Brain Implants Are Here — And Getting Better

Summary

Podcast Summary: Short Wave — "Brain Implants Are Here — And Getting Better"

Release Date: September 10, 2025
Host: Emily Kwong (NPR)
Guest: John Hamilton (NPR NeuroMancer Correspondent)
Highlight Guest: Dr. Lee Hochberg (Massachusetts General Hospital/Brown University)
Featured Voice: Casey Harrell (UC Davis, patient using BCI)
Total Content Time: ~12 minutes (excl. ads & credits)

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Episode Overview

In this episode, Emily Kwong joins NPR’s John Hamilton to explore the current reality, uses, and ethical questions surrounding brain-computer interfaces (BCIs). The conversation covers what BCIs can currently accomplish, how far the technology has advanced, the challenges in making them widely available, and the growing questions about brain privacy as BCI capabilities accelerate.

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Key Discussion Points & Insights

What are Brain-Computer Interfaces? [04:02]

• Definition: BCIs detect and translate electrical signals from the brain. Some devices can also send signals to the brain.
• Types:
  • Consumer "Caps": Non-invasive, not very effective, mainly marketed for meditation. Not the focus of the episode.
  • Implanted Devices: Placed on the surface or within the brain itself; far more accurate.
  • Notable Device: Neuralink calls their wireless implant "Telepathy."
    Quote, John Hamilton [01:17]:

    "The Neuralink device, it's called telepathy."

Who Benefits from BCIs Now? [04:53]

• Target Patients: Primarily individuals with severe paralysis—those who cannot move or speak due to injury or neurodegenerative disease.
• Early Example: Matt Nagel (2004) used an early BCI ("BrainGate") to manipulate a computer cursor with his mind, regaining a sense of agency despite paralysis. Quote, John Hamilton [05:41]:

  "He was able to do things that he had no ability to do with his body, but he could do with his brain."

Advances Since the Early 2000s [05:57]

• Wireless Tech: Moving from wired setups to fully wireless communication.
• More Electrodes: More precise neural listening, allowing better control and interfaces.
• Expanded Capabilities:
  • Controlling robotic arms (even delicate actions like sipping from a cup)
  • BCIs that send touch signals from robotic limbs back to the brain
  • Decoding intended speech, aiding those who cannot talk Quote, John Hamilton [06:28]:

  "Some can even provide that person with a sense of touch by sending signals from a robotic hand back to the brain."

Speech Decoding and Communication [06:57]

• Speech BCIs: Enable individuals with conditions like ALS to "speak" through devices that decode their brain's intended speech.
• Demonstration: Casey Harrell, a man with ALS, uses a BCI to speak via an artificial voice. Memorable Moment [07:24]:
  (Recording of Casey’s artificial voice)
  Emily Kwong [07:30]:

  "I mean, it's not super fast, but it's totally understandable. And this is coming from his thoughts?"

Why Aren’t BCIs Widely Available Yet? [08:24]

• No FDA-Approved BCIs—yet.
• Engineering Challenges: Moving devices from controlled labs to long-term use inside people is immensely difficult.
• Regulatory Hurdles: FDA approval requires extensive data, reliability, and proof of safety.
• Cost & Access: High development/manufacturing costs; insurance reimbursement remains uncertain. Quote, John Hamilton [09:50]:

  "It's really hard to take something that works in the lab, with lots of computers and wires... and turn that into something that functions reliably for years inside a person's skull."

Industry Perspective: Dr. Lee Hochberg [08:49, 10:23]

• Credentials: A leading figure in the field, involved since the first BCIs.
• Optimism: Believes commercially available, routine BCI therapies for restoring movement and communication are "just a few years" away. Quote, Dr. Hochberg [10:23]:

  "What I want to say [to a patient] is: I'm sorry this happened, but we have a technology that can restore your communication tomorrow and really mean that..."

AI’s Role and the Future [11:03]

• AI & BCI: Artificial intelligence is making brain signal decoding faster and more accurate, accelerating progress.
• Market Movement: Growing momentum, multiple well-funded startups, and a pipeline of tested patients; commercial BCIs may soon be reality.

Brain Privacy and Ethical Concerns [11:16, 12:32]

• Brain Privacy: As BCIs become more powerful (e.g., reading 'inner monologue'), the stakes for mental privacy rise.
• Concerns:
  • Devices that read, decode, maybe even store thoughts
  • Potential commercial or malicious misuse (ads in your mind, unwanted surveillance)
• Nita Farahani’s Input ([12:53]):
  • Advocate for BCIs in healthcare, but vigilant against abuse as consumer devices evolve.
  • New 'brain transparency' will be a major frontier for society—an ethical landscape not yet mapped. Quote, Nita Farahani [12:53]:

  "The more we push this research forward, the more transparent our brains become... this era of brain transparency really is an entirely new frontier for us that we haven't even begun to grapple with."

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Notable Quotes & Memorable Moments

• Dystopian Sci-Fi Tone (Lighthearted)
  • Emily Kwong [00:54]: "Let's keep them coming, John."
  • John Hamilton [13:20]: “It totally does. And that is why Farahani and a lot of the scientists... are trying to ensure that, say, a marketing company can't just eavesdrop on our thoughts."
• BCIs for Play
  • Emily Kwong [01:56]: "No, I'm not ready to enter the matrix, John."
• Patient Experiences
  • Matt Nagel's experience [05:39]: Opening email by mind in 2004 (“Cha Ching!”)
  • Casey Harrell’s communication [07:24]: Using thoughts to speak, despite ALS.

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Important Timestamps

| Time | Segment | |--------|--------------------------------------------------------------| | 00:19 | Episode opens; introduction of BCIs and John Hamilton | | 01:17 | Neuralink's "Telepathy" and promotional vision | | 04:02 | Technical definition and types of BCIs | | 04:53 | Real-world patient need: Matt Nagel, early BCI user | | 05:57 | Advances: wireless devices, more functions | | 06:47 | Speech decoding, demonstration with Casey Harrell | | 08:24 | Barriers to FDA approval and wider use of BCIs | | 08:49 | Dr. Lee Hochberg introduces himself | | 10:23 | Dr. Hochberg on the near future of BCI therapy | | 11:03 | AI's impact, industry momentum, and impending products | | 11:16 | The emerging challenge of brain privacy | | 12:32 | Discussion of ethical, privacy implications | | 12:53 | Nita Farahani’s call for brain privacy vigilance |

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Conclusion

The episode effectively demystifies BCIs, highlighting both their promise—life-changing capabilities for paralyzed individuals—and their challenges, from technical and regulatory barriers to the profound ethical questions science must soon answer. The hosts balance optimism with caution, emphasizing that widespread, everyday use will require not just innovation, but robust new norms around brain privacy and mental autonomy.

Recommended for: Listeners interested in neuroscience, the future of human-computer interaction, disability technology, and emerging ethical issues in technology.

Transcript

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[Emily Kwong]

You're listening to Shortwave from npr. Hey, shortwavers. Emily Kwong here. If you're listening to this, you know that this podcast has to travel through your ears to get to your brain. But why not take a more direct route, say from the Internet straight to your neurons? That's basically what we're talking about today. Brain computer interfaces with NPR's own NeuroMancer, John Hamilton. Hi, John.

[John Hamilton]

Hey, Emily. Happy to be part of today's consensual hallucination, as William Gibson would put it. And with that, I guess we should probably stop with the dystopian sci fi references.

[Emily Kwong]

Let's keep them coming, John. I mean, Elon Musk is out here talking about using a brain computer interface, a bci, to connect us all to cyberspace, right?

[John Hamilton]

I mean, he has mentioned that. And his company, neuralink, has surgically implanted its brain computer interfaces, which we will call BCIS for short, in a whole bunch of people. Oh, and the neuralink device, it's called telepathy.

[Emily Kwong]

So I'm right. The future is here.

[John Hamilton]

You are certainly right about what one tech billionaire is saying. But I am here to tell you that these interfaces are still a long way from putting our brain cells online.

[Emily Kwong]

Hmm.

[John Hamilton]

What they can do is pretty amazing. They can turn a person's thoughts into words or movement. And places like neuralink clearly hope they're going to do a lot more. So check out this promotional clip from neuralink. Imagine the joy of connecting with your loved ones, browsing the web or even playing games using only your thoughts. This is made possible by placing a small cosmetically invisible implant in a part of your brain that plans movement.

[Emily Kwong]

No, I'm not ready to enter the matrix, John.

[John Hamilton]

Not to worry, Emily. Right now, brain computer interfaces are still experimental. They're really only for people who are living with paralysis. Plus, neuralink is really just one of the companies in this space and some of their competitors are actually probably ahead and the other places are much less focused on, shall we say, joining the singularity.

[Emily Kwong]

Well, today on the show, what brain computer interfaces can and cannot do and.

[John Hamilton]

Why they're only a little bit scary, at least for now.

[Emily Kwong]

You're listening to Short Wave, the science podcast from NPR.

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[Emily Kwong]

Okay, so John, I'm really curious about what we're gonna discuss today. Brain computer interfaces. What does that mean?

[John Hamilton]

Yeah, okay. The term refers to technology that can detect and translate the electrical signals that are coming from your brain. Some of these devices can also send electrical signals to your brain.

[Emily Kwong]

Wow.

[John Hamilton]

There are a few consumer products that are worn like a cap or a headset and detect brain activity from outside the skull. We're not gonna talk about those. They're not that great. Some of them may help you meditate, but that's unclear. The devices we're gonna be talking about are the ones that are implanted inside the skull, which is a much better place to listen to the brain's electrical activity. Some of these devices are put on the surface of the brain, and other ones, like the neuralink device, they actually thread electrodes into the brain itself.

[Emily Kwong]

But why would someone want something inside their skull listening to their brain?

[John Hamilton]

So to answer that, I'm going to go all the way back to 2004. One of the first people to ever get a BCI was a guy named Matt Nagel. He's a young man who got stabbed in the neck sadly and was left paralyzed so he couldn't move his arms or legs. A team of scientists asked him if he wanted to try a device that was then called Braingate. The idea was this might let him move a computer cursor using just his thoughts. I managed to find this old video of him testing that BCI with a researcher named Abe Kaplan. What do you want to do first? So keep in mind this is all 20 some years ago. I'm gonna open my email first. Okay. Gonna open the first one. You're gonna open the first one.

[Emily Kwong]

Was that the sound of the email opening. The Cha Ching.

[John Hamilton]

Totally. Yeah. He was able to do things that he had no ability to do with his body, but he could do with his brain.

[Emily Kwong]

That sounds like life changing technology. That's pretty amazing. Okay, so this was in 2004. Has the technology advanced since then?

[John Hamilton]

In a lot of ways, yes. That brain gate device that Matt Nagel used required actual wires to go through his skull. Nowadays, devices are moving to wireless communication. They also use many more electrodes so they can listen to the electrical activity of more neurons. That makes them more accurate. And the latest devices can do a lot more than just, you know, move a computer cursor. They can let a person who is paralyzed control a robotic arm accurately enough to sip from a cup of water.

[Emily Kwong]

Whoa.

[John Hamilton]

Some can even provide that person with a sense of touch by sending signals from a robotic hand back to the brain. And BCIs can even decode speech signals in the brain, which means a person who can no longer talk because of a stroke or a disease like als, they can now communicate.

[Emily Kwong]

That's. I fully come around to this. This is amazing. That. So you're saying someone who can't control their own vocal tract can speak again with this assistance?

[John Hamilton]

Pretty much. The BCI detects the words that a person wants to say, and then it uses the computer to do the speaking. A lot of the work on speech BCIs has been done in California, including at the University of California, Davis. Let me play you a recording from UC Davis. This is of a man named Casey Harrell. He has ALS and can no longer physically produce words, but he can speak through a BCI that creates an artificial voice. Hi. Ah.

[Emily Kwong]

I mean, it's not super fast, but it's totally understandable. And this is coming from his thoughts?

[John Hamilton]

More or less. This particular bci, it relies on signals from the motor cortex in the brain. So the part of the brain that usually tells the muscles that are involved in speech what to do.

[Emily Kwong]

Oh, so the neurons used for signaling, like your voice box, your throat, your mouth, that's what the BCI is tapping into.

[John Hamilton]

Exactly. So when someone attempts to speak, the brain starts sending those signals and the BCI is able to turn those signals into words. This is something that several companies, including Neuralink, have included in their BCIs. But of course, it's all experimental. You know, we've had 20 plus years after the first BCI worked in a person, and there are still no FDA approved brain computer interfaces that are on the market.

[Emily Kwong]

I'm surprised by that. Why hasn't the FDA approved any BCIs?

[John Hamilton]

Well, they haven't really had any submitted. And I talked about the reason for that with Dr. Lee Hochberg. He's one of the scientists who've been in the BCI game since, you know, the beginning. Lee was one of the scientists who created the brain gate device we heard Matt Nagel using a few minutes ago. I don't quite know how to summarize his resume, so I'm just going to play you what he said when I asked him to list all of his credentials.

[Dr. Lee Hochberg]

I'm a critical care neurologist and vascular neurologist at Massachusetts General Hospital. I'm also a professor of engineering at Brown University and a neurologist and researcher at the Providence VA Medical Center. In addition, I direct the center for Neurotechnology and Neurorecovery at Mass General. And I'm one of the co organizers for the Implantable Brain Computer Interface Collaborative community.

[Emily Kwong]

This sounds like a Hollywood job, but it's real.

[John Hamilton]

It's a real job. You get the idea. He's got a lot of credentials.

[Emily Kwong]

Yeah. So what did Lee have to say about where we're at with bcis, which sounds like not as far as we could be.

[John Hamilton]

One thing he said was he never thought BCIs would take so long to become a commercial product. But he also talked about some of the reasons why it has taken so long. It turns out it's really hard to take something that works in the lab, you know, with lots of computers and wires and technicians, and turn that into something that functions reliably for years inside a person's skull and can also communicate with their smartphone.

[Emily Kwong]

I can't imagine why making this, like, portrait, affordable, reliable, forever sounds easy. No, not at all.

[John Hamilton]

I mean, there are a few steps in there, right? And then there's the whole FDA approval process. Sure, it's slow, especially when you're dealing with technology like this that's completely new. And one more thing is that these devices are expensive, so companies that make them have to be thinking about whether they'll be covered by a person's health insurance. You know, despite all those things Lee told me the industry is really finally close to getting actual products on the market. Wow.

[Dr. Lee Hochberg]

I hope it's just in a few years that if I see and I'm taking care of somebody in the neuro ICU who suddenly lost the ability to move or lost the ability to speak. What I want to say is I'm sorry this happened, but we have a technology that can restore your communication tomorrow and really mean that if that conversation is happening on a Wednesday that the technology will be deployed on Thursday and working.

[Emily Kwong]

You're saying this, this could be the reality for some patients, like when it.

[John Hamilton]

Could be just a few years. I mean, brain computer interfaces have been tested in dozens of patients. Now there are at least half a dozen well financed companies that are working on this technology.

[Emily Kwong]

Wow.

[John Hamilton]

And you've got artificial intelligence, which is making it much faster and easier to decode a person's brain signals. On the other hand, all that progress is raising some questions about what you might call brain privacy.

[Emily Kwong]

This has been my lingering fear this whole time. Like, I want to be into this, but I'm worried about the intrusion of this technology. I mean, devices that read our thoughts and use that information. Are we ready for that?

[John Hamilton]

Well, that was exactly the question that some researchers had. They did a study that looked at this issue in bcis that decodes speech. But remember how those devices initially relied on a person trying to get their vocal apparatus to actually form a word? There's a new generation of devices that kind of goes the next step. It can actually detect a person's inner monologue. You know, that voice in your head that says things like, is this meeting ever going to be over?

[Emily Kwong]

I don't have an inner monologue.

[John Hamilton]

Not everybody has an inner monologue. This is something that doesn't work for everybody.

[Emily Kwong]

Yeah, I'm safe.

[John Hamilton]

Yeah, exactly. But if you do have one, it's the easiest way to get sort of fluent speech out of a brain computer interface. Whoa. So what the authors found was there are ways to let people who are using a speech BCI switch off that inner monologue function, you know, but still, it's a little disturbing. And one of the people who's worried about this is Nita Farahani. She's a professor of law and philosophy at Duke. She wrote a book called the battle for your brain that talks about BCIs a lot. Nita told me she's all for better brain interfaces that will help people who are paralyzed. But she says things could get kind of weird when some of these functions come to consumer devices, like, say, a headset that lets you play a video game or post on social media using just your thoughts.

[Emily Kwong]

The more we push this research forward, the more transparent our brains become. And that's a double edged sword. And we have to recognize that this era of brain transparency really is an entirely new frontier for us that we haven't even begun to grapple with. Yeah, I mean, brain transparency, brain privacy. This all sounds like where we started. Dystopian sci fi except it's real.

[John Hamilton]

It totally does. And that is why Farahani and a lot of the scientists who actually work on BCIs, they're trying to ensure that, say, a marketing company can't just eavesdrop on our thoughts.

[Emily Kwong]

Yeah, if I get ads delivered to my brain, I'm gonna be mad.

[John Hamilton]

You and everybody else. But don't think there isn't somebody thinking about it.

[Emily Kwong]

I won't think anything. I'm gonna keep this non monologue on lock. Well, thank you so much, John Hamilton. It's great to have you on Short Wave.

[John Hamilton]

Always a pleasure, Emily.

[Emily Kwong]

This episode was produced by Rachel Carlson, it was edited by Rebecca Ramirez and Burleigh McCoy, and it was fact checked by Tyler Jones. Kwesi Lee was the audio engineer. Beth Donovan is our senior director and and Colin Campbell is our senior vice president of podcasting strategy. I'm Emily Kwong. Thank you for listening to Short Wave from npr.

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