Cheers!

This is high on health. Your weekly sneak peek into tomorrow's healthcare. Today's wonders and tomorrow's promises all served to spark your imagination. 🌟

This week at the office was a blast! First up, we hosted a top medtech company. Our brainstorm? Injecting AI into their already stellar hardware and software. The potential here is immense, and the discussion was energizing.

Then, we welcomed some bright young minds - one team of winners of the business@school competition across Germany¹ . Their entrepreneurial spirit? Absolutely infectious.

These encounters fuel my passion for healthcare (and) innovation. Collaborating with medtech giants and witnessing their journey towards digital transformation is both a challenge and a joy. It's where magic happens. ✨

And the students? Their drive is awe-inspiring. Back in my day, entrepreneurship was a distant dream. Now, it's their reality, ready to change the world, one idea at a time.

Outside office life, who's tried the new Apple Vision Pro?

I’m nodding along with WSJ's Joanna Stern - it's a classic first-gen product.

The internet was already having good fun. 🤣 ²

Also buzzing in the news - Elon Musk's Neuralink. Their first ‘brain-reading’ device in a human? That's our cue to dive deep (pun fully intended👆) into brain-computer interfaces (BCIs). 🧠

This week was a rollercoaster for Elon - a canceled $56 billion Tesla pay deal and the 'Most Overrated CEO' title. Seems like just another week in Musk-world! 🎢

That's it from my end.

Here's to a week filled with health, happiness, and groundbreaking innovations!

Take care!

¹ I highly recommend pitching this at your kids’ schools, and if they would like to apply for the school year 2024/2025, they must register as a teacher and complete the application form between November 1, 2023, and March 1, 2024.

² I have locked my eyes on the future, but this guy:

Brain-Computer Interfaces (BCI)

Introduction to BCIs

Imagine a world where your brain waves could control a computer or a robot. This isn't science fiction anymore; it's the realm of Brain-Computer Interfaces (BCIs). A BCI is a real-time communication bridge between your brain and external devices. It translates your brain's intent, captured through various signals, into actions.

The BCI journey starts in 1924 with Hans Berger, a German psychiatrist who invented the electroencephalogram (EEG, more on this below). His breakthrough? Recording the first human brainwaves, laying the groundwork for future BCI developments. Fast forward to 1977, a landmark year when EEG was first used to control a cursor on a screen – a modest but monumental step in BCI research.

The pace of innovation accelerated in 1988 with Stevo Bozinovski, Mihail Sestakov, and Liljana Bozinovska's experiment. They achieved a groundbreaking feat – using BCI and EEG to control a robot. This experiment marked a pivotal moment, proving that EEG could extend its influence beyond screens to physical objects.

The field BCI is rapidly expanding, with over 400 groups worldwide exploring new possibilities. In 2017, Elon Musk announced his venture into creating implantable BCI devices through Neuralink, which aims to merge cutting-edge technology with the human brain.

BCIs leverage machine learning algorithms to decipher EEG brain activity linked to specific emotions, actions, or expressions. When a match is found, these algorithms enable the BCI to issue commands to a connected device, be it a digital interface like a computer cursor or a physical object like a wheelchair. The result is a seamless translation of thought into action, exemplifying the power of BCIs in bridging the gap between the brain and technology.

But remember, BCIs aren't mind-readers. They're translators, turning brain activity into commands that replace traditional neuromuscular outputs. It's like giving your brain a new way to speak directly to the world.

At its core, a BCI establishes a direct communication line between the brain and an external device. The essence remains the same whether it's termed a brain-machine interface, neural-control interface, or mind-machine interface. BCIs are trained to interpret brain signals and convert them into commands for connected devices. This can range from detecting a user's emotional state in passive BCIs to enabling direct interaction with external devices in active BCIs. For instance, imagining an arm movement could control a robotic arm, illustrating active BCI in action.

These signals can be captured in various ways: from the scalp, underneath it, or even within the brain. And, BCIs are versatile. They work with different brain signals – electrical, magnetic, and even metabolic. The most common method uses EEG, which is non-invasive and safe, though limited in resolution. More invasive methods like ECoG¹ and intracortical recordings offer clearer signals but have surgical risks.

Medical applications of BCIs

BCIs aren't just for the lab; they're helping real people, especially those with severe disabilities, to interact with the world in new ways. They offer a voice to the voiceless, a movement to the immobile, dramatically enhancing life for them and their caregivers. It's about breaking barriers, fostering independence, and maybe even easing care burdens.

1. Revolutionizing Human Interaction with Technology

BCI technology is rapidly advancing, offering new possibilities for people with disabilities to control machines through thought. Think ALS (Amyotrophic lateral sclerosis² ), spinal cord injuries, or stroke. For people trapped in a "locked-in" state – fully aware but unable to move – BCIs can be a game-changer. This breakthrough enables them to engage with the world more independently, transcending physical limitations.

2. Thought Decoding and Memory Extension

The ability of BCIs to decode thoughts and potentially extend human memory is a burgeoning area of research. Questions like converting thoughts to text, mapping imaginations to physical objects, and understanding dreams are at the forefront of BCI development. The vision is to create systems that facilitate communication and serve as memory extensions, potentially changing how we store and retrieve information.

3. Telepathy and Advanced Communication

BCI is paving the way for telepathy-like communication, allowing individuals to connect without physical interaction. Integrating BCIs with IoT and other communication networks could vastly expand the exchange of information and experiences across distances. These advancements, however, necessitate careful ethical consideration.

4. Automation and Industry 4.0

BCI technology is increasingly recognized for its potential in automation, particularly home automation, assisting physically challenged individuals to live more independently. Looking forward, BCIs could play a significant role in industrial automation, contributing to the fourth industrial revolution and enhancing non-contact control systems in manufacturing.

5. Sharing Intelligence and Reprogramming the Brain

The potential of BCIs to enable intelligence sharing and even reprogramming the brain remains a tantalizing prospect. While it borders on science fiction, the fundamental principles of BCI technology hint at such futuristic capabilities.

Ross predicted this very concept. BTW, Black Mirror’s San Junipero is one of my favorite episodes. I swear I would live my afterlife in the 80s.

6. Harnessing Brain Energy

Given the brain's significant energy consumption, BCI technology could be used to harvest this energy to power external devices. Research into how much energy can be extracted from the brain for practical use is an intriguing study area.

7. Localized BCIs for Specific Functions

Refining BCIs to target specific brain regions for tasks like speech control could enhance their efficiency and reduce system size. This focused approach is envisioned to improve BCI performance by capturing more relevant signals and reducing noise.

In summary, Brain-Computer Interfaces are on the brink of transforming how we interact with technology, communicate, and even share intelligence. With their advancement, they bring new capabilities and ethical and practical considerations that must be carefully navigated.

What’s the deal with Elon’s trial

Neuralink, spearheaded by Elon Musk, is making headlines with its first 'brain-reading' device implanted in a person. This milestone in BCI technology aims to empower individuals with severe paralysis to control various devices through thought alone.

While this progress excites neurotechnology researchers, there's a mix of anticipation and skepticism due to limited detailed information about the trial.

As Neuralink's human trials progress, ensuring volunteer safety and well-being is paramount. Although the FDA has approved the trial, lacking detailed public information creates unease among researchers and potential BCI users. Transparency is crucial, not just for scientific validation but also for the confidence and expectations of those awaiting such life-altering technologies.

Here is the study brochure, but it’s not registered at ClinicalTrials.gov, a clinical trial registry run by the US National Institutes of Health. Federal law, some journal publication standards, and some funders require that clinical trials and even some clinical studies be registered on this publicly accessible database that supports compliance with these rules and regulations.

Safety is the prime concern in Neuralink's human trial. The trial's immediate goal is to ensure the device's safe implantation and operation, including monitoring for strokes, bleeding, and long-term issues. However, the lack of public information, including trial registration at ClinicalTrials.gov, raises questions about transparency and protocol details.

The trial's longer-term aim is to assess functionality, with volunteers using the device to control a computer. Key questions revolve around the longevity and stability of the device's performance in real-world settings beyond initial impressive results.

Neuralink's approach targets individual neuron activity, requiring electrodes that penetrate the brain. This contrasts with other companies' surface electrodes that capture averaged neuron signals, i.e., not individual ones. Though detailed neuron data is believed to be crucial for complex thought decoding, recent findings suggest that averaged signals can also decode intricate cognitive processes.

A standout feature of Neuralink's system is its fully implanted, wireless design – a first for BCIs targeting individual neurons. Earlier systems needed physical connections to computers, posing infection risks and practical limitations. Neuralink's chip, with its 1,024 recording sites and flexible polymer threads, potentially offers higher brain-machine communication bandwidth.

While Neurolink is getting the lion's share of the hype, others are getting traction.

• New York City-based company Synchron has shown that a low-bandwidth surface, i.e., not penetrating the brain BCI can provide basic but reliable smartphone control.

• Blackrock Neurotech’s BCIs are, besides Neurolink, the only other long-term single-neuron recording system implanted in humans.

Neuralink's venture into BCIs is a significant step in merging thought and technology. While its potential is immense, balancing innovation with safety, transparency, and ethical considerations is vital for the future of BCIs.

Challenges and Ethical Considerations Beyond Elon

Elon Musk is well known for his controversial takes and approaches on multiple matters.

1. Privacy and Security: Key Concerns in BCI

Privacy issues arise from the lack of specific standards in BCI development, leading to potential unauthorized access to sensitive brain signals. Security threats, especially in BCI-internet communications, expose users to cyber attacks and command alteration risks. Addressing these challenges requires robust encryption, access control protocols, and adherence to best practices in development and informed consent.

2. Safety: A Paramount Consideration in Invasive BCIs

Invasive BCIs, which are implanted into brain tissue, raise significant safety concerns. Risks include nerve cell and blood vessel damage, infection, immune rejection, and scar tissue formation that can degrade signal quality. Developing safe and quality BCIs necessitates a deep understanding of human biology and careful implantation techniques.

3. Ethical, Legal, and Social Implications

Using BCIs raises ethical questions regarding privacy, security, accountability, and equal access. Societal acceptance hinges on transparently addressing these concerns, including the legal implications of potential technological failures and the equitable distribution of this technology.

4. Convenience and Flexibility: User-Centric Design

BCI applications often require frequent recalibration, which can be inconvenient and time-consuming. Future designs should focus on adaptive systems that automatically adjust to changes in neural activity, enhancing user convenience and flexibility.

5. The Need for Multidisciplinary Collaboration

BCI research benefits from a multidisciplinary approach, yet fields like psychology are underrepresented. A more holistic research approach can lead to more practical and human-centric BCI systems.

6. Addressing the Big Data Challenge

The brain generates vast amounts of data, creating a big data problem for BCIs. A comprehensive understanding of neurological features and optimal electrode placement is crucial for effectively utilizing this data.

7. Challenges in Clinical Trial Participation

Engaging a diverse and sufficient number of participants for BCI clinical trials remains a challenge, especially in developing countries. Increasing participation and understanding of cultural differences are essential for adopting BCIs globally.

8. Standardization and Regulatory Approval

The lack of universal standards and clear approval procedures for BCI devices raises concerns about their quality and ethical compliance. Accelerating standards development and ensuring thorough regulatory approval processes are critical for safe and effective BCI commercialization.

9. Battery Lifetime and Sustainability

The longevity and efficiency of implantable BCIs are hampered by issues like material corrosion in the brain's environment. Research into durable insulating materials and alternative energy sources is essential for long-term device sustainability.

10. Making BCIs Affordable and Portable

High costs and sometimes bulky designs limit the accessibility of BCIs, particularly in developing countries. Developing cost-effective, portable BCI systems is crucial for making this technology available to a broader population.

In summary, BCIs offer groundbreaking possibilities, but their successful integration into society depends on addressing various technical, ethical, and practical challenges.

Conclusion and the future

BCI technology is full of untapped potential. But it's not all smooth sailing. We need a full-on, multidisciplinary attack to address its lurking threats. Psychologists, medics, scientists, and engineers must join forces to enhance BCI systems.

The realm of BCI research is vast and underexplored. There's a wealth of possibilities. BCI's got its share of challenges - from limited and unvaried clinical trials to the absence of global safety standards. These aren't just hurdles; they're critical issues that need addressing before BCIs can truly shine. BCIs may seem like a glimpse of the future, but they're not quite ready for the spotlight.

BCIs are at a crossroads of great promise and significant challenges. It's a thrilling yet cautionary tale of technological advancement. The next steps? More rigorous research and diverse clinical trials to unlock BCI's full potential.

I would love to get your thoughts and comments!

¹ Electrocorticography, a type of intracranial electroencephalography (iEEG), is a type of electrophysiological monitoring that uses electrodes placed directly on the exposed surface of the brain to record electrical activity from the cerebral cortex.

² In 1963, at age 21, Stephen Hawking was diagnosed with an early-onset slow-progressing form of ALS that gradually, over decades, paralyzed him. While he lived for 55 more years following his diagnosis, his was an unusual case.

Lacrosse Ball

This bad boy is an official size and weight lacrosse ball that conforms to NOCSAE standards, is NCAA and NFHS approved, and SEI certified for greater accuracy and better handling during training and playing.

No, I don’t play lacrosse. And, most likely, all of the above doesn’t matter. What matters, though, is that it costs only $5 on Amazon and is one of the best mobility tools I own. I always have one in my backpack and never travel without one (confused looks and probing questions at airport security included).

I learned about this through Dr. Kelly Starrett’s book “Becoming a Supple Leopard,” which is a must-read and study for everyone who wants to take mobility and movement patterns seriously. There are tons of videos available on YouTube, too.

Whether a runner fresh off a marathon or a desk warrior, your muscles deserve some TLC. Enter the humble lacrosse ball – a budget-friendly savior for soft tissue woes. Using just your body position and a bit of leverage, a lacrosse ball can become your personal masseur. It’s perfect for tackling tender spots, easing tightness, and soothing those pesky trigger points. This isn't just about temporary relief; it's about enhancing your movement quality, which translates to feeling better in action and recovery.

BTW, a soft or indoor lacrosse ball is your go-to for beginners or the sore-bodied. Tougher regular lacrosse balls have their place too, but it's all about what works for you. Stuck without one? Start with a tennis ball and work your way up.

Give it a try and feel the difference!

Reflecting on Stephen Hawking's quote, I find myself in a unique position. As an extrovert, I'm naturally drawn to social interactions and the energy of being around others. Yet, Hawking's words resonate with me, especially in those moments when I seek the comfort of silence and solitude.

In these periods of quiet, I realize a rich inner world within me often goes unnoticed in the hustle of my extroverted life. Hawking's insight reminds me that even in my love for outward expression, there's immense value in turning inward. The quiet moments become my sanctuary for deep thought and creativity, where my mind can wander freely¹ without the constraints of constant interaction.

Embracing both aspects of my personality, I see Hawking's quote as a bridge between my extroverted nature and my quieter, reflective side. It's a reminder that even the most outgoing among us have a universe of thoughts and ideas within, echoing loudly in our moments of solitude. In these instances, I find a surprising depth, a testament to the complexity of the human mind, beautifully captured by Hawking's profound words.

¹ Remember Passive learning? You let your mind wander with no intended destination. You read and learn broadly, talk to people from various backgrounds, and stumble haphazardly across topics you had never considered but spark your curiosity, often because it’s the topic you happen to need at that specific time of your life.

DISCLAIMER: None of this (such as text, graphics, images, and other materials) is medical or health advice. This newsletter is strictly for informational, educational, and entertaining purposes only. While I’m a medical doctor and a dentist by training, I’m not your doctor. The content is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on high on health! Please be careful and do your research.