What can Elon Musk’s brain startup Neuralink do?

By Sarah McBrideElon Musk has made plenty of claims about Neuralink Corp., his brain-machine interface company. On Twitter and on podcasts, the billionaire has touted abilities that sound nothing short of miraculous: easing depression, helping with obsessive compulsive disorder and treating traumatic brain injuries.Now, Neuralink, whose work has largely been shrouded in secrecy, is set to give a public “progress update” on Friday.In the run-up to the big reveal, Musk has allowed some glimpses at the company’s technology. An early look came a year ago, when the Neuralink team showed off tiny electrodes on thin, flexible probes they said would be able to penetrate brain tissue with minimal damage, and ultimately help restore brain function to people with traumatic brain injuries. The team has already been placing them in rats and primates.Will the devices actually be able to achieve the breakthroughs Musk says they can? Here’s a rundown of what we know so far about Musk’s startup—the most recent claims, the technology, and what neuroscientists say is actually possible.Claim: Neuralink will soon be able to implant its technology in humansOn May 7, Musk appeared on the popular podcast, the Joe Rogan Experience, and made a distinctive claim about Neuralink: The startup would “be able to implant a neural link in less than a year in a person, I think.”The prediction is not actually as groundbreaking as it might sound. Musk was describing a procedure that happens fairly routinely to treat conditions such as epilepsy and Parkinson’s, despite potentially fatal risks such as brain hemorrhages.Justin Sanchez, who helped fund research done by Neuralink scientists when he ran the biological technologies office at the Defense Advanced Research Projects Agency, estimates that about 200,000 people globally have some sort of neurotechnology implanted in their brain. In fact, the technology is so well developed at this point that the Battelle Memorial Institute, where Sanchez is a fellow, has developed a neurotechnology-based non-implanted device aimed at nothing more grandiose than helping people improve their golf swings.The other important element of Musk’s statement was that Neuralink is on track for human trials by next year. To test so quickly in humans, the company would need to get an exemption from the normal multi-year regulatory process from the Food and Drug Administration. That may be possible—other brain implants have received exemptions. But Neuralink’s device could face additional challenges.Currently, the company uses flexible polymers, which are unlikely to last a decade in the human body—the minimum timeframe the FDA likes to see in medical devices that can’t easily be removed. “If you want to test whether something can last 10 years, you really have to wait 10 years,” says Matt Angle, chief executive of Paradromics Inc., an Austin, Texas-based brain-machine interface company.A report in health news site Stat News this week detailed internal tensions at Neuralink, citing former employees who said the company culture could be chaotic and that it quickly cycled through scientific talent. According to two anonymous former employees, it had explored possibly by passing the U.S. regulatory process by pursuing human trials in China or Russia. 77796468Claim: Neuralink devices will be able to treat addiction and depressionOn July 10, Musk took to Twitter with another notable statement. A Twitter user asked Musk if Neuralink could be used to retrain the part of the brain that causes addiction and depression. Musk replied, “For sure. This is both great & terrifying.”Neuroscientists agree that placing electrodes in the brain could help mitigate those conditions. In fact, researchers beyond Neuralink are working on it now, including Alik Widge, a psychiatrist and biomedical engineer at the University of Minnesota. The treatment involves applying electrodes to a spot in the brain called the internal capsule, and works by stimulating connections to the prefrontal cortex to improve cognitive functions such as perception and judgment. About 200 patients worldwide have tried the technique for depression, Widge said. In several countries opioid addicts have had electrodes implanted into the areas of the brain that control addiction. That includes the U.S., where a West Virginia man underwent the procedure late last year at WVU Rockefeller Neuroscience Institute. He has abstained from opioids since, a spokeswoman said. A second opioid patient underwent the same surgery earlier this month.While there are hurdles to wide adoption, there is no reason Neuralink couldn’t push into these areas in the future. In a 2018 review of studies of deep brain stimulation and its effects on depression, scientists said the results “showed promise” but the technique remained experimental. “The psychiatrists I talk with say that they want to see much stronger efficacy data,” Widge said.Claim: The startup will be able to mitigate conditions like obsessive compulsive disorderOn July 18, a Twitter user asked if Neuralink could help patients with obsessive-compulsive disorder and if it could stimulate the release of oxytocin, serotonin and other chemicals. Musk replied simply, “Yes.”Programs around the country already do this, so it’s plausible that Neuralink could one day achieve the same, experts said. However, scientists’ grasp on exactly how the technology works is still evolving. “We just have the understanding of bits and pieces,” said Rachel Davis, director of OCD and neuromodulation programs at the University of Colorado Anschutz Medical Campus, which is working on the technology.Many scientists see big potential here, mainly because existing drugs often fall short when it comes to OCD and related conditions. “The next big wave for these stimulation technologies is going to be mood,” said Dave Rosa, CEO of NeuroOne Medical Technologies Corp.Claim: Neuralink could “solve” brain injuries, and treat conditions like autism and ALSOn July 18, responding to Musk’s call for job applicants who wanted to help “solve” brain and spinal injuries, a Twitter user asked if Neuralink could also help disabled people living with injuries, autism and amyotrophic lateral sclerosis, or ALS. Musk replied it had that potential.Deep brain stimulation, or treatment via electrodes implanted into the brain, is already used for traumatic brain injuries. Many patients have already undergone the procedure with promising results. Encouraging signs are also emerging that such technologies could help address autism. Implanting electrodes in the brains of autistic people has helped improve symptoms in many cases.Treating ALS, however, may be more difficult. Vikash Gilja, a former Neuralink employee who now teaches at the University of California, San Diego and runs a translational neural engineering research lab there, says that would be a tough disease to combat with brain-machine interfaces, because it affects such broad areas of the brain. “We’re more likely to see pharmaceutical treatments for that,” Gilja said. 77796540Claim: The company will be able to stream music directly into people’s brainsOn July 19, a Twitter user asked if someone with a Neuralink implant would be able to stream music “directly from our chips,” calling it a “great feature.” Again, Musk replied with a simple “Yes.”While it sounds far-fetched, neuroscientists say this feature wouldn’t differ markedly from existing technology. “That’s very technically feasible,” says Angle of Paradromics. “The auditory pathway is very well mapped.”Some in the scientific community have watched the company’s promises warily, fearing that they might prompt afflicted people to delay necessary procedures. “One issue that has come up time and time again is the ethics around creating false hope” around unknown timelines, said Gilja, the UCSD professor and former Neuralink employee. “Creating hope in a patient population can be a good thing, but it can be a negative if a patient is trying to determine whether to get treated.” They may believe a better solution lies in the near future, when in fact it could be years out.Musk doesn’t claim that Neuralink can do everything. Over the years, he has ignored questions ranging from the creepy (such as whether it will facilitate head transplants) to the quotidian (such as whether it will help with balance). “What will Neuralink do for the culinary arts?” asked one tweeter. Musk’s answer: silence.

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