Thinking to type sounds interesting to most of us. Crazy and futuristic, yes, but also freeing and fast. But for those with massive spinal cord injuries or degenerative diseases, brain-computer interface technology is an absolute lifeline.
In this TechFirst, we chat with Marcus Gerhardt, CEO of Blackrock Neurotech, about a brain-computer interface they’ve invented, “installed” for people who cannot use their arms or legs anymore, and enabled typing, speech, and the use of robotic arms to feed themselves and more.
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Blackrock’s tech enables thought-to-text typing at 90 characters per minute with 94% accuracy (just imagine what Dr. Stephen Hawking could have done with this) and gives tetraplegic patients the power to move a prosthetic arm, grab a glass of water, and drink by themselves again for the first time since their tragic accidents.
Check out my story at Forbes, or keep scrolling to watch the interview, subscribe to the podcast, and read the transcript …
Podcast: brain-computer interface for thought-to-text
Transcript: brain-computer interface, robotic arms, and newfound freedom
(This transcript has been lightly edited for length and clarity.)
John Koetsier: Would you like to type with your mind? Literally, as in thoughts-to-text? As attractive as that might sound for many of us, it’s absolutely essential for those who might be disabled, who might have spinal cord injuries or ALS. Blackrock Neurotech has built a brain-computer interface that enables thought-to-text typing at 90 characters per minute, with 94% accuracy.
Today, we’re chatting with the CEO, Marcus Gerhardt. Welcome, Marcus!
Marcus Gerhardt: John, thanks a lot. And thank you for giving me the time to talk about our technology and our fabulous patients.
John Koetsier: I read that as patience, ’cause I’m not a very patient person, but I understand that you mean patients, as in people who are using the technology. I want to talk about them. I want to talk about what they’re able to do, what the technology has enabled that they were not able to do … but let’s start at the beginning.
What is this technology?
This technology is a brain-computer interface or a neural interface, something that connects to the brain, in fact, picks up signals directly from individual neurons, takes that data out of the brain, does something cool with it, sometimes brings it back into the brain, and the effective outcome is that, let’s say a tetraplegic patient can move a prosthetic arm around, grab a glass or a canned bottle of water, and then drink themselves again for the first time since having tragic accidents.
It can allow a person who can’t communicate, let’s say an ALS maybe locked-in patient, to use this interface to communicate again. And we have the signals go back into the brain again, to the extent where, for example, Nathan Copeland has sensors on the front of his prosthetic hand, and he shakes a hand and he feels that the hand is warm because that warm temperature is sent right back through into his brain, telling him that the prosthetic hand that he is controlling is touching a warm hand. So it’s restoring the sense of touch and of feeling.
So some very profound discoveries for these human beings.
John Koetsier: This is literally jaw-dropping. I mean, you know, I’ve got the pre-materials from you, the information and stuff like that, but the way that you’re talking about it and what it’s capable of is — it’s science fiction. How does it work?
Marcus Gerhardt: Yeah, it works by picking up signals from the brain and then modulating those and sending data back to those neurons. So, it is an extremely intuitive technology. There’s a great sequence with Jan Sherman, a BCI pioneer — we refer to them as BCI pioneers, not patients — and…
John Koetsier: And that’s brain-computer interface, right? BCI?
Marcus Gerhardt: …[affirmative nod] brain-computer interface pioneer. And, Jan, out at Pittsburgh, she was asked on a 60 Minute interview, you know, ‘Is it hard work to be controlling this prosthetic arm?’ And Nancy suffered from a neurodegenerative disease, leaving her within weeks and months, going from a person who won a quiz show to somebody who couldn’t move anything from her neck down.
And she says to the reporter, she says, ‘Raise your arm.’ He raises his arm, puts it down. She says, ‘How hard was that?’ And he says, ‘I just thought it.’ She says, ‘That’s exactly the same for me. I just think it.’
Of course, initially there’s quite a bit of training to get it right, but she was thinking it. It’s intuitive. And that is why we get these phenomenal experiences for BCI pioneers, also on the think-to-communicate, right? Why has Stanford been able to show this high level of accuracy, this very high rate of characters per minute? And, I mean, they blow anything else out there out of the water. If you have an eye tracker, for example, it’s a tenth of the speed and not nearly the accuracy. The patients that Stanford work with, why does it work so well?
Because it’s intuitive. It connects directly with the neurons, with the brain, and picks up the signals from there and/or sends them back into the brain. That’s why this is so fast.
John Koetsier: Marcus, I literally interviewed the person who led the team that built the interface that Intel created that allowed … Brief History of Time, Stephen Hawking, to be able to communicate. And it was initially, that was, as you said, very painstaking — eye tracking, right? See a letter, see a letter, see a letter, that sort of thing. They built in AI and machine learning, predictive intelligence, and became orders of magnitude faster. But this is yet again orders of magnitude faster, and it just makes you wonder what Stephen Hawking might’ve communicated, what he might’ve written, what he might’ve told us if he had technology like this. Now, it is invasive, right, there’s…
Marcus Gerhardt: Ten times more. That’s what I can already tell you, ten times more. If his brilliant mind would have given up that much more creativity, because it would have been 10 times faster.
John Koetsier: Yes and less painful. Now this is invasive, right? There is surgery involved, there is an implant. Can you talk about that?
Marcus Gerhardt: Yeah. So this particular product embodiment is invasive, and it picks up signals from the neurons directly.
So it starts with a little microchip, it’s four by four millimeters with little pins that act like radio antennas, and they pick up these individual neurons and the data from these neurons. In fact, you can hear it. There’s some sounds you can check up on the internet and you can hear a neuron firing. It’s quite fabulous.
So it’s this little microarray chip — it’s the Utah Array, it was in fact invented here in Utah — and we designed it, improved it, and are manufacturing it exclusively. It’s that electrode that then connects to a whole system of a brain-computer interface to then bring the data out and help modulate it. But to just preempt the next question you may ask is, you know, does it always need to be invasive? I think today, to achieve these things of restoring function, yes, it does. And there is no way to get the same accuracy, the same speed from outside the brain.
Now, Blackrock exists to make people walk, talk, hear, and see again, but also to address neurological disorders and have patient impact on the 600 million people worldwide that suffer from neurological disorders. To address those disorders, we are not technology-focused, we are clinical-application focused. If the application requires an invasive technology, then that’s what we’ll deploy. But if the clinical application can be achieved through a non-invasive or a less-invasive technology, then that’s what we’ll do. And we have a whole neural interface platform that uses a variety of electrodes, a variety of miniaturized electronics, and some of them are invasive, some of them are not.
John Koetsier: So, this is interesting because it’s a much bigger picture than thinking thoughts and creating text on a computer, on a smartphone, or something like that, which already is — it would be amazing to me, if I was lying in a bed and unable to move, unable to communicate.
But you talked about being able to pick up a cup, being able to shake a hand and feel that, and now you’re mentioning actually walking … that’s incredible! I recently interviewed somebody who builds an exoskeleton. Right? And I can imagine communication in the future between a chip like this and an exoskeleton so that somebody who has partial paralysis or maybe even full paralysis can move around. Is that what you’re looking at doing?
Marcus Gerhardt: Yeah. I mean, there’s various avenues to that. So, restoring function and having people move again for us goes potentially into that direction, you know, connecting somebody with an exoskeleton. It could be connecting somebody to a prosthetic arm that moves for them. It can be connecting them to all sorts of different — we call them affectors — things that they want to affect to improve their independence, increase their quality of life. It could be to connect to a car and have them drive a car with their thought alone. It could be to connect them with their thoughts through a software to an accounting program, right?
We’ve got a BCI pioneer who’s currently back at university studying to be an accountant. Why not connect them directly to Excel? In fact, it’s a lot easier than some of the things that have already been proven to work. And, you know, I, for one, I’m not particularly passionate about Excel. I have to do it for work, but I’m not passionate. He’s passionate about it! Why should he not be as fast as I am, in fact, faster because he’s actually passionate about it. But no, here as an able-bodied person, I will beat him hands down right now, but once we integrate his thoughts with Excel, I won’t stand a chance.
So, there’s many different avenues this can run. We’ve got a research customer in stroke rehabilitation, and they’ve used this technology to show that you can use it to improve rehabilitation after a stroke. So this could be beneficial to individuals who are not fully tetraplegic but may have had a stroke, certain functions don’t work anymore, how do you restore those functions? And you use this kind of neural interface, this kind of brain-computer interface to accelerate how the body and the mind can restore certain functions. So I think there are many different avenues that this is going to end up working.
But the ones that grab the imagination that we lead with is to say, look, if somebody is tetraplegic, can’t move anymore, and we could create through a brain-computer interface a situation where they improve their independence, improve their quality of life, and they one day can move again … I mean, how great would that be?
John Koetsier: Absolutely. Where are you with the technology? You’ve talked about various tests. You’ve talked about working with universities, medical professionals. Where are you in terms of commercialization and what does that even look like in this type of application? And what kind of cost would it be?
Marcus Gerhardt: Yeah, it’s our belief that this technology is ready today and needs to go out to patients and be made available. And that’s not just our belief, it is driven largely by having talked to patients. So not too long ago, at a big conference on neuroscience, we put up on the panel three tetraplegic patients and asked them, what did they want? And all of them, consensus decision, was that the technology, while still here or there limited, was already providing them with certain benefits and that they would take it straightaway.
And that’s what Florian and I took on, took very responsibly and said, look, we have to provide this technology to patients. We have to make sure it’s safe, obviously, we have to follow the right regulatory pathways. So right now we’re in the process of getting FDA clearance on the first embodiments of this product. And while the product may not be perfect, it will address the needs of, let’s say, a fully tetraplegic patient population. So it’s our key endeavor not to get caught up in creating the perfect product, but in providing this technology that is already today working, functioning, it’s been in humans for over seven years … it is robust, making sure that the front end, all of the things around it are such that we can offer it to a higher number of patients and that it’s not just the remit of research studies where you have a lot of PhD students around the room, a lot of technicians helping.
We already take a lot of confidence from one of the BCI pioneers who was able to stay at home throughout the COVID period and do a lot, if not all of the research testing from home with sort of an at-home device. So it’s our belief that the technology is ready today to be made available.
It’s also our belief that the cost has to be in line with what the healthcare industry is generally used to. Some companies have suggested, look, this is so valuable, it should solicit a very high price tag. That’s not our take. We want to make sure there’s as few barriers to pick up as possible. And so from our perspective, it’s making sure it’s a safe technology, it is available, and it is cost efficient. So we have designed this technology to cost and made sure that it is not prohibitive, and that either insurance reimbursement codes apply and will cover it, or it’s at a level where even users could decide to raise the funds to make this happen and not have it be a price tag that is elusive to most — that wouldn’t fit with our key mission, which is to have patient impact.
John Koetsier: Yes. It is super interesting, because as an invasive technology it’s something that, you know, for instance, I wouldn’t run to do immediately, but if I had limitations you’re talking about — ALS or tetraplegic, or something along those lines — metaphorically speaking, I couldn’t run fast enough to do it because it would enable me, I feel, to be who I want to be, to be able to communicate, to be able to have some degree of independence that I have relinquished or it’s been taken away from me by whatever abilities I’ve lost, right? So I totally see that. I assume as well, that the more devices you have in people that are using them, you’re learning what works and what’s better, and you’re making it better as it goes, is that correct?
Marcus Gerhardt: That’s absolutely right. And that’s already happened over the last, I mean, we’re in this business now for a decade, providing the research community with tools and solutions. And so we have been tested by them day in, day out, and it’s allowed us to improve the technology to make it more robust and solid. And at the end of the day, that is the nexus of innovation technology and servicing a sector that is heavily regulated, the medical device sector, right? So we need to make sure that our technology is not just innovative and super cool, it has to do a job and it has to do it safely, and fit into a heavily regulated industry sector. And that’s been part of our design, a part of our approach, and it’s why we feel quite confident that over the coming years we will be able to get this technology to more and more patients. And you’re right, at first, it may seem quite invasive and so it may only appeal to the fully tetraplegic, for example, patient population to the ALS patient population that has no other choice.
But, I mean, we’re constantly rattling at that and making sure that the technology becomes less invasive, that the technology at some stage may be not invasive at all, but at least less invasive and with every step, I think what we’ll be able to do is increase the patient population. And if you think about it, there’s already implantable devices out there today that do this. I mean, if you look at cochlear implants, and the number of patients that today benefit from cochlear implants that are, you know, devices that are just implanted right behind your ear.
John Koetsier: Yep.
Marcus Gerhardt: There are now implants for sleep apnea. So I think, slowly but surely we are removing a little bit of the fear of an implant. Think about how many people today walk around with an implant in their heart in the form of a pacemaker. And so, I think that barrier and concern will also reduce. But we have to make sure that it is not risky, that it is safe, and that it provides the efficacy that patients need from this technology.
John Koetsier: I can certainly see … I know some biohackers and I can certainly see there’ll be plenty of people — maybe not a high percentage, but still a large number — who are interested in this technology even being able-bodied, and I’m sure that’s not where you’re aiming it right now, but I can see that especially as we go into more metaverse type stuff and we start living more and more digitally.
What’s interesting to me from a patient point of view is the costs, not just emotional costs of having to be cared for and not being able to do the things, but also the financial costs of 24/7 care for somebody who can’t get a glass of water; for somebody who can’t turn on the lights or turn off the lights, or can’t communicate if they need something. You would assume from an insurance perspective, especially for accident victims or also for long-term care patients, it would be potentially attractive from an insurance company perspective as well.
Marcus Gerhardt: Yeah, and you point to the part that is the no-brainer part — and no pun intended — but, you know, take a tetraplegic patient, if they become tetraplegic below the age of 30, and we’re talking fully tetraplegic, then they are going to incur a healthcare bill of between $3.7 and $5.4 million in their lifetime.
John Koetsier: Wow.
Marcus Gerhardt: That is an enormous amount that is born between a variety of insurance code plus privately, but it’s an enormous cost. What if we were able to halve that cost because they are now independent, they improve their quality of life, they are reliant on a healthcare provider only half the time or a quarter of the time. What if we could get these individuals to return to the workforce and not be…
John Koetsier: Doing Excel [laughing].
Marcus Gerhardt: And not be perceived as a burden on society. I feel we have, in fact, an ethical obligation to make sure this happens. And that’s what drives Florian and me. Now at the same time, and you started it with your question, we have the ethical question of what happens afterwards?
John Koetsier: Yep.
Marcus Gerhardt: And where do you draw the line between restoring function and then this kind of platform enhancing capabilities? And in order to navigate that — because we take those seriously, those questions very seriously — we’ve decided to create an ethics advisory board, because we believe that these are questions our society needs to be addressing right now, and we are part of it and we take responsibility for that as a business.
And so we’re very keen to really understand what this means for us as a society and how far should this kind of technology be pushed, to not just restore function for those who don’t have it, maybe provide health care that doesn’t exist today in the case of neurological disorders.
I mean, think about it, whether it’s depression or Parkinson’s or Alzheimer’s, I mean, these things don’t have very good healthcare solutions today. If we could use technology, neurotechnology to provide, for argument’s sake, an answer to depression, I mean, this was unbelievable, 14 million people suffer from this in the U.S. alone, major depressive disorder. More often than not, pharmaceuticals do not answer their needs. More often than not, they end up in an opioid crisis as a side effect. What if we were able to use neurotechnology to provide a solution here?
Are we not under an obligation to do so? I feel we are. But at the same time, we need to start to ask the questions of where else will this kind of brain-computer interface technology lead?
John Koetsier: Good segue, because what I want to ask you to do is cast your mind out about five years or so, and what does this technology look like? How’s it packaged? Who’s using it? What is this technology capable of about five years from now?
Marcus Gerhardt: Yeah, it’s a great question, and I think we’ll see an even more rapid development than we saw with a pacemaker. And I mean, the pacemaker did require two to three decades to move from the first, I think, pig that was operated on survived for hours, to today it being a device that is used as a prophylactic. So it took decades to run through that development.
I think in the case of brain-computer interfaces and a brain implant, that development will be much, much faster, and I think in five years we can be at a point where a device is less invasive. That is to say, it may still need to be connecting directly to the brain. I don’t think that noninvasive technology will get us to that point of accuracy and data bandwidth that we need today, but it will be less invasive. It may not require a full craniotomy as it does today. It may, it will be wireless, that will be another key factor to open up the patient population. And I think it will address in a very meaningful manner these questions of restoration of function, of increasing independence and improving quality of life.
I think, within five years, we will also start knocking on the door of enhancement, because at a point where it’s less invasive, the risks are much lower, the question will be asked, can this be used to drive enhancement as well? And so, it’s very timely and we need to start asking these questions of how we will interact with a brain-computer interface for these kinds of applications as well.
John Koetsier: Super interesting, and also makes me think of people as they age — which we have an increasingly aging population in countries like Japan notoriously have a very old population, right, with challenges — and whether those can be addressed here as well. I want to ask you one personal question before we finish … why are you in this industry, Marcus? How did you end up here and is there a personal reason why this captured your attention?
Marcus Gerhardt: Yeah. I met Florian at high school, so we’ve known each other for quite a while, and I asked him what he wanted to do in life, and he said he wanted to create the link between artificial and bionic limb. So I’ve always been intrigued by individuals who have a vision so early on in life of what they want to be doing. So in many ways, my passion is creating ventures and disruptive technology ventures.
So to put my services in behind Florian’s vision that he has made his life’s work, was for me a no-brainer. In the last 10 years of being involved in this, and in particular, since being CEO of Blackrock, the plight of BCI pioneers, of tetraplegic patients, and of the 600 million patients that suffer from neurological disorders, and seeing the very sorry state of care that we are able to provide today and you just said it, right, this is connected. These neurological disorders are connected pretty directly with aging, because with continued aging and an older and aging population, we will only see these neurological disorders increase in rate, increase in healthcare costs.
The last two years we’ll have added to that population number, I don’t know, another 80 million in just 12 months on the mental health front — if I hazard a guess for now, and I think we’ll get the numbers pretty soon — but we’ve all seen firsthand how mental health is affected and how quick it can go. We’re each of us a step away from it. So, these things, in my opinion, this may in fact be the one issue, the biggest issue we face as a Western society and culture with an aging population. How do we address these neurological disorders? And if we carry on doing it the way we have for the last 40 years … it’s not going to go well.
And so I’ve been having to make this my passion and put my all into it, but to see one of these BCI pioneers who’s been tetraplegic, paralyzed, and suddenly they are able to move a prosthetic arm and they can sense something, and feel something again, or move a bar of chocolate to their lips and take a bite independently … I mean, Florian and I always say, you know, you shouldn’t be talking to us. You should talk to one of these BCI pioneers.
John Koetsier: Yes.
Marcus Gerhardt: That is truly inspirational and so profound, that given that we have a very short time to live, one should always ask oneself what do you do with that short time. And to be able to do this fulfills me with enormous gratitude.
John Koetsier: Wonderful, wonderful. I should mention for everybody who’s listening or watching that the Florian you’re mentioning is your co-founder and the chairman, Florian [hesitant pronunciation] Solzbacher? Is that… [crosstalk]
Marcus Gerhardt: Solzbacher.
John Koetsier: [Laughing] Okay, I don’t have the German in there, but I want to thank you, Marcus, for this time. It’s been wonderful. It’s been super interesting. Thank you for taking the time.
Marcus Gerhardt: John, thank you very much.
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