Just four months ago, a circular bone was removed from Noland Arbor's skull, and a hair-thin sensor tentacle slipped into his brain. A computer the size of a stack of small quarters was placed on top of it, and the hole was plugged.
Arbaugh, who is paralyzed from the neck down, was the first patient in a clinical trial testing Elon Musk's Neuralink device, and his early progress has been greeted with excitement.
Arbaugh, 30, worked with engineers to train a computer program to translate the firing of neurons in his brain into the movement of a cursor up, down, left, and right. His cursor control soon became so agile that he could play Mario Kart against his stepfather or play empire-building video games late into the night.
But after a few weeks, about 85 percent of the device's tendrils slipped away from the brain. Neuralink staff had to rebuild the system to be able to regain control of the cursor. He has had to learn new ways to click things, but he can still skate the cursor around the screen.
Neuralink advised against surgery to replace the threads, he said, adding that the situation had stabilized.
The setback became public earlier this month. And while the decline in activity was initially difficult and disappointing, Arbaugh said it was worth it for Neuralink to move forward in the technological medical field aimed at helping people restore speech, vision and movement. Stated.
“I just want to take everyone on this journey,” he said. “I want to share with everyone how great this is. And it's been so rewarding. So I'm really excited to keep going.”
Mr. Arbaugh, who hails from a small desert town in Arizona, has emerged as a passionate spokesperson for Neuralink. The company is one of at least five companies leveraging decades of academic research to develop devices that help disabled people and people with degenerative diseases regain function.
While Musk's pitch centers on sci-fi ambitions like telepathy for high-tech consumers, Arbaugh's experience illustrates the medical advances that could lead to federal regulators allowing such risky research.
Neuralink announced in a news report this week that it received permission from the Food and Drug Administration to continue testing the implant in additional patients. The company did not provide many details about the unexpected flaw and did not respond to requests for comment.
Arbaugh has been paralyzed since a swimming accident in the wooded hills of northeastern Pennsylvania, where he was working as a camp counselor after graduating from college. He and a group of friends jumped into a waist-deep lake and sank to the bottom.
“I was face down in the water and I thought I couldn't move anymore. So what should I do? I don't think there's anything,” Arbaugh said. “Then I drank a lot and passed out.”
Mr. Arbaugh was paralyzed below the fourth vertebra in his neck.
Adjusting to life as a quadriplegic was far from the future he had envisioned. As a young man growing up in Yuma, Arizona, Mr. Arbaugh pursued all that the community had to offer. Even if he wasn't playing soccer, American football, or golf, he was participating in academic decathlons and chess tournaments. The first in his family to go to college, he enrolled at Texas A&M University, but there he smoked too much marijuana, spent a somewhat aimless semester in Australia, and was too young to graduate with a senior. He also admitted to skipping many classes.
In the years following the accident, he tried to adapt various devices to help paralyzed people. Although it didn't work effectively for most people for a long time, his Siri on his iPad has emerged as his most reliable assistant, allowing him to call and text friends.
Last year, his friend Greg Bain told him about Neuralink and encouraged him to apply for the company's first human trial.
Arbaugh said he didn't have strong feelings toward Musk, but felt that Musk pushed progress and that “what Musk touched turned to gold.”
After the implant was placed in late January, he began spending long days working with Neuralink staff to connect the neuronal patterns captured in his brain to actions he was about to take. He found the work tedious and repetitive, but rewarding.
Once he was trained, engineers gave him control of a cursor on a computer, and I thought, “If only they'd just take me off my leash, I could fly,” Arbaugh recalls.
On the first day of his solo flight, Arbaugh broke the 2017 world record for speed and accuracy of cursor control. “It was very, very cool,” Arbaugh said.
Long days training computer models with Neuralink staff have now been reduced to four-hour blocks of remote work, Arbaugh said. The team continues to work on spelling words, composing letters in sign language and envisioning writing them on the blackboard.
However, the Neuralink device continued to lose connections, and its tentacles gradually slipped out of the brain's tissue, possibly becoming lodged in the fluid surrounding the brain.
When only about 15% of the thread remained in place, Arbaugh completely lost control of the cursor. The engineer readjusted his computer program so that it could perform most of the tasks he had been able to perform before. Since the system mouse can no longer perform clicks, it uses a new tool that allows you to click by hovering over the item you want to select.
This defective implant highlights the concerns of some experts in the brain-computer interface field. A small round device implanted in the skull is thought to keep the thin tendrils of electrodes in place. But like a finger wobbling in a pie, a thread can fall out.
Arbaugh said the brain moved more than technicians had anticipated, and they have revised the surgical plan to implant the threads deeper into the brain of the next patient.
Neuralink is reviewing applications from other companies interested in participating in clinical trials. According to Neuralink, the company will cover travel and other expenses.
This first Neuralink experiment highlighted how complex the connections between the brain and the device are.
Lee Miller, professor of neuroscience and rehabilitation medicine at Northwestern University, explained the difficulty of working with the brain. They are bathed in salt water, move around by rotating and bobbing their heads, and have immune defenses to fend off invaders. Researchers observed that the brain formed scar tissue around the sensor and even rejected the entire sensing unit, which used a grid of tiny needles.
Kristin Well, a neurophysiologist at the University of Colorado who started the neural interface program at the Food and Drug Administration, which approves medical devices such as implants, said Neuralink's initial lawsuit shows the company still faces hurdles in developing durable devices. He said that this suggests that he is facing.
If the threads were implanted deeper, they could loosen and cause the fibers to rub against the surface of the brain, increasing scarring and signal loss in that area, she said.
“It's hard to know if it will work,” says Dr. Wells. “Fully flexible devices may not be a long-term solution.”
Arbaugh said the team expected scar tissue to form around the threads at the base of the brain. They thought the scar tissue would help hold the threads in place. Arbaugh said he has the option of discontinuing research after a year, but he plans to continue working at the company for much longer. Neuralink says the initial study will take about six years to complete.
Other large commercial companies are taking a different approach.
Brooklyn-based Syncron avoids the brain's delicate tissue by implanting a tiny metal tube through a blood vessel near the brain's motor cortex. But researchers in the field say the device doesn't sense as subtle neural activity as other devices that penetrate brain tissue; it records larger signals, like your intention to select an option from a menu on a screen. The company is conducting human clinical trials.
Manhattan-based Precision Neuroscience implants flexible strips equipped with sensors on the surface of people's brains and then scrutinizes data collected from patients while the strips are temporarily in place, said Michael Meagher, the company's CEO.
Researchers have been studying brain computing devices for decades. The standard is a 96-pin grid called the Utah array, which is placed at the top of the brain and picks up activity up to 1.5 millimeters below the surface. Ongoing human experiments tend to connect them to a small box attached to the head via wires inside the skull. However, the holes in the skull through which the wires pass are susceptible to infection, so BlackRock Neurotech in Salt Lake City is working on a fully implantable upgrade.
Paradromics, which also uses a device with a grid based on the Utah array, has been testing the implantable device in sheep for about a year, according to the company's CEO Matt Angle. They plan to be able to test it on humans soon.
All such research is highly regulated by the FDA, which weighs the risks and benefits of the procedures and will initially consider using these devices in people with severe disabilities or degenerative diseases. (The FDA did not comment specifically on Neuralink, but said such trials require regular reporting of expected and unexpected events.)
Additionally, researchers are wondering about the prospects for widespread adoption by non-disabled people who may want implants that allow them to communicate without speech or download language, as Musk has mused. Opinions are divided. Some researchers predict that it will be available to general consumers within a few decades. Some argue that activities such as surfing the web in the shower should never be allowed, given the risk of infection from repeated brain surgeries over a lifetime.
Paradromics' Angle said he could imagine the treatment becoming widespread, from people who can't talk or walk to people with serious mental illnesses who resist treatment.
From there, it could be 10 years before it's available to consumers, he said. After all, he said, the idea of Botox went from ridiculous to mainstream in about the same amount of time.
“If you said 100 years ago, 'Rich people get botulism in their faces,' that would sound completely ridiculous,” he says. “Once you understand the risks and allow people to make informed decisions, it makes sense.”
Arbaugh hopes the technology will first be used to restore function to people who have lost function.
“And it's about empowering people to improve themselves,” he said, adding, “as long as they don't give up their humanity along the way.”