Neuralink’s First Human Patient Update

The boundary between human biology and digital technology has shifted significantly. Neuralink, the brain-computer interface (BCI) company founded by Elon Musk, has shared detailed updates regarding its first human trial. Noland Arbaugh, a patient paralyzed from the shoulders down, has successfully used the implant to control a computer mouse cursor using only his thoughts.

Meet Noland Arbaugh: The First Human User

In January 2024, Noland Arbaugh became the first human to receive the Neuralink implant, known as the “Link.” Arbaugh, who is 29 years old, suffered a spinal cord injury during a diving accident approximately eight years ago. This injury resulted in quadriplegia, meaning he has no sensation or movement below his shoulders.

Before the surgery, Arbaugh relied on a mouth stick (a device held in the teeth) to interact with tablet computers. This method was functional but slow and physically tiring. Since receiving the Link, his interaction with technology has changed accurately.

Controlling the “Mouse” with the Mind

The most immediate application of the device has been cursor control. The snippet provided refers to the patient controlling a “mouse,” which in this context specifically means a computer mouse cursor. Arbaugh demonstrated the ability to move the cursor across a screen with high precision just by intending to move his hand.

This capability unlocked several digital activities for him:

  • Gaming: Arbaugh has played Civilization VI for roughly eight hours straight. He also plays Mario Kart and online chess.
  • Independence: He can browse the web, manage emails, and learn new languages without needing a caregiver to set up the mouth stick.
  • Speed: In early tests, Arbaugh achieved a cursor control speed that began to rival able-bodied users.

The Hardware Challenge: Thread Retraction

While the initial surgery was a success, the trial faced a significant technical hurdle in the weeks following the procedure. The Neuralink device relies on 64 flexible “threads” that are thinner than a human hair. These threads contain 1,024 electrodes that detect neural activity.

Approximately one month after surgery, Neuralink engineers noticed a decrease in the data streaming from the device. The issue was identified as thread retraction. A number of the threads had pulled back from the brain tissue. This resulted in fewer effective electrodes recording the neural signals required to move the cursor.

The Software Fix

Rather than performing a second surgery to replace the threads, the Neuralink team adjusted the recording algorithm. They modified the system to be more sensitive to neural population signals. This allowed the software to interpret the remaining signals with higher accuracy.

According to Neuralink, this software update not only recovered the lost functionality but actually improved the “bits per second” (BPS)—a metric used to measure the speed and accuracy of cursor control—beyond the initial post-surgery levels.

How the Technology Works

To understand the update, it is helpful to understand the mechanics of the “Telepathy” device (Musk’s name for the first product).

  1. The Implant: The device is about the size of a coin. It sits flush with the skull, meaning it is cosmetically invisible once the incision heals. It is powered wirelessly and connects to external devices via Bluetooth.
  2. The Robot: Because the threads are too fine for human hands to manipulate, a surgical robot named R1 performs the implantation. It inserts the threads into the motor cortex, the part of the brain that controls voluntary movement.
  3. The Signal: When Arbaugh thinks about moving his hand, neurons in his motor cortex fire. The electrodes catch these electrical spikes.
  4. The Decoding: A custom chip inside the implant processes these signals and transmits them to a computer, which translates the “thought” into a digital action.

Comparison to Competitors

Neuralink is not the only player in the BCI space. Understanding the competition highlights why this update is significant.

  • Synchron: This company beat Neuralink to human trials. Their device, the Stentrode, is inserted through the blood vessels (jugular vein) rather than requiring open brain surgery. While less invasive, it generally offers lower data bandwidth compared to Neuralink’s direct tissue insertion.
  • Blackrock Neurotech: This company has used the “Utah Array” in patients for nearly two decades. However, their systems typically require a wired connection through the skull, known as a pedestal. Neuralink’s fully wireless design represents a major quality-of-life improvement for the patient.

Future Plans and Second Patient

Following the stabilization of Arbaugh’s implant, Neuralink is moving forward. The company has received FDA approval to proceed with a second participant.

For the next surgery, Neuralink plans to mitigate the retraction issue. They intend to place the threads deeper into the brain tissue (8mm compared to the previous 3-5mm) to prevent them from pulling out as the brain moves slightly within the skull.

Elon Musk has also stated that future iterations of the device will target different brain regions. The goal is to develop a product called “Blindsight” intended to restore vision to the blind, even in cases where the optic nerve is damaged.

Frequently Asked Questions

Did the thread retraction hurt the patient? No. Noland Arbaugh reported that he did not feel the threads retracting. The issue was only discovered through the data logs showing a drop in signal quality.

Can the patient control physical objects? Currently, the control is limited to digital interfaces like a computer cursor. However, the long-term goal is to allow patients to control robotic limbs or wheelchairs.

Is the Neuralink implant permanent? The device is designed to be durable, but it can be removed or upgraded. The company aims to make the hardware upgradable as technology improves, similar to upgrading a smartphone.

How long does the battery last? The implant has a battery life that supports a full day of use. It charges wirelessly through an inductive cap that the patient wears over the implant site while sleeping or resting.