The Future Of Brain-Computer Interfaces

Predictions and Expectations:

• Max Hodak expects it is "very possible that the first people to live to a thousand are alive right now."
• Hodak believes the field has entered a "takeoff era" and feels "something new has happened on earth."
• Hodak is not sure if "curing all disease" will happen by 2035, but expects "new lateral options" that "totally reframe how we think about the human condition."
• Hodak expects "many more people" to reach 1000 years of age, rather than just one or two.
• Hodak expects "intelligence is going to become widely available" for those with the agency to deploy it.
• Hodak expects to see healthy 30-year-olds getting BCIs "eventually," as they age and become patients, but not soon.
• Hodak predicts that ultrasound BCI could enable "digital ambien or like a digital adderall" to stimulate focus or sleep.
• Hodak predicts that biohybrid interfaces will get built, allowing us to find out "what it would feel like" to have an ultra-high bandwidth brain-to-brain connection.
• Hodak predicts that "many people become patients" in the future where the risk-benefit ratio of brain surgery crosses over.
• Hodak predicts that the current BCI technology "will get much higher bandwidth" in the future.
• Hodak expects that "AI people are on the right track" regarding the unification of AI and neuroscience representations.
• Hodak is generally "optimistic" about the future, stating his "PDoom is pretty... below that."

Timelines and Milestones:

• Hodak expects approval for the Prima implant "later this year."
• Hodak predicts that optogenetic approaches require "five to seven years of clinical translation away."
• Hodak sees a path to close-to-native acuity (color, wide field of view) "in the next 10 years."
• Hodak expects that by 2035, humans will have "new lateral options" and a "reconfigured... interface between computers and humans."
• Hodak sets an "event horizon" at 2035, beyond which he cannot see the future.
• Hodak notes the current clinical trial began in the "fall" and was published in the "New England Journal of Medicine in the fall."
• Hodak expects the "first 10, 15 years of the steam engine" to be similar in transformative speed to the "next 15 years" of tech.
• Hodak mentions the electrical stimulation device was possible "circa 2021."

Technology and Product Direction:

• Hodak expects BCI to evolve into a "category like pharma" with "a bunch of BCI companies going after different applications" rather than a single product.
• Hodak expects bio-hybrid neural interfaces to function as a "new cranial nerve" or "USB port at the end" with living neurons growing together with the brain.
• Hodak plans to use hypoimmunogenic stem cell-derived engineered neurons to avoid genetic modification of the patient's brain.
• Hodak expects the Prima implant (electrical stimulation) to eventually provide color and fill in a "lot of the field of view," contrasting with current black-and-white, small field-of-view capabilities.
• Hodak expects the "vessel program" to create portable perfusion devices, such as a "backpack" for ECMO patients, rather than large private-jet logistics systems.
• Hodak expects the brain to be viewed as a "computer" with an "API" defined by cranial and spinal nerves.
• Hodak expects future BCIs to restore "balance, have a kilobit per second of motor control that is like you."
• Hodak expects the industry to move from "drug discovery" to a "neural engineering approach" where they can engineer the brain directly.

Market and Industry Outlook:

• Hodak believes "people still don't appreciate" AI and what is possible with it, noting it is "still not priced in."
• Hodak expects the BCI market to expand to treat glaucoma (optic nerve loss) and inherited retinal diseases via new clinical trials.
• Hodak predicts that the "bio-hybrid" approach will be necessary for "very highest end things" but may be "backloaded" for scalable medical needs.
• Hodak expects the field to shift from incremental improvements to a period of exceptional change similar to the Industrial Revolution.
• Hodak expects the "conjoined twins in Canada" case to serve as a natural study for understanding multi-modal consciousness and phenomenal binding.
• Hodak expects the "smartphone dividend" from companies like Apple and Samsung to enable the miniaturization of BCI electronics.

Company Plans:

• Science is "submitting for approval now" for the Prima implant.
• Science is "about to start a new clinical trial on inherited retinal disease" affecting younger people.
• Science plans to deploy three elements: the retinal prosthesis (Prima), neural interfaces, and the vessel perfusion program.
• Science developed optogenetic proteins sensitive to "indoor office lighting."
• Science acquired a technology from a small European company that was invented at Stanford a decade ago.
• Science plans to refine the "point where you could check a kidney as luggage on a united flight" to make organ perfusion transportable.

Financial Guidance:

• No financial guidance provided in the transcript.

Risks and Caveats:

• Hodak notes that "conventional optogenic proteins" take a "bright laser" to activate, requiring sensitive alternatives.
• Hodak warns that optogenetics has "five to seven years of clinical translation away" and "could run into" pitfalls.
• Hodak states that high-quality ultrasound currently "requires drilling through the skull."
• Hodak warns that if optogenetic gene therapy in the brain "goes wrong that can go really wrong" because it is a "one-way door."
• Hodak notes that patients with congenital cataracts fixed as adults faced overwhelming sensory input, with "several of them committed suicide."
• Hodak warns that cortical motor decoders (10-bit-per-second) are not yet better than keyboard/mouse (20-40 bits/second), making surgery not worth it for healthy people currently.
• Hodak acknowledges that "neural engineering" is limited by the ability to "record and stimulate these signals."
• Hodak warns that bio-hybrid devices introduce a new variable: "You took a device and you added a bunch of biology to it."
• Hodak warns that invasive devices with open skin carry an infection risk where "an infection will climb down."
• Hodak warns that without high-quality life support, patients on ECMO circuits risk dying when filters clot if not maintained.

Confidence and Disagreement:

• Hodak expresses strong confidence in the "first principles approach" of exploring all quadrants of retinal stimulation, stating "we very quickly figured out" the optimal path.
• Hodak is "not sure" about the specifics of the "qualia" of brain-to-brain interfaces, saying "I don't like impossible to imagine" they will be built and found out.
• Hodak is "not sure" if healthy 30-year-olds will get BCIs soon, but believes it will happen "eventually."
• Hodak disagrees with the notion that "biotech has just been so incremental" recently, stating "no longer it really feels so incremental to me."
• Hodak disagrees with the "struggle" of founding alone, advising to "go work for somebody like Elon" to level up ability.
• Hodak believes the "brain is a computer" but notes "saying that is gonna get me yelled at by some corner of the field."
• Hodak believes the "conjoined twins" case shows "phenomenal binding" is possible but notes "it's kind of tough to imagine what it would feel like."