Dr. Matthew MacDougall: Neuralink & Technologies to Enhance Human Brains | Huberman Lab Podcast

welcome to the huberman Lab podcast

where we discuss science and

science-based tools for everyday life

I'm Andrew huberman and I'm a professor

of neurobiology and Ophthalmology at

Stanford school of medicine today my

guest is Dr Matthew McDougall Dr Matthew

McDougall is the head neurosurgeon at

neurolink neurolink is a company whose

goal is to develop Technologies to

overcome specific clinical challenges of

the brain and nervous system as well as

to improve upon brain design that is to

improve the way that brains currently

function by augmenting memory by

augmenting cognition and by improving

communication between humans and between

machines and humans these are all of

course tremendous goals and neurolink is

uniquely poised to accomplish these

goals because they are approaching these

challenges by combining both existing

knowledge of brain function from the

fields of Neuroscience and neurosurgery

with robotics machine learning computer

science and the development of Novel

devices in order to change the ways that

human brains work for the better today's

conversation with Dr Matthew McDougall

is a truly special one because I and

many others in science and medicine

consider neurosurgeons the astronauts of

Neuroscience in the brain that is they

go where others have simply not gone

before and are in a position to discover

incredibly novel things about how the

human brain works because they are

literally in there probing and cutting

stimulating Etc and able to monitor how

people's cognition and behavior and

speech changes as the brain itself has

changed structurally and functionally

today's discussion with Dr McDougall

will teach you how the brain works

through the lens of a neurosurgeon it

will also teach you about neuralink

specific perspective about which

challenges of brain function and disease

are immediately tractable which ones

they are working on now that is as well

as where they see the future of

augmenting brain function for sake of

treating disease and for simply making

brains work better

today's discussion also gets into the

realm of devising the peripheral nervous

system in fact one thing that you'll

learn is that Dr McDougall has a radio

receiver implanted in the periphery of

his own body he did this not to overcome

any specific clinical challenge but to

overcome a number of daily everyday life

challenges and in some ways to

demonstrate the powerful utility of

combining novel machines novel devices

with what we call our nervous system and

different objects and Technologies

within the world I know that might sound

a little bit mysterious but you'll soon

learn exactly what I'm referring to and

by the way he also implanted his family

members with similar devices so while

all of this might sound a little bit

like science fiction this is truly

science reality these experiments both

the implantation of specific devices and

the attempt to overcome specific

movement disorders such as Parkinson's

and other disorders of deep brain

function as well as to augment the human

brain and make it work far better than

it ever has in the the course of human

evolution are experiments and things

that are happening now at neuralink Dr

McDougall also generously takes us under

the hood so to speak of what's happening

at neurolink explaining exactly the

sorts of experiments that they are doing

and have planned how they are

approaching those experiments we get

into an extensive conversation about the

utility of animal versus human research

in probing brain function and in

devising and improving the human brain

and in overcoming disease in terms of

neurosurgery and neural links goals by

the end of today's episode you will have

a much clearer understanding of how

human brains work and how they can be

improved by Robotics and engineering and

you'll have a very clear picture of what

neural link is doing toward these goals

Dr McDougall did his medical training at

the University of California San Diego

and at Stanford University School of

Medicine and of course is now at

neurolink so he is in a unique stance to

teach us about human brain function and

dysfunction and to explain to us what

the past present and future of brain

augmentation is really all about before

we begin I'd like to emphasize that this

podcast is separate from my teaching and

research roles at Stanford it is however

part of my desire and effort to bring

zero cost to Consumer information about

science and science related tools to the

general public in keeping with that

theme I'd like to thank the sponsors of

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first box and now for my discussion with

Dr Matthew McDougall Dr McDougall

welcome good to be here nice to see

Andrew great to see you again uh we'll

get into our history a little bit later

but just to kick things off

as a neurosurgeon and as a

neuroscientist can you share with us

your vision of the brain as an organ as

it relates to what's possible there I

mean I think most everyone understands

that the brain is along with the body

the seat of our cognition feelings our

ability to move Etc and the Damage there

can limit our ability to feel the way we

want to feel or move the way we want to

move but

surgeons tend to view the world a little

bit differently than most because as the

not so funny joke goes you know they

like to cut and they like to fix and

they like to mend and they in your case

have the potential to add things into

the brain that don't exist there already

so how do you think about and

conceptualize the brain as an organ and

what do you think is really possible

with the brain that most of us don't

already probably think about yeah that's

a great question

thinking about the brain as this three

pound lump of meat trapped in a prison

of the skull

it seems almost magical that it could

create a you know human a human set of

behaviors and a life

merely from electrical impulses when you

start to see patients and see say a

small tumor eating away at a little part

of the brain and see a very discrete

function of that brain go down in

isolation you start to realize that the

brain really is a collection of

functional modules pinned together duct

taped together

um in this in this bone box attached to

your head

um and sometimes you see very

interesting failure modes so one of the

most

memorable patience I ever had was very

early on in my training I was down at UC

San Diego and saw a very young guy who

had just been in a car accident we had

operated on him and you know as is so

often the case in neurosurgery we had

saved his life

potentially at the cost of quality of

life

when he woke from surgery with bilateral

frontal lobe damage he had essentially

no

impulse control left and so

you know we rounded on him after surgery

saw that he was doing okay to our you

know first guess at his uh health and we

continued on to see our other patients

and we were called back by his you know

80 year old recovery room nurse saying

you've got to come see your patient

right away something's wrong and we walk

in to see him and he points at his

elderly nurse and says she won't have

sex with me

and you know it was Apparent at that

moment his frontal lobes were gone and

that person is never going to have

reasonable human behavior again

um

and uh that's you know it's one of the

most tragic ways to have a brain

malfunction but uh you know anything a

brain does anything from control of

hormone levels in your body to Vision to

sensation to you know the most obvious

thing which is muscle movement of any

kind from eye movement to moving your

bicep all that comes out of the brain

all of it can go wrong any of it any

part of it or all of it

um

so yeah working with the brain is the

substance of the brain as a surgeon very

high stakes but you know once in a while

you get a chance to really help you get

a chance to fix something that seems

unfixable and you have you know

lazarus-like Miracles not not too

uncommonly so it's extremely satisfying

as a career

could you share with us one of the more

satisfying experiences or perhaps the

top Contour of what um qualifies as

satisfying in in neurosurgery yeah

um you know one of the relatively newer

techniques that we do is you know if

someone comes in with a reasonably small

tumor somewhere deep in the brain that's

hard to get to the traditional approach

to taking that out would involve cutting

through a lot of good normal brain and

disrupting a lot of neurons a lot of

white matter that you know kind of the

wires connecting neurons

um then the modern approach involves a

two millimeter drill hole in the skull

down which you can pass a little fiber

optic uh cannula and and uh attach it to

a laser and just heat the tumor up deep

inside the brain under direct MRI

visualization in real time so your this

person is in the MRI scanner you're

taking pictures every second or so as

the tumor heats up you can monitor the

temperature and get it exactly where you

want it where it's going to kill all

those tumor cells but not hurt hardly

any of the brains surrounding it and so

not uncommonly nowadays we have someone

come in with a tumor that previously

would have been catastrophic to operate

on and we can eliminate that tumor with

you know leaving a poke hole in their

skin

with almost no visual After Effects so

that procedure that you just described

translates into better clinical outcomes

meaning fewer let's call them side

effects or collateral damage exactly

right yeah we don't you know even in

cases that previously would have

considered totally inoperable say a

tumor in the brain stem or a tumor in

primary motor cortex or primary verbal

areas Brokers area

uh where we would have expected to

either not operate or do catastrophic

damage those people sometimes now are

coming out unscathed

I'm very curious about the sorts of

basic information about brain function

that can be gleaned from these clinical

approaches of lesions and

um strokes and um maybe even stimulation

so for instance in your example of this

patient that had bilateral frontal

damage

what do you think his lack of Regulation

reveals about the normal functioning of

the frontal lobes because I think the

obvious answer to most people is going

to be well the frontal lobes are

normally

um

limiting impulsivity right but as we

both know because the brain has

excitatory and inhibitory neurons to

sort of accelerators and breaks on

communication right that isn't

necessarily the straightforward answer

um it could be for instance that the

frontal lobes are acting as conductors

right and are kind of

um important but not the immediate

players in determining impulsivity so

um two questions really what do you

think the frontal lobes are doing

because I'm very intrigued by this uh

human expanded real estate we have a lot

of it compared to other animals and more

generally what do you think damage of a

given neural tissue

means in terms of understanding the

basic function of that tissue yeah it

varies I think from tissue to tissue but

with respect to the frontal lobes I

think they act as sort of a filter they

selectively are saying

backward to the rest of the brain behind

them

when part of your brain says that looks

very attractive I want to go grab it and

take it you know out of the jewelry

display case or you know whatever

the frontal lobes are saying

you can if you go pay for it first right

they're filtering the behavior they're

they're letting the impulse through

maybe uh but in a controlled way

um this is very high level very broad uh

thinking about how the frontal lobes

work and that

that patient I mentioned earlier is a

great example of when they go wrong you

know he had this impulse sort of strange

impulse to be attracted to his nurse

that normally it would be easy for our

frontal lobes to say this is completely

inappropriate wrong setting wrong person

wrong time

uh

in his case he had nothing there and so

even the slightest inclination to uh to

want something came right out to the

surface so

um yeah a filter calming the rest of the

brain down from acting on every possible

impulse when I was a graduate student I

was um running what are called you know

these uh what these are but just to

inform you what are called acutes which

are

um neurophysiological experiments that

last several days because at the end you

uh you terminate the animal this isn't

uh my apologies to those that um are

made uncomfortable by animal research I

now work on humans so a different type

of animal but at the time we were

running these acutes that would start

one day and maybe end two or three days

later and so you get a lot of data the

animals anesthetized and doesn't feel

any pain the entire time of the surgery

but the um one consequence of these

experiments is that the experimenter me

and another individual are awake for

several days with an hour of sleep here

an hour of sleep there but you're

basically awake for two three days

something that really I could only do in

my teens and 20s I was in my 20s at the

time and I recall

um going to eat at a diner after one of

these experiments and I was very hungry

and the waitress walking by with a tray

full of food for another table

and it took every bit of self-control to

not get up and take the food off the

tray something that of course is totally

inappropriate and I would never do and

it must have been based on what you just

said that my forebrain was essentially

going offline or offline from the sleep

deprivation right because there was a

moment there where I thought I might

reach up and grab a plate of food

passing by simply because I wanted it

right and um I didn't

um but I can relate to the experience of

feeling like the shh response is a

flickering in and out under conditions

of sleep deprivation so do we know

whether or not sleep deprivation limits

for brain activity in a similar kind of

way you know I I don't know specifically

if that effect is more pronounced in the

forebrain as opposed to other brain

regions but it's clear that sleep

deprivation has broad effects all over

the brain people start to see visual

hallucinations so the opposite end of

the brain as you know the visual cortex

in the far back

the brain is affected people People's

Court motor coordination goes down after

sleep deprivation so

um I think you know if I if you force me

to give a definitive answer on that

question I'd have to guess that the

entire brain is affected by sleep

deprivation and it's not clear that one

part of the brain is more effective than

another

so we've been talking about damage to

the brain and inferring function from

damage uh maybe we could talk a little

bit about what I consider really the

Holy Grail of the nervous system which

is neuroplasticity this incredible

capacity of the nervous system to change

its wiring strengthen connections weaken

connections maybe new neurons but

probably more strengthening and

weakening of connections right nowadays

we hear a lot of excitement about

so-called classical psychedelics like

LSD and psilocybin which do seem to

quote unquote open plasticity they do a

bunch of other things too but

um through the release of

neuromodulators like serotonin and so

forth

how do you think about neuroplasticity

and more specifically

what do you think the potential for

neuroplasticity is in the adult so let's

say older than 25 year old brain

with or without

machines being involved because

um in your role at neurolink and as a

neurosurgeon in other clinical settings

surely you are using machines and surely

you've seen plasticity in the positive

and negative direction right

what do you think about plasticity

what's possible there without machines

what's possible with machines so as you

mentioned or alluded to the plasticity

definitely goes down in older brains

uh it it is harder for older people to

learn new things to make radical changes

in their behavior uh to you know kick

habits that they've had for years

um

machines aren't the obvious answer so

implanted electrodes and computers

aren't the obvious answer to increased

plasticity necessarily compared to

drugs we already know that there are

pharmacologics some of the ones you

mentioned psychedelics that have a broad

impact on plasticity yeah it's hard to

know which area of the brain would be

most potent as a stimulation Target for

an electrode to broadly juice plasticity

compared to uh you know pharmacologic

agents that we already know about

I think with plasticity you're talking

in general you're talking about the

entire brain you're talking about

altering you know a trillion synapses

all in a similar way in their tendency

to be rewireable to their tendency to be

up or down weighted and

an electrical stimulation Target in the

brain necessarily has to be focused you

know with a device like potentially

neural links there might be a more broad

ability to steer current to multiple

targets with some degree of control but

you're never going to get that broad

um Target ability with uh

any electrodes that I can see coming in

our lifetimes so say that would be

coding the entire surface and depth of

the brain the way that a drug can and so

I think plasticity research will bear

the most fruit when it focuses on

pharmacologic agents I wasn't expecting

that answer given that you're at neural

link and um and then again I think that

all of us me included need to take a

step back and realize that while we may

think we know what is going on at

neurolink in terms of the specific goals

and the general goals and I certainly

have in mind I think most people have in

mind a chip implanted in the brain or

maybe even the peripheral nervous system

that can

give people super memories or some other

augmented capacity we really don't know

what you all are doing there and for all

we know um you guys are taking or

administering psilocybin and combining

that with stimulation I mean we really

don't know and I say this

um with a with a tone of excitement

because

um I think that one of the things that's

so exciting about the different

Endeavors that Elon has really

spearheaded

um SpaceX Tesla Etc is that early on

there's there's a lot of Mystique right

you know Mystique is a quality that

um is not often talked about but

um it's I think a very exciting time in

which

Engineers are starting to toss up big

problems and go for it and obviously

Elon is

certainly among the best if not the best

in terms of going really big I mean Mars

seems pretty far to me right electric

cars are all over the road nowadays are

very different than the picture a few

years ago right when you didn't see so

many of them

rockets and so forth and now the brain

so

to the extent that you are allowed could

you share with us what your vision for

the missions at neurolink are and what

the general scope of missions are and

then

um if possible uh share with us some of

the more specific goals I can imagine

basic goals of trying to understand the

brain and augment the brain I could

imagine clinical goals of trying to

repair things in humans that are

suffering in some way or animals for

that matter yeah it's it's funny what

you mentioned uh

neuralink and I think Tesla and SpaceX

before it end up being these blank

canvases that people project their hopes

and fears onto and so we we experience a

lot of upside in this people you know

assume that we have superpowers in our

ability to alter the way brains work and

people have terrifying fears of the

horrible things we're going to do

uh for the most part those extremes are

not true uh you know we are making a

neural implant we have a robotic

insertion device that helps Place tiny

electrodes the size uh smaller than the

size of a human hair all throughout a

small region of the brain in in the

first indication that we're aiming at we

are hoping to implant a series of these

electrodes into the brains of people

that have had a bad spinal cord injury

so people that are essentially

quadriplegic they have perfect brains

but they can't move use them to move

their body they can't move their arms or

legs because of some high-level spinal

cord damage exactly right and so this

you know pristine motor cortex up in

their brain is completely capable of

operating a human body it's just not

wired properly any longer to a human's

arms or legs and so our goal is to place

this implant into a motor cortex and

have that person be able to then control

a computer so a mouse and a keyboard as

if they had their hands on a mouse and a

keyboard even though they aren't moving

their hands their motor intentions are

coming directly out of the brain into

the device and so they're able to regain

their digital freedom uh and connect

with the world through the internet

why use robotics to insert these chips

and the reason I asked that is that sure

I can imagine that a robot could be more

precise

or less precise but in theory more

precise than the human hand no tremor

for instance right

um uh more Precision in terms of uh

maybe even a little micro detection

device on the the tip of the blade or or

something that could detect a capillary

that you would want to avoid and swerve

around that the human eye couldn't

detect and you and I both know however

that no two brains nor are the two sides

of the same brain

identical right so navigating through

the brain is perhaps best carried out by

a human however and here I'm going to

interrupt myself again and say

10 years ago face recognition

was very clearly performed better by

humans than machines and I think now

machines do it better right so is this

the idea that eventually or maybe even

now robots are better surgeons than

humans are in in this limited case yes

uh these electrodes are so tiny and the

blood vessels on the surface of the

brain so numerous and so densely packed

that a human physically can't do this a

human hand is not steady enough to grab

this you know couple Micron width Loop

uh at the end of our electrode thread

and place it accurately uh blindly by

the way into the cortical surface

accurately enough at the right depth to

get through all the cortical layers that

we want to reach

and

I would love if human surgeons were you

know essential to this process

but very soon humans run out of motor

skills sufficient to do this job and so

we are required in this case to lean on

robots to do this incredibly precise uh

incredibly fast incredibly numerous

placement of electrodes into the right

area of the brain so in some ways

neurolink is pioneering the development

of robotic surgeons as much as it's

pioneering the exploration and

augmentation and treatment of human

brain conditions right and as the device

exists currently as we're submitting it

to the FDA it is only for the placement

of the electrodes the the robot it's

part of the surgery I or or another

neurosurgeon still needs to do the you

know the more crude part of opening the

skin and skull and presenting the

robotic pristine brain surface to sew

Electric threads into

well surely getting quadriplegics to be

able to move again or maybe even to walk

again is a um heroic goal and one that I

think everyone would agree would be

wonderful to accomplish is that the

first goal because it's hard but doable

right

um or is that the first goal because you

and Elon and other folks at neurolink

have a passion for getting paralyzed

people to move again yeah broadly

speaking you know the mission of

neuralink is to reduce human suffering

at least in the near term you 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 a 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 shenoy 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 and he

was an advisor to neuralink

um 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

um

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

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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 uh reside

a lot of the brain structures that

control what Matt just referred to um

things controlling mood hormone output

how awake or asleep the brain is

um 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

yeah in some way yes I mean the 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 the housekeeping

functions to some degree body

temperature blood pressure sex

motivation

hunger or 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 Elon describe it as the

human brain is I'm essentially a monkey

brain with a super computer placed on

the outside which

um sparked some interesting ideas about

what neocortex is doing we have all this

brain real estate on top of all that

more stereotyped 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 um providing some

quieting of 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 involved in Vision or touch or

hearing but then there's also a lot of

real estate that just feels un

unexplored right so I'm curious whether

or not in your clinical work or work

with neural link

um or both whether or not you have ever

encountered neurons

that do something that's really peculiar

and intriguing

um and here I'm referring to examples

that could be anywhere in the brain yeah

like where you go wow like these neurons

when I stimulate them or when they're

taken away lead to something kind of

bizarre but interesting yeah yeah

there's

um 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

gelastic seizures which is sort of an

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

and so you know you don't normally think

of a deep structure in the brain like

the hypothalamus as being involved in

the you know a function like

humor and and certainly when we think

about this kind of laughter in these

kids with tumors it's

mirthless laughter is the the kind of

textbook phrase

humorless laughter it's just a reflexive

um 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 it's nice that you and I can

sit here and not have constant uh

disruptive fits of laughter coming out

of our bodies but that 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 right whether or not

it's through psychedelics or through

prescription drug or you know some other

compound

the other approach are these little

microelectrodes that are extremely

strategically placed right into multiple

regions in order to play essentially a

concert of electricity that is exactly

right to get a quadriplegic moving

um

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 that's enough for us

for now so um to just uh give us a bit

Fuller picture of this you were talking

about a patient who can't move their

limbs because they've have spinal cord

damage right

um the motor cortex that controls

movement is in theory fine right you

make a small hole in the skull and

through that hole a 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

um and out to the limbs because the

lesion hasn't been dealt with at all in

this scenario so just to clarify there I

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 right so prosthetic hand and arm

or just Mouse and and keys on a mouse

and keys on a keyboard for starters so

you wouldn't see anything in the world

move

uh 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 you know select

letters in sequence and they could type

this is the easy place to start easy in

quotes I would say because

um the transformation of electrical

signals from motor cortex through the

brain stem into the spinal cord and out

to the muscles is somewhat known right

through 100 years or more of incredible

laboratory research right but the

transformation meaning how to take the

electrical signals out of motor cortex

and put it into a a mouse or a robot arm

that's not a trivial problem I mean that

that's a whole other set of problems in

fact well we're taking we're unloading

some of that difficulty from uh from the

the brain itself from the brain of the

patient and putting some of that into

software so 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 you know a small army of

monkeys playing video games for you know

smoothie rewards and they do really well

we we actually have the world record of

a bit rate of information coming out of

a monkey's brain to you know

intelligently control a cursor on a

screen we're doing that better than

anyone else

and you know again thanks in no small

part due to Krishna shenoi and his you

know his lab and the people that have

worked for him that have been helping

neuralink

um but what you can't do with that

monkey is ask him what what he's

thinking you can't ask him we can ask

him but he won't get a very interesting

answer yeah

you can't tell him to try something

different you can't tell him to hey you

know try their shoulder on this early

try the other hand and see if there's

some cross body uh neuron firing that

that gives you a useful signal once we

get to people

we expect to see what they've seen when

they've done similar work in academic

Labs which is the the human can work

with you to vastly accelerate this

process and get much more interesting

results so one of the things out of out

of Stanford recently is

there was a lab that with Krishna and

Jamie Henderson and other people decode

speech out of the hand movement area in

the brain so 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

okay so here's the confidence test

there's a long history

uh dating back really prior to the 1950s

of scientists doing experiments on

themselves sure

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 if 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 right I'm not

pointing fingers at anybody but

psychiatrists are known to try the drugs

that they administer right 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

to patients but

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 yeah

you're not a quadriplegic right you can

move your limbs yeah but

given the state of the technology at

neurolink now

would you do that or maybe in the next

couple of years if you were allowed

would you be willing to do that yeah and

be the person to say hey turn up the

stimulation over there I feel like I

want to reach for the cup right with

that robotic arm but I'm feeling kind of

some resistance because it's exactly

that kind of experiment done on a 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 sure as opposed to

putting the electrodes first into

somebody who

um is imperative a number of levels and

then trying to think about why things

aren't working right right and again

that you know this is all with the the

goal of of reversing paralysis in mind

um but would you implant yourself with

these microelectrodes yeah absolutely I

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 a mouse typing in a keyboard

um we 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

it 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 than 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 it doesn't

really make sense for me to you know get

one when it allows me to you know 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 you know the hundreds of surgeries

that I've personally done with this I I

think it's much safer than many of the

industry standard FDA approved surgeries

that I routinely do on on patients that

you know are no one even thinks twice

about their standard of care neurolink

is 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 uh present

in the top of your hand for those

listening not watching there's a it

looks like a a small lump between

um

Dr mcdougall's forefinger and thumb or

index finger and thumb

um 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

um and why did you put it in there yeah

so it's a small writable 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 they

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 a deadbolt on my front

door

for some years it unlocked the doors at

neuralink and let me through you know

the the various locked doors inside the

building

um

it is writable I can write a small

amount of data to it and so for some

some years in early uh 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 uh crypto

currencies after it forked and 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

had 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 a phone

or other device and scanning it over the

the lump in your hand so to speak and

then it can read the data from there

yeah essentially yeah um 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 um yeah and recharge them

or replace them well 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 coated them in

another ring of silicone before

implanting that so it's 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

but you know that it it has a small

Niche use case and it's an interesting

proof of concept tiptoeing 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 subcutaneous implant in the

hand is a little different than a brain

implant but 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

um any anesthetic or is or no you know I

um I've seen people do this with

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 have to

never worry about losing your keys yeah

or passwords I actually would like them

for passwords because I'm dreadfully bad

at uh remembering passwords I have to

put them in places uh all over the place

and then it's like I'm like that kid in

um remember that movie Stand by me where

the kid hides the pennies under the the

porch and then uses the map yeah spends

all summer trying to wind them so I can

relate uh yeah so a little it was just a

little slit and then put in there no

local immune response no no pus no

swelling all the materials are

completely biocompatible that are on the

surface exposed to the body so no no bad

reaction it healed up you know in days

and it was fine very cool um since we're

on video here maybe can you just uh

maybe raise it and show us yeah so so

were you not to point out uh that little

lump I I would have known to to ask

about it but and uh any other members of

your family have have these a few years

after having this and seeing the

convenience of me being able to open the

door without keys uh my wife insisted

that I put one in her as well so she's

walking around with one fantastic we

consider them our sort of our our

version of wedding rings love it well

certainly um more permanent than wedding

rings in in some sense

um

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 get asked a lot

about

um the safety or lack thereof of a

Bluetooth headphones

um you work on the brain you're a brain

surgeon

um that's valuable real estate in there

and um you understand about

electromagnetic fields and sure

um any discussion about emfs immediately

puts us in the category of uh oh like

get their tin foil hats and yet I've

been researching emfs for a future

episode of the podcast sure and emfs 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

um 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 EMF Fields across the skull

no I mean I I think the energy levels

involved are so tiny that uh you know

ionizing radiation aside we're way out

of the realm of ionizing radiation that

people would worry about you know tumor

causing EMF Fields

even just the electromagnetic field

itself

as is very well described in a Bluetooth

frequency range the power level are tiny

in these devices and so you know we are

Awash in these signals whether you use

Bluetooth headphones or not for that

matter you're 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

um it's unavoidable uh 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 uh as

a result of being in the universe and

exposed to cosmic rays

in terms of electromagnetic fields there

it's just it's uh

you know the energy levels are way way

out of the range where I would be

worried about this what about heat

um 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

swallowed a handful of supplements that

included a Bluetooth a airpod pro

um I knew it I swallowed it the moment

after I

gulped it down by the way folks please

don't do this it was not a good idea it

was it wasn't an idea it was a mistake

and 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 um uh anyway there's a bad joke

there to be sure

um but in any event I tend to lose them

or misplace them so that's the main

reason but I did notice when I used them

that there's some heat generated there

um 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 so

it sounds to me like you're not

concerned about the use of of

um earbuds but

um what about heat near the brain I mean

there's the the cochlea the auditory

mechanisms that sit pretty close to the

surface there

um heat and neural tissue are not

friends sure

um I'd much rather get my brain cold

than hot yeah

um in terms of keeping the cells healthy

and Alive

um 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

the uh I use cars as an analogy a lot

and you know mostly internal combustion

engine cards so these analogies are

gonna start to be foreign and useless

for another generation of people that

grow up in the era of electric cars but

using cars as a as a platform to talk

about uh

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 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 that's that's

definitely damaging your DNA if you're

looking for things to be afraid of the

sun is a good one

now you're talking to the guy that tells

everybody he got 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 and different

individuals require different levels of

protection from the Sun sure some people

do very well in a lot of sunshine never

get basal 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 and 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 uh you

know for for a moment to compare it with

Bluetooth headphones your body is very

capable of carrying that heat away and

dissipating it you know via sweat

evaporation

or you know temperature Equalization so

any heat that's locally generated in the

ear

you know one there's a pretty large bony

barrier there but two 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 I'd like

to go back to brain augmentation you've

made very clear that one of the first

goals for neurolink is to get

quadriplegics walking again and again

what a marvelous goal that is and I

certainly hope you guys succeed well

again just just to be very clear the

first step is we we aren't reconnecting

the patient's own muscle system to their

motor Court allowing them um excuse me

uh agency over the movement of things in

the world yes and eventually their body

and you're exactly right yeah eventually

their body we would we would love to do

that and we've done a lot of work on uh

developing a system for stimulating the

spinal cord itself and so that gets to

the question that you uh 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 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

the injury caused by a car accident or

motorcycle accident or gunshot wound or

whatever and it should be possible to

reconnect the brain to the body in that

way so not out of the realm of

possibility that you know in some small

number of years that neuralink will be

able to reconnect to somebody's own body

to their brain

and here I just want to flag the

um 100 years or more of incredible work

by basic scientists

um the names that I learned about in my

textbooks as a graduate student were

like georgeopolis and um that won't mean

anything to anyone unless you're a

neuroscientist but churchopolis um

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

move is a limb

um Krishna shinoy being another

um 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 down the pavement

on the runway to do the sorts of big

clinical uh Expeditions that you all at

neurolink are doing yeah it can't be

said enough that you know we broadly

speaking in 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 unglorious

unglamorous way no stock option no stock

options

and you know the reward uh 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 uh academic researchers that

that made all this possible and we all

humanity and neuralink owe them a

massive debt of gratitude for all the

hard work that they've done and continue

to do

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along the lines of augmentation early on

in some of the public discussions about

neurolink 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 things like for instance

electrical stimulation of the

hippocampus that you so appropriately

have worn on your shirt today so for

those they have beautiful um looks like

either a it looks like a Golgi or a

kahal rendition of the hippocampus yeah

translates to seahorse 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 implants in the

hippocampus that would allow greater

than normal memory abilities perhaps

that's one idea sure 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 and you and I could

just sit here look at he 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

um to uh as our good friend Eddie Chang

and uh who's 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 you know I have some idea

although it might not 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

um 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

if 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 and

against I'm deliberately interrupting or

I can text an entire team of people sure

simultaneously and they can text me and

in theory I could have a bunch of

thoughts and

5 10 50 people could hear right

um or um probably more to their

preference um they could talk to me yeah

and and so you know texting each other

with our brains is maybe an uninspiring

rendition of this but it it's not uh

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 uh you know maybe via a

bone conducting implant so silently here

or or not silently like I could 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 cue up a device that would then

play my voice to them and just got off

the plane I'm gonna grab my bag and then

I'll give you a call right on their home

Alexa right

so that's all possible meaning we know

the origin of the neural signals that

give us rise to speech we know the

different mechanical and neural apparati

like the cochlea

um eardrums Etc that

transduce sound waves into electrical

signals right essentially all the pieces

are known we're just really talking

about like refining it yeah refining it

and reconfiguring it it's I mean it's

not an easy problem but it's really an

engineering problem rather than a

neuroscience problem for that for that

use case you know for a non-verbal

communication you might say

um that's a solved problem in a very

crude disjointed way uh so some Labs

have solved you know part one of it some

Labs have solved part two of it there

are products out there that solve you

know say the implanted bone conduction

part of it for the for the deaf

Community

um

there are there are no implementations

I'm aware of that are pulling all that

together into one product that's a

streamlined package from end to end I

think that's a few years down the road

and we I think have some hints of how

easily or poorly people will adapt to

these um let's call them novel

Transformations a few years ago I was on

Instagram and I saw a post from a woman

um her name is cassar Jacobson and she

is deaf since birth and can sign and to

some extent can relapse but she was

um

discussing uh neosensory so this is a a

device that translates sound in the

environment into touch Sensations on her

hand or wrist she's a uh admirer of

birds and all things Avian and

um I reached out to her about this

device because I'm very curious because

this is a very interesting use case of

of neuroplasticity in the sensory domain

which is a fascination of mine and she

said that

um yes 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

um 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 neosensory has made for a

better

worse or kind of um

equivalent experience of avians in the

world which were her is a near Obsession

um so she Delights in them

um what are your thoughts about in a

peripheral devices like that periphery

peripheral meaning outside of the the

skull no requirement for a uh a surgery

do you think that there's a more

immediate or even a uh just generally

potent

um use case for peripheral devices and

do you think that those are going to be

used more readily before the kind of

brain surgery requiring devices are used

yeah

um certainly the barrier to entry is

lower the barrier to adoption is low you

know 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 not have to

get your skin cut at all

um

what you know again there's no perfect

measure of the efficacy of a device of

one device compared to another

especially across modalities but one one

way that you can start to compare apples

to oranges is bitrate you know useful

information in or out of the brain as

you know transformed into digital data

and 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 uh 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 you know a direct brain

surgery Could you um perhaps say what

you just said but in a way that um maybe

people who aren't as familiar with

thinking about bitrate might um

might be able to digest there I'm

referring to myself

um I mean I understand bitrate I

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 and

um to what extent is the the newness of

that valid and adaptive well I'm saying

more uh

it's hard to measure utility in this

space it's hard to you know put a single

metric single number on how useful a

technology is

one crude way to try to get at that is

is uh bit rate think of it as as back in

the days of dial-up modems the bit rate

of your modem was you know 56k or 96 I

can still hear the sound of the dial up

in the background

yeah that was a bit rate that thankfully

kept steadily going up and up and up

your your internet service provider

gives you a number uh 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 in into

the brain and out of the brain usefully

and right now that 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

and for a lot of these Technologies the

theoretical maximum is is very low

disappointingly low even if it's

perfectly executed and and perfect

developed as a technology and I think

the thing that attracts a lot of us to a

technology like neuraling 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 and developed

further so that's the kind of wide band

you know high bandwidth brain interface

that you want to develop if you're

talking about

um and a semantic prosthetic uh an AI

assistant to your cognitive abilities uh

you know the more sci-fi things that we

think about in the coming decades

um

so uh it's an important caveat when

you're evaluating these Technologies

they really want it to be something that

you can expand off into the Sci-Fi

so let's take this a step further

because as you're saying this I'm

realizing that people have been doing

exactly what neurolink is trying to do

now for a very long time let me give you

an example

um

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

a an electrode it's not neosensory right

none of that stuff

what it is is essentially a a stick that

has

um

an interface with a surface so it swept

back and forth across the ground and

you're translating what would otherwise

be visual cues into

somatosensory cues sure and we know that

blind people are very good at

understanding

um even when they are approaching say a

curb Edge because they are integrating

that information from the tip of the

cane

um up through their somatosensory cortex

and their motor cortex with other things

like the changes in the the wind and the

sound as they round a corner and um here

I'm imagining a like a corner in San

Francisco downtown which you get to the

corner it's a completely different set

of auditory cues

and 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 that they

aren't aware of the fact that they're

integrating these other cues but they

nonetheless do them subconsciously right

um and in doing so get pretty good at

navigating with a cane right now Kane

isn't perfect but you can imagine the

other form of of navigating as a blind

person uh which is to just attach

yourself

or attached to you another nervous

system the best that we know being a dog

sighted dog sure that can cue you again

with a stopping at a curb's edge or even

if there are some individuals that might

seem a little sketchy dogs are also very

good at sensing

um different uh arousal States and

others threat danger sure I 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 right in some sense what neurolink

is trying to do is that but with

robotics to insert them and chips which

raises the 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 neuraling specializes in we

also hear about AI another example where

there's great promise and great fear

right we 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 right

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 you know it goes both

ways basically what you're doing is

taking a very crude software

intelligence I would say not exactly a

full full-blown AI but it's 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 and

you're allowing the two to learn each

other so undoubtedly the human that has

a neuralink device will get better at

using it over time undoubtedly the

software that the neurolink engineers

have written will adapt to the firing

patterns that that the device is able to

record and over time focus in on

meaningful signals toward movement right

so if a neuron is fire a 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 so you 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 and right and so you develop a

model

um

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 right 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

um very difficult problem but a human

brain is good enough with the aid of

software to solve that problem and and

map well enough to a semi-stable 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 I'm recalling a recent experience I

got one of these um rowers you know for

to exercise and I am well aware that

there's a proper row stroke and there's

a improper row stroke and most everybody

including me who's never been coached in

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 I mean to play a game

where you can actually

um every row stroke you generate arrows

on toward a dartboard and it knows

whether or not you're generating the

appropriate forces at the given segment

to the row the initial pull when you're

leaning back Etc and adjusts the

trajectory of the arrow so that when you

do a proper row stroke it gets closer to

a bullseye and it's very satisfying

because you now have a visual feedback

that's unrelated to this

um 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 row stroke and get

as I understand pretty close to Optimal

row stroke

in 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 neurobiofeedback 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 it's the

default and the obvious way to do it is

to have people and monkeys play video

games do you play video games yeah sure

which video games

let's see I you know play old ones I'm a

little nostalgic so uh I uh like the old

Blizzard game Starcraft and Warcraft I

don't even know those I remember the

first Apple computers I mean I go how

old are you uh 43 okay 44 now as of a

few days ago happy birthday so we're a

little bit offset there yeah I can

recall um Mike Tyson's punch out like

the original Nintendo game Super Mario

Brothers

um but the game so the games you're

describing I don't recall that my

understanding is that the newer games

are are far more sophisticated in some

respects I I did recently find time to

play cyberpunk

um which was really satisfying and maybe

appropriate

it's a game where the characters are all

fully modded out with cybernetic

implants well perfect um but you know

the 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

the reason I ask about video games is um

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 gazzali's Lab at

UCSF and other Laboratories have shown

that actually provided that um

children in particular and adults are

also spending time in normal face to

let's call them more traditional

face-to-face interactions that video

games can actually make nervous systems

that is people a much more proficient at

learning and motor execution sure

um visual detection

um and on and on yeah there's some work

uh showing that surgeons are better if

they play video games so I try to

squeeze some in as a you know a

professional development activity great

great well I'm sure you're getting

cheers from the uh 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 uh

they're familial disputes among

themselves

let's talk about pigs sure

neural link has been

um quite generous I would say in

announcing their discoveries and their

goals and I I want to highlight this

because I think it's quite unusual for a

company to do this

um I'm probably going to earn a few

enemies by saying this

um despite the fact that I've always

owned Apple devices and from the South

Bay

um 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

um a serious extent neural link has been

pretty open about their goals right with

the understanding the 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

and Elon and others their 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

um in people and in some people evokes

extremely strong emotions sure

um

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 right I assume at some point

there will be one of these public

symposia where

um 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

um and

for all my years as a neuroscientist and

having worked admittedly on every

species from mice to cuttlefish to

humans to hamsters to uh you know I

confess um 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 well let me let me say

first neurolink is almost entirely

composed of animal loving people the

people at norlink 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

and so as is the case for any medical

advancement essentially exactly I do

want to highlight this that the the FDA

and the other governing bodies

um

oversee these types of experiments and

ensure that they're done with a minimum

of discomfort to the animals of course

but

um I think there's an inherent

speciesism right in uh in most humans

not all some people truly see

equivalence 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 and feel that if you have to

work on a biological system

in order to solve the problem

um working on non-human animals first

makes sense right to most people sure

but certainly there's a category of

people that feels very strongly in the

opposite direction sure and you know I

think we would probably be having a very

different conversation around animal

research if uh we weren't you know we as

a species we as a culture weren't just

casually

slaughtering millions of animals to eat

them

um

every single day and so that is a

background against which that 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 end their lives are are

done for food or for fur or for fur or

these other reasons that people you know

have historically used animals so we in

in that context we do animal research

because we have to there's no other way

around it if tomorrow

uh 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 uh yeah

um and I wouldn't be alone and that you

know is a potential way that animals

could maybe be spared uh being unwilling

participants in this

on that note to whatever extent possible

I think neuralink goes

um

really really far much much farther than

anyone I've ever heard of any

organization I've ever heard of any

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 our star monkey pager doesn't want

to play video games for Smoothie no one

forces them to ever this is a very

important point and I want to cue people

to really what Matt is saying here

um obviously the animals are being

researched on for neural links so they

don't get to opt in to opt out of the

experiment right

um but what he's saying is that they

play these games during which neural

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

um 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 kisses 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 right

and 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 right in

order to motivate an animal

to play a video game right depriving

them of something that they yearn for is

a very efficient way to do that we don't

do that we 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 there's never any

deprivation there's never any adverse

negative stimuli that pushes them to do

anything I must say I'm impressed by

that decision

um because uh

training animals to do tasks in

laboratory settings is very hard and the

reason so many researchers have

defaulted to water deprivation and and

having animals work for a ration of

water is because frankly it works right

it allows people to finish their PHD or

their postdoc more quickly than having

to wait around

um and try and figure out why uh their

monkey isn't working that day in fact

having known a number of people who've

done these kinds of experiments although

we've never done them in my lab

my monkey isn't working today is a

common uh gripe among graduate students

and postdocs who do this kind of work

um and for people who work on mice okay

so this is um uh very important

information to get across and there's no

Public Relation statement uh woven into

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 it's one of the one of the

underappreciated Innovations out of

neurolink is how far the Animal Care

team has been able to 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

um more 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 and

I've 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 um you know you can

optimize for different uh

characteristics there's mini pigs

there's

um you know Yorkshires there's uh 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 when we're studying how their

limbs move for some of our spinal cord

research

um 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 can reach out and hit a

button or a lever exactly how are they

signaling that they um saw or

um sent 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 the monkeys are

where we are really doing our heavy

lifting in terms of ensuring that we're

getting good signals out of the device

that that what we expect to see in

humans is validated on a functional

level in 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

he said you know the skull is actually a

pretty lousy uh biological adaptation

far better would be a titanium plate You

Know spoken like a true neurosurgeon uh

with a radio receiver implanted in his

hand

um but in all seriousness

you know drilling through the skull with

a two millimeter hole certainly don't do

this at Home Folks

um please don't do this but

um that yes that's a small

um 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

um uh

environmental conditions in place to

limit infection

what did you mean when you said that the

skull is a poor adaptation in 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

um hard enough

you know maybe I'm being too harsh about

skull the skull is uh 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

um that said there are a couple puzzling

vulnerabilities

some of the thinnest bone in the skull

is in the temporal region this is uh 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 of the

temporal

um part of the skull has one of the

largest arteries that goes to the lining

of the brain right attached to the

inside of it and so this 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 middle

meningeal artery that leads to a big

blood clot that crushes the brain that's

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 pressure

arterial blood that crushes the 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 it's

an enduring mystery but this is probably

the most obvious failure mode in 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 the architecture of

human anatomy probably given all other

possible architectures that can arise

from development it's not that bad

really

um

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

the brain you may know is

um it's mostly fat it floats in salt

water in our brains so our brains are

all floating in in salt water and so

with rapid acceleration deceleration

that sheath of salt water 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

um

you can imagine things being a lot worse

and there's probably a lot fewer tbis

than would exist if a human designer was

taking a first crack at it

as you describe the the thinness of this

temporal bone and the in the presence of

a critical artery just beneath it

um I'm thinking about most helmets

um and here I also want to cue up the

fact that while whenever we hear about

TBI or CTE or brain injury people always

think football hockey but most traumatic

brain injuries are things like car

accidents or construction work right and

it's not football and hockey 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

um uh you know was in a car accident or

environmental environmental accidents 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 um

helmet engineering that um you know I

can understand why you'd want to have

your peripheral vision out the sides of

your eyes uh per free of your eyes but

it seems to me if this is such critical

real estate why why isn't it being

better protected

you know I'm no expert in helmets but

um I don't think we see a lot of

epidural hematomas and squirts 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 to a temporal bone

fracture an epidural hematoma

um with sports injuries you know you

don't often see that especially in

football with uh you know a a sharp

sharper object coming in contact with

the head it's usually another helmet

right is the the mechanism of injury uh

so I I 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

um 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

um 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

um any data or any particular practices

come to mind I mean I think we've all

heard the obvious one don't don't get a

head injury right if you do get a head

injury make sure it gets treated and

don't get a second head injury right but

those are sort of duh type

um answers that um I'm able to give so

I'm curious about the answers that um

perhaps I'm not able to give yeah well

you know the obvious ones it's one that

you you talk about a lot

um and I see a lot of the the smoldering

wreckage of humanity you know in the

operating room uh and in the emergency

room for people that come in you know I

work my practices in San Francisco right

next to the tenderloin 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 uh you

know very often on the scans they 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 that it's

not something that we are all paranoid

about we're

um people think that I don't drink it

all I'll occasionally have a drink I I

could take it or leave it frankly if all

the alcohol in the plant disappeared I

wouldn't notice but I do occasionally

have a drink maybe one per year or

something like that but I am shocked at

um this current state of affairs around

alcohol consumption and advertising Etc

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 and the amount of

brain atrophy and to me it's like it's

just sort of obvious from the these

large-scale studies that

um as you point out alcohol atrophy is

the brain yeah it kills neurons right

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

um that we're talking about you know the

Resveratrol and red wine which is at you

know infinitesimally small amounts and

not even clear Resveratrol is good for

us anyway by the way

um a matter of debate I should point out

but um so alcohol certainly alcohol and

excess is bad for the brain sure

um in terms of uh okay so we have head

hits bad alcohol bad

um you're working as you mentioned

you're the tenderloin

um is there any awareness that

amphetamine use can can disrupt brain

structure or function you know that

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

yeah I ask in part because

um maybe you know a colleague or will

come across a colleague who's working on

this is there's just such a

um a incredible increase in the use of

things like Adderall Ritalin modafinil

armodafinil which I think in small

amounts in clinical clinically

prescribed situations can be very

beneficial but

um let's be honest many people are using

these on a chronic basis right I don't

think we really know what it does to the