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Brain Interfaces: The Future is Ours

In this Brain Interfaces series we covered the early technology developers, the array of use cases, surgically implanted brain interface devices, wearable technologies, and the amazing bionic pioneers. The road to where we are today is paved with great successes and agonizing failures, but that is par for the course. There are technologies that are making a societal impact today and those that have just begun to blossom into the next generation of brain interfaces.

None of the development and advancement in brain interface technology could have occurred without the early investments. The vision of those who supported the early efforts made the compelling case for funding support. These are not the swanky Wall Street hedge funds, the enterprising venture capitalists, or corporate investors. This is a reference to the funding agencies. That’s right, the government funders. Often viewed as agency bureaucrats, the funding agencies make the riskier investments in new and novel technologies; ones that Wall Street would never touch. They also tend to be the forgotten supporters.

Early Financial Support

This is the case in brain interfaces. In the United States, funding agencies like the National Science Foundation, the National Institutes of Health, Veterans Administration and DARPA (Defense Advanced Research Projects Agencies) funded the foundational research for the development of many brain interface modalities. As with any scientific endeavor, the early investments led to enterprising technologies. The most well-known and significant financial support came in the form of the Brain Research through Advancing Innovative Neurotechnologies or BRAIN Initiative. This is the Human Genome Project of our time. Announced at the U.S. White House in 2013, the focus was aimed at revolutionizing our understanding of the human brain leading to new ways to treat, cure and even prevent brain disorders. The vision was and still is to expand opportunities to explore how the brain enables the human body to record, process, utilize, store and retrieve information at an incredible speed. The initiative launched as a collaboration between 14 NIH Institutes and centers as well as other aforementioned agencies. As of 2019, the NIH alone has contributed $1.45 billion to the Initiative. This effort has now grown around the world and in 2018, the International Brain Initiative was launched as a collaboration of programs around the world in the scientific effort to better understand the human brain.

There were also early visionaries at DARPA which launched smaller programs in the early 2000s. One notable effort was BioFutures. In 2005, the small program brought together biology, electronics and information sciences to develop a new human-computer interface with seed funding of $12 million. That seems like a lot of money but the findings from that early investment evolved into programs leading to human trials like the Revolutionizing Prosthetics launched in 2006. RE-NET (Reliable Neural-Interface Technology) launched in 2010. Restorative Encoding Memory Integration Neural Devices (REMIND), SUBNETS (Systems-Based Neurotechnology for Emerging Therapies) and Restoring Active Memory (RAM) programs that began in 2013. Follow-on DARPA programs continue to expand development and investments with many having parallel goals to translate technologies to impact society.

These are only a few of the early investments that sparked the development of brain interfaces. Today, we are now experiencing the translational efforts and many of the technologies highlighted in this series were supported by the early investments. Those technologies and the ones that will follow have been de-risked to aid in the translational efforts to appeal to commercial investors who also take risks to push the technology from laboratories into treatments, products, and diagnostics that can be used in the clinic or at-home. To do so, commercial ventures need to realize the market forces like therapeutic efficacy, cost-effectiveness, real-world outcomes, and clinical or consumer adoption. This is where we begin to realize the societal impact.

“Those who do not remember the past are condemned to repeat it.”

— George Santayana

Ethical considerations

Today, we are living through the perils and societal complications of social media. We do tend to have short-term memories. With that in mind if we can learn from the mistakes of today then we are less probable to make them again in the future. Brain interfaces are in their market infancy. They are where social media was in the 1990s. Back then social media was considered only a communication alternative. Today it impacts so many facets of our society. The brain interfaces of today and tomorrow have the potential to do the same.

There are several efforts around the world to look at the various potential aspects of neurotechnology that can impact our lives. Today, the main focus is in the medical realm but it has begun and will continue to expand into other areas like entertainment, arts, sports, legal, wellness and more. Even in the medical field there are difficult questions to address like articulating the potential risks and long-term consequences of technical failures, assessing the viable options for obsolete implanted devices, or securing privacy and sensitive personal data against malevolent programming.

One of the published guidance on ethics in neurotechnology was made available in 2019 by the Organization for Economic Co-operation and Development or OECD. Through a five-year process, this provided the first international standard in neurotech titled Recommendation on Responsible Innovation in Neurotechnology. The guidance addresses areas like safety, inclusivity, collaborations, and cultures of stewardship to name a few. Another international effort has been led by IEEE Brain. Here they are building a neuroethics framework to address not only the ethical issues but also those of legal, social and cultural influences. Their approach addresses the implication within a variety of application domains such as the most common uses of medical or wellness applications to others that are not so common (yet) such as work and employment, sports competition, and entertainment.

Despite the international collaborative efforts, some countries are taking the approach to address ethical implications now as a human rights issue. Chile is the first country in the world to adopt a bill of rights for its citizens in the form of “neurorights.” In late 2021, the Chilean National Congress passed a constitutional amendment and it was signed into law by the President of Chile. This bill provides protections which subject all neurotech devices in Chile to the same regulations as medical devices. For context, in some countries, if a device is not making a medical claim and is sold as a wellness device, it typically does not require regulatory review. The new amendment in Chile provides protections of neural data banning the buying and selling of this data. It basically considers human neural data to be equivalent to a human organ.

Even with these international and specific country neuroethical efforts there are still many unanswered questions. Human augmentation is one that comes to mind. Performance enhancement and social justice are others. The topic of ethics and neurotechnology still has many iterations of development particularly as neurotech emerges into other markets outside of the medical domain.

Future Directions

The future is bright for this once small and emerging field. The pace of technological advancement is accelerating to transform as we learn about the human experience. The introduction of cortical plasticity refers to the adaption or modification of neural connectivity in the human nervous system, particularly the brain. This phenomenon opens the door for recovery from injury or degeneration due to disease whereas the neural circuits reorganize themselves. New rehabilitation paradigms can harness neuroplasticity leading to the recovery of function. Another area of development is sensory feedback or closed-loop systems. Also referred to as adaptive systems, technology has the ability to sense a neural activity and either deliver a notice to the user or change the response based on this feedback. This allows neurotech systems to learn the behavior of the user and customize the treatment. One more area of technical development is the emergence of minimally invasive or non-invasive devices. New modalities like focused ultrasound, injectables, and optogenetics can lead to targeted treatments or therapies without long surgical procedures. If and when they are applied in clinical practice, these new modalities offer promise to lower costs, improve the accessibility, and ease the user burden of neurotech devices.

The growth of neurotechnology has traditionally been in the medical application domain. This is justified by the early investments for the early versions and use cases of the technology. One of the first expansions from this traditional space was into wellness. This includes both emotional and physical well-being. Think about areas like relaxation, stress reduction, attention enhancement and sleep productivity. This domain expansion is not as controversial as some others such as workplace or employment applications. Arguably, some neurotech devices can be used to monitor human behavior, measure productivity or evaluate alertness. Absent of protections this has the potential to fuel workplace conflicts and blur the lines of privacy. On a lighter note, another expanding domain for neurotech is in entertainment. Say goodbye to those 3D glasses. Neurotech can be an entertainment wearable in the form of virtual reality, EEG gaming headsets, brain-to-brain artistic expression or biometric feedback. Innovations in this field have the potential to transform visual, audio, and event movement artistic expression and artistic experiences.

This brain interface series was intended to provide an overview of brain interface technology from the early stages through the modern-day pioneers. If you missed the earlier installments, please access them below or through our website. Most recently, the Milken Institute published the Neurotechnology: A Giving Smarter Guide. It provides a good overview of the industry, research landscape and the opportunities to help move it forward in the future.

The Brain Interfaces was a five-part series. Early commentaries are:

More information about neurotech devices for various neurological conditions and other network resources may be found on the Neurotech Network website. The entire series can be found on Medium.

Brain Interfaces Series: Has the evolution only just begun?

Is it just hype or are brain interfaces here to stay? Are we at an inflection point? There has been an explosion of non-invasive modalities for the brain while at the same time a thrust to commercialize brain implant technology. At this point, it seems donning a ball-cap or helmet to read signals from the brain seems more accepting than a surgical implant. On another note, a brain implant to treat a chronic medical condition seems more acceptable while the idea of a brain implant to augment human performance leads to discussions toward fears of the unknown or potential unethical practices. Overall, are brian interfaces the right thing to do? Setting aside the technical and scientific jargon, our focus is to probe this area of neurotechnology. In this series, we will explore the origins of brain interfaces, embodiment options, the bionic pioneers of our time, and where we are headed in the future. If there is a specific area that you would like to see covered, post a comment and we will add it.

Brain Computer, Brain Machine or just Brain Interfaces

Human and machine interfaces have been evolving for several decades. The heart pacemaker has advanced tremendously since its first-in-human implant in 1958. Today, they seem to be commonplace with new bells and whistles like wireless communications, rechargeable batteries, and remote monitoring. Still, the heart pacemaker seems to be in a different class since it is an intervention for a muscular organ rather than the complex neural network of the brain.

Read More Here.

Richdeep, Sandra & Jon

Early experiences with Spinal Cord Stimulation for Spinal Cord Injuries

Meet Richdeep, Sandra and Jon who participated in a panel discussion about their experiences as clinical trial participants using spinal cord stimulation for the treatment of spinal cord injuries. The discussion is moderated by Barry Munro with the Canadian Spinal Research Organization and John Chernesky with the Praxis Institute. Topics explored include participant expectations, benefits of involvement, and challenges to participate.

Learn more about neurotechnologies for spinal cord injury with our neurotech directory.

Jessica G.

How closed-loop spinal cord stimulation gave her a new outlook

Watch this exclusive video interview.

Learn more about neurotechnologies for pain management with our neurotech directory.

Jon L.

Deep Brain Stimulation for symptoms of Parkinson’s disease

Parkinson's disease
Deep Brain Stimulation

This story is a combination of immediate impact and slow progression of Parkinson’s Disease, a degenerative brain disorder, and how one man changed his cards to gain a better quality of life.

As a cardiac anesthesiologist, Jon was living his dream. He had a great job, a wonderful wife and two beautiful daughters. Although there was stress related to his job and long hours, he truly enjoyed his work. A strange symptom surfaced that sparked Jon to seek medical assistance. He was pouring a Coke into a glass and observed his pinky finger quivering. That was it, a tremor. That tremor motivated Jon to seek the advice of a neurologist. Without any hesitation, the neurologist diagnosed Jon with Parkinson’s Disease. He was 38 years old. After receiving the news, there was a sense of relief. He was relieved to have a name associated with the strange symptoms he was experiencing. Now that he had a diagnosis, he educated himself about the disease and ways to manage the symptoms.

The initial symptoms of Parkinson’s Disease can be very subtle and often do not surface until the symptoms reach an escalated level. People can have Parkinson’s Disease all their lives but they do not receive a diagnosis until a larger amount of neurons in the brain begin to be impacted. At that point, the outward symptoms begin the surface.

Accepting his diagnosis, Jon began to educate himself about the disease and inventory his options. Being an anesthesiologist helped with his quest.  One of his options for the treatment of Parkinson’s Disease is a medical device called Deep Brain Stimulation (DBS). Several times in the past, Jon had been the anesthesiologist during surgeries to implant deep brain stimulators. Even with this knowledge, Jon took the medical advice and began the typical pharmaceutical regime of taking a myriad of medications.

As Jon began to do his research about DBS, he watched video after video on the internet about success stories of people who received a DBS system. Not all of the videos were about success stories. Jon watched one video about a man for whom the DBS was not successful and he had the device removed. In his research, Jon educated himself about the system, how it works, the surgical procedure, the complication rates and spoke with other doctors regarding the DBS technology. He approached his neurologist with an inquiry as to whether he would be a candidate for the technology. Once Jon asked, his neurologist agreed that he would be good candidate.

As he became more resistant to the medications, his symptoms began to impact every aspect of his life. He was no longer able to work much less perform basic activities of daily living. For Jon, DBS was an option he couldn’t deny. “Once I get my wires, I’ll be able to function.”

The day that the system was activated was a vivid day for him. His appointment was for one o’clock in the afternoon. That morning, he could not take any of his medications and his body reacted to the lack of medications. His symptoms were severe as Jon’s body became stiffer and stiffer. To one point, he could hardly move. He went to the hospital early with the escort of his parents.  His doctor came into the waiting room and said, ‘Come with me.’ It was time to activate the system; one side of the electrode at a time.  His doctor activated one side and immediately the stiffness in Jon’s muscles melted away. The DBS system gave him new freedom of movement that was strangled by Parkinson’s Disease.

This short story is an adaptation of Jon’s full story featured in the book Bionic Pioneers.

There are many symptoms associated with Parkinson’s disease. There’s an array of options includes those of neurotechnologies like DBS, robotic therapy, peripheral nerve stimulation, and more. Learn about neurotechnologies for Parkinson’s disease with our neurotech directory

Patrick S.

Wellness & Cranial Stimulation

The feeling that you have exhausted all of your options. Have you ever felt this way? For many people who know that feeling, the search for alternatives almost becomes a life pursuit. This is a common feature among people who use alternative therapies. For Patrick, he went down a similar path. Medically discharged from his career as a medic in the military, Patrick found himself retired at a relatively young age. While in the process of building his house, he started to get panic attacks. Clinically, it could be classified as anxiety, depression, or even PTSD but for Patrick is was impacting his daily life. 

Over the course of four years, he tried various pharmaceutical treatments for either anxiety or depression. He tried traditional therapies with his psychiatrist, but nothing seemed to work. He even tried ECT sessions without success. “It was just day after day after day. It is doesn’t seem to stop.” Feeling like he had tried all of his clinical options, he started to look for other lifestyle modalities in the field of wellness. Diet and meditation seemed to help but they just didn’t get him to a sense of balance. “I just ran out of ideas,” he expressed about his search for balance and away from the roller coaster of anxiety and depression.

He was on Facebook one day and saw an advertisement for a device that uses pulsed electromagnetic field therapy (PEMF). Patrick swore he would never buy anything on Facebook, but he felt compelled to click on this advertisement. PEMF is a therapy that has long had different forms over the decades but its history dates back to ancient eastern medicine in the use of magnetic fields. The technology used today takes the form of a home-use device that is non-invasive and worn as a headset. Patrick was not convinced this type of therapy could help him but he decided to learn more about PEMF.

To him, science is important so he looked into the scientific research on PEMF. He found nothing that raised the red flags about the therapy. With claims that it could help him with sleep, relaxation, and meditation, there was some potential with this therapy. He even discussed it with his psychiatrist. She was aware of PEMF and encouraged him to try it. As a device that can be purchased on-line, he was skeptical but the vendor offered a 60-day money-back guarantee and they accepted Paypal. He bought it.

Within 5 days, he saw results. He uses the device to help him with meditation. It seems to help him focus. After more use, Patrick started to see a change in his sleep patterns. Before using PEMF, he was a restless sleeper and would typically get three hours of sleep per night. Now, he is enjoying a full 8 hours per night. Today, he uses it twice per day along with meditation. He feels like he has some normalcy back in his life. For others in a similar situation, Patrick advises to “Do the research and find a good doctor who can help guide you.”

To learn more about neurotech devices and treatments related to wellness and human performance, visit our free directory.

Ray D.

Post-traumatic Stress (PTSD) & Chronic Pain

This veteran’s name and photo have been masked to protect his identity.

All too often neurological conditions are complex and there are combined conditions to treat for one person. This is a story of a veteran living with PTSD and chronic pain.

High altitude is high adrenaline for Ray, a retired Marine serving from 1997 to 2003 with two years in Iraq then Marine reserves until 2012. He was conducting reconnaissance missions that logged more than 300 jumps from airplanes at a high altitude. From that flight level, your thoughts revolve around the oxygen that you need at the time but not the real toll that jump is taking to your body upon landings. With over 560 parachute landings under his belt, Ray’s back and legs were damaged in the process. When he returned from the combat zone, he knew that he had mental health issues but pushed them aside for work. He found himself drinking and isolating himself and then turning to suicide to ease the pain. He was diagnosed with spinal disc damage and as a result lives with severe chronic pain.

It was not until 2009 did he finally seek help. The DAV (Disabled American Veterans) assisted him with his paperwork. When he finally received help, he was diagnosed with PTSD. He finds his network of fellow veterans helps him with his PTSD and he also volunteers for the veterans crisis line. In 2012, two major events happened in his life. His wife signed him up for the VA wheelchair games and after doing so she passed away. Still grieving from the loss of his wife, he attended the VA wheelchair games any way. He found that attending those games was the greatest gift his deceased wife could give him. He recognized that he is not alone and there are other veterans living with PTSD. Adaptive sports and, even more so, the competition helped him turn his life around. 

But even with adaptive sports, work, and volunteer duties, Ray still deals with chronic pain on a daily basis. He finds in the evenings when things settle from the day, he slips into symptoms of PTSD and he focuses on his pain. Both make it difficult for him to sleep. He tried many different treatments but just dealt with the pain. This scenario frequently happens with people living with multiple complex conditions. Treating clinicians tend to focus on one area rather than looking at how the various conditions can mask or magnify other conditions. In Ray’s case, he tries to live with the pain while addressing the symptoms of PTSD.

A novel neuromodulation device was introduced to him as a non-invasive high-frequency surface stimulation device. He agreed to try it for three months to see how it works. After one week, his response was “this thing is amazing.” With 6 slipped disks in his back, his pain ranges from his legs, back and arms. He wears the device for 4 hours per day which happens to be the life of its rechargeable battery.  “It feels like a vibration on the skin, like a deep massage,” Ray explains. The small adhesive patch with a smartwatch size processor is a wearable that recently came onto the market with FDA clearance. Ray wears it all day and can’t tell that he is wearing it. On first use, he feels pain relief within 10-15 minutes of turning the device on with a residual effect for about 24 hours. He feels like his pain levels have dropped by 20% within just one week of use. The device connects to a smartphone app allowing Ray to control the device including the levels of current going into his body with a range of 0 to 100 milliamps. He has tried TENS units before but this is nothing like a TENS. “There are no wires and it’s comfortable like a massage.”  Even his mother noticed a difference in Ray, she mentioned to him that he has been able to focus more than before. With his pain reduced, Ray’s mind can now concentrate on other things other than his pain.