Dr. Matthew MacDougall: Neuralink & Technologies to Enhance Human Brains

29:00You know, there's hope that eventually there's a use here that makes sense for a brain interface to bring AI as a tool embedded in the brain that human can use to augment their capabilities. I think that's pretty far down the road for us. But definitely on a desired roadmap. In the near term, we really are focused on people with terrible medical problems that have no options right now. With regard to motor control, you know, our mutual friend recently departed, Krishna Chenoy was a giant in this field of motor prosthesis. It just so happens that his work was foundational for a lot of people that work in this area, including us.

29:50And he was an advisor to Nuralink. That work was farther along than most other work for addressing any function that lives on the surface of the brain. The physical constraints of our approach require us currently to focus on only surface features on the brain. So we can't say go to the really very compelling surface deep depth functions that happen in the brain like, you know, mood, appetite, addiction, pain, sleep. We'd love to get to that place eventually, but in the immediate future, our first indication or two or three will probably be brain surface functions like motor control. I'd like to take a quick break and acknowledge one of our sponsors, Athletic Greens.

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31:51So for those listening, the outer portions of the brain are filled with or consist of rather neocortex. So the the bumpy stuff that looks like sea coral, some forms of sea coral look like brains or brains look like them. And then underneath reside a lot of the brain structures that control what Matt just referred to, things to control mood hormone output, how awake or asleep the brain is. And would you agree that those deeper regions of the brain have in some ways more predictable functions. I mean that lesions there or stimulation there lead to more predictable outcomes in terms of deficits or improvements in function.

32:35Yeah, in some way, yes, I mean the deeper parts of the brain tend to be more stereotyped as in more similar between species than the the outer surface of the brain. They're kind of the firmware or the housekeeping functions to some degree body temperature, blood pressure, sex motivation, hunger, things that you don't really need to vary dramatically between a fox and a human being. Whereas the the outer more reasoning functions of problem solving functions between a fox and a human are vastly different. And so the physical requirements of those brain outputs are different. I think I heard you long described as the human brain is essentially a monkey brain with a supercomputer placed on the outside, which sparks some interesting ideas about what neocortex is doing.

33:28We have all this brain real estate on top of all that more stereotype function type stuff in the deeper brain. And it's still unclear what neocortex is doing in the case of frontal cortex. As you mentioned earlier, it's clear that it's providing some shh, quieting of impulses, some context setting, rule setting, context switching. All of that makes good sense. But then there are a lot of cortical areas that sure are involved in vision or touch or hearing. But then there's also a lot of real estate that just feels unexplored. So I'm curious whether or not in your clinical work or work with neural link or both, whether or not you have ever encountered neurons that do something that's really peculiar and intriguing.

34:18And here I'm referring to examples that could be anywhere in the brain. Like where you go, wow, like these neurons when I stimulate them or when they're taken away leads to something kind of bizarre but interesting. Yeah, yeah. There's the one that comes immediately to mind is unfortunately in a terrible case in kids that have a tumor in the hypothalamus that lead to what we call jelastic seizures, which is sort of a uncontrollable fit of laughter. There's been cases in the literature where this laughter is so uncontrollable and so pervasive that people suffocate from failing to breathe where they laugh until they pass out.

35:03And so you don't normally think of a deep structure in the brain like the hypothalamus as being involved in a function like humor. And certainly when we think about this kind of laughter in these kids with tumors, it's a worthless laughter is the kind of textbook phrase humorless laughter. It's just a reflexive, almost zombie -like behavior. And it comes from a very small population of neurons deep in the brain. This is one of the other sort of strange loss of functions you might say is, you know, it's nice that you and I can sit here and not have constant disruptive fits of laughter coming out of our bodies.

35:57But that's a neuronal function that's, you know, thank goodness, due to neurons properly wired and properly functioning and any neurons that do anything like this can be broken. And so we see this in horrifying cases like that from time to time. So I'm starting to sense that there are two broad bins of approaches to augmenting the brain either to treat disease or for sake of increasing memory, creating super brains, etc. One category you alluded to earlier, which is pharmacology. And you specifically mentioned that the tremendous power that pharmacology holds. Whether or not through psychedelics are through prescription drug or, you know, some other compound.

36:43The other approach are these little micro electrodes that are extremely strategically placed into multiple regions in order to play essentially a concert of electricity that is exactly right to get a quadriplegic moving. That sparks two questions. First of all, is there a role for and is neural link interested in combining pharmacology with stimulation? So not immediately right now we're solely focused on the extremely hard. Some might say the hardest problem facing humans right now of decoding the brain through electrical stimulation and recording. That's enough for us for now. So to just give us a bit fuller picture of this, we're talking about a patient who can't move their limbs because they have spinal cord damage.

37:35The motor cortex that controls movement is in theory fine. Make a small hole in the skull and through that whole robot is going to place electrodes. Obviously motor cortex, but then where how is the idea that you're going to play a concert from different locations? You're going to hit all the keys on the piano in different combinations and then figure out what can move the limbs. What I'm alluding to here is I still don't understand how the signals are going to get out of motor cortex past the lesion and into and out to the limbs because the lesion hasn't been dealt with at all in this scenario.

38:08So just to clarify there, I should emphasize we're not in the immediate future talking about reconnecting the brain to the patient's own limbs. That's on the road map, but it's way down the road map a few years. What we're talking about in the immediate future is having the person be able to control electronic devices around them with their motor intentions alone. So prosthetic hand in arm or just mouse and keys on a mouse and keys on a keyboard for starters. So you wouldn't see anything in the world move. As they have an intention, the patient might imagine say flexing their fist or moving their wrist and what would happen on the screen is the mouse would move down and left and click on an icon and bring up their word processor and then a keyboard at the bottom of the screen would allow them to select letters in sequence.

39:01So they could type, this is the easy place to start easy and quotes. I would say because the transformation of electrical signals from motor cortex through the brainstem and to the spinal cord and out to the muscles is somewhat known through a hundred years or more of incredible laboratory research. But the transformation meaning how to take the electrical signals out of motor cortex and put it into a mouse or a robot arm, that's not a trivial problem. That's a whole other set of problems in fact. We're unloading some of that difficulty from the brain itself, from the brain of the patient and putting some of that into software.

39:46So we're using smarter algorithms to decode the motor intentions out of the brain. We have been able to do this in monkeys really well. So we have a small army of monkeys playing video games for smoothie rewards. And they do really well. We actually have the world record of bit rate of information coming out of a monkey's brain to intelligently control a cursor on a screen. We're doing that better than anyone else. And again, thanks in no small part due to Krishna Shanoi and his lab and the people that have worked for him that have been helping Narlink. But what you can't do with that monkey is ask him what he's thinking.

40:33You can't ask him. You can ask him but you won't get a very interesting answer. You can't tell him to try something different. You can't tell him to try their shoulder on this. Try the other hand and see if there's some cross body neuronal firing that gives you a useful signal. Once we get the people, we expect to see what they've seen when they've done similar work in academic labs, which is the human can work with you to vastly accelerate this process and get much more interesting results. So one of the things out of Stanford recently is there was a lab with Krishna and Jamie Henderson and other people decode speech out of the hand movement area in the brain.

41:20So what we know is that there are, you know, multitudes of useful signals in each area of the brain that we've looked at so far. They just tend to be highly expressed for say hand movement in the hand area, but that doesn't mean only hand movement in the hand area. So here's the confidence test. There's a long history dating back really prior to the 1950s of scientists doing experiments on themselves. Not because they are reckless, but because they want the exact sorts of information that you're talking about. The ability to really understand how intention and awareness of goals can shape outcomes in biology.

42:05If that is vague to people listening, what I mean here is that for many, probably hundreds of years, if not longer, scientists have taken the drugs they've studied or stimulated their own brain or done things to really try and get a sense of what the animals they work on or the patients they work on might be experiencing. Psychiatrists are sort of famous for this, by the way. I'm not pointing fingers at anybody, but psychiatrists are known to try the drugs that they administer. And some people would probably imagine that's a good thing just so that the clinicians could have empathy for the sorts of side effects and not so great effects of some of these drugs that they administer to patients.

42:42But the confidence test I present you is, would you be willing or are you willing, if allowed, to have these electrodes implanted into your motor cortex? You're not a quadriplegic. You can move your limbs. But given the state of the technology at NeuralLink now, would you do that? Or maybe in the next couple of years, if you were allowed, would you be willing to do that? And be the person to say, hey, turn up the stimulation over there. I feel like I want to reach for the cup with that robotic arm, but I'm feeling some resistance. Because it's exactly that kind of experiment done on a person who can move their limbs and who deeply understands the technology and the goals of the experiment that I would argue actually stands to advance the technology fastest.

43:34As opposed to putting the electrodes first into somebody who is impaired at a number of levels and then trying to think about why things aren't working. And again, this is all with the goal of reversing paralysis in mind. But would you implant yourself with these micro electrodes? Yeah, absolutely. I would be excited to do that. I think for the first iteration of the device, it probably wouldn't be very meaningful. It wouldn't be very useful because I can still move my limbs. And our first outputs from this are things that I can do just as easily with my hands, right? Moving them out, typing in a keyboard.

44:12We are necessarily making this device as a medical device for starters for people with bad medical problems and no good options. It wouldn't really make sense for an able -bodied person to get one in the near term. As the technology develops and we make devices specifically designed to perform functions that can't be done even by an able -bodied person, say eventually refine the technique to get to the point where you can type faster with your mind and one of these devices. And then you can, with text to speech, or speech to text and your fingers, that's a use case that makes sense for someone like me to get it.

44:59It doesn't really make sense for me to get one when it allows me to use a mouse slightly worse than I can with my hand currently. That said, the safety of the device I would absolutely vouch for from the hundreds of surgeries that I've personally done with this. I think it's much safer than many of the industry standard FDA approved surgeries that I routinely do on patients that are no one even thinks twice about their standard of care. Nurellink has already reached in my mind a safety threshold that is far beyond a commonly accepted safety threshold. Along the lines of augmenting one's biological function or functions in the world, I think now's the appropriate time to talk about the small lump present in the top of your hand.

45:54And for those listening, not watching, there's a, it looks like a small lump between Dr. McDougall's four finger and thumb or your next finger and thumb placed on skin on the top of his hand. You've had this for some years now because we've known each other for gosh, probably seven years now or so. And you've always had it in the time that I've known you, what is that lump? And why did you put it in there? Yeah, so it's a small, rightable RFID tag. What's an RFID? What does RFID stand for? Yeah, radio frequency identification. And so it's just a very small implantable chip that wireless devices can temporarily power if you approach an antenna.

46:42They can power and send a small amount of data back and forth. So most phones have the capability of reading and writing to this chip. For years, it, it let me into my house, it unlocked the deadbolt on my front door. For some years, it unlocked the doors at NERLINK and let me through, you know, the various locked doors inside the building. It is rightable. I can write a small amount of data to it. And so for some, some years in early, the early days of crypto, I had a crypto private key written on it to store a cryptocurrency that I thought was, you know, a dead offshoot of one of the main crypto currencies after it had forked.

47:29And so I put the private wallet key on there and forgot about it and remembered a few years later that it was there and went and checked and it was worth, you know, a few thousand dollars more than when I left it on there. So that was a nice finding change in the sofa in the 21st century. And then when you say you read it, you're essentially taking a phone or other device and scanning it over the RFID lump in your hand, so to speak. And then it can read the data from there, essentially. What other sorts of things could one put into these RFIDs in theory and how long can they stay in there before you need to take them out and recharge them or replace them?

48:07Well, these are passive. They're coded in biocompatible glass. And as an extra, I'm a rock climber and so I was worried about that glass shattering during rock climbing. I additionally coded them in another ring of silicone before implanting that. So it's pretty safe. They're passive. There's no battery. There's no active electronics in them. So they could last the rest of my life. I don't think I'd ever have to remove it for any reason. You know, at some point, the technology is always improving. So I might remove it and upgrade it. That's not inconceivable already. There's, you know, 10x more storage versions available that could be a drop in replacement for this if I ever remove it.

48:51But, you know, it has a small niche use case and it's an interesting proof of concept tip towing towards the concept that you mentioned of, you know, you have to be willing to go through the things that you're suggesting to your patients in order to, you know, say with a straight face that you think this is a reasonable thing to do. So a small subcukain is implant in the hand. It's a little different than a brain implant. Yeah, what's involved in getting that RFID chip into the hand? Is it, I'm assuming it's an outpatient procedure, presumably you did it on yourself. Yeah, yeah. This was a kitchen table kind of procedure.

49:30Any anesthetic or no. You know, I've seen people do this with a lidocaine injection. I, for my money, I think a lidocaine injection is probably as painful as just doing the procedures. A little cut in that thin skin on the top of the hand. Right. Some people are cringing right now. Other people are saying, I want one because you'll never worry about losing your keys. Yeah. Well, passwords. I actually would like it for passwords because I'm dreadfully bad at remembering passwords. I have to put them in places all over the place. And then it's like, I'm like that kid in that. Remember that movie Stan Bimy where the kid hides the pennies under the porch and then uses the map.

50:06Yeah, spends all summer trying to find them. So I can relate. Yeah, so a little, it was just a little slit and then put in there. No local immune response, no, no post no swelling. All the materials are completely bio compatible there on the surface exposed to the body. So no, no bad reaction and healed up, you know, in days and it was fine. Very cool. Since we're on video here, maybe can you just maybe raise it and show us. Yeah, so, so were you not to point out that little lump, I would have known to ask about it. Right. And any other members of your family have had these a few years after having this and seeing the convenience of me being able to open the door without keys.

50:48My wife insisted that I put one in her as well. So she's walking around with one fantastic. We consider them are sort of our version of wedding rings. Well, certainly more permanent than wedding rings in in some sense. I can't help but ask this question, even though it might seem a little bit off topic, as long as we're talking about implantable devices and Bluetooth and RFID chips in the body, I could ask a lot about the safety or lack thereof. Of a Bluetooth headphones. You work on the brain, you're a brain surgeon. That's valuable real estate in there. And you understand about electromagnetic fields and any discussion about EMS immediately puts us in the category of like get their 10 foil hats.

51:32And yet I've been researching EMS for a future episode of the podcast. And EMS are a real thing. That's not a valuable statement. Everything's a real thing at some level, even an idea. But there does seem to be some evidence that electromagnetic fields of sufficient strength can alter the function of maybe the health of but the function of neural tissue given that neural tissue is electrically signaling among itself. So I'll just ask this in a very straightforward way. Do you use Bluetooth headphones or wired headphones? Yeah, Bluetooth. And you're not worried about any kind of EMS fields across the skull.

52:11No, I mean, I think the energy levels involved are so tiny that you know ionizing radiation aside, we're way out of the realm of ionizing radiation that people would worry about, you know, tumor causing EMS fields. Even just the electromagnetic field itself, as is very well described in a Bluetooth frequency range, the power levels are tiny in these devices. And so, you know, we are a wash in these signals, whether you use Bluetooth headphones or not. For that matter, you're getting bombarded with ionizing radiation in a very tiny amount, no matter where you live on earth unless you live under huge amounts of water.

52:58It's unavoidable. And so I think you just have to trust that your body has the DNA repair mechanisms that it needs to deal with the constant bath of ionizing radiation that you're in as a result of being in the universe and exposed to cosmic rays. In terms of electromagnetic fields, it's just, it's, you know, the energy levels are way, way out of the range where I would be worried about this. What about heat? You know, I don't use the earbuds any longer for a couple of reasons. Once as you know, I take a lot of supplements and I reach into my left pocket once and swallow a handful of supplements that included a Bluetooth, a AirPod pro.

53:44I knew it, I swallowed it at the moment after I gulped it down. By the way, folks, please don't do this. It was not a good idea. It wasn't an idea. It was a mistake. But I could see it on my phone as registering there. Never saw it again. So I'm assuming it's no longer in my body, but anyway, there's a bad joke there to be sure. But in any of that, I tend to lose them as places. So that's the main reason. But I did notice when I used them that there's some heat generated there. I also am not convinced that plugging your ears all day long is good. There's some ventilation through the, through the sinus systems that include the ears.

54:20So it sounds to me like you're not concerned about the use of earbuds. But what about heat near the brain? I mean, there's the cochlea, the auditory mechanisms that sit pretty close to the surface there. Heat and neural tissue are not friends. I'd much rather get my brain cold than hot in terms of keeping the cells healthy and alive. Should we be thinking about the heat effects of some of these devices or other things? Is there anything we're overlooking? Well, think about it this way. I use cars as an analogy a lot and mostly internal combustion engine cars. So these analogies are going to start to be foreign and useless for another generation of people that grow up in the era of electric cars.

55:07But using cars as a platform to talk about fluid cooling systems, your body has a massive distributed fluid cooling system similar to a car's radiator. You're pumping blood all around your body all the time at a very strictly controlled temperature. That blood carries a, it's mostly water. So it carries a huge amount of the heat away or cold away from any area of the body that's focused heating or focused cooling. So you could put an ice cube on your skin until it completely melts away and the blood is going to bring heat back to that area. You can put, you can stand in the sun under much more scary heating rays from the sun itself that contain UV radiation.

55:57That's definitely damaging your DNA. If you're looking for things to be afraid of, the sun is a good one. You're talking to the guy that tells everybody you get sunlight in their eyes every morning. But I don't want people to get burned or give themselves skin cancer. I encourage people to protect their skin accordingly. And different individuals require different levels of protection from the sun. Sure. Some people do very well in a lot of sunshine. Never get basil cell or anything like that. Some people, and it's not just people with very fair skin, a minimum of sun exposure can cause some issues.

56:29And here I'm talking about sun exposure to the skin. Of course, staring at the sun is a bad idea. I never recommend thinking about the sun just as a heater. For a moment, to compare with Bluetooth headphones, your body is very capable of carrying that heat away and dissipating it via a sweat evaporation or temperature equalization. So any heat that's locally generated in the year, one, there's a pretty large bony barrier there. But, too, there's a ton of blood flow in the scalp and in the head in general and definitely in the brain that's going to regulate that temperature. So I think certainly there can be a tiny temperature variation, but I doubt very seriously that it's enough to cause a significant problem.

57:14I'd like to go back to brain augmentation. You've made very clear that one of the first goals for neural link is to get quadriplegic's walking again. And again, what a marvelous goal that is. I certainly hope you guys succeed. Well, again, just to be very clear, the first step is we aren't reconnecting the patient's own muscle system to their motor cortex. Allowing them, excuse me, agency over the movement of things in the world. And eventually their body. And you're exactly right. Yeah, eventually their body. We would love to do that. And we've done a lot of work on developing a system for stimulating the spinal cord itself.

57:55And so that gets to the question that you asked a few minutes ago of how do you reconnect the motor cortex to the rest of the body. Well, if you can bypass the damaged area of the spinal cord and have an implant in the spinal cord itself connected to an implant in the brain and have them talking to each other, you can take the perfectly intact motor signals out of the motor cortex and send them to the spinal cord, which most of the wiring should be intact in the spinal cord below the level of, say, the injury caused by a car accident or motor cycle accident or gunshot wound or whatever. And it should be possible to reconnect the brain to the body in that way.

58:32So not out of the realm of possibility that, you know, in some small number of years that NERLINK will be able to reconnect somebody's own body to their brain. And here I just want to flag the 100 years or more of incredible work by basic scientists. The names that I learned about in my textbooks as a graduate student were like George Opholists. And that won't mean anything to anyone unless you're a neuroscientist, but George Opholists performed some of the first sophisticated recordings out of motor cortex, just simply asking like what sorts of electrical patterns are present in motor cortex as an animal or human moves a limb.

59:11Krishna Shanoi being another major pioneer in this area and many others. Right. And just really highlighting the fact that basic research where a exploration of neural tissue is carried out at the level of anatomy and physiology really sets the body. Down the pavement on the runway to do this sorts of big clinical expeditions that you all at neural ink are doing. Yeah, it can't be said enough that, you know, we broadly speaking in the industry sometimes are and sometimes stand on the shoulders of academic giants. They were the real pioneers that they were involved in the grind for years in an unglurious, unglamerous way.

59:53No stock option. No stock options. And you know, the reward for all the hard work is a paper at the end of the day that is read by, you know, dozens of people. And so, you know, they were selfless academic researchers that that made all this possible. And we all humanity and neural ink owe them a massive debt of gratitude for all the hard work that they've done and continue to do. I agree. Along lines of augmentation early on in some of the public discussions about neural ink that I overheard between Elon and various podcast hosts, etc. There were some lofty ideas set out that I think are still very much in play in people's minds.

1:00:38Things like, for instance, electrical stimulation of the hippocampus that you so appropriately have worn on your shirt today. So for those, yeah, beautiful. It looks like either it looks like a goal G or a call rendition of the hippocampus. Translates to see horse and it's an area of the brain that's involved in learning and memory and among other things. There was this idea thrown out that a chip or chips could be implanted in the hippocampus that would allow greater than normal memory abilities. Perhaps that's one idea. Another idea that I heard about in these discussions was, for instance, that you would have some chips in your brain and I would have some chips in my brain.

1:01:21And you and I could just sit here, look at looking at each other or not nodding or shaking our heads and essentially hear each other's thoughts, which sounds outrageous. But of course, why not? Why should we constrain ourselves as our good friend Eddie Chang, who was a neurosurgeon who was already on this podcast once before said, speech is just the shaping of breath as it exits our lungs. Incredible. Really, when you think about it. But we don't necessarily need speech to hear and understand each other's thoughts because the neural signals that produce that shaping of the lungs come from some intention.

1:01:56I have some idea, although I don't seem like it, about what I'm going to say next. So is that possible that we could sit here and just hear each other's thoughts and also how would we restrict what the other person could hear? Yeah, well, so absolutely. I mean, think about the fact that we could do this right now. If you pulled out your phone and started texting me on my phone and I looked down and started texting you, we would be communicating without looking at each other or talking, shifting that function from a phone to an implanted device. It requires no magic advance, no leap forward. It's technology we already know how to do.

1:02:38If we say put a device in that allows you to control a keyboard and a mouse, which is our stated intention for our first human clinical trial. Or I'm deliberately interrupting or I can text an entire team of people simultaneously and they can text me and in theory, I could have a bunch of thoughts and 5, 10, 50 people could hear. Or probably more to their preference, they could talk to me. Yeah, and so texting each other with our brains is maybe an uninspiring rendition of this, but it's not very difficult to imagine the implementation of the same device in a more verbally focused area of the brain that allows you to more naturally speak the thoughts that you're thinking and have me have them rendered into speech that I can hear.

1:03:29Or maybe via a bone conducting implant. So silently here. Or not silently. Let's say I was getting off the plane and I wanted to let somebody at home know that I had arrived. I might be able to think in my mind, think their first name, which might queue up a device that would then play my voice to them and say, just got off the plane. I'm going to grab my bag and then I'll give you a call on their home Alexa. So that's all possible, meaning we know the origin of the neural signals that gives rise to speech. We know the different mechanical and neural apparatus like the cochlea, eardrums, etc. That transduce sound waves into electrical signals.

1:04:16Essentially all the pieces are known. We're just really talking about refining it. Yeah, refining it and reconfiguring it. It's not an easy problem, but it's really an engineering problem rather than a neuroscience problem. For that use case, nonverbal communication, you might say. That's a solved problem in a very crude disjointed way. Some labs have solved part one of it. Some labs have solved part two of it. There are products out there that solve, say, the implanted bone conduction part of it for the deaf community. There are no implementations I'm aware of that are pulling all that together into one product.

1:05:01That's a streamlined package from end to end. I think that's a few years down the road. We have some hints of how easily or poorly people will adapt to these, let's call them novel transformations. A few years ago I was on Instagram and I saw a post from a woman, her name is Kasar Jacobsen, and she is deaf since birth and can sign and to some extent can read lips. She was discussing neocensory. This is a device that translates sound in the environment into touch sensations on her hand or wrist. She's a admirer of birds and all things avian. I reached out to her about this device because it was very curious because this is a very interesting use case of neuroplasticity in the sensory domain.

1:05:56She was a fascination of mine. She said that, indeed, it afforded her novel experiences. Now when walking past, say, pigeons in the park, if they were to make some, whatever sounds that pigeons make, that she would feel those sounds and that indeed it enriched her experience of those birds in ways that obviously it wouldn't otherwise. I haven't followed up with her recently to find out whether or not ongoing use of neocensory has made for a better, worse or kind of equivalent experience of avians in the world, which for her is a near obsession. So she delights in them. What are your thoughts about peripheral devices like that peripheral meaning outside of the skull, no requirement for a surgery?

1:06:50Do you think that there's a more immediate or even a just generally potent use case for peripheral devices? And do you think that those are going to be used more readily before the brain surgery requiring devices are used? Yeah, certainly the barrier to entry is lower, the barrier to adoption is low. If you're making a tactile glove, that's hard to say no to when you can slip it on and slip it off and not have to get your skin cut at all. Again, there's no perfect measure of the efficacy of a device, of one device compared to another, especially across modalities. But one way that you can start to compare apples to oranges is bit rate, useful information in or out of the brain as transformed into digital data.

1:07:46And so you can put a single number on that and you have to ask when you look at a device like that is, what is the bit rate in? What is the bit rate out? How much information are you able to usefully convey into the system and get out of the system into the body into the brain? And I think there's what we've seen in the early stabs at this is that there's a very low threshold for bit rate on some of the devices that are trying to avoid direct brain surgery. Could you perhaps say what you just said, but in a way that maybe people who aren't as familiar with thinking about bit rates might be able to digest.

1:08:29I'm referring to myself. I understand bit rate, understand that adding a new channel of information is just that adding information. Are you saying it's important to understand whether or not that new information provides for novel function or experience and to what extent is the newness of that valid and adaptive? Well, I'm saying more, it's hard to measure utility in this space. It's hard to put a single metric, single number on how useful a technology is. One crude way to try to get at that is bit rate. Think of it as back in the days of dial up modems. The bit rate of your modem was 56K or 96.

1:09:17I guess you'll hear the sound of the dial up in the background. That was a bit rate that thankfully kept steadily going up and up and up. Your internet service provider gives you a number that is the maximum usable data that you can transmit back and forth from the internet. That's a useful way to think about these assistive devices. How much information are you able to get into the brain and out of the brain, usefully? Right now that number is very small, even compared to the old modems. But you have to ask yourself when you're looking at a technology, what's the ceiling? What's the theoretical maximum?

1:09:54For a lot of these technologies, the theoretical maximum is very low, disappointingly low. Even if it's perfectly executed and perfectly developed as a technology. I think the thing that attracts a lot of us to a technology like NERLINK is that the ceiling is incredibly high. There's no obvious reason that you can't interface with millions of neurons as this technology is refined and developed further. That's the kind of high bandwidth brain interface that you want to develop if you're talking about a semantic prosthetic and AI assistant to your cognitive abilities. The more sci -fi things that we think about in the coming decades.

1:10:43It's an important caveat when you're evaluating these technologies. Do you really want it to be something that you can expand off into the sci -fi? Let's take this a step further. As you're saying this, I'm realizing that people have been doing exactly what NERLINK is trying to do now for a very long time. Let me give you an example. People who are blind who have no pattern vision have used canes for a very long time. Now the cane is not a chip, it's not an electrode, it's not neocensory, none of that stuff. What it is is essentially a stick that has an interface with a surface, so it's swept back and forth across the ground.

1:11:34It translates what would otherwise be visual cues into sematicensory cues. We know that blind people are very good at understanding even when they are approaching, say, a curb edge. Because they are integrating that information from the tip of the cane up through their sematicensory cortex and their motor cortex with other things like the changes in the wind and the sound as they round a corner. You're imagining a corner in San Francisco downtown where you get to the corner, it's a completely different set of auditory cues. Very often we know, and this is because my laboratory worked on visual repair for a long time, I talked to a lot of blind people who use different devices to navigate the world.

1:12:18They aren't aware of the fact that they're integrating these other cues, but they nonetheless do them subconsciously. And in doing so, get pretty good at navigating with a cane. Now, a cane isn't perfect, but you can imagine the other form of navigating as a blind person, which is to just attach yourself or attach to you another nervous system, the best that we know being a dog, a sighted dog that can cue you again with stopping at a curb's edge or even if there are some individuals that might seem a little sketchy. The dogs are also very good at sensing different arousal states and others threat danger.

1:13:00I mean, they're exquisite at it, right? So here what we're really talking about is taking a cane or another biological system, essentially a whole nervous system and saying this other nervous system's job is to get you to navigate more safely through the world. In some sense, what neural link is trying to do is that, but with robotics to insert them and chips, which raises the question, people are going to say, finally, a question. The question is this, we hear about BMI, brain machine interface, which is really what neural link specializes in. We also hear about AI, another example where there's great promise and great fear.

1:13:36We hear about machine learning as well. To what extent can these brain machine interfaces learn the same way a seeing eye dog would learn, but unlike a seeing eye dog, continue to learn over time and get better and better and better because it's also listening to the nervous system that it's trying to support. Put simply what is the role for AI and machine learning in the type of work that you're doing? That's a great question. I think it goes both ways. Basically what you're doing is taking a very crude software intelligence. I would say not exactly a full blown AI, but some well designed software that can adapt to changes in firing of the brain and you're coupling it with another form of intelligence, a human intelligence.

1:14:25You're allowing the two to learn each other. Undoubtedly the human that has a neural link device will get better at using it over time. Undoubtedly the software that the neural link engineers have written will adapt to the firing patterns that the device is able to record. And over time focus in on meaningful signals toward movement. Right. So if a neuron is fire high firing rate when you intend to move the mouse cursor up and to the right. It doesn't know that when it starts when you first put this in it's just a random series of signals as far as the chip knows, but you start correlating it with what the person what you know the person wants to do as expressed in a series of games.

1:15:15So you assume that you know that the person wants to move the mouse on the screen to the target that's shown because you tell them that's the goal. And so you start correlating the activity that you record when they're moving toward an up and right target on a screen with that firing pattern. And similarly for up and left down and left down right. And so you develop a model semi intelligently in the software for what the person is intending to do and let the person run wild with it for a while and they start to get better at using the model presented to them by the by the software as expressed by the mouse moving or not moving properly on the screen.

1:15:58Right. So it's imagine a scenario where you're asking somebody to play piano, but the the sound that comes out of each key randomly shifts over time. Very difficult problem, but a human brain is good enough with the aid of software to solve that problem and map well enough to a semi -sable state that they're going to know how to use that mouse even when they say turn the device off for the night come back to it the next day. And some of the signals have shifted. So you're describing this. I'm recalling a recent experience. I got one of these rowers to exercise. And I am well aware that there's a proper roast stroke and there's an improper roast rock.

1:16:44And most everybody, including me, who's never been coached and rowing gets on this thing and pushes with their legs and pulls with their arms and back and it's some mix of incorrect and maybe a smidgen of correct type execution. There's a function within the rower that allows you, in this case, me to play a game where you can actually every roast stroke you generate arrows toward a dart board. And it knows whether or not you're generating the appropriate forces at the given segment of the row, the initial pull when you're leaning back, etc. And adjust the trajectory of the arrows so that when you do a proper roast stroke, it gets closer to a bullseye.

1:17:22And it's very satisfying because you now have a visual feedback that's unrelated to this, the kinds of instructions that one would expect like, oh, you know, hinge your hip a bit more or you know, splay your knees a bit more reach more with your arms or pull first with your back all the rowers are probably cringing as I say this because they're realizing the what is exactly the point, which is I don't know how to row, but over time, simply by paying attention to whether or not the arrow is hitting the bullseye or not. More or less frequently, you can improve your roast stroke and get as I understand, pretty close to optimal roast stroke.

1:17:56In the same way that if you had a coach there telling you, hey, do this and do that. What we're really talking about here is neuro biofeedback. Sure. So is that analogy similar to what you're describing? Yeah, that's a great analogy. You know, humans are really good at learning how to play games in software. So video games are an awesome platform for us to use as a training environment for people to get better at controlling these things. In fact, it's the default and the obvious way to do it is to have people and monkeys play video games. Yeah, sure. Which video games? Let's see, I, you know, play old ones.

1:18:34I'm a little nostalgic. So I like the old Blizzard games, Starcraft and Warcraft. I don't even know those. I remember the first Apple computers. I mean, I hold you 43. Okay, 44 now as of a few days ago. I have a birthday. So we're a little bit offset there. Yeah, I can recall Mike Tyson's punch out like the original Nintendo games Super Mario Brothers. It's hard game. But the game so that games you're describing, I don't recall that my understanding is that the newer games are far more sophisticated. In some respects, I did recently find time to play Cyberpunk, which was really satisfying and maybe appropriate.

1:19:14It's a game where the characters are all fully modded out with cybernetic implants. Well, perfect. But, you know, the root of the game is run around and shoot things. So maybe not so different from, you know, Duck Hunt or whatever from our childhoods. Reason to ask about video games is there's been some controversy as to whether or not they are making young brains better or worse. And I think some of the work from Adam Gazelle's lab at UCSF and other laboratories have shown that actually provided that children in particular and adults are also spending time in normal face to face. Let's call them more traditional face to face interactions that video games can actually make nervous systems.

1:19:54That is people a much more proficient at learning and motor execution. Visual detection and on and on. Yeah, there's some work showing that surgeons are better if they play video games. So I try to squeeze some in as a, you know, professional development activity. Great. Great. Well, I'm sure you're getting cheers from those that like video games out there. And some of the parents who are trying to get their kids to play fewer video games are cringing. But that's okay. We'll let them settle their familial disputes among themselves. Let's talk about pigs. Neural link has been quite generous, I would say, in announcing their discoveries and their goals.

1:20:38And I want to highlight this because I think it's quite unusual for a company to do this. I'm probably going to earn a few enemies by saying this. Despite the fact that I've always owned Apple devices and from the South Bay, you know, the Apple design team is notoriously cryptic about what they're going to do next. Or when the next phone or computer is going to come out is is is vaulted to a serious extent. Neural link has been pretty open about their goals. Right. With the understanding that goals change and have to change. And one of the things that they've done, which I think is marvelous is they've held online symposia where you and some other colleagues of mine from the neuroscience committee Dan Adams, who have tremendous respect for.

1:21:22And Elon and others, they're at Neural link have shared some of the progress that they've made in experimental animals. I'm highlighting this because I think if one takes a step back, I mean, just for most people to know about and realize that there's experimentation on animals, implantation of electrodes and so on. Is itself a pretty bold move because that understandably evokes some strong emotions in people. And in some people evokes extremely strong emotions. Neural link did one such symposium where they showed implant devices in pigs. Right. Then they did another one. You guys did another one where it was implant devices in monkeys.

1:22:07Right. I assume at some point there will be one of these public symposia where the implant devices will be in a human. What was the rationale for using pigs? I'm told pigs are very nice creatures. Yeah. I'm told that they are quite smart. Right. And for all my years as a neuroscientist and having worked admittedly on every species from mice to cuddle fish to humans to hamsters to, you know, I confess. Various carnivore species, which I no longer do. I work on humans now for various reasons. I never in my life thought I would see a implant device in the cortex of a pig. Sure. Why work on pigs? Yeah.

1:22:55Well, let me, let me say first. Neural link is almost entirely composed of animal loving people. The people at Neural link are obsessive animal lovers. There are signs up all around the office, you know, spontaneously put up by people within the organization, you know, talking about how we want to save animals. We want to protect animals. If there was any possible way to help people, the way we want to help people without using animals in our research, we would do it. It's just not known how to do that right now. And so we are completely restricted to making advances to getting a device approval through the FDA by first showing that it's incredibly safe in animals.

1:23:42And so as is the case for any medical advancement, essentially. I do want to highlight this that the FDA and the other governing bodies oversee these types of experiments and ensure that they're done with a minimum of discomfort to the animals, of course. But I think there's an inherent species in most humans. Not all. Some people truly see equivalents between a lizard and a human, lizard life being equivalent to human life. Most human beings, I think, in particular human beings, who themselves or have loved ones that are suffering from diseases that they hope could be cured at some point, view themselves as species.

1:24:23And feel that if you have to work on a biological system in order to solve the problem working on non -human animals first makes sense to most people. But certainly there's a category of people that feels very strongly in the opposite direction. Sure. And I think we would probably be having a very different conversation around animal research if we weren't, you know, we as a species, we as a culture weren't just casually slaughtering millions of animals to eat. Eat them every single day. And so that is a background against which the relatively minuscule number of animals used in research. It becomes almost impossible to understand why someone would point to that ridiculously small number of animals used in research when the vast vast majority of animals that humans use and their lives are done for food or for for or for for or these other reasons that people, you know, have historically used animals.

1:25:29So we in that context, we do animal research because we have to. There's no other way around it. If tomorrow laws were changed and the FDA said, okay, you can do some of this early experimentation in willing human participants. That would be a very interesting option. I think there would be a lot of people that would step up and say, yes, I'm willing to participate in early stage clinical research. You already volunteered. Yeah. And I wouldn't be alone. And that, you know, as a potential way that animals could maybe be spared being unwilling participants in this. And on that note, to whatever extent possible, I think Nurelink goes really, really far much, much farther than anyone I've ever heard of.

1:26:16Any organization I've ever heard of, anything I've ever seen to give the animals agency in every aspect of the research. We have just an incredible team of people looking out for the animals and trying to design the experiments such that they're as purely opt in as humanly possible. No animal is ever compelled to participate in experiments beyond the surgery itself. So if, say, on a given day, our star monkey, Pager doesn't want to play video games for smoothie. No one forces him to ever. This is a very important point. And I want to cue people to really what Matt is saying here. Obviously, the animals are being researched on for Nurelink so they don't get to opt into opt out of the experiment.

1:27:08But what he's saying is that they play these games during which Nurel signals are measured from the brain because they have electrodes implanted in their brain through a surgery that thankfully to the brain is painless, right? No pain receptors in the brain. And are playing for reward. This is very different, very different than the typical scenario in laboratories around the world where people experiment on mice, monkeys, some cases pigs. Or other species in which the typical arrangement is to water, deprive the animals. We never do that. And then have the animals work for their daily ration of water.

1:27:48And some people are hearing this and probably think, wow, that's barbaric. And here I'm not trying to point fingers at the people doing that kind of work. I just think it's important that people understand how the work is done in order to motivate an animal to play a video game, depriving them of something that they yearn for is a very efficient way to do that. We don't do that. They have free and full access to food this entire time. So they aren't hungry, they aren't thirsty. The only thing that would motivate them is if they want a treat extra to their normal rations. But there's never any deprivation, there's never any adverse negative stimuli that pushes them to do anything.

1:28:27I must say I'm impressed by that decision because training animals to do tasks in laboratory settings is very hard. And the reason so many researchers have defaulted to water deprivation. And having animals work for a ration of water is because, frankly, it works. It allows people to finish their PhD or their postdoc more quickly than having to wait around and try and figure out why. And then they're not working that day. In fact, having known a number of people who've done these kinds of experiments, we've never done them in my lab. My monkey isn't working today is a common gripe among graduate students and postdocs who do this kind of work.

1:29:13And for people who work on mice. Okay, so this is a very important information to get across. And there's no public relation statement woven into this. This is just we're talking about the nature of the research. But I think it is important that people are aware of this. Yeah, that's one of the one of the underappreciated innovations out of Neuralink is how far the animal care team has been able to move in the direction of humane treatment of these guys. Wonderful. As an animal lover myself, I can only say wonderful. Why pigs? Yeah, pigs are, you know, they're actually fairly commonly used in medical device research.

1:29:50More, you know, in the cardiac area, their hearts are, you know, somewhat similar to human hearts. How big are these pigs? I've seen little pigs that have seen big pigs. Yeah, there's a range. There's a bunch of different varieties of pig. There's a bunch of different species that, you know, you can optimize for different characteristics. There's many pigs. There's, you know, Yorkshire's. There's a lot of different kind of pigs that we use in different contexts. When we're trying to optimize a certain characteristic. So, yeah, the pigs are, we don't necessarily need them to be smart or task performers, although occasionally we have, you know, trained them to walk on a treadmill.

1:30:31When we're studying how their limbs move for some of our spinal cord research. But we're not, you know, recording interesting, say cognitive data out of their minds. They're really just a biological platform with a skull that's close enough in size and shape to humans to be a valid platform to study the safety of the device. Unlike a monkey or a human, a pig, I don't think it can reach out and hit a button or a lever. Exactly. How are they signaling that they saw or sensed to something? Yeah. So, again, the pigs are really just a safety platform to say the device is safe to implant. It doesn't, you know, break down or cause any kind of toxic reaction.

1:31:15The monkeys are really doing our heavy lifting in terms of ensuring that we're getting good signals out of the device that what we expect to see in humans is validated on the functional level in monkeys first. Let's talk about the skull. Yeah. Years ago, you and I were enjoying a conversation about these very sorts of things that we're discussing today. And you said, you know, the skull is actually a pretty lousy, biological adaptation. Far better would be a titanium plate, you know, spoken like a true neurosurgeon with a radio receiver implanted in his hand. But in all seriousness, drilling through the skull with a two millimeter hole, certainly don't do this at home, folks.

1:32:01Please don't do this. But that, yes, that's a small entry site. But I think most people cringe when they hear about that or think about that. Sure. And it obviously has to be done by a neurosurgeon with all the appropriate environmental conditions in place to limit infection. What did you mean when you said that the skull is a poor adaptation and a titanium plate will be better? And in particular, what does that mean? In reference to things like traumatic brain injury? I mean, are human beings unnecessarily vulnerable at the level of traumatic brain injury because our skulls are just not hard enough?

1:32:42You know, maybe I'm being too harsh about skull. The skull is very good at what it does given the tools that we are working with as biological organisms that develop in our mother's uterus. The skull is, you know, usually the appropriate size. It's one of the hardest things in your body. That said, there are a couple puzzling vulnerabilities. Some of the thinnest bone in the skull is in the temporal region. This is, you know, neurosurgeons will all know that I'm heading toward a feature that sometimes darkly is called God's Little Joke, where the very thin bone of the temporal part of the skull.

1:33:25Has one of the largest arteries that goes to the lining of the brain right attached to the inside of it. And so this bone just to the side of your eye tends to fracture if you're struck there. And the sharp edges of that fractured bone very often cut an artery called the middlemeninjial artery that leads to a big blood clot that crushes the brain. This is how a lot of people with, you know, otherwise would be a relatively minor injury end up dying. Is this large blood clot developing from high pressured arterial blood that crushes the brain. And so why would you put the artery right on the inside of the very thin bone that's most likely to fracture?

1:34:09It's an enduring mystery. But this is probably the most obvious failure mode in, you know, the design of a human skull. Otherwise, you know, in terms of general impact resistance. I think the brain is a very hard thing to protect. And the architecture of human anatomy probably given all other possible architectures that can arise from development. And it's not that bad really. One of the interesting features in terms of shock absorption that hopefully prevents a lot of traumatic brain injury is the fluid sheath around the brain. The brain you may know is. It's mostly fat. It floats in saltwater in our brains.

1:34:52Our brains are all floating in saltwater. And so with rapid acceleration, deceleration, that sheath of saltwater adds a marvelous protective cushion. Against development of, you know, bruising of the brain say or bleeding in the brain. And so I think for any flaws in the design that do exist. You can imagine things being a lot worse. And there's probably a lot fewer TBI's than would exist if a human designer was taken first crack at it. As you describe the thinness of this temporal bone and the presence of a critical artery just beneath it. I'm thinking about most helmets. And here I also want to queue up the fact that well, whenever we hear about TBI or CTE brain injury, people always think football hockey.

1:35:47But most traumatic brain injuries are things like car accidents or construction work. And it's not football and hockey. That for some reason football and hockey and boxing get all the attention. But my colleagues that work on traumatic brain injury tell me that most of the traumatic brain injury they see is somebody slips at a party and hits their head or, you know, was in a car accident or environmental accident of various kinds. To my mind, most helmets don't actually cover this region close to the eyes. So is there is there also a failure of helmet engineering that, you know, I can understand why you'd want to have your peripheral vision out the sides of your eyes, prefer your eyes.

1:36:33But it seems to me if this is such critical real estate, why isn't it being better protected? You know, I'm no expert in helmets, but I don't think we see a lot of epidural hematomas in sports injuries. To get this kind of injury, you usually need a really focal blunt trauma like the baseball bat to the head is a classic mechanism of injury that would lead to a temporal bone fracture in epidural hematoma. With sports injuries, you know, you don't often see that, especially in football with, you know, a sharp, sharper object coming in contact with the head. It's usually another helmet, right, is the mechanism of injury.

1:37:18So I can't think off the top of my head of an instance of this exact injury type in sports. You spent a lot of time poking around in brains of humans. And while I realize this is not your area of expertise, you are somebody who I am aware, you know, cares about his health and the health of your family and I think generally people's health. When you look out on the landscape of things that people can do and shouldn't do if their desire is to keep their brain healthy. Do any data or any particular practices come to mind? I mean, I think we've all heard the obvious one. Don't get ahead injury. If you get ahead of injury, make sure it gets treated and don't get a second head injury.

1:38:05But those are sort of type answers that I'm able to give. So I'm curious about the answers that perhaps I'm not able to give. Yeah, well, you know, the obvious one is one that you talk about a lot. And I see a lot of the smoldering wreckage of humanity, you know, in the operating room and in the emergency room for people that come in. You know, I work my practices in San Francisco right next to the tender line. And so a lot of people that end up coming in from the tender line have been drinking just spectacular amounts of alcohol for a long time. And their brains are, you know, very often on the scans.

1:38:44They look like small walnuts inside their empty skull. There's so much atrophy that happens with an alcohol soaked brain chronically that I would say that's, you know, far and away. The most common source of brain damage that many of us just volunteer for. And it's, you know, when you look at the morbidity, kind of the human harm in aggregate that's done, it's mystifying that it's not something that we are all paranoid about. People will think that I don't drink at all. I'll occasionally have a drink. I could take it or leave it, frankly, if all the alcohol in the plant disappeared, I wouldn't notice.

1:39:26But I do occasionally have a drink maybe one per year or something like that. But I am shocked that this current state of affairs around alcohol consumption and advertising, et cetera, when I look at the data mainly out of the UK brain bank, which basically shows that for every drink that one has on a regular basis. When you go from zero to one drink per week, there's more brain atrophy, thinning of the gray matter cortex. You go from one to two, more thinning, you go from two to three. And there's a near linear relationship between the amount that people are drinking in the amount of brain atrophy.

1:39:58And to me, it's like, it's just sort of obvious from these large scale studies that as you point out, alcohol atrophy is the brain. It kills neurons. And I don't have any bias against alcohol or people that drink. I know many of them. But it does seem to me kind of shocking that we're talking about the rest of our withdrawal and red wine, which is that, you know, infinitesimally small amounts, not even clear. The rest of our withdrawal is good for us anyway, by the way, a matter of debate. I should point out. But so alcohol, certainly alcohol and excess is bad for the brain. In terms of, okay, so we have head hits, bad alcohol, bad.

1:40:41You're working, as you mentioned, you're the tenderloin. Is there any awareness that amphetamine use can disrupt brain structure or function? You know, that's not an area that I spent a lot of time researching in. I, you know, I incidentally take care of people that have used every substance known to man in quantities that are, you know, spectacular. But I haven't specifically done research in that area. I'm not super well versed on the literature. I ask in part because maybe you know a colleague or will come across a colleague who's working on this is there's just such an incredible increase in the use of things like Adderall, Ritalin, Modaphanol or Modaphanol, which I think in small amounts in clinical, clinically prescribed situations can be very beneficial.

1:41:28But let's be honest, many people are using these on a chronic basis. I don't think we really know what it does to the brain. Aside from increasing addiction for those substances, that's very clear. Well, for better or worse, we're generating a massive data set right now. Well put. I'd like to briefly go back to our earlier discussion about neuroplasticity. You made an interesting statement, which is that we are not aware of any single brain area that one can stimulate in order to invoke plasticity. Right. This is malleability of neural architecture. Years ago, Mike Merzenick and colleagues at UCSF did some experiments where they stimulate nucleus basalus and paired that stimulation with eight kilohertz tone or in some cases they could also stimulate a different brain area, the ventral segmental area, which causes a release of dopamine and pair it with a tone.

1:42:24And it seemed in every one of these cases they observed massive plasticity. Now, I look at those data and I compare them to the kind of classic data. I think it was Carl Ashley that did these experiments where they would take animals and they'd scoop out a little bit of cortex, put the animal back into a learning environment. And the animal would do pretty well, if not perfectly. So they scoop out a different region of cortex and a different animal. And by the end of maybe three, four years of these kinds of lesion experiments, they referred to the equal potential of the cortex, meaning they concluded that it didn't matter which piece of the cortex you took out that there was no one critical area.

1:43:05So on the one hand, you've got these experiments that say, you know, you don't really need a lot of the brain. And he'd every once in a while a new story will come out where they'll patient person will go in for a brain scan for some other reason or an experiment. And the person seems perfectly normal and they're like missing half their cortex. And then on the other hand, you have these experiments like the stimulation of basalus or VTA where you get massive plasticity from stimulation of one area. I've never been able to reconcile these kinds of discrepant findings. And so I'd really like just your opinion on this.

1:43:39You know, what is it about the brain as an organ that lets it be both so critical at the level of individual neurons and circuits so, so critical. And yet at the same time, it's able to circumvent these what would otherwise seem like massive lesions and holes in itself. Yeah, I mean, a lot of a lot of it to reconcile those experiments, you first account for the fact they're probably in different species, right. You take out a particular portion of a pig or a rabbit brain, a small amount. You might not see a difference, but a small portion of a human brain say the part most interested in coordinating speech or finger movement.

1:44:21And you're going to see profound losses or visual cortex, right. I take out a small portion of V1 and you'll you'll have a visual deficit. And so species matters, age matters. If you take out half of the brain in a very young baby, that baby has a reasonable chance of developing a high degree of function by having the remaining half, subsume some of the functions lost on the other side. Because they're very, very young and their brain is still developing, it's a it's to some degree a blank slate with extremely high plasticity over many years. So that can overcome a lot of deficits. Taking an adult animal's brain that isn't very well differentiated functionally to begin with, you might not see those deficits so apparently there's a lot of redundancy as well, right.

1:45:16There's a lot of say cerebellar and spinal circuits in other animals that generate stereotype behavior patterns and might not need the brain at all to to perform say a walking movement or some other sequences of motor activities. So a lot of that depends on the experimental setup. I would say in general adult humans are very vulnerable to losing small parts of their brains and losing discrete functions. I'm going to take the liberty of asking a question that merges across neural link and Tesla. I could imagine that cars, whether or not they're on autopilot mode or being driven by the human directly.

1:46:00And society generally would benefit from knowing whether or not a human is very alert or sleepy. I don't know no Tesla. Perhaps this technology already exists, but is there any idea that a simple sensor, maybe even a just eyelid position or pupil size or head position could be introduced to a car like the Tesla or another car for that matter. And resolve a common problem, which is that when people are less alert, not just when people fall asleep, but the simple drop in alertness that occurs when people are sleepy is my read of the data is responsible for approximately a third. It's incredible of accidents between vehicles and then of course some percentage of those are going to be lethal accidents.

1:46:54So in terms of preserving life, this might seem like a minor case, but it's actually a major case scenario. Yeah, I have no special insight into how Tesla software works. I know they have brilliant engineers. When I have a Tesla, when I drive it, it seems to know when I'm looking at the road versus not and it yells at me if I'm not looking at the road. How does it do that and what voice does it use? There is a small camera up by the review mirror. And I think it's a simple eye track. My guess here is that it's a simple eye tracking program. And so it may already be the case that it's implemented that it's detecting whether your eyes are open or not.

1:47:35Obviously, you know, it's not strict. It's not stringent because sunglasses. And I've seen forums on the internet where people tape over that small camera. So they can wallast. Goodness. But you know, I think they're definitely making efforts to try to save lives here. Incredible. I'm saying incredible just because I think I'm fortunate enough to live in a lifetime where there were no electric cars when I was growing up. And now things are moving so fast. No one intended. What is your wish for brain machine interface and brain augmentation? So let's assume that the clinical stuff can be worked out.

1:48:21Or maybe you have a pet clinical condition that you just are just yearning to see resolved. That would be fine too. But in addition to that, you really just expand out. Let's say we can extend your life 200 years or we're thinking about the kind of world that your children are going to live in and their grandchildren will live in. But what do you think is really possible with brain augmentation and brain machine interface? And here, please feel no bias whatsoever to answer in a way that reveals to us your incredible empathy and consideration of clinical conditions. Because that's how you spend your days is fixing patients and helping their lives be better.

1:49:08So if it lands in that category, great. But for sake of fun and for sake of delight and for sake of really getting us the audience to understand what's really possible here, please feel no shackles. Yeah. Well, you know, I love the idea down the road. And we're talking, you know, a 10 year, maybe 20 year time frame of humans just getting control over some of the horrible ways that their brains go wrong. Right. So I think everybody at this point has either known someone or second order known someone a friend of a friend who has been touched by addiction or depression, suicide, obesity, these functions of the brain or malfunctions of the brain or what drives me.

1:50:02These are the things that I want to tackle in my career. You know, in terms of my kids lifetime, I'm thinking, you know, full human expansion of human cognition into AI, full immersion in the internet of your cognitive abilities. Having no limitation for what you think as bottlenecked by needing to read the Wikipedia article first to have the data to inform your thoughts. Having communication with anyone that you want to unrestricted by this, you know, flapping air past meat on your face. It's a, you know, a means of communication that's ridiculously prone to being misunderstood. It's also a tiny narrow bottleneck of communication where, you know, trying to send messages back and forth through a tiny straw.

1:51:02And there's no reason that needs to necessarily be true. It's the way things have always been, but it isn't the way things are going to be in the future. And I think there's a, you know, a million very sci -fi possibilities in terms of banding human minds together to be even more potent as a multi -unit organism, you know, as an opt -in multi -brain. You know, these are things that are so far down the road, I can't even directly see how they would be implemented, but the technology we're working on is a little crack in the door that allows some of this stuff to even be thought about in a realistic way.

1:51:47Well, to that point, I, you know, encourage anyone who is, you know, excited about things like that, you know, especially mechanical engineers, software engineers, robotics engineers come to the NERLINK website and look at the jobs we've got. We need the brightest people on the planet working on these, the hardest problems in the world in my opinion. And so if you want to work on this stuff, come help us. I have several responses to what you just said. First off, I'll get the least important one out of the way, which is that years ago I applied for a job at NERLINK. The NERLINK website at that time was incredibly sparse.

1:52:27It was just said, NERLINK, and it said, if you're interested, give us your email. So I put my email there, I got no response. So the, they made a wise choice in. Interimly interacting. Now, fast forward several years, I am very grateful and I think very lucky that you who passed through fortunately for me through my lab at one point. And we had some fun expeditions together in the wild. NERL explorations, we can talk about some other time as well as I'm learning from you as you pass through your time at Stanford. But have arrived there at NERLINK and I'll say they're very lucky to have you and folks like Dan Adams who have known for very long time.

1:53:13So phenomenal neurosurgeons like yourself, neuroscientists and vision scientists like Dan and others. It's really an incredible mission. So I really want to start off by saying thank you to you and all your colleagues there. I know that NERLINK is really tip of the spear in being public facing with the kinds of things they're doing and being so forthcoming about how that work is done in animals and exactly what they're doing. And that's a very brave stance to take, especially given the nature of the work. Well, that's classic Elon, right? He doesn't keep secrets in public too commonly. He tells you what he's going to do and then he does it and people are always amazed by that.

1:53:54He releases the Tesla master plan and tells you exactly what the company intends to do for the next several years. And people assume that there's some subterfuge that he is misdirecting but it's right out there in the open. And I think NERLINK follows in that path of we want people to know what we're doing. We want the brightest people in the world to come help us. We want to be able to help patients. We want the most motivated patients with quadriplegic to visit our patient registry and sign up to be considered for clinical trials that will happen in the future. We'll put a link to that by the way.

1:54:33So maybe the direct call could happen now. So you, this is for people who are quadriplegic or who know people who are quadriplegic, who are interested in being part of this clinical trial. It's a patient registry right now that we're just collecting information to see who might be eligible for clinical trials that will happen in the future. We're still working with the FDA to hammer out the details and get their final permission to proceed with the trial. So please see the note in the show note, the link, excuse me in the show note captions for that. Yeah, I want to thank you guys for your stance in public facing and also doing the incredibly hard work.

1:55:10I also think the robotics aspect which you've clarified for me today is extremely forward thinking and absolutely critical. So a lot of critical engineering that no doubt will wake out into other domains of neurosurgery and medical technology, not just serving neural links mission directly. And I really want to thank you first of all for coming here today and taking time out of your important schedule of seeing patients and doing brain surgery literally. Happy time to do it. Time away from your family and time away from your mission at neural link briefly to share with people what you guys are doing.

1:55:46As I mentioned before, there's a lot of mystique around it. And even despite the fact that a neural link has gone out of their way to try and erase some of that mystique. This to me is the clearest picture ever to my knowledge that has been given about what's going on there and the stated in the real mission and what's going on at the level of nuts and bolts and guts and brains and this kind of thing. And I really just want to thank you also for for being you, which is perhaps sounds like a kind of an odd thing to hear. But I think as made apparent by the device implanted in your hand, you don't just do this for a job.

1:56:26You live and breathe and embody truly embody this stuff around the nervous system and trying to figure out how to fix it, how to make it better. And you live and breathe it and I know your deep love for it. So I want to thank you for not just the brains that you put into it and the energy you put into it, but also for the heart that you put into it. Thanks for that, Andrew. I appreciate that. We just want to help people. We want to make things better. Well, I know that to be true, knowing you and thank you again for coming here today. And I look forward to another round of discussion and whenever the time happens to be when these incredible technologies have spelled out to the next major milestone.

1:57:08Thank you. Thank you for joining me for today's discussion with Dr. Matthew McDougall. All about the human brain and how it functions, how it breaks down and the incredible efforts that are being carried out at neural link in order to overcome diseases of brain and nervous system function and to augment how the human brain works. If you'd like to learn more about Dr. McDougall's work and the specific work being done at neural link, please see the links that we've provided in the show note captions. If you're learning from and are enjoying this podcast, please subscribe to our YouTube channel. That's a terrific zero cost way to support us.

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1:59:51Thank you.