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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.