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Evening Standard
Evening Standard
World
Andrew Williams and Rachael Davies

What is Neuralink and how does it work? Elon Musk's firm says first brain-chip patient now plays online chess

Eight years after its inception, Neuralink owner Elon Musk told the world back in January that the first device had been implanted in a human brain.

Now, a video has been shared on X depicting just what the brain chip can do, as well as revealing the identity of the patient for the first time.

29-year-old Noland Arbaugh was shown playing chess and pausing music on a laptop, controlling the mouse on the screen using only his thoughts.

As well as helping give paralysed patients like Arbaugh the ability to interact with technology and communicate more easily with those around them, it has further potential to be a revolutionary use of technology.

Just as Tesla helped make electric vehicles mainstream, the big question is whether Neuralink can have the same paradigm-shifting impact in the field of brain implants. 

The initial key use for such an implant is to help people with paralysis live more independently. But the ambition does not end there. 

What is Neuralink and how does it work?

Neuralink’s first implant is called Telepathy, according to Musk. It “enables control of your phone or computer, and through them almost any device, just by thinking,” he says

“Initial users will be those who have lost the use of their limbs. Imagine if Stephen Hawking could communicate faster than a speed typist or auctioneer. That is the goal.”

There’s a long history of this sort of endeavour. In the 1970s, Jacques Vidal used monitoring of eye movements to enable paralysed patients to control a computer mouse. The first human brain-computer interface (BCI) implant was installed in a person in the late '90s. 

And a pioneer of those early experiments, Philip Kennedy, paid someone to put a Neuralink precursor implant in his head in 2014. 

Just like Neuralink, these implants monitor brain activity to translate it into computer input, in what might come across as telepathy – hence the name of this first Neuralink product. 

“From just a few neurons, patients could move a cursor on a computer screen and communicate by picking words or letters from a menu,” reads MIT Technology Review’s explainer on Kennedy’s career. 

However, Kennedy ended up paying to have the implant removed, as the implant site failed to properly heal, inviting potential infection. But, 10 years later, Neuralink is implanting what are effectively successors to this work.

Neuralink was granted FDA (Food and Drug Administration) approval for human trials in May 2023, leading to this first human implant in January 2024. 

US citizens can sign up on the Neuralink website to express an interest in becoming involved in future trials.

What happens now a Neuralink device is in someone's head? "I expect Neuralink will want to give the participant time to recover before they start training their system with the participant," says Anne Vanhoestenberghe, professor of Active Implantable Medical Devices at King’s College London.

"We know Elon Musk is very adept at generating publicity for his company, so we may expect announcements as soon as they begin testing, although true success in my mind should be evaluated in the long-term, by how stable the interface is over time, and how much it benefits the participant.”

How does Neuralink work?

You can think of the Neuralink implant as having two parts. There’s the exterior casing, which holds the battery and electronics. It sits on the skull.

This includes the “brain” of the device and its Bluetooth chip/antenna. Neuralink transmits data wirelessly, much like sending music to a pair of wireless headphones. 

The neural lace is the second part: “1,024 electrodes distributed across 64 threads” need to be implanted under the skull of the patient, on the brain’s surface.

A robot surgeon is used for this part, as the procedure requires precision not possible with the human hand. 

While the process may have changed a little since, Musk explained the basics of the invasive surgery back in 2020. 

“You remove a coin-sized piece of skull. And then the robot inserts the electrodes. Then the device replaces the portion of skull that was removed. And we basically close that up with actually super glue, which is how a lot of wounds are closed. And then you can just walk around right afterwards. It’s pretty cool,” Musk said, as reported by VentureBeat

This lattice of electrodes lets the Neuralink device monitor the firing of brain neurons, perceived as signal “spikes”. And by monitoring patterns in these spikes, Neuralink can learn to recognise types of brain activity – a kind of mind reading. 

The concept is nothing new, but where older implants might collect just a handful to a couple of hundred of these spike-data points, Neuralink can register 1,024. This should make it capable of recognising more complicated thought patterns, and translating them into actions in a computer or, taking the concept further, a robotic prosthetic limb, for example. 

Once implanted, Arbaugh also shared more insights into exactly how the chip works, highlighting that using it means learning the difference between imagined movements and attempted movements. Instead of attempting to move the mouse, he needs to imagine where the mouse will go in order for it to function.

How much would a Neuralink cost?

Neuralink has not announced pricing for the implant. However, Bloomberg estimates the cost at $10,500 (around £8,300), and suggests insurance companies would end up being charged $40,000 (£31,500) for the procedure in the US. 

Neuralink dangers and controversies

Neuralink hardware has been tested on animals. In 2020, the company showed the technology implanted in a pig called Gertrude, while monkeys and sheep are known to have also been subjected to animal testing. 

More than 1,500 animals have been killed as a result, according to a Reuters investigation. This led to a federal investigation reported in December 2022, although this preceded the company’s FDA approval for human trials. 

These human trials are not without danger, too, by their very nature. There’s a risk of infection and of brain damage during the procedure. 

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