It’s a space attracting much attention, involving invasive brain-computer interfaces (BCI) attached to the brain or electrodes placed on the scalp. Rehabilitation areas impacted positively encompass mobility assistance, neuro-prosthetic limbs, precision surgeries, and speech and hearing enablement. Exploratory areas of promise include deep brain stimulation for Parkinson’s disease, epilepsy, chronic pain, psychiatric issues, and improving memory and cognitive abilities for those with brain injuries.
A recent article in the journal Nature featured Gert-Jan Oskam, who suffered an accident in 2011 that paralysed him from the waist down. Gregoire Courtine, a neuroscientist at the Swiss Federal Institute of Technology, Lausanne, explained how brain implants helped capture Oskam’s thoughts through an AI decoder, bypassed injured sections and sent these commands to another implant in his spinal cord, resulting in voluntary muscle movements.
Apart from Neuralink, other entities in the BCI business include Bryan Johnson-founded Kernel, which focuses on non-invasive neural interfaces to improve health and cognition; Blackrock Neurotech, developer of a platform for neural signal processing and novel implant solutions; and Synchron, which has developed an endovascular BCI that uses blood vessels to access every corner of the brain.
Various universities too have research centres – like Brown University’s BrainGate Project, the Center for Neurotechnology at the University of Washington, the Wyss Centre for Neuroengineering at Geneva and the University of Michigan’s Direct Brain Interface. The Defence Advanced Research Projects Agency (Darpa), a US government agency, has invested in developing high-resolution neural interfaces. Medical devices companies like Medtronic and Boston Scientific have been involved in the manufacture, regulatory compliance and clinical trials of other devices.
A year ago, Musk made headlines when he said he was so confident about implants that he would be willing to put them in his children. Researchers echo that confidence, citing Oskam’s case.But when the brain communicates with external systems, physiological, ethical, social, legal and technical issues must be considered. Device failure could happen at a critical time, with a prosthetic motor functioning suboptimally, or endangering life if a wheelchair fails to respond to commands at a street crossing. Implants could cause neural tissue scarring, or there could be unanticipated side effects. Authors fantasise about the excellent powers of an integrated man-machine cyborg. And neuro-researchers worry about the change in character, identity and ethical core of the man-machine hybrid – especially in a situation where the implant gets signal inputs from the brain, resulting in irrational, unchecked actions from passing thoughts.Ethical aspects of grave import include informed consent: the BCI recipient should get contextual information, must be able to comprehend it entirely, and is not coerced to decide. This presents a dilemma for non-communicative patients, or, in a more nuanced way, in the case of patients with exaggerated optimism about benefits. There are also new angles emerging about the extent of privacy, which could be breached when BCI devices ascertain information relating to relationships, mental states, attitudes and likely responses. Hacking and device manipulation are other vulnerabilities, apart from over-dependence on devices.
Not surprisingly, it takes a long while before such devices get the regulatory green signal. As of May, no company had received the US Food and Drug Administration‘s (FDA) final approval. Neurotech start-up Paradromics, a Neuralink competitor founded in 2015, announced in mid-May that it had received the FDA Breakthrough Device designation for its Connexus Direct Data Interface. Human clinical trials are expected to commence in the first half of 2024. Neuralink, founded in 2016, appears to be on a faster track and announced toward the end of May that it had got FDA approval for its first human clinical trial.
The future is exciting and unpredictable. It may be dangerous too when the play is for competitive advantage – like when humans are directly connected to a computer array when we start using BCI for individual cognitive superiority, or when BCI is embedded in animals. And it’ll get fascinating when marketers leverage BCI to figure out customer emotions – and make you an offer you can’t refuse.
The writer is founder, ThinkStreet
