As of January 29th, the Elon Musk startup Neuralink delivered its first brain implant to a human. As described in initial reports, the patient seems to be doing well and is already benefiting from increased interneuronal communication. The goal of this application is to empower those with disabilities, specifically those with sensory and motor deficits, to be able to control a keyboard or a cursor using their brain. This new clinical tool was greatly reviewed to ensure the safety of the technology, and as of the past year, Neuralink was given clearance for their device by the Food and Drug Administration (FDA) along with approval to begin patient recruitment for an ensuing clinical trial.
Brain-computer interfaces (BCI) are a type of computer system that collects and translates brain signals into orders that are used to accomplish specific tasks. The brain chip created by Neuralink is one such type of BCI that is surgically implanted into a patient’s cerebellum. The device consists of a chip and electrodes that are connected to the cerebral cortex to obtain thoughts related to movement. The activity of the chip is then monitored via neuron spike detection to determine the success of microchip implantation. From here, if successful, an application will translate these signals in order to complete a desired task. For this, both the patient and the system are trained to ensure that they are able to work together synergistically. As of now, this new technology is mostly aimed at patients with quadriplegia. Therefore, the tasks that are set to be completed can range from controlling a video game with one’s mind to executing difficult computer calculations. Since patients with quadriplegia have significant paralysis by definition, this new technology is especially suited to assist them in interacting with their surrounding environment.
Although some have high hopes for how BCIs might help current and future generations of patients with paralysis, there are many challenges and risks that come with BCI implantation. As with any implant, there are general risks that accompany surgery, such as infection or hemorrhaging. Although these risks are common during surgical procedures, there are also challenges specific to this technology. A considerable danger associated with this procedure is an increased risk of epilepsy or epileptic activity due to the type of brain simulation produced by BCIs. Additionally, there have been questions raised regarding the long-term success and function of BCIs given the body’s predisposition to identifying the BCI as foreign material. As BCIs are a newer development, it is difficult to predict the overall outcome and longitudinal effect they might have on patients. Accordingly, due to the risk of adverse events occurring, the procedure is only offered to patients with inoperable disabilities, such as those with paralysis, wherein surgical intervention is not indicated. Although potential risks exist, the advancement of technologies such as BCIs for patients with neuromuscular disorders may improve their quality of life.
Even though Neuralink has largely focused on thought-regulated movement to assist patients with quadriplegia or other forms of inoperable paralysis, the company’s goal is to be able to help individuals with OCD or severe depression by interacting with deeper parts of the brain than Neuralink is currently capable of reaching. Furthermore, there have been talks regarding monitoring the cognitive processes that are associated with obesity in individuals. Overall, while it is important to take the technology’s current risks into consideration, further clinical trials and data analysis are needed to evaluate the potential of Neuralink and other BCIs to help improve patients’ quality of life in instances where the current standard of care has been unable to do so.
Shalini Yagnik is an undergraduate student. Tejas Sekhar is a medical student.
