Bernd van Ruremonde
Introduction
Neuralink, Elon Musk’s brain-computer interfacing company, has recently been gaining a lot of publicity with its seemingly incredible breakthroughs in the field of neuroscience. However, as with many scientific advancements, the product is also seeing a lot of controversy, both from the scientific community and from the general public (Singh and Kumar, 2023). Many people seem scared of brain implants, afraid that their thoughts will be listened to, or even influenced. While most of these fears may quickly be debunked, it is clear that the public still shows significant hesitation towards acceptance of brain implants.
Neuralink: Implant or Interface?
Let’s first make an important distinction. The field of brain implants is massive, and Neuralink and other similar products only occupy a tiny fraction of this field. These products are called ‘brain-computer interfaces’ (BCIs). As the name suggests, they allow humans to interact with computers using only their brain as an input device. While Neuralink is an implantable BCI, many other BCIs are not implanted and rather sit on top of the head.
The term ‘brain implants’ often refers to therapeutic devices that are surgically inserted into the brain, to treat neurodegenerative disorders such as Alzheimer’s or Parkinson’s, or other neurological disorders such as epilepsy or an essential tremor. Implants are mostly used in the later stages of a disorder, when medication can no longer provide an adequate effect (Fymat, 2020). When this stage is reached, brain implants can provide a powerful and attractive alternative. It is worth noting that, while there are still significant advancements being made, most of these devices treat, and don’t cure. There is no widely accepted cure for most neurodegenerative and aforementioned neurological disorders available at this time.
Neurodegenerative Disorders
The most well-known function of brain implants is to treat neurodegenerative disorders. These are disorders that are primarily caused by the death or damage of nerve cells in the brain. One such disorder is Alzheimer’s Disease (AD), a form of dementia where a build-up of Beta-Amyloid (Aβ) peptide – also called ‘senile plaques’ – in the brain inhibits the regular functioning of the nervous system (Chen et al., 2017). Diagnosis and treatment of AD have seen large advancements in recent times, with machine learning showing increasingly accurate diagnoses (Chelladurai et al., 2023).
The treatment of AD has taken many different routes. One emerging technique considers preventative immunotherapy (Lathuiliere et al., 2016). The treatment is based on a cellular implant that leads to the production of Aβ-antibodies, which has shown a significant reduction in plaque buildup in animal models. While this method is preventative and might not work retroactively, studies have shown that AD can be visible in a preclinical stage through biomarkers (Sperling et al., 2011). These two methods combined could mean a significant improvement in the treatment of AD.
Another common neurodegenerative disorder is Parkinson’s Disease (PD). PD is a movement disorder, thought to be caused by impaired dopamine (DA) release in the body (Cramb et al., 2023). Dopamine is what modulates the basal ganglia, which in turn controls how energetic your motor control is. Common treatments for PD are what many people think about when the word ‘brain implant’ is mentioned: an actual device that is surgically implanted in the head to modulate certain parts of the brain. This is also called ‘Deep Brain Stimulation’, or DBS (Fymat, 2020). It allows DA release to return back to a more functional state.
Ethical issues & Risks
Brain implants carry some serious risks and ethical critiques. DBS, for one, requires brain surgery, and while generally safe, every surgery carries risks. Additionally, a long-term analysis of 82 PD patients who underwent DBS surgery showed that more than 20% experienced non-reversible adverse effects that were possibly related to DBS (Buhmann et al., 2017). These adverse effects included symptoms like impaired gait, depression, cognitive disturbances, or urinary incontinence.
Another big concern is hacking. Implants like Neuralink, while allowing the user to control devices in their environment (Janarthanan et al., 2024), inevitably become a part of the vulnerable Internet-of-Things (IoT) network. This network has been shown to have significant weaknesses (AlSalem et al., 2023), leading to worries that these implants could act as a gateway for hackers into our mind and behavior.
Finally, there have been questions about the psychological and mental influence of DBS implants. Numerous studies suggest that DBS can affect an individual’s personal identity, raising ethical and legal issues (Klaming and Haselager, 2013). For instance, if a patient is influenced by DBS to a point where they commit a crime, can they be held liable? Or could they ‘plead insanity’ similar to a patient with a severe mental illness? Would it make a difference if the influence could be reversed by turning off the DBS? These are all valid questions as to the legal and ethical liability of DBS patients.
Conclusion
While numerous treatment methods for neurodegenerative disorders currently exist on the market, brain implants present an attractive long-term solution for patients with disorders like AD and PD. Implants like Neuralink also seem promising, both for ‘recreational’ and clinical use. However, for both of these categories, numerous ethical issues should be addressed before moving further in the field.
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Further Reading
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Buhmann, C., Kassubek, J., & Jost, W. H. (2020). Management of Pain in Parkinson’s Disease. Journal of Parkinson’s Disease, 10(s1), S37–S48. https://doi.org/10.3233/JPD-202069
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