Brain-computer interface trials are taking off

脑机接口试验正在蓬勃发展

EXECUTIVE SUMMARY This week, I covered the story of Casey Harrell—a man with ALS who is “the first power user” of a brain implant, according to the researchers who worked with him. Harrell is paralyzed and unable to speak coherently without the device. He has now spent almost three years using a brain-computer interface (BCI) that enables him to “speak,” surf the web, and perform his job as a climate activist, largely independently.

执行摘要 本周，我报道了凯西·哈雷（Casey Harrell）的故事——据与他合作的研究人员称，这位患有渐冻症（ALS）的男子是脑植入设备的“首位超级用户”。哈雷目前处于瘫痪状态，如果没有该设备，他无法连贯地说话。他使用脑机接口（BCI）已经快三年了，这使他能够“说话”、上网，并基本独立地完成他作为气候活动家的工作。

Since Harrell was implanted with the device, in July 2023, a team at the University of California, Davis, has worked with him to adjust and improve its offerings. They’ve refined its accuracy, for example. And they’ve introduced settings including a privacy mode and a “profanity filter” that lets Harrell talk to his daughter without risking accidental swearing. Harrell told me that, for him, the device is “nothing short of revolutionary!” It has enabled him to maintain an income, reconnect with friends and family, and read to his daughter.

自2023年7月哈雷植入该设备以来，加州大学戴维斯分校的一个团队一直与他合作，对其功能进行调整和改进。例如，他们提高了设备的准确性，并引入了包括隐私模式和“脏话过滤器”在内的设置，让哈雷在与女儿交谈时不必担心意外说出脏话。哈雷告诉我，对他而言，这个设备“简直是革命性的！”它使他能够维持收入、与亲友重新建立联系，并能给女儿读书。

The team that developed his BCI is one of several working on ways to use technology to allow people with paralysis to communicate, engage with the online world, and regain some independence. And Harrell is one of a growing number of people volunteering their brains to, as he puts it, “pay it forward and do the scientific research … [and] get some personal benefit.” Over the past couple of years, the number of BCI trial volunteers has soared. This year, China became the first country to approve a BCI for medical use. Advances in technology are allowing engineers to provide more features than ever. BCI research is properly taking off.

开发他所用BCI的团队只是众多致力于利用技术帮助瘫痪人士进行交流、参与在线世界并重获部分独立性的团队之一。哈雷是越来越多自愿贡献大脑的人之一，正如他所说，这是为了“回馈社会并推动科学研究……（同时）获得一些个人益处”。过去几年里，BCI试验的志愿者人数激增。今年，中国成为首个批准BCI用于医疗用途的国家。技术的进步使工程师能够提供比以往更多的功能。脑机接口研究正在真正起飞。

I should first point out that BCIs come in different forms. Harrell’s device includes a set of electrodes embedded in his brain that pick up the electrical activity associated with speech. Those electrodes are connected to two docking ports on top of his head that can be plugged into a computer. That computer is loaded with software trained to decode his brain signals into phonemes (units of sound in speech) and predict what Harrell wants to say. He can then use an eye gaze tracker to make any corrections before the speech is played out loud.

我首先要指出，脑机接口有不同的形式。哈雷的设备包括一组植入他大脑的电极，用于捕捉与语言相关的电活动。这些电极连接到他头顶的两个对接端口，可以插入电脑。电脑中加载了经过训练的软件，可以将他的大脑信号解码为音素（语音中的声音单位），并预测哈雷想说什么。然后，他可以使用眼动追踪器在语音播放出来之前进行任何修正。

But some BCIs don’t need to be “plugged in”—they’re fully implanted and wireless. Others are less invasive; they might involve placing wired electrodes on the surface of the brain or simply wearing a cap of electrodes, for example. There are trade-offs—the closer you get to the neurons you want to record from, the better your signal will be. But generally speaking, the more invasive the surgery, the higher the risk of complications.

但有些脑机接口不需要“插线”——它们是完全植入式且无线的。另一些则侵入性较小；例如，它们可能涉及将有线电极放置在大脑表面，或者仅仅是佩戴一个电极帽。这其中存在权衡——你离想要记录的神经元越近，信号就越好。但总的来说，手术的侵入性越高，并发症的风险就越大。

BCIs can also have different functions. Harrell has ALS, but most BCIs in use today are sitting in the brains of people with spinal cord injuries. Typically, these individuals have some degree of paralysis; for example, they may be unable to move their arms and legs, but their face and ability to speak are unaffected. In those cases, BCIs can be used to control other kinds of devices that might help with mobility.

脑机接口也可以有不同的功能。哈雷患有渐冻症，但目前使用的大多数脑机接口是植入在脊髓损伤患者的大脑中。通常，这些人有一定程度的瘫痪；例如，他们可能无法移动四肢，但面部和说话能力不受影响。在这种情况下，脑机接口可以用来控制其他有助于行动的设备。

In 2024, Michelle Patrick-Krueger, then at the University of Houston, and her colleagues published a roundup of all trials of BCIs conducted between 1998, which is when they believe the first device was implanted, and the end of 2023. They identified 21 research groups that, among them, had trialed BCIs in a total of 67 volunteers. “Since then, that number has increased a lot,” says Mariska Vansteensel, a BCI researcher at University Medical Center Utrecht.

2024年，当时在休斯顿大学的米歇尔·帕特里克-克鲁格（Michelle Patrick-Krueger）及其同事发表了一份综述，汇总了从1998年（他们认为首个设备植入的时间）到2023年底进行的所有脑机接口试验。他们确定了21个研究小组，这些小组总共在67名志愿者身上进行了脑机接口试验。“从那时起，这个数字已经大幅增加，”乌得勒支大学医学中心的脑机接口研究员玛丽斯卡·范斯滕塞尔（Mariska Vansteensel）说。

In January, Neuralink (the BCI company founded by trillionaire Elon Musk) announced that it has implanted 21 people with its device in the past two years. Synchron, another BCI company, is currently testing its devices in trials in North America and Australia. Shanghai-based Neuracle has been trialing a BCI since November 2024, and it recently obtained approval for the device to be used outside of clinical trials. Precision Neuroscience, cofounded by a former co-creator of rival Neuralink, is also trialing its BCI, which sits on the surface of the brain.

今年1月，Neuralink（由亿万富翁埃隆·马斯克创立的脑机接口公司）宣布，在过去两年中已为21人植入了其设备。另一家脑机接口公司Synchron目前正在北美和澳大利亚进行设备试验。总部位于上海的博睿康（Neuracle）自2024年11月以来一直在进行脑机接口试验，并于近期获得了该设备在临床试验之外使用的批准。由Neuralink前联合创始人共同创立的Precision Neuroscience公司也在测试其放置在大脑表面的脑机接口。

At the same time, academic research has continued. The UC Davis team that worked with Harrell is part of BrainGate—a BCI research effort that has been running for the past two decades. Other academic teams are exploring a variety of devices, from the fully implanted to the minimally invasive. Since 2024, when Patrick-Krueger’s paper was published, the number of people who have been implanted with a brain electrode has more than doubled, according to Vansteensel. “My current estimation would be around 150 people,” she says.

与此同时，学术研究也在继续。与哈雷合作的加州大学戴维斯分校团队是BrainGate的一部分——这是一个已经进行了二十年的脑机接口研究项目。其他学术团队正在探索各种设备，从完全植入式到微创式。据范斯滕塞尔称，自2024年帕特里克-克鲁格的论文发表以来，植入脑电极的人数已经增加了一倍多。“我目前的估计大约是150人，”她说。

The technology is improving too. Take the BrainGate trial, for example. The first 17 years of that trial focused on the use of what researchers call “point-and-click” communication—allowing users to control a cursor and “click” with their brain activity. But in recent years the team has pivoted toward decoding speech, says David Brandman, the lead investigator on the team (and the person who implanted Harrell’s electrodes). Today, Harrell’s device uses a voice clone—the speech it produces is based on previous recordings of Harrell’s voice.

技术也在不断进步。以BrainGate试验为例，该试验的前17年专注于研究人员所称的“点击式”交流——允许用户通过大脑活动控制光标并进行“点击”。但该团队的首席研究员（也是为哈雷植入电极的人）大卫·布兰德曼（David Brandman）表示，近年来团队已转向解码语音。如今，哈雷的设备使用语音克隆技术——它产生的语音是基于哈雷之前的录音。

But BCIs are still experimental. And plenty of questions remain about who might benefit from them—and how long the devices will last. So far, most BCIs have been implanted in people with spinal cord injuries. We know even less about how they might benefit other people who have ALS, for example. In some cases where the devices initially helped people with ALS—even someone who was completely locked in—the BCIs eventually stopped working. And scientists don’t really know why.

但脑机接口仍处于实验阶段。关于谁能从中受益以及设备能持续多久，仍有许多问题。到目前为止，大多数脑机接口都是植入在脊髓损伤患者身上。例如，我们对它们如何使其他渐冻症患者受益知之甚少。在一些最初帮助过渐冻症患者（甚至是完全“闭锁”状态的患者）的案例中，脑机接口最终停止了工作。而科学家们并不真正知道原因。

The only way they’ll find out is through more research—and the participation of volunteers like Harrell. So it’s exciting to see trials truly take off. And I promise I’ll update you on where they stand two years from now.

他们找到答案的唯一途径是通过更多的研究，以及像哈雷这样的志愿者的参与。因此，看到试验真正起飞令人兴奋。我承诺，两年后我会向大家更新它们的进展情况。