Five Years with a Brain Implant: A Journey of Innovation and Adaptation

Rodney Gorham has reached a significant milestone as one of the few individuals to have lived with a brain-computer interface for five years. Implanted by the startup Synchron, this experimental device enables Gorham, who suffers from amyotrophic lateral sclerosis (ALS), to control digital devices using his thoughts. This technology has been crucial for Gorham, who can no longer walk, talk, or use his hands due to his condition.

Synchron is part of a group of companies, including Elon Musk's Neuralink, that are working to commercialize brain-computer interfaces to assist individuals with paralysis. Over the past five years, Synchron's technology has evolved significantly, with Gorham playing a key role in its development. He is the longest user of Synchron's implant, having received it in December 2020 as part of a trial in Australia.

The implant, known as the Stentrode, is a small mesh tube placed in a blood vessel near the brain to collect neural signals. These signals are transmitted to an external receiver via a surgically placed unit in the chest. Synchron is preparing for a larger trial to gain regulatory approval, discussing with the US Food and Drug Administration the clinical endpoints needed to assess the device's safety and effectiveness.

Brain-computer interfaces translate brain activity into intended actions using decoding algorithms. Gorham initially used the interface for single clicks, progressing to multi-clicks, sliding controls, and eventually moving a computer cursor in two dimensions. His feedback has been instrumental in developing new features, such as Apple's Switch Control, which allows users to control devices like iPhones and iPads with their thoughts.

Gorham's use of the implant has been demonstrated in various applications, including controlling home devices like smart speakers and robotic vacuums. Field clinical engineer Zafar Faraz visits Gorham twice a week to monitor the device's performance and explore its capabilities, contributing valuable data to improve the system's reliability and user-friendliness.

Gorham's experience has highlighted the need for improvements in the system's setup, particularly the removal of a wire component that complicates the device's use for paralyzed individuals. Synchron's second-generation system aims to address this issue by eliminating the wire, making the device easier for caregivers to manage.

As Gorham's condition progresses, the challenges of using the implant have increased, raising questions about the long-term viability of such devices for patients with neurodegenerative diseases. The potential for mental fatigue and the need for insurance coverage for these costly devices are significant considerations for companies like Synchron.

Caroline, Gorham's wife, emphasizes the importance of considering the human element in the development of brain-computer interfaces, as each individual's needs and capabilities differ. The journey with the implant has been a testament to innovation and adaptation, offering hope for improved quality of life for those with paralysis.