Neuralink Surgeon MacDougall Targets Paralysis Bypass, Cognitive AI

Andrew Huberman

Direct brain-machine interfaces can bridge spinal trauma to restore movement within years before scaling to eliminate the bandwidth bottlenecks of human vocal speech.

AI-assisted summary of Essentials: Neuralink & Technologies to Enhance Human Brains | Dr. Matt MacDougall — original source. Check the original for full context.

Source published: 2026-10-15

Key ideas

Neuralink's initial clinical endpoint focuses on helping quadriplegic patients control digital cursors and keyboards by decoding motor cortex intentions, bypassing damaged spinal pathways. (4:38)
A specialized robotic surgical system is required because human hand dexterity cannot safely insert hundreds of micro-scale electrode threads around dense cortical surface vasculature. (7:04)
Functional brain-machine interface control relies on bidirectional co-adaptation, where the user's neural plasticity and decoding algorithms simultaneously adjust to compensate for continuous signal drift. (18:44)
Neuralink uses pigs primarily as biological safety platforms to assess hardware stability and foreign-body reactions, while rhesus macaques validate high-bandwidth neural decoding on voluntary, opt-in tasks. (24:18)

Detailed notes

## Background This Huberman Lab Essentials episode was published by Andrew Huberman on YouTube on October 15, 2026. According to the page description, the discussion features Neuralink neurosurgeon Dr. Matthew MacDougall exploring how brain-machine interfaces help paralyzed individuals control computers, the role of robotic surgery in placing micro-electrodes, implant safety, animal research ethics, and future possibilities for restoring movement, treating psychiatric conditions, and augmenting cognition.

## TL;DR Dr. Matthew MacDougall details the mechanical modularity of the human brain and how advanced neurosurgical tools—from MRI-guided laser ablation to Neuralink's robotic sewing system—overcome traditional surgical limitations. He outlines Neuralink's clinical roadmap, starting with translating motor cortex intentions into digital inputs for quadriplegic patients before expanding toward spinal cord bypasses to restore biological limb movement. MacDougall also addresses safety data, ethical voluntary protocols in animal research, bidirectional learning between the brain and decoding software, and his personal subdermal RFID implant. Looking ahead, he envisions neural interfaces treating severe neuropsychiatric conditions and radically transforming human communication and AI integration.

## Atmosphere & style The conversation carries an intimate, intellectually charged, and collegial atmosphere rooted in the seven-year friendship between Andrew Huberman and Dr. Matthew MacDougall. The tone smoothly balances the clinical gravity of high-stakes brain trauma and severe paralysis with infectious, cutting-edge technical optimism. Listening feels like sitting in on an earnest, demystifying exchange where science fiction concepts—such as robotic brain surgery, telepathic digital texting, and cognitive augmentation—are grounded in rigorous anatomy, humble human empathy, and pragmatic engineering reality.

## Bulletin - [04:38](https://www.youtube.com/watch?v=YdIJW8RTptU&t=278s) Neuralink's initial clinical endpoint focuses on helping quadriplegic patients control digital cursors and keyboards by decoding motor cortex intentions, bypassing damaged spinal pathways. - [07:04](https://www.youtube.com/watch?v=YdIJW8RTptU&t=424s) A specialized robotic surgical system is required because human hand dexterity cannot safely insert hundreds of micro-scale electrode threads around dense cortical surface vasculature. - [18:44](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1124s) Functional brain-machine interface control relies on bidirectional co-adaptation, where the user's neural plasticity and decoding algorithms simultaneously adjust to compensate for continuous signal drift. - [24:18](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1458s) Neuralink uses pigs primarily as biological safety platforms to assess hardware stability and foreign-body reactions, while rhesus macaques validate high-bandwidth neural decoding on voluntary, opt-in tasks.

## Key takeaways - [00:23](https://www.youtube.com/watch?v=YdIJW8RTptU&t=23s) The brain operates as a collection of discrete functional modules pinned together, meaning localized trauma can eliminate specific traits like impulse control while leaving other capacities intact. - [02:57](https://www.youtube.com/watch?v=YdIJW8RTptU&t=177s) Real-time MRI-guided laser thermal ablation through a 2-millimeter burr hole enables surgeons to destroy deep-seated, previously inoperable tumors while sparing healthy brain parenchyma. - [04:38](https://www.youtube.com/watch?v=YdIJW8RTptU&t=278s) Public perception of Neuralink frequently swings between unrealistic godlike expectations and dystopian fears, contrasting with its grounded clinical focus on severe spinal cord injuries. - [10:00](https://www.youtube.com/watch?v=YdIJW8RTptU&t=600s) The primary near-term application of Neuralink's brain-computer interface is digital device agency, translating imagined movements into mouse and keyboard inputs. - [07:04](https://www.youtube.com/watch?v=YdIJW8RTptU&t=424s) Human surgical dexterity is insufficient to place Neuralink's flexible micro-threads across the cortex without damaging blood vessels, necessitating robotic insertion. - [11:05](https://www.youtube.com/watch?v=YdIJW8RTptU&t=665s) Dr. MacDougall considers the implant procedure safer than many routine, FDA-approved standard-of-care neurosurgeries based on extensive preclinical surgical experience. - [12:51](https://www.youtube.com/watch?v=YdIJW8RTptU&t=771s) Dr. MacDougall carries a custom-buffered, passive subdermal RFID chip in his hand used for everyday access control, demonstrating personal adoption of implantable tech. - [15:34](https://www.youtube.com/watch?v=YdIJW8RTptU&t=934s) Restoring natural biological limb movement requires bridging the injury site by pairing a motor cortex implant with a secondary stimulator placed below the spinal cord lesion. - [16:31](https://www.youtube.com/watch?v=YdIJW8RTptU&t=991s) Silent brain-to-brain communication represents an evolutionary extension of modern digital texting, shifting the interface directly from external smartphones into cortical speech or motor circuits. - [20:00](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1200s) Brain-machine interface decoding functions like playing a piano with drifting keys, requiring continuous mutual adaptation between biological neural networks and machine learning models. - [21:14](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1274s) Neuralink conducts animal research under strict regulatory mandates while enforcing an opt-in model where animals voluntarily participate without food or water deprivation. - [24:18](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1458s) Pigs serve as biological platforms to evaluate implant biocompatibility and hardware safety, whereas non-human primates validate high-bitrate neural signal extraction. - [26:44](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1604s) Long-term horizons for neural interfaces include treating circuit-level neuropsychiatric disorders like severe depression and addiction, as well as enabling direct cognitive integration with AI.

## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=YdIJW8RTptU&t=0s) Brain Function, Frontal Lobes & Impulse Control

Andrew Huberman introduces this *Essentials* episode featuring Dr. Matthew MacDougall, neurosurgeon at Neuralink, setting up a conversation around what is surgically and technically possible within the human brain. Huberman asks MacDougall to share his distinct perspective—as both a practicing neurosurgeon and a neuroscientist—on how he conceptualizes the brain as an organ and what possibilities lie ahead that most people never consider.

Dr. MacDougall explains his mechanical and modular view of neuroanatomy, remarking that “the brain really is a collection of functional modules, pinned together, duct taped together in this bone box attached to your head.” Because of this modular design, neurological failures can manifest in jarring ways. Early in his surgical training at UC San Diego, MacDougall treated a young man involved in a severe car crash. The surgical team successfully saved the patient's life, but MacDougall notes the tragic reality of neurosurgery: life is sometimes saved at the direct expense of its quality. When the patient woke up, bilateral damage to his frontal lobes had stripped away his impulse control entirely.

The surgical team was urgently called to the recovery room by an 80-year-old nurse who reported that something was terribly wrong. Walking in, the patient immediately pointed at the elderly nurse and announced, “She won't have sex with me.” MacDougall realized in that instant that because the man's frontal lobes were destroyed, he would never exhibit normal human social behavior again. Everything the brain governs—hormone regulation, sensory processing, vision, and motor actions from eye twitches to bicep contractions—can fail entirely or in discrete pieces. Despite the high-stakes risk, MacDougall finds the career profoundly rewarding, noting that neurosurgeons occasionally achieve "Lazarus-like miracles" by mending injuries and deficits previously considered hopeless.

[02:57](https://www.youtube.com/watch?v=YdIJW8RTptU&t=177s) Brain Tumors, Laser Surgery & MRI

Huberman asks MacDougall to illustrate what counts as a deeply satisfying outcome in modern neurosurgery. MacDougall contrasts traditional neurosurgical interventions with modern, minimally invasive techniques for treating small, deep-seated brain tumors. In the past, resecting a deep lesion required cutting through healthy, functional brain tissue, severing intact neurons and destroying critical white matter tracts along the way.

Today, surgeons use an advanced technique requiring only a 2-millimeter drill hole in the skull. A tiny fiber-optic cannula is guided through the hole directly into the tumor bed and linked to a laser:

```mermaid flowchart LR accTitle: Real-Time Laser Ablation Process accDescr: Three-step workflow showing 2-millimeter skull access, fiber-optic cannula heating, and real-time MRI thermal tracking.

A["2 mm Drill Hole in Skull"] --> B["Pass Fiber-Optic Cannula to Tumor"] B --> C["Laser Thermal Ablation"] C --> D["Real-Time MRI Monitoring"] D -->|"Kill Tumor Cells / Spare Healthy Brain"| E["Patient Leaves Unscathed"] ```

While the patient lies inside the MRI scanner, scans are acquired roughly every second to track thermal dissipation in real time. The surgical team can precisely calibrate the temperature to eradicate malignant cells while leaving surrounding, critical parenchyma uninjured. This technique enables neurosurgeons to clear lesions once considered completely inoperable—including deep tumors in the brainstem, primary motor cortex, or Broca's area—leaving the patient with only a small puncture mark in their scalp and their neurological function fully intact.

- Traditional methods required cutting through normal brain matter and severing white matter tracks to reach deep lesions. - Modern laser thermal ablation operates through a 2-millimeter drill opening. - Real-time MRI imaging captures updates roughly once per second to track temperature boundaries. - Previously inoperable lesions in eloquent regions (e.g., Broca’s area or the brainstem) can now be eliminated without devastating functional deficits.

[04:38](https://www.youtube.com/watch?v=YdIJW8RTptU&t=278s) Neuralink, Brain Implants & Paralysis

Huberman shifts the focus to MacDougall’s work with Neuralink, noting how visionary engineering pushes past conventional clinical limitations. He asks MacDougall to delineate the current mission, scope, and specific clinical endpoints of the enterprise.

MacDougall acknowledges that Neuralink, much like Tesla and SpaceX, tends to act as a cultural mirror for outsized public expectations: “Neuralink and I think Tesla and SpaceX before it end up being these blank canvases that people project their hopes and fears onto.” People swing between believing the company has godlike powers to manipulate minds and harboring deep paranoia about nightmarish dystopias. The concrete reality is far more grounded: the team is building an advanced neural implant paired with an ultra-precise robotic insertion platform.

The initial clinical trial target is severe spinal cord injury. Patients living with quadriplegia retain an intact, fully functioning primary motor cortex capable of commanding voluntary movement, but the physical wiring carrying those signals down the spinal cord to peripheral limbs is broken. Neuralink’s immediate goal is to place an array of flexible electrode threads directly into the patient's motor cortex. By recording intended movements directly from cortical neurons, the device translates those motor intentions into computer inputs—allowing a paralyzed individual to control a digital cursor and keyboard as seamlessly as if their hands were resting on physical peripherals, returning their ability to communicate and interact online.

[07:04](https://www.youtube.com/watch?v=YdIJW8RTptU&t=424s) Robotic Surgery & Electrode Placement

Huberman asks why a robotic system is required to place these neural interfaces instead of relying entirely on human surgical skill. MacDougall explains that the electrode threads are extraordinarily delicate—thinner than a human hair—and terminate in a microscopic loop only a couple of microns across. The surface of the cerebral cortex is blanketed by a dense, fragile mesh of blood vessels that must not be disrupted.

MacDougall admits that although he would love for human hands to be irreplaceable, human dexterity fails at this scale: “I would love if human surgeons were essential to this process, but very soon humans run out of motor skills sufficient to do this job.” A human hand lacks the micro-steadiness required to grasp these micro-loops, navigate around surface vasculature, and insert hundreds of threads at exact depths through every target cortical layer without direct line of sight. The robotic platform is engineered to perform this ultra-precise, high-speed, repeatable insertion at a density and scale humans cannot reproduce.

In the current setup being evaluated by the FDA, the robot's role is strictly confined to placing the electrode threads into the brain. The neurosurgeon still conducts the initial manual steps: creating the scalp incision, opening the skull, and exposing an undamaged cortical surface ready for the robotic sewing system.

Beyond the surgical hardware, MacDougall outlines Neuralink’s broader roadmap:

- **Near-term priority:** Alleviating severe human suffering by providing functional interfaces for people with severe, untreatable neurological conditions such as quadriplegia. - **Future ambition:** Integrating artificial intelligence as an embedded cognitive tool that enhances baseline human processing power and communication, though MacDougall stresses this capability remains far off on the long-term horizon.

When Huberman asks whether the system intends to bypass the spinal cord lesion to immediately restore movement to the patient's biological limbs, MacDougall clarifies that directly reconnecting the brain to paralyzed limbs remains years away on the development roadmap; the near-term clinical target focuses entirely on giving patients control over digital interfaces.

[10:00](https://www.youtube.com/watch?v=YdIJW8RTptU&t=600s) Decoding Motor Intentions to Control Computers

Andrew Huberman and Dr. Matthew MacDougall discuss how Neuralink translates motor intentions into digital actions without requiring physical movement in the real world. Initially, this setup does not move a robotic limb; instead, it allows a user to control basic computer interfaces such as a mouse and keyboard. If a paralyzed patient imagines flexing their fist or twisting their wrist, smarter decoding algorithms translate that neural activity into cursor movements on a display—for instance, guiding the cursor down and to the left to click on a word processor icon, followed by selecting characters sequentially on an on-screen keyboard to type text.

MacDougall explains that this decoding capability has already been demonstrated extensively in animal subjects. Rhesus macaque monkeys at Neuralink play computer games for smoothie rewards, reaching unprecedented performance benchmarks. As MacDougall highlights:

> “We actually have the world record of bitrate of information coming out of a monkey's brain to intelligently control a cursor on a screen.”

- Paralyzed patients control digital interfaces strictly through imagined physical movements (e.g., clenching a fist or rotating a wrist). - Animal subjects demonstrate voluntary cursor control while receiving smoothie treats as positive reinforcement. - Neuralink holds the world record for neural information bitrate extracted from a non-human primate brain for cursor control.

---

[11:05](https://www.youtube.com/watch?v=YdIJW8RTptU&t=665s) Augmentation vs. Medical Need and Implant Safety

When Huberman asks MacDougall whether he would personally be willing to have Neuralink electrodes implanted into his own motor cortex, MacDougall responds enthusiastically, though with practical caveats. For an able-bodied person with full motor function, the first iterations of the implant offer little practical utility because the current outputs simply replicate standard mouse navigation and typing—tasks that can already be done effortlessly with physical hands. The primary mission of early-generation devices is therapeutic, aimed at patients who suffer from catastrophic neurological conditions and have no other viable clinical alternatives.

However, MacDougall envisions a future threshold where the technology exceeds normal human biological bandwidth. If the interface improves to the point where an individual can think and type far faster than through physical typing or voice-to-text dictation, receiving an implant would offer a compelling advantage to healthy individuals. Furthermore, he expresses complete confidence in the physical safety of the procedure based on his extensive surgical experience with the hardware:

> “From 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 surgeries that I routinely do on patients that, you know, no one even thinks twice about their standard of care.”

He emphasizes that Neuralink’s safety standards have surpassed conventional clinical thresholds, making the procedure safer than many routine neurosurgical operations performed across modern hospitals.

---

[12:51](https://www.youtube.com/watch?v=YdIJW8RTptU&t=771s) The Subdermal RFID Hand Implant

Huberman shifts the conversation to biological augmentation by pointing out a visible lump nestled between MacDougall’s thumb and index finger, an implant Huberman has noticed throughout their seven-year friendship. MacDougall explains that the lump is a small, writable radio-frequency identification (RFID) tag. The chip contains no internal battery or active electronics; instead, it remains entirely passive until placed near an antenna, which temporarily powers it to transfer small packets of data. Most standard smartphones can read and write data to this tag.

For years, MacDougall utilized the implant for practical access control, using it to unlock the electronic deadbolt on his front door at home and badging through secure doorways at Neuralink headquarters. Because he is an active rock climber and was concerned about the standard biocompatible glass casing fracturing under mechanical stress, he manually encased the tag inside an extra protective ring of silicone prior to implantation. Because the chip is fully passive, it could theoretically remain in his hand for life without needing replacement or maintenance, although newer commercial chips already offer ten times the data storage capacity as drop-in upgrades. MacDougall notes that walking the walk by carrying implants himself gives him credibility when proposing implantable devices to his patients.

```mermaid flowchart LR accTitle: Subdermal RFID Operation Flow accDescr: Diagram illustrating passive external powering and everyday access applications of the RFID tag. subgraph Hand ["Subdermal Hand Implant"] Chip["Passive RFID Tag"] Glass["Biocompatible Glass Casing"] Silicone["Custom Silicone Buffer"] Glass --- Silicone --- Chip end

subgraph Readers ["External Field & Devices"] Phone["Smartphones (Read/Write)"] Door["Home Deadbolt"] Office["Neuralink Security Doors"] end

Readers -->|"Inductive RF Power"| Chip Chip -->|"Data Return"| Readers ```

- **Device Construction:** Passive, battery-free RFID tag encapsulated in biocompatible glass with an added layer of silicone specifically added to resist rock-climbing trauma. - **Power Mechanism:** Powered entirely via near-field induction when brought near an RF antenna. - **Everyday Functions:** Electronic deadbolt door key for home and keyless security badge access at Neuralink facilities.

---

[15:34](https://www.youtube.com/watch?v=YdIJW8RTptU&t=934s) Bridging Spinal Cord Injuries to Reconnect Brain and Body

Returning to the topic of motor restoration, Huberman clarifies the distinction between Neuralink's immediate clinical objective—giving quadriplegic patients agency over computers and external devices—and the long-term objective of restoring bodily movement. MacDougall confirms that while the initial clinical trials target software and cursor control, the ultimate goal is to physically reconnect the brain to the patient's own paralyzed limbs.

To achieve this, Neuralink has explored direct spinal cord interfaces. In traumatic injuries resulting from motor vehicle accidents, falls, or gunshot wounds, the motor cortex in the brain remains fully functional, and the downstream spinal cord neural networks below the injury level often remain intact. The deficit is purely a communication breakdown across the focal site of injury. By placing one implant in the motor cortex to capture motor intention and a secondary implant below the lesion in the spinal cord, software can bypass the severed tract:

> “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 motor cortex and send them to the spinal cord, which most of the wiring should be intact in.”

MacDougall states that achieving this bypass to restore natural movement to a patient’s paralyzed limbs is a realistic technical milestone achievable within a modest number of years.

---

[16:31](https://www.youtube.com/watch?v=YdIJW8RTptU&t=991s) Telepathic Communication and High-Bandwidth Brain Interfaces

Huberman asks about the conceptual sci-fi vision often discussed by Elon Musk on podcasts: direct brain-to-brain communication, where two individuals with implants exchange silent thoughts without speaking or moving. MacDougall demystifies the idea by drawing an analogy to existing smartphone behavior. Two people sitting across a table from each other texting on their phones are already communicating silently and digitally. Shifting that interface directly into the brain requires no conceptual leaps:

> “Shifting that function from a phone to an implanted device, it requires no magic advance, no leap forward.”

While texting via motor-cortex cursor control represents a rudimentary baseline, the same architecture could eventually be implanted over verbal processing regions of the cortex. This would allow an individual to formulate thoughts into internal speech, which could be converted into synthetic audio and transmitted directly to another person via a bone-conduction implant. MacDougall notes that Neuralink’s fundamental appeal lies in its immense scalability: the architecture has no obvious physiological ceiling preventing it from interfacing with millions of neurons simultaneously, laying the framework for advanced semantic prosthetics and direct cognitive AI integration.

---

[18:44](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1124s) Bidirectional Adaptation: How Brains and Algorithms Learn Together

Huberman asks how brain-machine interfaces improve their performance over time and whether they actively learn from the biological nervous system they monitor. MacDougall explains that functional improvement is an inherently bidirectional learning process between human neuroplasticity and adaptive decoding software.

At the moment of surgical implantation, the chip only reads raw, uncalibrated electrical signals. The decoding software correlates these firing patterns with the patient's intended physical trajectories (such as wanting to guide a cursor toward the upper right). As the patient practices, their biological brain alters its firing patterns to drive the cursor more effectively, while the software simultaneously refines its algorithmic model:

> “So undoubtedly the human that has a Neuralink device will get better at using it over time. Undoubtedly, the software that the Neuralink engineers have written will adapt to the firing patterns that the device is able to record and over time focus in on meaningful signals toward movement.”

This continuous closed loop between human neural plasticity and adaptive software algorithms allows the user and the device to co-adapt, transforming crude, noisy baseline signals into precise, fluid digital control.

[20:00](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1200s) Brain-Machine Interface Adaptation: Decoding Intent and the "Shifting Piano"

Dr. Matthew MacDougall explains how the Neuralink system decodes a user's intent through calibration games on a screen. Because the participant cannot physically move the mouse, the system relies on assumed intention: when a target appears on the screen, the software assumes the user is trying to guide the cursor toward it. The software then records neural firing patterns and correlates specific electrical activity with movements in particular directions—such as up and right, up and left, down and left, or down and right. Over time, the software builds a semi-intelligent predictive model of the user's intent. Once the user is allowed to interact freely, a dynamic co-adaptation takes place: the user learns how to operate the model presented by the software, refining their neural output based on whether the cursor behaves as intended.

To illustrate how challenging this learning problem is, MacDougall draws an analogy to learning a musical instrument whose physical behavior constantly drifts. “Imagine a scenario where you're asking somebody to play piano that the sound that comes out of each key randomly shifts over time,” MacDougall explains. Despite that shifting baseline, the human brain, working alongside adaptive software, is capable of stabilizing the interaction. The user and the algorithms settle into a semi-stable functional state, allowing the person to retain control of the mouse even after powering the device down for the night and returning the following morning to slightly altered neural signals.

```mermaid flowchart TD accTitle: Brain-Machine Interface Co-Adaptation Loop accDescr: Diagram illustrating the closed-loop calibration between user neural firing and software decoding models. subgraph UserSide["User Intent & Action"] A["Visual Target Presented"] --> B["User Intends Directional Movement"] B --> C["Neural Firing Patterns Recorded"] end subgraph DecoderSide["Algorithm & Feedback"] C --> D["Software Builds Directional Model"] D --> E["Cursor Moves on Screen"] E -->|"Visual Feedback"| B E --> F["Co-Adaptation to Drift & Signal Shifts"] end ```

[21:14](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1274s) Animal Research Ethics and Voluntary Participation

Addressing the public sensitivity and emotional reactions surrounding animal testing at Neuralink, MacDougall emphasizes that the company consists almost entirely of animal lovers who would completely bypass animal research if an alternative existed. However, under current regulatory standards, the FDA mandates demonstrating rigorous safety and biocompatibility in animal models before any device can be approved for human clinical use. MacDougall points out that society casually slaughters millions of animals every single day for food, making the sharp focus on the miniscule number of animals used to develop life-saving medical devices disproportionate. If regulatory frameworks allowed willing human volunteers to participate in early-stage safety studies, he notes, many people—including Andrew Huberman, who had already offered to volunteer—would readily step forward.

Within those regulatory constraints, MacDougall states that Neuralink goes to unprecedented lengths to respect animal welfare by making experimentation strictly opt-in. Animals are never coerced into performing tasks once surgical recovery is complete. For example, their star rhesus macaque, Pager, only plays video games when he chooses to. The animals enjoy continuous, unrestricted access to their baseline food and water rations, meaning they are never deprived of basic needs to manufacture compliance. Sweet treats like smoothies serve purely as optional rewards. MacDougall identifies this humane, agency-centered experimental protocol as one of Neuralink's most overlooked internal innovations.

- FDA regulations require exhaustive animal safety data before approving human medical device trials. - Experimental participation for animals is entirely opt-in; no deprivation or negative reinforcement is permitted. - MacDougall reflects on the societal double standard: “In that context, we do animal research because we have to. There's no other way around it.”

[24:18](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1458s) Pigs vs. Monkeys: Safety Platforms and Functional Validation

MacDougall clarifies the distinct experimental roles played by pigs and non-human primates in Neuralink's research pipeline. Pigs are a standard model across medical device engineering, particularly in cardiology, because their physiology shares strong similarities with humans. In Neuralink's work, pigs are not used for complex cognitive decoding tasks. Instead, their skull dimensions and biological resilience make them an ideal safety testing platform. Implantation in pigs allows the team to confirm that the hardware remains physically stable, resists degradation in living tissue, and does not trigger toxic, inflammatory, or foreign-body reactions over time. On occasion, pigs have also walked on treadmills to evaluate limb kinematics and neural signaling for spinal cord restoration research.

Monkeys, by contrast, shoulder the functional workload of the brain-machine interface program. Because their cortical architecture and motor control closely mirror human biology, primates are necessary for validating whether the high-channel-count electrode arrays can extract high-fidelity motor and intention signals. As MacDougall summarizes: “The pigs are really just a safety platform to say the device is safe to implant. It doesn't 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 what we expect to see in humans is validated on a functional level in monkeys first.”

[26:44](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1604s) The Future of Brain Augmentation: From Neuropsychiatry to Direct Mind-to-Mind Connection

Looking toward the clinical horizon over the next 10 to 20 years, MacDougall's primary motivation is ending the devastating neuropsychiatric malfunctions that plague human lives. He points out that virtually everyone has either personal or second-hand experience with conditions like addiction, severe depression, suicide, and obesity. Using targeted neural interfaces to correct these circuit-level malfunctions represents what drives his surgical career.

When Huberman asks him to set aside clinical constraints and envision the long-term potential for human augmentation across generations, MacDougall describes a radically altered cognitive paradigm:

- **AI Immersion and Bottleneck Elimination:** Integrating human cognition directly with artificial intelligence and the web, eliminating the need to read through intermediate sources like Wikipedia articles to obtain foundational data for thought. - **Transcending Vocal Speech:** Moving past verbal language, which MacDougall describes as an inefficient bottleneck: “communication with anyone that you want to, unrestricted by this, you know, flapping air past meat on your face. It's a, you know, a means of communication that's ridiculously prone to being misunderstood. It's also a tiny, narrow bottleneck of communication.” - **Multi-Brain Networks:** Speculative, opt-in networks where multiple human minds combine into a higher-order, multi-unit organism with enhanced collective problem-solving capabilities.

MacDougall views Neuralink's current hardware as cracking open the doorway to these long-range possibilities. To turn these concepts into reality, he invites mechanical, software, and robotics engineers to apply to Neuralink, emphasizing that the team requires the world's best talent to tackle what he considers the planet's hardest engineering challenges.

[29:15](https://www.youtube.com/watch?v=YdIJW8RTptU&t=1755s) Concluding Reflections

Huberman closes the conversation by thanking MacDougall for stepping away from his active neurosurgical duties, his clinical patients, his family, and his work at Neuralink to discuss the technology. Huberman highlights that MacDougall's dedication is not merely theoretical or professional—pointing to the RFID chip implanted beneath the skin of MacDougall's own hand as evidence that he lives and breathes neural augmentation. Huberman commends him not only for his technical intellect and energy, but for the genuine empathy and heart he brings to patient care and neurotechnology. MacDougall offers a humble final thought on their core purpose: “We just want to help people. We want to make things better.”

## Notable quotes > [00:00](https://www.youtube.com/watch?v=YdIJW8RTptU&t=0s) the brain really is a collection of functional modules, pinned together, duct taped together in this bone box attached to your head. — Dr. Matthew MacDougall

> [04:38](https://www.youtube.com/watch?v=YdIJW8RTptU&t=278s) Neuralink and I think Tesla and SpaceX before it end up being these blank canvases that people project their hopes and fears onto. — Dr. Matthew MacDougall

## Mentioned Neuralink, Dr. Matthew MacDougall, Andrew Huberman, Elon Musk, Tesla, SpaceX, FDA, UC San Diego, Broca's area, Pager

## Video description In this Huberman Lab Essentials episode, my guest is Dr. Matthew MacDougall, a neurosurgeon at Neuralink. We discuss how brain-machine interfaces could help people with paralysis control computers using their intended movements, and how robotic surgery enables the placement of tiny electrodes in the brain. We also explore advances in brain tumor surgery, implant safety, how the brain and software learn to work together, and the role of animal research. Dr. MacDougall shares his vision for future applications, including restoring movement, addressing mental health conditions and expanding human cognition and communication.

Show notes: https://www.hubermanlab.com/episode/essentials-neuralink-and-technologies-to-enhance-human-brains-matthew-macdougall

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Timestamps 00:00:00 Matt MacDougall 00:00:23 Brain Function, Frontal Lobes & Impulse Control 00:02:57 Brain Tumors, Laser Surgery & MRI 00:04:38 Neuralink, Brain Implants & Paralysis 00:07:04 Robotic Surgery & Electrode Placement 00:09:09 Motor Cortex, Controlling Computers With the Brain 00:11:05 Implant Safety & Brain Augmentation 00:12:51 RFID Hand Implant & Everyday Uses 00:15:34 Spinal Cord Stimulation, Reconnecting Brain & Body 00:16:31 Brain-to-Brain Communication & AI 00:18:44 Brain-Machine Interfaces, Learning & Adaptation 00:21:14 Animal Research & Welfare 00:24:18 Pigs & Monkeys, Device Safety & Function 00:26:44 Future Applications, Mental Health & Human Cognition 00:29:15 Acknowledgements

Disclaimer & Disclosures: https://www.hubermanlab.com/disclaimer

[Source](https://www.youtube.com/watch?v=YdIJW8RTptU)

中文简报

Neuralink神经外科医生MacDougall剑指瘫痪绕道治疗与认知AI 直接脑机接口可在数年内跨越脊髓创伤以恢复运动功能，并在未来进一步拓展，消除人类口语表达的带宽瓶颈。 Matthew MacDougall博士详细阐述了人脑的机械模块化特性，以及从磁共振引导的激光消融到Neuralink手术缝合机器人等先进神经外科工具如何克服传统手术的局限性。他概述了Neuralink的临床路线图：首先将四肢瘫痪患者的运动皮层意图转化为数字输入，随后逐步扩展至脊髓旁路绕道技术，以恢复人体生物肢体的运动能力。MacDougall还谈及了安全性数据、动物研究中遵循的自愿参与伦理方案、大脑与解码软件之间的双向学习机制，以及他个人植入的皮下RFID芯片。展望未来，他设想神经接口将用于治疗严重的神经精神疾病，并从根本上改变人类通信与AI整合的模式。 Neuralink的初步临床终点侧重于通过解码运动皮层意图，绕过受损的脊髓通路，帮助四肢瘫痪患者控制数字光标和键盘。 (4:38) 之所以需要专用的手术机器人系统，是因为人手的精细度无法安全地在密集的大脑皮层表面血管周围植入数百根微米级电极丝。 (7:04) 脑机接口的功能性控制依赖于双向共同适应，即用户的神经可塑性与解码算法同时进行调整，以补偿持续存在的信号漂移。 (18:44) Neuralink主要将猪用作生物安全性评估平台，以测试硬件稳定性和异物反应，而恒河猴则在自愿参与的任务中用于验证高带宽神经解码。 (24:18)

Reading summary

Neurosurgeon Dr. Matthew MacDougall argues that high-density brain implants represent a natural evolution in neurosurgical precision, with immediate therapeutic applications for severe paralysis and long-term potential for cognitive augmentation. Modular Brain Function and Surgical Precision (0:00) MacDougall views the human brain as an assembly of functional anatomical modules, meaning focal neurological damage can selectively eliminate specific human capacities while leaving other processes intact. He cites an early residency case where severe bilateral frontal lobe trauma completely abolished a patient's social impulse control while preserving his motor and sensory functions. Because brain tissue does not tolerate broad mechanical disruption, modern neurosurgery increasingly relies on hyper-focused interventions, such as real-time MRI-guided laser ablation operating through a 2-millimeter burr hole to destroy deep-seated tumors without cutting functional white matter tracts. Robotic Insertion and Motor Intention Decoding (4:38) Neuralink's immediate clinical objective focuses on severe spinal cord injury, where patients retain intact motor cortical command but lack physical wiring to their peripheral limbs. Because the flexible electrode threads are thinner than a human hair and terminate in micron-scale loops, human surgical dexterity cannot safely place hundreds of them across delicate surface vasculature. MacDougall explains that an automated robotic sewing system performs the micro-insertions at high speed, while human neurosurgeons handle the initial scalp incision and bone opening under current FDA evaluation protocols. Bidirectional Co-Adaptation and Interface Calibration (10:00) Rather than physically moving a limb, early iterations translate imagined movements—such as flexing a fist or rotating a wrist—into direct computer cursor controls. MacDougall highlights that the interface functions via a continuous closed loop of bidirectional learning: algorithmic decoders dynamically interpret shifting electrical patterns, while the patient's neural plasticity learns to guide the software model. He compares this calibration challenge to learning to play a piano whose keys constantly change tone, a dynamic baseline that user and software stabilize together across daily sessions. Safety Benchmarks and Preclinical Animal Testing (21:14) Addressing animal testing protocols required by the FDA before human clinical trials, MacDougall states that Neuralink enforces strictly voluntary, opt-in experimental paradigms without food or water deprivation. Pigs serve primarily as a durable physiological safety model to verify structural biocompatibility, tissue stability, and the absence of toxic or inflammatory reactions. Non-human primates handle the functional decoding workload, where rhesus macaques choose when to play computer tasks for fruit smoothie rewards, setting benchmark neural bitrates for cursor control. From Restorative Prosthetics to Cognitive Augmentation (15:34) Over the near-to-mid term, MacDougall outlines direct spinal cord bridging—linking an intracortical implant directly to a spinal implant below the injury site—to physically reanimate paralyzed limbs within a modest timeframe. Over longer horizons, he anticipates using the scalable architecture to treat neuropsychiatric disorders like severe depression and addiction. Further out, he envisions high-bandwidth cognitive interfaces that bypass the physical constraints of vocal speech, enabling direct digital communication and collective multi-brain networks. While MacDougall expresses strong confidence in the safety profile of robotic electrode placement compared to routine neurosurgery, direct physical limb reanimation and high-bandwidth cognitive augmentation remain future milestones rather than immediate commercial or clinical realities.

精炼阅读摘要

Neuralink神经外科医生Matt MacDougall指出，人脑呈现出高度模块化的组织特性，脑机接口技术正在开启超越传统神经外科的精准修复与生物增强时代。该技术近期聚焦于通过手术机器人植入超细柔性电极，帮助四肢瘫痪患者将运动意图解码为数字交互，远期则致力于实现脊髓神经通路桥接乃至人机高带宽共生。脑功能模块化与微创激光热消融突破 (2:57) MacDougall基于其临床实践指出，人脑本质上是由颅骨包裹的一套功能模块的集合。这种模块化特性使得神经损伤往往表现出局灶而极端的形态，例如双侧额叶受损会彻底摧毁个体的冲动控制能力，导致不可逆的社会行为失常。在救治此类重症时，传统开颅手术往往必须切开健康的脑皮质并破坏关键白质传导束，导致在挽救生命的同时严重牺牲了生活质量。现代神经外科技术通过微创激光消融实现了重大转变：外科医生仅需在颅骨上钻出一个2毫米的微孔，将光纤套管精准置入深部肿瘤区域。在患者接受磁共振成像（MRI）扫描期间，系统以大约每秒一次的频率实时监控热量分布边界，精确控制温度以灭活病变细胞，同时保护周围功能正常的脑实质。该方案使得原本被判定为无法手术的深部病灶（如脑干、初级运动皮层或Broca区）得以在不造成灾难性功能缺失的前提下被安全清除。机器人精准植入与运动意图的神经解码 (7:04) 针对严重脊髓损伤导致的四肢瘫痪，Neuralink的近期临床重点是恢复患者对数字接口的自主掌控。瘫痪患者的初级运动皮层通常保留着完整的运动指令产生能力，仅仅是向下传导信号的物理神经纤维受损。Neuralink将柔性电极线程阵列植入运动皮层，通过解码算法将患者想象的物理动作（如握拳或旋转手腕）转化为计算机屏幕上的光标位移与虚拟键盘输入，相关技术已在恒河猴实验中创下提取神经信息控制光标的信息传输率（bitrate）世界纪录。 MacDougall解释，之所以必须研发手术机器人，是因为电极线程比人类头发更纤细，末端仅有数微米级的小环，且大脑皮层密布着脆弱的微血管网。人类外科医生的手部微操作稳定性无法在避开血管的同时将数百根线程精确植入目标皮层深度。在目前接受FDA评估的流程中，机器人专注于高精度的电极穿刺缝合，而开颅与暴露皮层等前置步骤仍由人类外科医生完成。人机双向共适应与应对神经漂移的闭环机制 (20:00) 脑机接口的操控能力并非在植入后一蹴而就，而是依赖于生物神经可塑性与自适应软件算法之间的双向闭环学习。在校准阶段，系统通过在屏幕上呈现目标并假定使用者的移动意图，从而将实时记录的神经放电模式与特定方向的轨迹关联起来，构建预测性解码模型。在随后的自由交互中，使用者会根据视觉反馈动态调整自己的神经输出，算法模型也在同步迭代以捕捉关键运动信号。 MacDougall将这种学习过程比作“弹奏一台键音随时间随机漂移的钢琴”。尽管电极记录到的神经基线信号在设备断电过夜后可能发生轻微漂移，但人类大脑与自适应算法能够通过相互微调达到半稳定的功能平衡，使用户在经历停机后重新上线时依然能够保持平稳流畅的光标控制。实验伦理规范与分阶段的生物增强演进 (21:14) 在回应外界对动物实验的关切时，MacDougall说明FDA法规严格要求在开展人体临床前提供详尽的动物安全性与生物相容性数据。Neuralink推行严格的自愿参与（opt-in）实验机制，实验动物在基础饮食完全不受限的前提下自主决定是否参与测试，仅以果昔作为奖励。在验证分工上，猪凭借与人类相似的生理构造作为硬件物理耐久度、生物毒性及异物反应的安全性评估平台；灵长类动物则承担高通道神经信号与复杂运动意图解码的功能验证任务。在技术演进路径上，Neuralink计划在数年内通过大脑运动皮层与脊髓受损段下方的双重植入体构建通信旁路，直接恢复瘫痪肢体的自主活动。放眼未来10至20年，MacDougall认为靶向神经接口有望直接纠正重度抑郁、成瘾等回路层面的神经精神疾病，甚至有望突破语言发音的低带宽瓶颈，实现人类认知与人工智能的直接交互乃至多脑协同网络。 MacDougall指出，脑机接口技术现阶段的首要底线是满足重症瘫痪与神经疾病患者的迫切医疗需求，其手术安全性在数百次实践中已超越诸多传统开颅手术标准。然而，从单向的光标运动解码迈向高带宽的人工智能直接融合与无声心智交互，技术路径仍面临长期生物材料稳定性、深层语义解析以及复杂的工程扩展性挑战。

Source quotes

[0:00] Dr. Matthew MacDougall: the brain really is a collection of functional modules, pinned together, duct taped together in this bone box attached to your head. [4:38] Dr. Matthew MacDougall: Neuralink and I think Tesla and SpaceX before it end up being these blank canvases that people project their hopes and fears onto.

Original transcript

[0:00] Welcome to Huberman Lab Essentials, 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. Matthew McDougall. Dr. McDougall, welcome. Good to be here. 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. 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. 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. The brain really is a collection of functional modules, pinned together, duct taped together in this bone box attached to your head. And sometimes you see very interesting failure modes. So one of the most memorable patients 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 we were called back by his 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 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 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 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 unfixable and you have Lazarus-like miracles not too uncommonly. 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 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 that, you know, kind of the wires connecting neurons. The modern approach involves a two-millimeter drill hole in the skull 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 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 brain 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 a leaving a poke hole in their skin, 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, Broca's area. where we would have expected to either not operate or do catastrophic damage. Those people sometimes now are coming out unscathed. 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 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, to the extent that you are [5:00] 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 humans that are suffering in some way. 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 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. Those extremes are not true. 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 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 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. 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 and connect with the world through the Internet. Why use Facebook? 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 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, 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. I would love if human surgeons were 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, incredibly fast, incredibly numerous placement of electrodes into the right area of the brain. 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. is only for the placement of the electrodes, the robot's part of the surgery. I or another neurosurgeon still needs to do the more crude part of opening the skin and skull and presenting the robot a pristine brain surface to sew electrodes into. Broadly speaking, the mission of Neuralink is to reduce human suffering, at least in the near term. 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. So to just give us a bit, fuller picture of this. We're talking about a patient who can't move their limbs because they have spinal cord damage. The motor cortex that controls movement is in theory fine. 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 hasn't been dealt with at all in this scenario. So just to clarify there, 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 roadmap, but it's way down the roadmap a few years. What we're talking about in the immediate future. [10:00] is having the person be able to control electronic devices around them with their motor intentions alone, right? Prosthetic hand and arm or just mouse and keys on a... Mouse and keys on a keyboard, for starters. So you wouldn't see anything in the world move. 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 select letters in sequence and they could type. So we're using smarter algorithms to decode the motor intentions out of the brain. We have been able games for smoothie rewards. And they do really well. We actually have the world record of bitrate of information coming out of a monkey's brain to intelligently control a cursor on a screen. 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 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 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. 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. 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, then 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 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 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 patients that, you know, are no one even thinks twice about their standard of care. Neuralink has 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 present in the top of your hand. For those listening, not watching, there's a small lump between Dr. McDougal's forefinger and thumb or index finger and thumb 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 and why did you put it in there? Yeah. So it's a small, writeable RFID tag. 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. Most phones have the capability of reading and writing to this chip. For years, 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 the various locked doors inside the building. IDs in theory, and how long can they stay in there before you need to take them out 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, uh, during rock climbing. I additionally coated them in another ring of silicone, uh, before implanting that. So 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. At some point, the technology is always improving. So I might remove it and upgrade it. Already, there's 10x more storage versions available. That could be a drop-in replacement for this if I ever remove it. It has a small niche use case. And it's tip toeing towards the concept that you mentioned of you [15:00] to be willing to go through the things that you're suggesting to your patients in order to say with a straight face that you think this is a reasonable thing to do. I'd like to go back to... brain augmentation. You've made very clear that one of the first goals for Neuralink is to get quadriplegics walking again. Well, again, just to be very clear, the first step is we aren't reconnecting the patient's own muscle system to their motor cortex. Allowing them, excuse me, 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 love to do that. And we've done a spinal cord itself. And so that gets to the question 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 motor cortex and send them to the spinal cord, which most of the wiring should be intact in the say, 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 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 neural link that I overheard between Elon and various podcast hosts, et cetera, there was this idea thrown out that, 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 looking at each other or not, nodding or shaking our heads and essentially hear each other's thoughts. Is that possible that we could sit here and... just hear each other's thoughts 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. And so, you know, texting each other with our brains is maybe an uninspiring rendition of this, but it's, It's not 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, you know, maybe via a bone conducting implant. So silently hear it. 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 as this technology is refined and developed further. So that's the kind of wide band, high bandwidth brain interface that you want to develop if you're talking about a semantic prosthetic. And... AI assistant to your cognitive abilities. You know, the more sci-fi things that we think about in the coming decades. So it's an important caveat when you're evaluating these technologies, you really want it to be something that you can expand off into the sci-fi. To what extent can these things 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, I would say not exactly a full-blown AI, but some well-designed software that can adapt to changes in firing of the brain, and you're the two to learn each other. So undoubtedly the human that has a neural link device will get better at using it over time. Undoubtedly, 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 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 is [20:00] know the person wants to do as expressed in a series of games. So you assume that 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 are 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 software as expressed by the mouse moving or not moving properly on the screen. Imagine a scenario where you're asking somebody to play piano. that 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 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. Let's talk about pigs. Elon and others there at 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 neuralink is almost entirely composed of animal loving people, 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 to making advances to getting a device approval through the FDA by first showing that it's incredibly safe in animals. 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 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. And so that is a background against which the relatively miniscule 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 done for food. In that context, we do animal research because we have to. There's no other way around it. If tomorrow 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. Yeah. And I wouldn't 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, 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 star monkey pager doesn't want to play video games for Smoothie, No one forces them to ever. 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. There's never any deprivation. There's never any adverse negative stimuli that pushes them to do anything. It's one of the underappreciated innovations out of Neuralink is how far the animal care team has been able 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. More, you know, in the cardiac area, their hearts are, you know, somewhat similar to human hearts. There's a lot of different kind of pigs that we use in different contexts when we're trying to optimize a certain characteristic. So, yeah. 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. But we're not, you know, recording interesting [25:00] 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. So again, the pigs are really just a safety platform to say the device is safe to implant. It doesn't 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 what we expect to see in humans is validated on a functional level in monkeys first. What is your wish for brain-machine interface and brain augmentation? So let's assume that the clinical stuff can be worked out. Or maybe you have a pet clinical condition that you just are yearning to see resolved. That would be fine too. But in addition to that, you really just expand out. Let's say we can extend your life 200 years or we're thinking about the kind of world that your children are going to live in and their grandchildren will live in. What do you think is really possible with brain augmentation and brain machine interface And here please feel no bias whatsoever to answer in a way that reveals to us your incredible empathy and consideration of clinical conditions because that's how you spend your days is fixing patients and helping their lives be better. So if it lands in that category, great. But for sake of fun and for sake of delight and for sake of 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 timeframe of humans just getting control over some of the horrible ways that their brains go wrong, right? So 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, obesity, these functions of the brain or malfunctions of the brain are what drives me. These are the things that I want to tackle in my career. In terms of my kids' lifetime, I thinking full human expansion of human cognition into AI full immersion in the internet of your cognitive abilities, having no limitation for what you think as bottlenecked by needing to read the Wikipedia article first to have the data to inform your thoughts. communication with anyone that you want to, unrestricted by this, you know, flapping air past meat on your face. It's a, you know, a means of communication that's ridiculously prone to being misunderstood. It's also a tiny, narrow bottleneck of communication. We're, you know, trying to send messages back and forth through a tiny straw, and there's no reason that needs to necessarily be true. It's the way things have always been, but it isn't the way things are going to be in the future. I think there's a million very sci-fi possibilities in terms of banding human minds together to be even more potent as a multi-unit organism, as an opt-in multi-brain. These are things that are so far down the road I can even directly see how they would be implemented but the technology we working on is a little crack in the door that allows some of this stuff to even be thought about in a realistic way To that point, I encourage anyone who is excited about things like that, 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 in the world. in my opinion. And so if you want to work on this stuff, come help us. I really want to thank you, first of all, for coming here today and taking time out of your important schedule of seeing patients and doing brain surgery, literally. Have to do it. Time away from your family and time away from your mission at Neuralink briefly to share with people what you guys are doing. And I really just want to thank you also for being you, which is perhaps sounds like a kind of an odd thing to hear but I think as made apparent by the device implanted in your hand you don't just do this for a job you live and breathe and embody truly embody this stuff around the nervous system and trying to figure out how to fix it how to make it better and you live and breathe it and I know your deep love for it so I wanted [30:00] you for not just the brains that you put into it and the energy you put into it, but also for the heart that you put into it. Thanks for that, Andrew. I appreciate that. We just want to help people. We want to make things better.