There Are Two Sides to the Brain Implant Story

As Neuralink recently showed, the medical case for brain-machine interfaces is clear. Experts are divided on the next step: upgrading otherwise healthy humans.

March 27, 2024 6:26 am
A human brain depicted with a computer chip and circuits coming out of it. We look at the state of brain-machine interfaces with the advances from Elon Musk's Neuralink and other companies.
"[There] are ethical issues it would be wise for society to get ahead of before they become more pressing," says Andrew Jackson, professor at the University of Newcastle.

It is, some say, the stuff of X-Men — the road to man-machines. In January, Neuralink, Elon Musk’s brain-computer interface company, implanted a device in a quadriplegic man in the region of his brain that controls the intention to move. Now, according to videos posted on Friday, he can control a computer cursor and even play video games like Mario Kart using just his thoughts. Some were aghast at Neuralink’s audacity in already beginning human trials; meanwhile, Musk appears to be looking towards the future: How long before brain implants are routine in the treatment of schizophrenia, depression, autism or — the company’s first stated aim — paralysis? 

These adventures in gray matter are not exactly new. The fact is that electrodes have been installed in brains since the 1990s, and able to operate in either direction too, sending useful data to a computer or receiving electrical stimulation to help manage diseases like Parkinson’s. More invasive and advanced implants have been developed in recent years as well. The first implant to work wirelessly was tested on rhesus monkeys in 2016 and found to restore movement in the legs. 

Similar technology has been found to work in people too: BrainGate — a system of pill-sized electrodes, one in the brain’s motor cortex communicating with another somewhere else in the body — was able to restore the movement to the arms and hands of a man who was paralyzed in a bicycle crash eight years prior. Last year, a different brain-spine interface was employed to bypass a spinal cord injury in one subject. The system is not as compact as might be hoped for — there is a lot of wiring, and a headset, for example — but the recipient, incredibly, regained control over his legs.

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Yet, as impressive as these early proofs of concept are, they all have one thing in common: they’re about fixing what is already broken. They are, in short, a long way from the science fiction — or science-fiction dystopia, depending on your perspective — of an implant offering abilities beyond normal brain function. Tracy Laabs, chief development officer at the Wyss Center for Bio and Neuroengineering in Geneva, Switzerland, reckons it’s likely to be a long time before the latter becomes a reality. 

“The idea of using brain implants clinically is well-established — just think of cochlear implants or deep brain stimulation — and there are a number of clinical trials now to expand the use of that to the treatment of diseases more complex than motor diseases,” explains Laabs. “Of course, many people have an interest in making their brain function somehow ‘better’ too. But [the fact is that] we don’t understand the brain virtually at all, and I say that as someone with a neuroscience Ph.D.” 

She points out that the human brain remains by far the most complex thing humanity has ever come across. Consequently, some plug-and-play adaptation — an engineering solution to a scientific challenge — will likely only follow when that complexity isn’t, as it is now, largely opaque to us.

I don’t see why eventually we shouldn’t ultimately enhance our brain function. After all, it’s just physics, not magic.

Christof Koch, meritorious investigator at the Allen InstitutE

It’s precisely that complexity which means that should the installation of what are called BMIs — brain-machine interfaces — become routine, it will likely be through the kind of physical implants that can be carefully targeted in their positioning. 

Christof Koch, meritorious investigator at the Allen Institute for Brain Science in Seattle, stresses that there are millions of neurons interacting in unfathomable ways in a piece of brain matter the size of a grain of rice, yet the necessary trick will be to speak “to that neuron there, do nothing for those there, while suppressing those there,” as he puts it. “The patient smiles or moves [thus triggering other neuronal activity] and it all goes wrong.” This is why, so far, attempts to use brain implants to, say, control a wheelchair have so far failed outside of lab conditions. 

“I love science fiction as much as the next guy, but there’s a lot to learn,” he adds. “I imagine that advancement in our understanding of the brain, and of invasive brain technology, will develop in tandem. I don’t see why eventually we shouldn’t ultimately enhance our brain function. After all, it’s just physics, not magic.”

Not everyone is so sure. If the brain were capable of enhancements that have been proposed by certain implants, there is an argument that evolution would already have allowed for these. But even if they are possible, whether the technology to provide them should be developed is a bigger question.

For one, would there be demand? Practically speaking, there is a certain “yuck factor,” as Andrew Jackson, professor of neural interfaces at the University of Newcastle, puts it. His work has focused on the development of tiny implants to restore injured nervous systems and, in a world first, to actually head off, rather than respond to, epileptic seizures. 

“The question is what kind of risk profile would be needed for someone to consider it,” Jackson says. “If [the procedure] is like getting a tattoo or maybe cosmetic surgery, then perhaps people will see some consumer application in having a [brain] implant.”

There may, in time, be a way around the yuck factor. Pharmacological methods might be preferable — not least because fragile brain matter doesn’t get along well with bits of metal and wiring, eventually forming a barrier of scar tissue around the implant. But delivering chemical enhancements accurately and without side effects might be even more complex. 

That’s why the race to develop injectable implants is already on. Stentrode, the world’s first endovascular electrode array — meaning it enters the brain through a blood vessel in the neck — has been developed by Synchron, a company seed-funded by the U.S. Defense Advanced Research Projects Agency. More recently, a team at Linköping University in Sweden has been working on a gel that, once injected, solidifies into an electrically-conductive polymer as soft as the brain around it. It appears to work in zebrafish.

But risk is not the only issue here. What will these applications allow people to do? Controlling computers with our minds may be a huge benefit to someone who has been paralyzed. As Anil Seth, professor of cognitive and computational neuroscience at the University of Sussex, and author of Being You: A New Science of Consciousness, underscores, the medical case for BMIs seems both clear and exciting, even if it already starts to blur the line between repair and improvement. Where, he asks, is the line between a BMI implanted to help with depression and one implanted to provide a sunnier disposition? But just how much is the man on the street likely to want some added functionality if it means having something he doesn’t otherwise need to have: a hole drilled into his head.

There is the idea that BMIs could bring increased brain efficiency or productivity — that is, it will make you better employees. But what I haven’t seen is the idea of an application that could enhance ‘the good life’ in some way.

Andrew Jackson, professor at the University of Newcastle

There may yet be some kind of utility offered — one that trumps what evolution has already provided — to persuade many of the need for such a dangerous operation. But both Seth and Jackson are not convinced that the applications people talk about now for BMIs will be the breakthrough ones. As Seth puts it, he already has supremely effective brain-machine interface devices, and they’re called his hands and his mouth. It will take a lot to beat those.  

“Being able to turn your Tesla on by thinking about it is not a big enough sell to me,” Jackson laughs. “But the original applications of plenty of tech didn’t seem that inspiring to start with, either. It took other creatives, outside of science and engineering, to see something very different in its potential. There is the idea that BMIs could bring increased brain efficiency or productivity — that is, it will make you better employees. But what I haven’t seen is the idea of an application that could enhance ‘the good life’ in some way. The latest BrainGate trials are seeing BMIs allow almost real-time speaking through a voice synthesizer. What if a BMI could allow the creation of music just by thinking about it? That I would be interested in.”

It may pay to read the small print of your user agreement first, though. As Laabs points out, the prospect of making technology a more or less permanent part of our physical beings — taking us, in effect, along the path to cyborgism — is rife with practical considerations. How long should our implants be expected to last before they will need replacing? If they can be updated, should that update require permission? Even though it will be part of you, will the manufacturer continue to own the implant? Could it be hacked? Who would own the data generated? And if BMIs can receive as well as transmit, what kind of firewall are you going to need?

Seth adds that there’s potential to open yourself to algorithmic bias too, a problem that’s increasingly evident in the development of artificial intelligence. If BMIs are trained on data from just a small subset of society — “the more technologically-aware, more elite end of society” — then making them function as they’re intended to might require thinking like that subset too. “This is quite a far-out scenario,” he concedes, “but we’ve had to learn to use smartphones, for example, and that has made us function in certain ways. BMIs could lead to a kind of mental monoculture.”

Never mind the method behind BMIs — is there still some madness to it, regardless of technical feasibility? It’s a philosophical question. For all the sci-fi fans out there, Philip Goff, professor of philosophy at Durham University and author of Why? The Purpose of the Universe, proposes the possibility of what he calls “zombification, the idea that [BMIs put us on] a slippery slope towards ever more ‘mechanized’ brains that slowly remove our consciousness.” Our brains may then be functionally superior to natural brains, he says, “but we’d have no inner experience.”

Certainly, says Anil Seth, this is clearly an ethical issue too, even if the ethics are not clear. The likes of Musk may see humanity’s full embrace of any technological advantage as necessary for its survival, but the consequences of making those who could afford the implants smarter than those without — effectively creating an artificially high-functioning technocracy — could prove disastrous for a society already woefully unequal, in terms of wealth, opportunity, physical prowess and so on. As we’re already seeing, even those without smartphones, let alone brain-boosting chips in their head, are at a distinct disadvantage in society in 2024.

“This does trouble me, and yet we use all sorts of [technological and pharmacological] enhancements already. I wear contact lenses and consider a smartphone to be in some way an extension of my memory. We have a cognitive overclass already — some people pay to get a better education than others,” he says; likewise some of us use caffeine and other drugs to pep ourselves up, or steroids to beef ourselves up. “But this situation has to be handled very carefully. It’s hard to point at precisely where, but there is some significant line that feels like it’s being crossed in going from [matters] outside of the brain to inside it.”

Andrew Jackson stresses that “what we do [with BMIs] now is relatively simple, a matter of recognizing patterns in brain activity and how they relate to certain actions. We’ve only just scratched the surface [of brain interfacing].” Yet the potential for BMIs to bring what he calls “neuro-exceptionalism” is there, and that may eventually require some charter of neuro rights “to add to those ethical issues that other tech is already bringing up,” like data privacy and undue influence. “These are ethical issues it would be wise for society to get ahead of before they become more pressing,” he urges.

That’s Ian Pearson’s concern. As the man behind Futurizon, a leading futurology institute, he’s paid by big business to predict the future of technology. He reckons, perhaps optimistically, that some form of truly revolutionary consumer BMI — he suggests one that might perhaps work via a synthetic DNA that would give us not only control of our bodies at the cellular level but a telepathic connectivity with everyone else — will be available by the 2060s.

“That’s both utopian in some ways (imagine how it might bring us together), but dystopian in others (thought crime could quite literally become something the state monitors). It would be like living in a mental prison,” he says, cheerfully.

Which way does he predict BMIs will go? “Well, I look at the way humanity runs things now and lean towards the more dystopian. Besides, that’s the more fun side to talk about.”

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