
Gan Di, deputy chief physician of the Emergency Trauma Treatment Center at Tongji Hospital in Shanghai, explained that spinal cord injuries in this area are almost the most severe conditions. “Since the nerves controlling the limbs extend from the fifth cervical vertebra downwards, injuries to this part of the spinal cord will result in quadriplegia. Further damage to the spinal cord will affect the respiratory muscles, endangering the patient’s life.”
Currently, international brain-computer interface clinical trials are targeting the goal of re-establishing neural signals from the brain to the limbs after years of disconnection, using brain-computer interfaces to transmit these signals and control external devices, thereby helping patients regain communication with the outside world.
The video showed that Nolan Albo, the patient, could play chess and the game “Civilization VI” by controlling a computer mouse with his thoughts. In late January of this year, Albo underwent surgery to implant Neuralink’s first brain-machine interface product, “Mind Control.” He was discharged from the hospital the next day without any cognitive impairments.
However, some experts mentioned that since the brain-machine interface was implanted in the human body for a short time, less than two months, the long-term safety of “Mind Control” still needs to be tested.
Urgent Need to Address Engineering Capability Shortcomings
Although controlling a mouse and playing games by thought is no longer novel in the field of brain-machine interfaces, Neuralink’s first clinical trial of implanting brain-machine interfaces into the human brain and achieving wireless charging, high-quality signal acquisition, and transmission are still significant steps forward. Tao Hu, deputy director of the Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, and chief scientist of Brain Tiger Technology, believes that using wireless methods throughout the entire system and successfully implanting it into the human brain is quite challenging. “In the future, the hardware advantages of the system will come into play.”
Hong Bo told that “Mind Control” likely implanted 64 electrodes in the patient’s brain, and the system’s decoding accuracy is very high judging from the cursor’s movement. However, from the video, it can be seen that the device needs frequent charging, and the head cannot be too far away from the rear receiver rack, or it will affect the reception of brain signals.
Engineering is one of Neuralink’s strengths, from surgical robots to the design and processing of implanted brain-machine interfaces, demonstrating the team’s outstanding engineering capabilities. Since its establishment in 2016, Neuralink has been committed to establishing communication channels between the human brain and external devices. Although brain-computer interface technology has been around for decades, Neuralink has achieved wireless implantation of implants and continuously increased the number of implanted electrodes by mobilizing a large amount of innovative resources.
Musk has stated that Neuralink aims to “control your phone or computer with just your thoughts and use them to control almost any device,” ultimately allowing late-stage ALS patients like Stephen Hawking to communicate faster than typists or auctioneers.
Currently, there are research teams that may exceed Neuralink’s experiment in signal decoding accuracy, but due to engineering capabilities, they have not yet achieved the overall implantation of wireless devices. Gan Di believes that this reflects the advantages of resource allocation in commercial operations.
Rationally Treat the Efficacy of Brain-Computer Interfaces
A month ago, Musk claimed that Neuralink’s first human trial participant seemed to have fully recovered without any known adverse reactions, and the participant could move the mouse on the computer screen just by thinking. However, Albo stated that this new technology is “not perfect,” and they “encountered some problems.”
In the video, Albo mentioned that after the device was implanted, he gradually transitioned from habitually thinking about moving his hand to moving the mouse, ultimately making moving the cursor on the computer screen a “second nature.”
New technologies always require continuous iteration to mature and improve. Brain-machine interfaces have ignited new hopes for more and more neurologically disabled patients. Musk also revealed that Neuralink is developing Blindsight, a brain-machine interface expected to restore vision. Even if someone loses both eyes and optic nerves, Neuralink can help them regain sight.
At the same time, Hong Bo believes that the clinical application of brain-computer interfaces is just beginning, and there will be many uncertainties and unknowns in the actual treatment process, so avoid excessive glorification. “Brain-computer interfaces are essentially tools, and the design of specific treatment plans needs to be rooted in a clear understanding of the human nervous system.” He cited an example: neural rehabilitation training for hand injuries is relatively easy, while getting patients with lower limb paralysis to stand up again is more difficult. This is because research on the neural encoding of the upper limbs is more in-depth, while the neural circuits and networks involved in standing are more complex and still not fully understood.
