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Neuralink's brain chip: How brain-computer interfaces may revolutionise treatment for disabilities

Patients with severe paralysis use Stentrode's brain-computer interface to text, email, shop, and bank online.
Patients with severe paralysis use Stentrode's brain-computer interface to text, email, shop, and bank online. Copyright AP Photo
Copyright AP Photo
By Imane El Atillah
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Neuralink's first human trial has shown how brain-computer interface (BCI) technology can transform the lives of patients with disabilities, helping them become more independent.

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Neuralink, Elon Musk’s brain implant company, is seeking three paralysed patients to participate in a study aiming to assess the effectiveness of their brain-computer interface (BCI) device.

The company recently concluded its first human trial, which successfully helped Noland Arbaugh, a 30-year-old patient paralysed from the neck down, to regain some autonomy through its implantable BCI device. It also last week announced it had opened registrations in the UK.

However, Arbaugh's journey with the implantable chip was not without challenges, as the device faced issues after implantation.

According to a Neuralink blog post, several threads retracted from his brain in the weeks following the surgery, causing Arbaugh to lose some of the abilities he had regained.

Neuralink had to refine the algorithm, which ultimately allowed for improvements that "superseded Noland’s initial performance," according to the blog post.

While Arbaugh's experience highlights the potential impact of Neuralink's BCI chip on the medical field and the lives of people in similar situations, he is not the first patient to benefit from this technology.

BCI technology has been in clinical trials for years, though implantable devices have not been used extensively.

Many companies have been developing their own versions of the device, which could potentially improve the lives of patients suffering from medical conditions ranging from paralysis to mental health disorders.

What is BCI and how does It restore lost functions?

A brain-computer interface, or BCI, serves as a communication link between the brain’s signals and an external device, such as an artificial limb or a computer.

"The brain-computer interface is a device which can essentially obtain brain signals directly from the brain and decode them to some output commands," Dr Shahram Majidi, director of cerebrovascular services and a neurosurgeon at Mount Sinai Hospital in New York, told Euronews Health.

BCIs are particularly useful in cases where patients have lost specific functions like speaking or moving parts of their body for various medical reasons.

According to Dr Majidi, in some instances where the brain’s command centre is still intact and able to generate signals, BCI devices can help regain some control over those functions.

"In these conditions, if you have a system which can capture those signals from the brain and decode them, then you will be able to replace that function with a new output," he explained.

Typically, when humans want to make a specific move or perform a specific task, the brain generates unique, reproducible signals that enable the action.

However, in cases of accidents or diseases, the brain may no longer be able to command these actions, and that’s when BCI technology becomes invaluable.

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"What the brain-computer interface does is capture these signals, and assign them to specific output. For instance, when you have the brain-computer interface in place in the vicinity of the brain, they ask the patient to make a fist or show a thumbs up,” Majidi explained.

“And in each of those tasks, the brain will generate a particular signal that the BCI will capture, then we can decode this to certain outputs".

Essentially, patients who are disabled or paralysed from diseases such as ALS, stroke, or spinal cord injury can still think about specific functions and actions but are unable to perform them.

However, merely thinking about the specific action still causes the brain, which needs to be intact, to fire the signal that the BCI captures and translates.

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Overview of BCI procedures

According to Majidi, BCI technology has been around for several decades and has seen significant advancements in both technology and operation.

Traditionally, BCI devices required invasive open-brain surgery, but more recent models, such as the Stentrode, which Majidi has been using in clinical trials, allow the BCI to function without surgically entering the brain to implant the device.

"The advantage that Stentrode electrodes have is that it is a minimally invasive endovascularly placed brain-computer interface,” Majidi said.

“That means that we don't violate the brain anatomy. We don't cut the skin, we don't remove the bone, we don’t penetrate the brain," he added.

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With these devices, surgeons use the veins surrounding the brain to navigate to the desired location where the BCI is implanted.

Majidi further explains that this method minimises the brain's negative reaction to the electrodes used in BCIs, which can cause inflammation.

A woman uses the NextMind hands-free brain-computer interface device at the NextMind booth during CES Unveiled. 2020
A woman uses the NextMind hands-free brain-computer interface device at the NextMind booth during CES Unveiled. 2020John Locher/AP Photo

Still, these new versions of BCI tend to capture fewer signals compared to the more invasive ones.

Despite this limitation, they still offer a more durable and practical alternative.

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Although all BCI devices are currently only approved for use within clinical trials and not for real-world application, many patients have experienced life-changing benefits from this technology.

‘For severely disabled patients, this is a monumental change’

The conditions that qualify patients for BCI typically leave them severely disabled and bedbound.

According to Majidi, these patients are unable to speak, move their arms or legs, or get out of bed, making them completely dependent on their caregivers.

"So, essentially, the ALS causes these patients to be completely isolated from the outside world. They are forced to stay in their bed, their wheelchair and their room and are completely disconnected from the world," Majidi said.

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However, BCI technology enables these individuals to begin performing regular tasks such as texting, surfing the internet, and sending emails among other computer functions.

It also improves communication with their caregivers, allowing them to report pain and request assistance.

"Although it looks like a small step, for the severely disabled patients this is a monumental change, and a new window to a world to get out of the isolation and have some level of independence,“ Majidi said.

Other uses of brain-computer interface devices

“When we think about neurotech and BCI, there's been a lot of emphasis on helping people with spinal cord injury and paralysis, and that's a huge area of need,” Jacob Robinson, founder and CEO of Motif Neurotech, told Euronews Health.

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“But I think that the people who are suffering from mental health conditions are just as worthy of that type of technology,” he added.

Motif Neurotech is a company that has found a different use for BCI technology by developing devices specifically designed to help people with mental health conditions such as depression.

These devices, implanted in the bone over the brain, create precise patterns of electrical stimulation that activate neurons in targeted brain regions.

For individuals with mental disorders, certain brain areas that aid in recovery behaviours like exercising or socialising are underactive.

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Brain implants help by stimulating these areas to enhance a patient's ability to engage in behaviours that could improve their mental health.

"We're essentially tapping directly into the language of activity inside the brain and modifying it for people who suffer from psychiatric conditions," Robinson explained.

“Any neurological disorder, any psychiatric condition that involves dysregulation in the brain states can be treated if we stimulate the right region of the brain,” he added.

According to Robinson, there is a big need for such technology since a lot of people with mental health disorders struggle with the side effects of drugs and are constantly suffering.

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“When we looked at the market for every person with a spinal cord injury, there are ten people suffering from treatment-resistant depression,” Robinson said.

“It's just invisible compared to people in wheelchairs,” he added.

Future of the technology

For BCI technology, the future appears promising to Majidi.

"I think because of advances in technologies that we had in the past few decades, we see Stentrode, we see Neuralink, and other types of BCI. We're gonna just keep advancing the field and adding more to what we know about BCI, the limitations, the opportunities,” Majidi said.

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"Not all of them will succeed, but we will learn from them, we will adjust, and we will improve,” he added.

For Robinson, these devices could provide real-time feedback on how well therapy is working for patients and treat mental health conditions without the side effects of medication.

“Where I see the future is one where neurotechnology is not just helping people with communication and paralysis, but it's also helping people feel better, get their lives back to help the mental health conditions that are the silent killers,” Robinson said.

Majidi adds: "The future is gonna be bright, there's no question there. BCI is here to stay, and it's gonna just keep getting better”.

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