MANOUSH ZOMORODI, HOST:
Today on the show - the power of the mind. So we've talked about how our understanding of the mind has changed and why accepting our thoughts and staying present can help us. Now let's go to the future of the mind. If you ever learned to program a computer, the first thing you probably did was get it to type out the phrase hello world. And it probably felt like magic if it worked, like you had given technology a brain. But what if a brain was given technology?
TOM OXLEY: A brain-computer interface is a device that goes into your brain, and it can listen to activity in certain parts of the brain.
ZOMORODI: This is physician Tom Oxley. He specializes in vascular neurosurgery.
OXLEY: And I'm the founding CEO of Synchron, a brain-computer interface company.
ZOMORODI: In 2020, Tom's company started testing their device in people, including a man named Phillip O'Keefe.
OXLEY: Phillip was the second participant in our first in-human study of our implantable brain-computer interface. He lives in Melbourne, Australia. And Phillip has ALS, or motor neurone disease. And he was facing a progressing loss of control of his body as the ALS progressed. So if your muscles stop working, but your brain is still working, you can in a sense become trapped inside your head. So this technology is a way to put almost what is a microphone right on top of the brain and bypassing the inability of the body to transmit out your intention or your will to move.
ZOMORODI: Basically, the technology decodes what part of the body the brain is trying to activate and then sends out a signal that makes a cursor move or a computer mouse click.
OXLEY: Yeah. So you're able to directly manipulate a mouse or a keyboard by thinking about trying to move, even though your body is no longer moving, almost like a Bluetooth mouse directly controlled out of the brain that can work on any system.
ZOMORODI: Phillip started off doing simple tasks using his BCI, like sending an email and browsing the web. But after a year, he wanted to take things to the next level. So he sent out a tweet.
OXLEY: The first tweet said hello world. That was what it meant to him. He was saying hello back to the world because he'd gone quiet. He'd gone dark, and he was back. And that's really what this technology is about.
(SOUNDBITE OF TED TALK)
OXLEY: Phillip O'Keefe can't use his fingers to type like you or I, but thanks to a tiny brain implant, he was able to send the following tweets.
ZOMORODI: Here's Tom Oxley on the TED stage.
(SOUNDBITE OF TED TALK)
OXLEY: Hello world - short tweet, monumental progress. No need for keystrokes or voices. I created this tweet just by thinking it. My hope is that I've paved the way for people to be able to tweet through thoughts - Phil. Now, you might be thinking there are some people out there who should not be allowed to tweet directly from their brain.
(LAUGHTER)
OXLEY: I agree. But for people with paralysis and disability, this technology can be life-changing. They will fill up brain signals up on the screen. They're connected to their computers via Bluetooth. The device is fully internalized, invisible to the outside world. And they learn to control the keyboard with clicks directly coming from their brain. Now, BCIs conjure up images of science fiction, like "The Matrix," with a cable jacked up into your brain through a hole in your skull. But I'm here to show you that the future can be much more elegant than that.
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ZOMORODI: I mean, it's crazy. Do you remember the first time that you heard about brain-computer interfaces? Because people have been trying to do this for a while, right?
OXLEY: The first report of a human implant was in 2006 by Leigh Hochberg and colleagues in Nature. And I was immediately besotted with the idea that this was going to be a transformational technology. I went into medicine because I loved the brain. There was this mystery and romanticism about what the brain was, how it worked, how it generated consciousness. And then you realize that there's not many things that you can do for neurological disease. You can't reverse the death of neurons. You can't replace neurons. And I realized that this is a field in medicine which is sort of behind the other areas of medicine in the ability to treat conditions. And it struck me that the ability to directly interface with the brain was going to change that.
ZOMORODI: Because up until then, what scientists have been trying to do, they had to go directly - like, drill a hole and put a device in people's brain. Is that what the challenge was?
OXLEY: Yeah. The breakthrough early research device is a series of needles that sit on a base, and those needles get pushed into the brain tissue, and they are able to record information out of the brain. There's an issue with putting a needle into the brain, and that is that it can cause a inflammation reaction.
ZOMORODI: The brain does not like to be invaded.
OXLEY: The brain has an immune response which is different to the rest of the body. You can put a tattoo under your skin, and it will not cause a huge inflammatory reaction, but you can't do that necessarily on the brain. So my concept was, well, how do we avoid putting something directly into the brain? What's the next closest we could do? And the idea that we had was let's try and solve getting these sensors into the blood vessels, and it can stay there for a lifetime.
(SOUNDBITE OF TED TALK)
OXLEY: The blood vessels are the natural highways into the brain. These are hollow tubes that connect every corner of the brain. The largest vein at the top there is right next to the motor cortex, the exact part of the brain that we want to connect to to restore control to the outside world. Now, we already know how to travel through the blood vessels. If anyone here today has had a heart attack, there's a pretty good chance you've had a stent. A stent is a metal scaffold delivered through a catheter which opens up like a flower into the blood vessel. Millions of stents are delivered each year, not in the OR but in the cath lab, or catheter laboratory. It's now common in the cath lab to navigate up into the brain through the blood vessels.
But what's really amazing about this is that for BCIs, we already know that devices can be left inside a blood vessel, cells grow over it, incorporate it into the wall like a tattoo under the skin, and we're protected from that immune reaction. This is part of the reason why our team became the first in the world to receive a green light from the FDA to conduct clinical trials of a permanently implanted BCI. We called this the Stentrode.
(APPLAUSE)
ZOMORODI: So you've basically built a brain-computer interface into a stent, and you place it not just in the brain but in the brain's blood vessels, right?
OXLEY: Yeah.
ZOMORODI: It's extraordinary. Can you take me through that process?
OXLEY: The procedure involves putting a catheter into the jugular vein in the neck, then slipped up inside the skull through a little preexisting hole that the jugular vein goes up. So it's kind of going up the drain pipes of the brain. So you carry your way up through those pipes all the way up into the brain, until you sit on the blood vessel that's sitting right on top of the motor cortex. And what we had to solve was how do you put sensors - how do you build an electronic circuit onto that stent? So then that device opens up. It sits in the blood vessel. It's connected to a cable. That cable exits that point in the neck and the jugular, and it plugs into a device in the chest that sends the information from the brain, wirelessly, out of the body. So if you were to look at the patient with the device in, you wouldn't know that it was there.
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ZOMORODI: OK, so once the stent has been put in, do you just think something and out it comes onto the keyboard? How do you - do you have to train the patient in order to use their mind effectively to communicate through technology?
OXLEY: The patients do undergo training. What's interesting is that we are born in bodies where there's a part of the brain attached to a muscle, and that's all that part of the brain does. So if you make a fist right now, there's a very particular part of your brain that's firing to do that. But once you digitize that, you can apply what used to be a particular movement, say closing a fist or putting up your finger or bending your elbow, and the patient will realize that that performs a particular task on the computer.
(SOUNDBITE OF MUSIC)
ZOMORODI: When we come back, would you want to be able to tweet directly from your mind? The possible future of brain computer interfaces. On the show today - Part 1 of our series, Mind, Body, Spirit. I'm Manoush Zomorodi, and you're listening to the TED Radio Hour from NPR.
It's the TED Radio Hour from NPR. I'm Manoush Zomorodi. On the show today - the mind and brain-computer interfaces that could change the way we think. As we were hearing, neurointerventionist Tom Oxley has been testing his company's device, the Stentrode, in people. It's a tiny sensor that sends signals from the brain to a receiver in the chest, which then, via Bluetooth, helps the patient send an email, search the web, connect to their devices and the world. For now, the goal is to help people with neurological diseases who can't move their bodies or speak. But what about in the future?
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ZOMORODI: One of the most famous people who's in this brain-computer interface field is, of course, Elon Musk. And he has laid out a vision where people control all kinds of things with their minds - virtual reality games, but also way more than that. He's talking about the brain fusing with artificial intelligence. Are you thinking of those things, too, where it's not just for people who have medical issues, but for anyone who wants to enhance their mind?
OXLEY: I watch Netflix, and I read science fiction novels. And I can see that there's a likely outcome where this technology progresses into humans being able to control things in a way which wasn't previously possible. The thing is that we're talking on a very long time scale. And I think it's important for people to remember that this technology is critical for people who have lost the ability to engage in the world. So I just worry that the conversation goes into a 100-year-out time frame, and we start looking at all the possibilities of how this could go wrong, and we forget why actually we're doing this right now and who is it for. You know, I'm not dismissing the ethical considerations for where this goes. Like, I've seen "Black Mirror." And I think the answer to that is let's confine the problem right now to what is needed to really help people and lay down a really strict regulatory framework about, you know, remaining in that domain.
ZOMORODI: I mean, that's the thing, right? It's a Venn diagram of medical device and Silicon Valley utopian, maybe out-there futurism. And, I mean, your company is a for-profit company. You've taken venture capital. And presumably, your investors would like you to move as fast as you possibly can with this and scale it. So I guess I'm wondering, when do the ethical considerations - like, when does that conversation start? Because we've seen it start way too late with so many other technologies in the past.
OXLEY: I mean, you're right. The conversation has started for us now. We have a ethical charter. We have internal conversations about this a lot. We're talking with the FDA, and we've been in close contact with them and continue to discuss these issues in an ongoing basis. I think the community's taking it very seriously. The kind of Venn diagram into the tech utopia - I think our investors are investing because they see that there is a huge unmet need in the medical domain for paralysis. Now, I mean, one other thing that I'd probably add to it is if I was to think ahead about what it might look like into that tipping point and who would be the people in the consumer world that would start to do this, the corollary I think about is Lasik surgery.
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OXLEY: Lasik surgery started 30 years ago, and it's a laser on your eyeball, and it makes you see better. This is a procedure that's a day procedure. You have to go into a hospital. You have to see a physician. It's regulated by FDA. But if your visual disturbance is only mild, you can still go and do that, and you can take on the risk and benefit to get that done. I think BCI might go in that direction. I'm not saying next year. This is probably, like, on a 15-year horizon. But once the technology is demonstrated to be safe and effective and it's in a day procedure and it's invisible to the outside world, there probably will be a portion of society who think, well, I would like to be able to engage in systems without having to touch anything, so I don't have to hold my phone. I can see that as a possibility.
(SOUNDBITE OF TED TALK)
OXLEY: In the future. I'm really excited about the breakthroughs BCI could deliver to other conditions like epilepsy, depression and dementia. But beyond that, what is this going to mean for humanity? What's really got me thinking is the future of communication. Take emotion. Have you ever considered how hard it is to express how you feel? You have to self-reflect, package the emotion into words and then use the muscles of your mouth to speak those words. But you really just want someone to know how you feel. For some people with certain conditions, that's impossible. So what if rather than using your words, you could throw your emotion just for a few seconds and have them really feel how you feel. At that moment, we would have realized that the necessary use of words to express our current state of being was always going to fall short. The full potential of the brain would then be unlocked.
ZOMORODI: You mentioned just how many mysteries there still are about the human brain and how our minds work. Where are we now in that understanding? I mean, it feels like, you know, we've mapped the human genome. That was exciting. We're now starting to hear about people getting genetic treatments. Where are we with the brain, with our minds?
OXLEY: For me, the huge mystery is the unconscious. You know, we've for the most part mapped the brain and understand it, but we have not figured out how the random, chaotic, unconscious world that exists when we're dreaming interacts with our day-to-day life. You know, I started psychiatry, and I decided not to do psychiatry because I didn't feel like we fully had a biological or physiological framework to understand why people were suffering. But I still don't feel like we've really cracked how the unconscious works, and we haven't integrated that into a clear physiological framework yet.
And so I'm on a journey right now. I think BCI has been incredible, and it starts to equate to a reverse engineering of how the brain works. And the brain works similarly in different parts, and we're learning that now. But I'm hoping that over our lifetime, we're going to have major breakthroughs in the ability to integrate the whole mind, which includes the subconscious and the collective unconscious. I think it's going to be a really interesting 50 years to unlock those mysteries.
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ZOMORODI: That's Dr. Tom Oxley. He's a neurointerventionist and the founder and CEO of Synchron. You can see Tom's full talk at ted.com.
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