Neuralink’s First Human Patient: What We Know So Far
In January 2024, the field of neuroscience shifted from theoretical research to practical application when Neuralink successfully implanted its brain-computer interface (BCI) into a human subject. This milestone represents a significant step forward for assistive technology. The procedure was part of the company’s PRIME Study, which aims to evaluate the safety of the implant and the surgical robot used to insert it. For observers tracking the intersection of biology and technology, the results from this first patient provide concrete data on the current capabilities and limitations of the “Telepathy” device.
Who is the First Patient?
The first human recipient of the Neuralink N1 implant is Noland Arbaugh, a 29-year-old Arizona resident. Arbaugh became a quadriplegic eight years prior to the surgery due to a diving accident that dislocated his C4 and C5 vertebrae. This injury left him with no sensation or movement below his shoulders.
Arbaugh volunteered for the clinical trial with the hope of regaining a degree of digital independence. Before the implant, he relied on a mouth stick (a stylus held in the mouth) to interact with tablet devices. This method required him to be upright and assisted by a caregiver. The promise of the Neuralink device was to allow him to control a computer using only his neural activity, regardless of his physical position.
Capabilities: Cursor Control and Gaming
The primary function of the N1 implant in this initial phase is cursor control. The device captures neural signals associated with the intention to move and translates them into digital commands via Bluetooth.
Gaming Achievements
Arbaugh has demonstrated remarkable proficiency with the interface. In a livestream demonstration on the social media platform X, he was shown playing online chess. He described the experience as intuitive, likening the control mechanism to “using the Force” from Star Wars. He simply stares at a location on the screen and imagines the cursor moving there.
Beyond chess, Arbaugh has successfully played complex strategy games. He specifically cited playing Civilization VI, a turn-based strategy game. Before the implant, he required extensive assistance to play such games. With the BCI, he reported playing for eight consecutive hours, stopping only when the implant’s battery required recharging. He has also navigated Mario Kart 8, demonstrating the interface’s ability to handle dynamic, real-time inputs.
Digital Independence
The implant has allowed Arbaugh to multitask more effectively. He can listen to audiobooks while browsing the internet or studying. This level of autonomy is significant for patients with quadriplegia, as it removes the constant need for a caregiver to adjust physical input devices like trackpads or mouth sticks.
The Hardware: The N1 Implant and R1 Robot
To understand the patient’s experience, it is helpful to look at the specific hardware involved.
- The N1 Implant: This device is roughly the size of a coin. It replaces a small piece of the skull and sits flush with the head, making it invisible under the hair. It contains a battery, processing chips, and communication electronics.
- The Threads: The critical component involves 64 ultra-thin threads containing 1,024 electrodes. These threads are thinner than a human hair and are inserted directly into the motor cortex of the brain.
- The R1 Robot: Because the threads are so fine and the brain moves during respiration, a human surgeon cannot insert them manually. Neuralink developed the R1 Robot to perform the insertion with micron-level precision to avoid damaging blood vessels.
Challenges: The Retraction Issue
The trial has not been without technical complications. In the weeks following the surgery, Neuralink reported that a number of the threads had retracted from Arbaugh’s brain.
Cause and Consequence
The retraction meant that fewer electrodes were recording data effectively. This resulted in a decrease in “bits per second” (BPS), which is the standard metric for measuring the speed and accuracy of cursor control. As threads pulled back, the signal quality degraded, and the cursor became less responsive.
Industry experts speculate the retraction occurred because the brain moves inside the skull (due to breathing and heartbeat), while the implant is anchored to the bone. This mechanical mismatch may have pulled the threads out.
The Software Solution
Rather than performing a second surgery to replace the threads, Neuralink engineers modified the recording algorithm. They adjusted the system to be more sensitive to neural population signals (averages of neuron activity) rather than relying solely on individual neuron spikes. They also improved the way these signals translate into cursor movements.
According to Neuralink’s progress reports, these software updates not only recovered the lost performance but allowed Arbaugh to exceed his initial speeds. This demonstrated that the system is upgradeable over the air, a crucial feature for long-term medical devices.
Future Outlook and FDA Status
The FDA gave Neuralink approval for the PRIME (Precise Robotically Implanted Brain-Computer Interface) study to assess safety and functionality. The experience with Noland Arbaugh has cleared the path for the next steps.
Neuralink is currently seeking a second participant for the trial. Based on the data from Arbaugh, the company plans to alter the surgical procedure slightly. For the next patient, the threads will likely be inserted deeper into the brain tissue (specifically the motor cortex) to prevent the retraction issue seen in the first case.
Long-term goals for the technology extend beyond cursor control. Elon Musk has stated that future iterations, such as “Blindsight,” aim to restore vision to the blind, while other applications may bridge signals from the brain to the spinal cord to restore physical mobility to paralyzed limbs.
Frequently Asked Questions
How is the Neuralink device charged? The N1 implant is charged wirelessly from the outside via an inductive charger. It functions similarly to wireless phone chargers. The patient wears a hat or a specialized charging coil over the implant site for a few hours to recharge the battery.
Can the implant be removed or upgraded? The design intention is for the device to be upgradeable. Because technology moves faster than biology, Neuralink aims to allow users to swap out older implants for newer models. However, the explantation (removal) process is complex due to the threads growing into the brain tissue, and safety data on removal is still being gathered.
Does the surgery hurt? The brain itself has no pain receptors. The surgery is performed under anesthesia to ensure the patient remains still and comfortable. Noland Arbaugh reported that the surgery was easy and that he was released from the hospital the following day.
How does this compare to other BCIs? Traditional BCIs, like the Utah Array, often require a pedestal that protrudes through the skin, which carries a risk of infection. Neuralink is fully implanted and wireless. Additionally, Neuralink uses significantly more electrodes (1,024) compared to standard arrays (often around 100), potentially allowing for higher data bandwidth and more precise control.