Host/Interviewer (4:15)

So tell us about the device. What is it? How big is it? What does it do? How do you put it in there? And how, if it's temporary, how do you take it out?

Michael Mager (4:23)

So the brain is electrical. This is something that may not be intuitive for people, but when you have a thought, when you recall memory, when you have a new idea that feels abstract, but there is actually a physical manifestation of those thoughts, and the physical manifestation is electrical. So what a brain computer interface does is it records that electrical activity out at the source and then transmits it to a computer to decode what the neural activity means and uses that to drive an intention. So again, in the first instance for us, it's about control of compute. This sounds like science fiction, but it is something that has existed in academic settings for actually more than 20 years now. So the first person was implanted with a modern brain computer interface in 2004. So 22 years ago. And over the course of the past two decades, around 75 people have been implanted with systems that have enabled them to send emails and text messages, create digital art, play video games, all only using their thoughts, not using their arms and hands in the way that able bodied people, you know, control computers. The issue has been that this has existed really in academic labs and the systems that have been implanted in people are not robust enough to go through the FDA regulatory process. To be manufactured at scale. They involve physical wires coming out of people's skulls and connecting to the computer. Almost all of them have been implanted with devices that penetrate into the brain and create a connection between the electrodes in the brain through penetrating into neural tissue and killing neurons. There's a historical reason for why the industry developed in that way, but I think the drawbacks are pretty intuitive and obvious. Every implantation involves killing brain cells. And so.

Host/Interviewer (6:31)

And you. So your device is different than that?

Michael Mager (6:33)

That's right. Our device is different from that. And yet I should say that that has been. The conventional wisdom has been you had to do. Those drawbacks were just inevitable. And so neuralink is actually based on this same basic premise. It's a more sophisticated, much more sophisticated version of a system that was deployed in academia, but still based on the idea of penetrating into the brain and killing neurons. I think fundamental insights from my partner Ben, and one of the reasons that he left neuralink after being a co founder was that he knew that that just wasn't true, that the conventional wisdom was wrong and that you could enable high performance brain computer interface functionality without doing damage. And the way that we do that is a very, very thin film that sits gently and conformally on the surface of the brain. So it's underneath the skull, under the, underneath the dura. So you're interacting directly with neural tissue. But instead of penetrating into the brain, the system just sits on the surface of the brain and creates a very high bandwidth link without doing the damage that other systems entail.

Host/Interviewer (7:41)

And you mentioned that some of the prior systems, you were connected in a lab, you had wires coming out of your head. Not a very pretty picture. What does this look like? How big is it? How do you get it in there? How does it communicate with the computer?

Michael Mager (7:54)

So there are a lot of breakthroughs that are required in order to take this technology to the millions of people who stand to benefit. And making it wireless is a key aspect of that. And so our system is fully implanted in the body. It's invisible, and it's able to transmit the data that is coming off the system entirely wirelessly and recharges wirelessly. But the system itself, the way that it enables the function, is through a very, very thin film that has 1024 tiny platinum electrodes deposited on it. And we manufacture this system using the same technique as semiconductor chip manufacturing. So photolithography, which has never been been done before in a biomedical application, and I should say we implant it. The final piece of your question, we implant It So neuralink and others, you have to remove a decent sized portion of your skull in order. In Neuralink's case, there's a robot. But how does the robot access the brain? A neurosurgeon has to do a craniotomy, and that's been the traditional way of deploying these systems. One of the advantages of having a neurosurgeon co founder is he can think really deeply about the actual surgical workflow and how to do it better. And so we have patented an approach that involves a very, very thin slit that's drilled in the skull and in the dura and the array then slides through the slit like a letter through a letterbox or like a floppy disk through a. I mean, it depends on your generation, but, you know, so effectively it obviates the need for a very invasive craniotomy and it allows arrays to be deployed to different areas of the brain in a minimally invasive manner.

Host/Interviewer (9:49)

So neuralink and many other approaches to this in the past have been much more invasive. As you were saying, my understanding is the advantage of that is you get much more accurate data and so does the fact that you are effectively floating on top hurt or limit what you can do relative to an embedded device?

Michael Mager (10:08)

I think it's. I wouldn't say accurate or inaccurate data. I would say it's slightly different data. I think the rationale from the neuroscience. So taking a step back, what's the history here and why did the industry develop as it has, the initial devices that were implanted starting sort of in 2004, were actually developed for non human primate research by neuroscientists. And neuroscientists are interested in single unit activity. So basically the behavior of individual neurons. That's kind of the fundamental building block of neuroscience. It's, you know, each individual brain cell, that system, which had been, you know, used at that point for sort of 10 or 15 years, was deployed in a human being and it worked. And so the conventional wisdom evolved such that, oh, you had to penetrate in the brain in order to drive powerful bci, you do have to penetrate into the brain in order to see individual neurons. That is true, but you do not need to see individual neurons. That's not how neural activity is represented. In a way that's going to be useful for us to drive a system. So we're looking at very small groups of neurons operating in concert with each other. And we're able to do it over a larger amount of surface area of the brain than these competing systems. The system that we've developed does not have the drawbacks of penetrating arrays and has a lot of pretty fundamental strategic advantages that are going to be hard to compete with.

Host/Interviewer (11:40)

And then one last, just how they were questioned. Why do you have to go in there at all? Why can't you just give me a helmet, for example?

Michael Mager (11:50)

My life would be easier if all you had to do is develop a helmet. Actually, you know, working within the FDA regulatory process for a Class 3 medical device is difficult and you know, for good reason. But the short answer is that the skull is a major physical barrier. It just attenuates the signals from the brain in a way that, you know, people have been trying to enable basic brain computer interface technology non invasively for a very long time. There's a group of people today who hope that AI is going to create breakthroughs. I would say it's really hard. You see very, very, very poor signal quality. Just given the barrier of the brain between the activity that you're trying to record. And I would say AI, you know, the power of these algorithms is obviously increasing massively. And so what's possible tomor may be different from what's possible today. But I think that that's even more the case for what we're doing where if you take a crappy signal and apply AI to it, maybe you can create something that's vaguely useful. If you take a really good signal and apply AI to it, I think you're going to be able to do some pretty magical things.

Host/Interviewer (13:10)

And I talked to Nita Farahani recently who studies this from a legal perspective and she was saying that the amount of information that you can gather just from things like ear pods or a headband or what have you, or a helmet, that there is a lot of information there and we should potentially worry about that from a rights point of view and privacy and so forth. But it sounds like what you're talking about, what you're trying to do, is much deeper than that. It's giving me the ability to effectively control things just by thinking about it.

Michael Mager (13:40)

Yeah, I know Nita well. I have a lot of respect for her and I think she's right about one of the complexities of this discussion is that consumer neurotechnology and medical neurotechnology get lumped together inevitably during this discussion. And they're really, they operate in completely different worlds. You know, consumer neurotechnology, as you said, you know, technology that's embedded in earphones and headbands and things like that, there's very. They exist in a Very weak or maybe non existent regulatory framework both in terms of how they handle the data that they're collecting as well as the claims that they make. And I would say that's something that the ftc, I hope the FTC does look at. I think there are some good actors, but there are a lot of people who are effectively selling snake oil and talking about functionality that simply doesn't exist for implanted medical technology. We exist within the confines of the FDA regulatory process, which has very stringent requirements in terms of data security and data privacy. We also exist within the HIPAA framework. And so there's a ton of, you know, really well thought through regulation around critical health data that I would say, you know, we're in one of the most highly regulated industries on earth and again, rightfully so. But some of the distinctions between the medical world and the consumer world gets a little bit lost during some of these discussions.

Host/Interviewer (15:18)

All right, so you slide your, your device into my head. What happens then? What, what are you doing and how is it enabling me to move things and what, what can I do with it?

Michael Mager (15:33)

So as I mentioned, you know, thought has an electrical representation. And so we are recording over a billion data points per patient per minute, effectively recording this electrical activity from the brain at its source. The signals then pass through the array to a very small package that's implanted in between the scalp and the skull. So it's outside the skull but underneath the skin and so you can't see it. And we have an ASIC that digitizes the signals, that amplifies them, that multiplexes them and then sends them down a effectively a USB C wire, a very fancy USB C wire which again has never been used in medical technology because you've never had to transfer data at high rates in a medical implant before. But the wire is then connected to a chest wall unit where we have the wireless power, so the wirelessly rechargeable as well as the telemetry to send the signals out to a computer. And the computer then makes sense of, it's really pattern recognition. So it's matching. You know, these neurons fire in this pattern when you want to move the computer cursor up and to the right versus down to the left versus, you know, whatever. We're doing this now. So we actually, I mean, just even as we speak, we have our system implanted in two pages, patients in University of Chicago and at Buffalo. And we are in the process of creating some demonstration videos showing the system in action. One of the differentiation points of us versus others is this work is happening today in temporary implants. So I mentioned that we have a FDA clearance to market and sell the device for implantation up to 30 days. And that's really a function of the fact that our system's reversible, it's safe, it's non damaging and you can remove it. This allows us to get into market and we've actually signed, we announced last month a partnership with Medtronic, one of the best medtech companies in the world, $100 billion market cap company, to co develop and commercialize a temporary version of the system that I'm describing right now. So there is a commercial benefit to having a system that you can actually market and sell. And we're working with Medtronic on that. But it also enables us to prove the system function. You know, again, when we started precision, we got a lot of pushback. No, you have to penetrate the brain, you have to do damage to the brain in order to enable powerful bci. And so what we're able to do in the clinic today before the permanent implant is being implanted is first of all cross this sort of threshold question of we can enable at the highest degree of performance, thought based computer control, but it also enables us to start collecting the neural data to feed the system. I think it's a major sort of strategic benefit of the approach that we've taken and enables us really to, by the time we go into the permanent implants, we will have worked through all of the inevitable growing pains associated with developing a new technology and deploying it.

Host/Interviewer (19:07)

And so who are you implanting them in and what can they do that they were not able to do?

Michael Mager (19:12)

So right now we are enabling people to control computers with their thoughts who actually are otherwise. They're not healthy because they're in the hospital for some reason, but they're not paralyzed, they're able bodied. So as an example, we have our first demo video and it shows someone who went into the hospital for a benign brain tumor. Gentleman is fine, he's going to be fine. He had a procedure to remove the tumor and he had to stay in the hospital for monitoring post procedure. And so in cases like that, the surgeon asks, you have to be in the hospital anyway for the next three, four, five days, a week, two weeks, whatever it is. Would you like to have the precision system implanted during that period and you know, control a computer with your thoughts or not? And 50% of people say, yeah, that sounds really exciting. And of course there's also an aspect here of, you know, people trying to help the advance of medical technology that could help lots of people. And so there's a really sort of benevolent aspect of, of this work. So this gentleman was able to, you know, control computer cursor on a grid. At first what we do is we use a joystick and there's a sort of a series of boxes or targets, I should say. And you move the computer cursor towards the targets using the joystick. And we're looking at the neural activity associated with different movements of the joystick. We then unplug the joystick. At that point, in this case, the patient is still moving the joystick, but it's not connected to anything. And the computer cursor continues to move at the same rate towards the targets, but it's powered only by his brain activity. The final piece of this, and this is something that we have not shown publicly yet, but is actually the first time it's ever happened in human history, is we then take away the joystick entirely. And he again, an otherwise healthy, able bodied person, has controlled the computer cursor not through imagined movement or intended movement, but just through his imagination, through just moving the computer cursor with his thoughts on the screen. And I think this gives you a sense of where this technology may be headed. Where you had someone who is a normal person. He went into the hospital for a procedure and for a few days he had this superhuman ability. And then at the bedside the system was removed and he went back to being a normal person. And I think that that gives you a sense of a system that is safe and reversible, may have applicability in healthy populations over time.

Host/Interviewer (22:04)

So basically you're training the system. They say you're having me move a joystick and it's watching what's happening in my brain. And then I don't move the joystick, but I think about it and you recognize the same thing and it moves. What if I can't move? What if I'm paralyzed? How do you train it then? Because I gather every brain is different. You're not looking for a very consistent signal. It's just exactly what happens when I move my hand.

Michael Mager (22:26)

Yeah, we're talking right now about the motor cortex and specifically we're targeting and others are too, the part of the motor cortex that controls the hands and the fingers. Those parts of the brain are pretty similar across people. You need to calibrate it a little bit. But, but it takes us 10 or 15 minutes to enable people to operate these systems. For someone who is paralyzed, you just say Imagine moving your arm to the right, to the left, up, down, they can't. But again, the signals are originating in the brain in the same way that they would for you and me, and that actually happens even if you're a decade or two post injury. For someone who's had a spinal cord injury, the neural activity remains effectively the same.

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Host/Interviewer (25:21)

All right, so that's where we are today. And it's. So what's the maximum that I can do with that? We talked about moving a cursor on a screen. Are there other things that are similar to that?

Michael Mager (25:33)

Yeah, I mean, I think right now I'll answer that in kind of three parts. Right now we control computers with primarily a keyboard and a mouse. We are today at precision, and this is same thing at Neuralink and others. We're basically replicating a keyboard and a mouse. Is that the right way to do it? Well, no, I think almost certainly it's not. I think this, you know, being able to operate a keyboard and a mouse means that you can regain control of computers and the whole digital ecosystem. And our goal is to enable people to live higher quality lives and rejoin the workforce if they choose. If you think about paralyzed people who are homebound, physically isolated, often, let's say you've had a car accident, you're in your 20s, your 30s, your 40s, you're totally sound of mind, but you've been injured such that you're not just physically isolated, but if you can't operate a computer or a smartphone or a tablet, you can't really have a job. There are very few jobs available. And so our goal is to enable people to rejoin the workforce and become financially independent if they choose. But is that really the best way for people to control computers? If you're unencumbered by our own biology, if you can, if you can directly through thought control digital devices, is there a more intuitive, efficient, productive way of controlling computers? Almost certainly the answer is yes. I think we're starting at this place because we know we can do something important. But I think very quickly this is going to evolve such that not only only are we developing a new medical technology, a new area within sort of medtech, but actually I think a new way for human beings to control computers more generally. And I think that that may be profound. I think it would have been very hard to predict what the keyboard and the mouse would unleash in terms of productivity and creativity. And I think that same thing with the advent of the mobile Internet, you know, the control of computers really moved to sort of smartphones. It's now moving again. Do we want to control AI in the same way that we have, you know, sort of more traditional software? Probably not. I think, you know, Sam Altman and Jony I've are working on a new product that is going to involve some degree of contextual learning and and, you know, well, I think they imagine it to be a better way of control, like an AI first software universe. But I think as this evolves, direct neural control is very likely the end state. And I think we're starting to explore what that might look like today.

Host/Interviewer (28:33)

All right, so our high visibility advocate of this technology, Elon Musk, talks about the short term and the long term. In the long term, he talks about things like, no, this is going to be a super high bandwidth direct connection and AI is going to make humans irrelevant. And so our only way forward is to effectively merge with AI. We're going to stick AI right into our brains. We'll be human AI creatures. And anybody that I want to talk to this about immediately says, well, when can I download languages? And also when can I upload my memories so I don't ever forget anything and so forth. So talk about that like, where are we headed and how far out is that?

Michael Mager (29:15)

I think that relies on a series of assumptions that may or may not be true. You know, can we accelerate the rate at which human beings are able to learn and ingest new information, new skills? Can we download, you know, kung fu like they do in the Matrix? Maybe and maybe not. I think that, that, that, that whole concept, I think is pretty conjectural. That said, that is neuralink's stated mission and goal. And that's the reason that Elon Musk founded neuralink. I think for precision. We have a very different founding credo and mission. Ours is to heal and empower. And I think that there are going to be a number of breakthroughs that this technology enables in healthcare. So we've talked a lot about sort of computer control for paralyzed people. And that's where it starts, because we know it works. We know that there's a group of, you know, millions of people globally who have nothing available to them today. But looking out a little bit farther, you know, I think that there are some directions that this could go in, in medicine that are for me much more exciting than the mission that, that you just described for neuralink as an example. I think if you think about some of the advances in human health over the course of the past 20, 30 years, many have been enabled by being able to digitize parts of our biology and then apply compute to them. The genomics revolution is a great example. I mean, the COVID vaccines developed in a matter of minutes are another example. The ability to digitize the brain. The brain has really been sort of impervious to this digitization. It's encased in the skull, which is, from an evolutionary standpoint, helpful. It's a protective barrier, but it's meant it's just very difficult to access. And then even once you can get into it, it's mushy and it's delicate and it's hard to interact with in a way that is safe and scalable. I think one of the ways that we think about what we're doing at Precision is really to digitize neural activity for the first time so that we can apply cutting edge compute to it. And I think that we've had very modest advances in neurology as a field for the past 50 or 60 years. I was reading the Wall Street Journal yesterday and there was an article about Alzheimer's and two expert bodies disagreeing about how you even diagnose Alzheimer's. That's the state of the neurological field in 2026. And I think part of the reason is that the brain has just remained completely analog. And so I think what we're doing is really creating an opportunity to apply cutting edge compute to the brain in a way that's never before been possible. And that has the potential to lead to a number of pretty foundational insights and breakthroughs.

Host/Interviewer (32:28)

Take us down five, 10 years down the road for your roadmap. Like what breakthroughs? What are we going to be able to do?

Michael Mager (32:33)

Well, I mean, I think our roadmap involves initially moving to severely paralyzed people, so enabling thought based computer control. But beyond that, I think that there are additional applications that involve really, really significant unmet needs. One is as an example, refractory depression. So first of all, refractory depression is still treated with electrical therapy, with electroconvulsive therapy. And that's something that some people find surprising. But over 100,000 people every year in the United States get electroconvulsive therapy. There are significant side effects, but it's effective. Applying electricity to the brain to disrupt certain pathways and neural circuits is effective, but you're talking about something that's extremely macroscopic and coarse. And so I think both on the diagnosis side, so being able to sense brain states and modulate therapy appropriately, I'll describe what that means. And then also actually to apply the therapy, which involves injecting current into the brain, we can do a much better, much more precise job. One of the things that I think about sometimes is again, just going back to this concept of like neurology being sort of analog. So much of neurological health is still diagnosed through people's subjective descriptions and a physician trying to interpret that and make Sense of it. So you go into your doctor and you say, you know, I have a headache or I feel sad or I feel anxious or I'm having trouble focusing. You know, your physician then sort of ingests this. This subjective description and tries to make sense of it. And really, you know, prescribes medication generally on a trial and error basis. There's no ability to track over long periods of time, you know, people's objective biomarkers associated with, you know, depression or pain or some of these just completely fundamental things that make us who we are. We're tracking our health in all sorts of ways. I wear a whoop and, you know, we're aura rings. We're tracking more and more of our data to try to make sense of it again. The brain has been this sort of black box, and I think I look forward to a future in which that's not the case, in which case we can really track efficacy of certain therapies over time, modulate the therapies according to how the brain is actually behaving, and hopefully really alleviate a lot of human suffering that today just kind of feels inevitable.

Host/Interviewer (35:23)

And so where are we now? What's the timeline like? How far away from an actual product that I can buy that has, you know, is implanted all the time? And what do we need to get there?

Michael Mager (35:34)

This is a question that I think even folks within the medtech community still feel like brain computer interfaces are a long way away. And I think part of that is just because, you know, people have been talking about brain computer interfaces for a couple decades, and it still hasn't reached the clinic. And so people have become a little bit jaded. But it is happening now. So we expect to have our pma, which is the approval that's required to implant people to market and sell a device that's implanted permanently in 2030. We expect to implant our first patient permanently next year. So in 2027. And then you go through the process of an early feasibility study and then a pivotal study and eventually clearance. There's a lot of testing, both bench testing, animal testing, and then a small cohort of initial patients who get the system. And that's just part of the FDA regulatory process. We meet. So I mentioned we're in the breakthrough device program at fda. We're in the TAP program, which is a subset of breakthrough devices that the FDA deems particularly high potential. And the purpose of the program is really to help technology that has the potential to reach a lot of people and do a lot of good, make it to market. We meet with the FDA every month. And so all of our plans, all of our timelines, all of the testing protocols have not just been vetted by the FDA at this point. We've actually, you know, together really constructed a lot of our plans. Again, that doesn't mean that we're going to be, we're guaranteed success. You know, we have to execute on the plans. But what we're talking about now is just taking a system that is working in the clinic and basically packaging it hermetically and biocompatible packages that can be implanted in the body, you know, for decades.

Host/Interviewer (37:39)

So you and neuralink regulated by the fda, I think relatively stringent. You've talked about some of the hurdles. My understanding is there are companies working on this in China and elsewhere. Do you feel like you're at a disadvantage because of the regulatory environment?

Michael Mager (37:55)

Yes and no. Yes, but probably not what you would think. So you're absolutely right. Brain computer interface technology is on China's five year plan. It's an area of, of really significant strategic focus and that is growing. Over the summer the Chinese government did a lot in terms of coordination efforts among some of the leading academic centers in the country with some of the leading companies. So they are very actively supporting the development of an implanted brain computer interface industry. The US is still in the lead. I think there is a precision neuroscience equivalent in China, there's a neuralink equivalent in China. But so far the systems that are being developed in this country are ahead of where they are in China. I think the biggest risk in the United States is actually it's not all of the testing and the FDA regulatory process that I just mentioned. Even if there were no fda, we would do things largely similarly to what is being prescribed by the fda. The biggest issue for the United States is actually it's reimbursement. So in the United States, the way medical technology gets commercialized is initially through the fda, which measures safety and efficacy. But then in order to actually get, you know, commercialized device and get paid for it, you need to then go through cms, center of Medicare and Medicaid. And they have a whole different framework of judging the sort of value of medical technology as well as a different evidentiary standard. And so on average there is a three to four year gap between FDA approval and CMS reimbursement, which is crazy. Not only. So if you think about this from a funding perspective, if you start a medtech company, you need to convince investors to give you capital to provide 100% of the funds for the company until approved. So that's six, seven, eight, nine years with no revenue until you have approval. And then once you have approval, it's another three or four years between approval and eventual reimbursement. So this just means that, you know, companies don't, that should get funded, don't. And I think that that is, you know, holding ourselves back unnecessarily. I think if you talk to people at Medicare and Medicaid or cms, they agree. I think no one would design a system from scratch in this way. Cms, you know, when CMS was created, medical devices were like a cane or a wheelchair. So the whole system is not set up for cutting edge medical technology. What the United States can and should do is very simple. It should just be very clear that, that when BCIs are through the FDA regulatory process, we are going to reimburse them immediately at a high rate that justifies the enormous amount of capital that's required to develop these systems. And whether it's Precision or Neuralink or any other company, we don't need any preferences and we don't need any favors. We just need clarity. And I think that that will unlock an enormous amount of capital into this industry that will really enable us to maintain the leadership position that the United States has.

Host/Interviewer (41:33)

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Michael Mager (41:49)

We heard you.

Host/Interviewer (41:50)

Nine years of bring back the snack.

Michael Mager (41:51)

Wrap and you've won. But maybe you should have asked for more.

Host/Interviewer (41:56)

Say hello to the hot honey snack wrap.

Michael Mager (41:59)

Now you've really won. Go to McDonald's and get it while you can.

Bella Freud (42:05)

Hi, everyone. This week on on with Keris Fisher, I'm joined by the iconic actor and activist Jane Fonda.

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You've heard of her.

Bella Freud (42:11)

Jane and I talked about her roots as an activist dating back to the 1970s when she was protesting the Vietnam War, to her ongoing fight for climate free speech and ultimately our democracy. Here's a taste of what she had to say. Hope is very different than optimism. You know, optimism is everything's going to be fine and you don't do anything about it. Hope is a muscle. Hope is when you fight, hope can be Rage filled, breaking down the door with a battering ram. This is a wonderful. I am privileged to be able to talk to people like this. Jane Fonda is the bomb. She just is. She's always been that way. She remains that way. She will go down in history as that. You can listen to wherever you get your podcasts and search for us too, on YouTube and be sure to follow on with Kara Swisher for more.

Host/Interviewer (43:06)

All right, let's close a little bit with ethics. One of the things that I talked about with Professor Farhani was just what is described, I guess generally as neuro rights. This idea that we have this new class of data. You talk about recording a billion pieces of data per minute. Presumably there's a lot of valuable information there. And again, talking to Professor Farahani, from a legal perspective, the ability for your ear pods or a headband or whatever to get some sort of emotional state that could then be used in court. Were you feeling guilty at the time? Does that indicate that you're guilty or what have you? What happens with that and how much are you worried about that?

Michael Mager (43:46)

That. I think in order to approach answers to that question, it's helpful to separate out different, different, different concepts of neural data and what they. What they mean and what we should be scared about and what we shouldn't be. I think in the first instance, we're looking, as I mentioned, at the hand motor cortex. So which neurons fire in your motor cortex associated with different intended movements? Computer cursor or taps on a keyboard? If you talk to the people who stand to benefit from this technology, we have a patient advisory board. We have from the very beginning of the company, we've tried to really use patient feedback as pretty fundamental to our product design development from the beginning anyway. But we asked them about these questions also. And in general, the answer is like, I don't care whether, like that's not who I am, you know, which neurons fire in which pattern. My motor cortex is pretty super superficial. I care a lot more, by the way, about what those outputs are used to type. So my emails, my letters, my diary, the output of those motor movements is much more personal to me than the neurons firing. So that's maybe the answer for brain computer interfaces for the next five, six, seven years. I think the deeper question, though, gets posed when and as these systems become more and more performant. And I think that academic work suggests, and I think it's very likely that these systems will be able to, for example, decode silent speech. So speech that's not vocalized but instead is imagined and what do you do with that information and how do you handle it? These are like really deep and important questions. You know, I will say as the CEO of a company, I am one voice that needs to be active in this discussion. But I think that this is something that needs to be decided with really a multi stakeholder group. You know, Nita and I both sit on the global. She's actually the chair or the co chair of the Global Future Global Futures Council through the WEF that is is trying to answer some of these questions and that involves people like me who are in industry, but also academics and ethicists and patient advocates. And a similar sort of parallel effort is happening here in the United States through something called a collaborative community. I think, you know, these are really important questions as we move forward and I think that, you know, trying to predict where these systems are going and trying to be somewhat proactive in a way that maybe we haven't been with other areas of technology and we're the worse for it, I think is the right approach. That said, when you really ask me like what are the ethics of this and what you're doing? We're trying to develop medical technology for people who right now have no options. And beyond that there are, according to who, a billion people globally who suffer from a neurological illness at one point in their lives. I think if we can enable a decrease in human suffering, I think the ethics of that are honestly pretty straightforward.

Host/Interviewer (47:25)

And so just as a last question like where from where you sit, there's always this question and tension in the United States between Silicon Valley, which talks exactly the way you just talked, which is there's so much amazing stuff we can do and we got to get to the future before China gets to it and others get to it. Just let us figure it out, don't try to restrict us and limit us. Then you have have much more different view which is like whoa, like let's look at the damage that's happening in some of these companies and you know, move fast and break things like enough of that, we got to clamp down. We gotta have tighter regulation given that we are now truly on a global stage where whether people have really realized it or not, China is blowing past the United States in a lot of future technologies. And they're doing it, as you've said, because they have have great government coordination. They make it a national priority. We have had a very hands off attitude about that. And I think a lot of the dialogue is we're not stringent enough on the regulation, we should clamp down. What's your sense? You operate in a global environment. You see around the world. Where is the United States relative to where it should be in terms of regulation, this balance between let us do it and no, no, you must do it this way. And it must be much more careful.

Michael Mager (48:45)

I mean, I think, you know, know, to answer the first part of your question, first, we're developing a tool, and like any tool, it can be used for good or for ill. I think for what we're doing, which is a medical implant, I think the good is, you know, massively outweighed by the potential ill. But I think it can be used for ill, and I think that that's just worth recognizing. I think in terms of the second part of the question and the US versus China piece, you know, I, I, I mean, if you notice what I said, like, I didn't say that the government needs to support us or any BCI company, and I don't think it does. I think what the government can do in our case is just create certainty and clarity, and I think let us and others compete to develop the best product, that that's going to end up, you know, doing a lot of good. And ultimately, you know, we're developing something that requires an elective neurosurgical procedure that's a high bar. So we got to deliver something that people really, really view as valuable and as helpful in their lives. I think as long as the United States has a lead, and it doesn't just have a lead in the tech side, but actually the FDA itself is much more sophisticated and much more advanced than any other regulatory body in the world, including Europe and any parts of Asia. The people who regulate US at the FDA are PhDs who have worked with brain computer interfaces. That's, by the way, one of the reasons they're generally supportive, because they've seen this industry get stuck in the academic setting for two decades and not reach the people who stand to benefit. And they want to see it out there, obviously safely and reliably, but still they want to see it out there. So I think we have a technological advantage, and I think we have a regulatory advantage. And I think that as long as we enable companies like ours to move with pace by creating a system that has clear incentives for developing the technology and getting it out into the world, I think the United States can do really well.

Host/Interviewer (51:01)

Michael, thank you. Good luck to you and your colleagues at Precision Neuroscience. It's incredibly exciting to talk about and wish you all the best. And thank you for your time.

Michael Mager (51:09)

Thank you. Bye Senator.

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