In short · Summary by AI
Neurosurgeon and Neuralink team member Dr. Matthew MacDougall discusses brain-machine interfaces, focusing first on restoring digital control for people with paralysis from spinal cord injuries. He explains the robotic electrode insertion, animal safety testing in pigs and monkeys, and his longer-term vision of expanded cognition, while stressing the near-term goal is reducing human suffering.
- MacDougall describes the brain as a set of functional modules and recounts a patient whose frontal lobe damage left him without impulse control after a car accident.
- Neurosurgeons can now use MRI-guided laser ablation through a 2-mm skull hole to destroy deep tumors with far less collateral damage than traditional surgery.
- Neuralink's first target is people with severe spinal cord injuries, using implanted electrodes in motor cortex to let them control a computer cursor and keyboard by thought.
- A robot is needed to insert electrodes thinner than a human hair accurately into the cortex, because human hands cannot place them precisely enough or fast enough.
- Reconnecting brain signals to a patient's own limbs by bypassing spinal cord damage is described as a longer-term goal, not an immediate one.
- The decoding software and the user's brain adapt to each other over time, so performance improves with use, as seen in monkeys playing video games for smoothie rewards.
- Pigs are used for safety testing of the device because their skulls and hearts resemble human ones, while monkeys are used to validate signal quality, and animals are kept opt-in with free food and water.
- MacDougall describes a longer-term vision of treating addiction, depression, and obesity, and possibly direct brain-to-brain communication, while noting the device's current purpose is medical.
- 0:00Introduction and Brain Function
- 1:19Frontal Lobe Injury Case
- 3:32Laser Tumor Ablation Technique
- 5:25Neuralink's Mission and Goals
- 7:30Why Robots Insert Electrodes
- 9:56Controlling Devices by Thought
- 12:27RFID Chip in His Hand
- 15:11Reconnecting Brain to Spinal Cord
- 16:58Thought Sharing and Brain Learning
- 21:39Animal Research and Pig Use
- 25:43Long-Term Vision for Brain Interfaces
Introduction and Brain Function
0:00Welcome to Huberman Lab Essentials, [music] where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health, and performance. I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. And now for my discussion with Dr.
0:18Matthew MacDougall. Dr. MacDougall, welcome. Good to be here. Just to kick things off, as a neurosurgeon and as a neuroscientist, could you share with us your vision of the brain as an organ as it relates to what's possible there? Surgeons tend to view the world a little bit differently than most because they like to fix and they like to mend and in your case have the potential to add things into the brain that don't exist there already.
0:46So, 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? >> The brain really is a collection of functional modules pinned together, duct taped together in this bone box attached to your head.
1:06And sometimes you see very interesting failure modes. So, one of the most um memorable patients I ever had was very early on in my training. I was down at UC San Diego and saw um 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.
Frontal Lobe Injury Case
1:33Um when he woke from surgery with bilateral frontal lobe damage, he had essentially no impulse control left. And so, we're 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."
1:59Uh 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. 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, uh all that comes out of the brain, all of it
2:33can go wrong. Any part of it or all of it. So, yeah, working with the brain is the substance of the brain as a surgeon, very high stakes, but 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.
2:51Uh so, it's extremely satisfying as a career. >> Could you share with us one of the more satisfying experiences or what qualifies as satisfying in in neurosurgery? >> Yeah, 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, the
3:25you know, kind of the wires connecting neurons. Um then the modern approach involves a 2-mm drill hole in the skull that down which you can pass a little fiber optic cannula and attach it to a laser and just heat the tumor up deep inside the brain under direct MRI visualization in real time. So, you're this person is in the MRI scanner, you're taking pictures every second or so.
Laser Tumor Ablation Technique
3:49As the tumor heats up, you can monitor the temperature uh 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 brain surrounding it. And so, uh 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.
4:15Even in cases that previously would have considered totally inoperable, say a tumor uh in the brain stem or a tumor in uh primary motor cortex or primary um verbal areas, Broca's area, uh where we would have expected to either not operate or do catastrophic damage, those people sometimes now are coming out unscathed.
4:38>> In your role at Neuralink and as a neurosurgeon in other clinical settings, surely you are using machines. It's I think a very exciting time in which um engineers are starting to uh toss up big problems and go for it. And and obviously, Elon is certainly among the best, if not the best, in terms of going really big.
4:56To the extent that you are allowed, could you share with us what the missions at Neuralink are and what the general scope of missions are? And then, if possible, 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 um humans that are suffering in some way.
5:20>> Neuralink and I think Tesla and SpaceX before it uh end up being these blank canvases that people project their hopes and fears onto. And so, we uh we experience a lot of upside in this. People, you know, assume that we have superpowers uh in our ability to alter the way brains work, and people have terrifying fears of the horrible things we're going to do.
Neuralink's Mission and Goals
5:41Those 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 smaller than the size of a human hair all throughout a small region of the brain. Uh, 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.
6:12So, 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. 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.
6:33And 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.
6:55And so, they're able to regain their digital freedom and connect with the world through the internet. >> Why use robotics to insert these chips? >> 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 a human hand is not steady enough to grab this, you know, couple micron width loop at the end of our electrode thread and place it accurately uh, blindly, by the way, into the cortical
Why Robots Insert Electrodes
7:30surface uh, accurately enough at the right depth to get through all the cortical layers that we want to reach. I would love if human surgeons were, you know, essential to this process. Uh, 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.
8:02>> So in some ways Neuralink 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, uh, the robot's part of the surgery.
8:23Uh, 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 robot a pristine brain surface surface to sew electrodes into. Broadly speaking, you know, the mission of Neuralink is to reduce human suffering at least in the near term.
8:41Um, you know, there's hope that eventually there's a use here that makes sense for, uh, a brain interface to uh, bring AI uh, as a tool embedded in the brain uh, that a human can use to augment their capabilities. I think that's pretty far down the road for us. Um, but definitely on a desired road map.
9:02In the near term, we really are focused on people with terrible medical problems that have no options right now. >> So, um, to just, uh, give us a bit fuller picture of this. You're talking about a patient who can't move their limbs because they've have spinal cord damage. >> Right. >> The motor cortex that controls movement is, in theory, fine.
9:22>> 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? 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
9:43scenario. >> to clarify there, I I um 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?
Controlling Devices by Thought
10:06>> 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 uh allow them to you know, select letters
10:34in sequence and they could type. 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 uh you know, a small army of monkeys playing video games for uh you know, smoothie rewards. Um and they do really well. We We actually have the world record of bit rate of information coming out of a monkey's brain to you know, intelligently control a cursor on a screen.
11:03Uh we're doing that better than anyone else. >> Would you be willing or are you willing if allowed to have these electrodes implanted into your motor cortex? >> Yeah, absolutely. I I would be excited to do that. I think for the first iteration of the device, it wouldn't be very useful because I can still move my limbs.
11:22And our first outputs from this are things that I can do just as easily with my hands. Right? Moving a mouse, typing on a keyboard. We are necessarily making this device as a medical device 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.
11:43As the technology develops and we make devices specifically designed to perform functions that can't be done even by an able-bodied person, uh say eventually refine the technique to get to the point where you can type faster uh with your mind and one of these devices than you can with text-to-speech uh or speech-to-text and your fingers, that's a use case that makes sense for someone like me to get it.
12:10It 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 uh from you know 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 uh surgeries that I routinely do on patients that you know are are no one even thinks twice about.
RFID Chip in His Hand
12:38They're standard of care. Uh Neuralink has already reached, in my mind, uh a safety threshold that is far beyond uh a commonly accepted safety uh 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 um the small lump present in the top of your hand.
13:00For those listening not watching, there's a a small lump between Dr. McDougall's um forefinger and thumb or your next finger and thumb placed on skin on the top of his hand. Um you've had this for some years now because we've known each other for gosh, probably 7 years now or so, and you've always had it in the time that I've known you.
13:21What is that lump um and why did you put it in there? >> Yeah. So, it's a a small uh writable RFID tag. So, it's just a very small implantable uh chip that wireless devices can uh temporarily power if you approach an antenna. Uh they can power and send a small amount of data back and forth. Most phones have the capability of reading and writing to this chip.
13:47For years, it let me into my house. It unlocked the deadbolt on my front door. For some years, it unlocked the doors at Neuralink and let me through, you know, the the various uh locked doors inside the building. >> What other sorts of things could one put into uh 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?
14:10>> Well, the these are passive. They're coated in uh biocompatible glass. And as an extra, I'm a rock climber, and so I was worried about that glass shattering uh during rock climbing. I additionally coated them in another ring of silicone uh before implanting that. So, it's it's pretty safe. They're passive.
14:27There's no battery. There's no uh 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 the technology's always improving, so I might remove it and upgrade it. Already, there's, you know, 10x more storage versions available that could be a a drop-in replacement for this if I ever remove it.
14:50It has a small niche uh 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 uh in order to, you know, say with a straight face that you think this is a reasonable thing to do.
15:09>> I'd like to go back to brain augmentation. Um you've made very clear that one of the first goals for Neuralink is to get quadriplegics walking again. >> 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 cortex. >> them um excuse me uh agency over the movement of things in the world.
Reconnecting Brain to Spinal Cord
15:32>> Yes. >> Um and eventually their body. >> And you're exactly right. Yeah, eventually their body. We would we would love to do that. We've done a lot of work on developing a system for stimulating the spinal cord itself. Uh and so that gets to the question that you that you asked a few minutes ago of how do you reconnect the motor cortex to the rest of the body?
15:49Well, 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.
16:17And uh 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 somebody's own body to their brain. >> Along the lines of augmentation, early on in some of the public discussions about Neuralink that I overheard between Elon and various podcast hosts, etc., there was this idea thrown out that for instance that you would have some chips in your
16:43brain and I would have some chips in my brain and you and I could just sit here looking at each other or not, nodding or shaking your heads and essentially hear each other's thoughts. >> Sure. >> 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?
Thought Sharing and Brain Learning
17:00>> 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. Uh shifting that function from a phone to an implanted device, it requires no magic advance, no leap forward.
17:22It's technology we already know how to do. If we say put a device in that allows you control keyboard and a mouse, which is our stated intention for our first human clinical trial. 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
17:55into speech that I can hear, you know, maybe via a bone conducting implant. Uh, so, silently hear. The thing that attracts a lot of us to a technology like Neuralink is that the ceiling is incredibly high. There's no obvious reason that you can't interface with millions of neurons uh, as this technology is refined and developed further.
18:15So, that's the kind of wide band, you know, high bandwidth brain interface that you want to develop if you're talking about 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. So, the it's an important caveat when you're evaluating these technologies.
18:38They really want it to be something that you can expand off into the sci-fi. To what extent can these brain-machine interfaces learn and get better and better and better because it's also listening to the nervous system that it's trying to support. >> Right. It goes both ways. Basically, what you're doing is taking a very crude software intelligence.
18:59I would say not exactly a full 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, 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.
19:23Undoubtedly the software that the Neuralink 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 high firing rate when you intend to move the mouse cursor up into the right, it doesn't know that when it starts.
19:52When 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.
20:13And 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 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
20:44moving properly on the screen, right? 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 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
21:13shifted. >> Let's talk about pigs. >> Sure. >> Elon and others, um their Neuralink, have shared some of the progress that they've made in experimental animals. That understandably evoke some strong emotions in people. What was the rationale for using pigs? >> Well, let me let me say first uh Neuralink is almost entirely composed of animal-loving people.
21:34If 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 uh to getting a device approval through the FDA by first showing that it's incredibly safe uh in animals.
Animal Research and Pig Use
21:59>> As is the case for any medical advancement, essentially. >> 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 every single day.
22:14Uh and so, that is a background against which the the relatively minuscule number of animals used in research uh it it becomes almost impossible to understand why someone would point to that ridiculously small number of animals uh used in research when the vast vast majority of uh animals that humans use and end their lives are done for food.
22:41In that context, uh 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'd be a lot of people that would step up and say, "Yes, I'm I'm willing to participate in early stage clinical research.
23:06>> You already volunteered? >> I yeah. Um and I I wouldn't be alone. 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 uh to give the animals agency in every aspect of the research.
23:26We have just an incredible team uh 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 uh to participate in experiments beyond the surgery itself. Um so, if say on a given day our our star monkey Pager doesn't want to play video games for smoothie, no one forces him to ever.
23:54They 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. There's never any deprivation, there's never any adverse negative stimuli that pushes them to do anything.
24:09It's one of the underappreciated innovations out of Neuralink is how far the animal care team has been able to to move in the direction of humane treatment of these guys. >> 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.
24:29Their hearts are you know, somewhat similar to human hearts. There's uh a lot of different kind of pigs that we use in different contexts um when we're trying to optimize a certain characteristic. Um so, yeah, uh 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 um when we're studying how their limbs move uh for some of our spinal cord research um but we're not, you know, recording interesting,
25:00say, cognitive data out of their minds. They're really just, uh, 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. So, again, the the pigs are really just a safety platform to say the device is safe to implant.
25:16It 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. >> What is your wish for brain machine interface and brain augmentation?
25:39So, let let's let's assume that the the clinical stuff can be worked out. Or maybe you have a uh a um pet clinical condition that you just are um just yearning to see resolved. That would be fine, too. But, in addition to that, wait, you really just expand out. Let's say we can extend your life 200 years or um we're thinking about the kind of world that your children are going to live in and their grandchildren will live in.
Long-Term Vision for Brain Interfaces
26:06What do you think is really possible Yeah. with brain augmentation and brain machine interface? And here, please feel no bias whatsoever to answer in a way that um reveals to us your um your incredible empathy and consideration of clinical conditions cuz that's how you spend your days is fixing patients uh and helping their lives be better.
26:27So, if it lands in that category, great. But, um for sake of of fun and for sake of delight and for sake of um really getting us, the audience, to understand what's really possible here, please feel no shackles. >> Yeah. I love the idea down the road, and we're talking, you know, a 10-year, maybe 20-year time frame of uh humans just getting control over some of the horrible ways that their brains go wrong, right?
26:58So, 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, uh obesity. These functions of the brain or or malfunctions of the brain are what drives me. These are the things that I want to tackle in my career.
27:18In terms of my kids' lifetime, uh I'm thinking, you know, full human expansion of human cognition into uh AI, full uh immersion in the internet of your cognitive abilities, um having no limitation for what you think as bottlenecked by needing to read the Wikipedia article first uh to have the data to inform your thoughts.
27:48Um having communication with anyone that you want to uh unrestricted by this, you know, flapping air past meat on your face. Um it's a, you know, a 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 and there's no reason that needs to necessarily be true.
28:15It's the way things have always been, but it isn't the way things are going to be in the future. Uh I think there's a a million very sci-fi possibilities in terms of banding human minds together to be even more potent as a as a multi-unit uh organism, you know, as an opt-in um multi-brain. Uh 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
28:49be thought about in a realistic way. 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 Neuralink website and look at the jobs we've got. We need the brightest people on the planet working on these the hardest problems uh in the world uh in my opinion.
29:09And so uh if you want to work on this stuff, come help us. >> I really want to thank you uh first of all for coming here today and uh taking time out of your important schedule of seeing patients and doing brain surgery, literally, time away from your family and time away from uh your mission at Neuralink briefly to uh to share with people what you guys are doing.
29:31And I really just want to thank you also for for being you, which is uh perhaps sounds like a a a kind of an odd um thing to hear, but I think, as made apparent by the device implanted in your hand, uh you don't just um do this for a job. You live and breathe and embody, truly embody this stuff around um the nervous system and trying to figure out how to fix it, how to make it better.
29:55And you live and breathe it and I know your deep love for it. So, I want to thank you for um not just the uh brains that you put into it and the energy you put into it, but also for that the heart that you put into it. Thanks for that, Andrew. I appreciate that. >> Uh we we just want to help people. We want [music] to make things better.
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