Short Wave - Tweeting Directly From Your Brain (And What's Next)

Episode Date: March 18, 2023

Our friends at NPR's TED Radio Hour podcast have been pondering some BIG things — specifically, the connection between our physical, mental, and spiritual health. In this special excerpt, what if you could control a device, not with your hand, but with your mind? Host Manoush Zomorodi talks to physician and entrepreneur Tom Oxley about the implantable brain-computer interface that can change the way we think. Keep an eye on NPR's TED Radio Hour podcast feed the next few weeks, as they unveil the series.See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

Hey, short waivers. Emily Kwong here with a very special guest, Manus Zamoroti, the host of NPR's TED Radio Hour. Hi, Manoosh. Hello, Emily, and hello, short waivers. Manus, I am so excited you're here. And I understand you have a special present for us today. Oh, I do. The grand reveal of part one of a big series you've been working on. Tell us about it. Okay, so we've all heard the hashtag mind, body, spirit. I said it to my 12-year-old daughter, and she was like, ew, that's such a cliche. And I was like, well, okay, it is a cliche, but there's a reason why it exists. Mind, body, spirit, this connection between these three things. People have been trying to understand it for millennia. And it's become this hashtag that means nothing.

Well, we are reclaiming it and we are doing a special three-part series, one episode examining the mind and new ideas about how we perceive the world, another examining the body, new ideas about feeling good in our bodies. and feeling like we understand how our bodies work. And then finally, an episode about the spirit. How do we stay resilient these days? Some really, really fascinating scientists and researchers and artists, and we are bringing them all together in this three-part series.

Wow. I love how you're reclaiming this. It's so cool. You're going to play a segment of one of the stories today. Give us a little tease. What is this episode about? Yes. Okay, so we are bringing you a segment with a neurointerventionist. What does that mean? Well, it is somebody who is developing brain computer interfaces or BCIs that is literally putting a computer, in this case a sensor in a stent in a person's brain. So, you know, we've heard Elon Musk saying like this is the future. Humans and computers will become one. Well, what does that even look like? This is the the guy actually doing it. And it doesn't, you know, at first you're like, well, this sounds like a

nightmare. It's actually, you know, this is a medical device at this point. And that's how a lot of technology starts, right? It is actually helping people who need the technology. It's when we start putting it out there for anyone to use that the problem starts. But we get into that as well in this segment. Okay. Before we hit play on this episode, I am most intrigued. You've been reporting on technology for a long, long time. How do you feel about this series coming out? What does it mean to you? Oh, gosh, you know, I'm always torn.

I'm on the seesaw, right? On the one hand, I love technology. It makes me, I'm intrigued by it. I love how it helps me in my life. I'm able to be in so many different places all at once. It's incredible. On the other hand, I know that we are not interdisciplinary enough about the rollout of this technology and thinking through the ethical and societal implications.

And so, you know, I think that's become more and more our job, Emily, is to sort of explain how this stuff works so that we regular people ask the right questions before it just becomes the norm because the techies want it to be. And I think, Tom, this neurologist you're about to hear, is very thoughtful about this as well. All right. So today on the show, the power of the mind, Manouche takes us on a futuristic tour of brains enhanced by implanted. computers. And if that makes you nervous, don't be nervous. Manusia's going to help you navigate all of it. Yes, definitely. 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? A brain computer interface is a device that goes into your brain, and it can listen to activity in certain parts of the brain.

This is physician Tom Oxley. He specializes in vascular neurosurgery. And I'm the founding CEO of Synchron, a brain computer interface company. In 2020, Tom's company started testing their device in people, including a man named Philip Oki. Philip was the second participant in our first in human study of our implantable brain computer interface. And Philip has ALS or motor neuron 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. 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. Yeah, so you're able to directly manipulate. 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. Philip 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. The first tweet said, hello world. That was what it meant to him. 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. Philip 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. Here's Tom Oxley on the TED stage.

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 pave 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. 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 devices fully internalized, invisible to the outside world, and they learn to control the keyboard with clicks directly coming from their brain.

Now, BCI's 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. 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? The first report of a human implant was in 2006 by Leaseau. Hockberg 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. It 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 realize that this is a field in medicine, which is sort of behind the other areas of medicine and an ability to treat conditions. And it struck me that the ability to directly interface with the brain was going to change that. Because up until then, scientists had to go directly, like, drill a hole and put a device in people's brain. Is that what the challenge was? 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. The brain does not like to be invaded. 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 senses into the blood vessels going to the brain. 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's 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, incorporated into the wall like a tattoo under the skin, and we're protected from that immune reaction. We called this the stentroid. 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? Yeah. It's extraordinary.

Can you take me through that process? The procedure involves putting a catheter into the jugular vein in the neck, then slipped up inside the skull through a little pre-existing 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 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. Okay, 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? 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. When we come back, would you want to be able to tweet directly from your mind? The possible future of brain computer interfaces. As we were hearing, neurointerventionist Tom Oxley has been testing his company's device,

the stentroid 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? 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? 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 hundred 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. 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, you're coming. You're It's 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 start? Because we've seen it start way too late with so many other technologies in the past. 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 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.

a world that would start to do this. The corollary I think about is LASIC surgery. LASIC 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. 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. 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? 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. 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. That's Dr. Tom Oxley. He's a neuro-interventionist and the founder and CEO of Synchron. You can see Tom's full talk at TED. Thank you so much for listening to this segment from our mind episode. The entire show is fascinating. And so are the other two episodes in this three-part series. So please join me and NPR's TED Radio Hour for our mind, body, spirit, special series wherever you get your podcasts.