Long-term Play
Oxley “honestly [acknowledged] that we debated internally as to whether we should even do this,” citing costs, time, risks, perceptions and unknowns. Ultimately, GPT’s 4o multimodal capabilities provided the impetus to move forward, to better connect users like Mark to digital systems today, and unlock broader applications across a rapidly evolving consumer technology ecosystem of tomorrow.
Synchron's BCI system includes the Stentrode Endovascular Electrode Array (top right)
Reflections and Ripples
As a casual user of various popular LLMs, I admitted to Oxley that when I first saw the press release, I shrugged. Despite knowing full well that off-the-shelf GPT I use differs substantially from this application, I still had trouble seeing the significance. Several neurotech executives have expressed similar scrutiny in private.
But with early stage technology, it’s good to have more questions than answers. As a skeptical optimist, here are some summary reflections and lingering thoughts about what LLM could represent for user applications in commercial neurotech markets.
Burden of Interpretation
Communicating normally is something most of us do without thinking, and thus take for granted: Analyzing a question for intent, gathering broader context based on external cues and internal feelings, and factoring that into a reply, all at conversational pace.
However, what able-bodied folks like me can’t fathom is how this can represent a hurdle or even a barrier for those living with different forms of impairment, including early BCI users. If you’ve struggled to use a remote control to browse Netflix, just imagine if that was what all communication required.
By removing even some burden of interpretation and other friction for users, LLM can substantially improve utility of BCI technology and lead to new use cases. Basic features are a good place to start. I’m excited to see what ideas and features emerge from end users, patient advocacy groups, caregiver circles, registries, and trial participants.
Form Factor
A common category of question I receive is about minimally invasive versus non-invasive neural interfaces. In this case, the question might be “Why is an implanted device even necessary to incorporate LLM?”
Leaving aside various critical distinctions between implanted and non-invasive tools, in this case the question is a good one. Cognixion, Augmental, Synaptrix, and many others are commercializing wearable or non-invasive means to decode user intent into digital signals, in some cases with advantages in upgradability, cost, and safety.
So while Synchron’s integration with OpenAI is fairly high profile, the truth is LLM are modality-agnostic. The upshot: Expect several other neurotech players to adopt similar and different approaches to leverage prompt automation and other LLM-enabled features in the months ahead.
Towards Social Robotics
Thanks to comments by Musk, enough ink has already been spilled on BCI as a portal to transhumanism, a topic Oxley has
shrugged off. But a separate area in need of speculation is the role that semi-autonomous AI agents could play in future BCI markets where human privacy and safety can be protected, and LLM reliability ensured.
Beyond responsive prompts, there is tremendous value to unlock through small automations for these users (and others). If personalized agents could become capable and, again, reliable, they could help with checking in, communicating with the medical team, collecting patient-reported outcomes, and possibly handling administrative labor, from managing appointments, medications, paying bills, dealing with insurers or disability offices, initiating interpersonal requests to caregivers, say to charge a device or flag other needs, and so on.
Those examples are all text-based; the possibilities for incorporating audio, cameras, sensors, wearables, other inputs (e.g. BCI-derived neural data for additional passive sensing) could produce applications that arguably go beyond what we can even imagine today. To be clear, all indications suggest this level of reliability with LLM is likely years away. But, today’s prototype from Synchron, with a laser focus on user privacy and simple, value-add features, opens the door for those possibilities to take shape in the future.
Widget vs. Platform
Some think a reckoning is due for the frothy implantable BCI space, driven by the hype of Synchron’s main competitor. Just this week, Neuralink’s valuation hit a
reported $8b, which represents a larger size than all active US neuromodulation markets segments last year ($6.6b) as per
LSI’s recent analysis.
The
hype factor is real, but this only makes sense if one looks at BCI as an enabling platform technology. Synchron’s integration offers a keyhole view. Think of it this way: if a commercially available API can significantly augment user functionality of a class III medical device - during active clinical trials - then BCI are not simply a point solution, but an enabling technology whose features and functions are up to the market (and not necessarily regulators.)
This integration is the latest example of how today’s BCI companies are
building in public. What seems like relatively narrow use cases and target markets will expand because they only can, given the speed of innovation across AI, ML, materials science, surgical innovations, consumer technology, and beyond.
Originally published in Forbes, July 24, 2024.