Would you put wires in your brain? The Elon Musk-founded Neuralink is a neurotechnology company and its product is an implantable brain-computer interface (BCI) designed to turn thoughts into actions. In late November 2024, University Health Network (UHN) was selected as the first — and only — hospital in Canada to begin testing Neuralink in a study called Canadian Precise Robotically Implanted Brain-Computer Interface (CAN-PRIME). 

Six patients with partial or complete paralysis in both hands due to spinal cord injury or amyotrophic lateral sclerosis — a neurological disease that affects motor functions — are currently being selected for surgery to implant a network of electrodes into their brains. Electrodes are conductors of electricity, and in this case, they will carry brain signals. These electrodes will wirelessly connect to each patient’s personal computer, allowing them to control the device with just their thoughts. 

In 2023, Neuralink reached out to Andres Lozano, the Alan and Susan Hudson Cornerstone Chair in Neurosurgery at UHN, with the idea. He is a key figure in the field of deep brain stimulation, a therapeutic technology in which electrodes are implanted in the brain to stimulate specific areas. 

Lozano told Reuters that he and his team “jumped at the possibility” of working with Neuralink. “This landmark surgery has the potential to transform and improve outcomes for patients who previously had limited options,” he explained. 

The surgery: R1 implants N1

While UHN reassures the public that the trials will be properly safeguarded, some concerns remain. The device — known as the N1 implant — is roughly the size of a coin, but it remains foreign material to the body. As with any invasive procedure, the insertion of Neuralink electrodes carries the risk of complications, such as infection, bleeding, and damage to brain tissue near the implant. 

The N1 implant in CAN-PRIME contains 64 tiny electrodes connected to the brain with thin wires. These wires are inserted into the brain to measure and transmit brain activity from the area that controls hand movement. Thinner than human hairs, the wires are precisely inserted by R1, Neuralink’s two-ton surgical robot.

The current number of electrodes in state-of-the-art BCIs is around 1,000, each detecting only a few neurons. Given that the adult human brain contains around 16 billion neurons, these electrodes detect only a small percentage of the total neural activity; however, they still provide significant insights. The information these electrodes detect is then processed by a computer, enabling further analysis and conversion into movement.

BCIs have already been shown to successfully collect data about neurons stimulated during various activities on animals; such as Gertrude the pig, one of Neuralink’s early animal test runs. The brain is incredibly complex, and some of its functions are still largely a mystery. Understanding the patterns of neurons activated during different activities provides valuable insights into brain functionality. Once processed, a computer can use this information to send signals to the implanted electrodes, activating the same patterns of neurons to elicit specific responses. 

Restore autonomy today, unlock human potential tomorrow

Every step Neuralink takes toward enhancing the lives of those impacted by neurological disorders brings the technology closer to its ultimate goal: human-AI integration. However, this goal is not universally shared. Ethicists have long been concerned about technology surpassing the human brain, but if that technology were embedded within the brain, would the advancement still be more impressive than frightening?

Could a paid surgery to insert a BCI give those who can afford such a luxury a cognitive advantage over others? How would we know if a person is truly themselves? 

With the rise of BCIs come complicated questions about how we measure autonomy. Under a BCI’s influence, is a person entirely responsible for their own actions? 

What does this mean for now?

Despite promises of a world where disability no longer defines capability, the Neuralink trials have sparked widespread concern among the public. These concerns focus on the safety and privacy of Neuralink, as well as the rapid pace at which some of Musk’s previous inventions have gained traction.

In a world where warfare and espionage are entirely digital, what are the implications of someone gaining access to how a Neuralink user actually thinks?