Modern technology opens the way to the brain

With electrodes connected to the brain, you can already treat diseases today. With Neuralink, Elon Musk has turned the spotlight on the possibilities of tomorrow’s brain technology.

In the summer of 2020, Elon Musk-founded Neuralink implanted a chip in the pig Gertrude’s brain. Two months later, the company demonstrated how the implant could register brain activity from Gertrude.

During a question and answer session in the Clubhouse app, Elon Musk now states that Neuralink has implanted a wireless chip in a monkey’s brain.

– We already have a monkey with a wireless implant in its skull and small wires, which can play computer games by using their thoughts. And he looks completely happy. He does not look like a dissatisfied monkey, he says during question time, according to The Independent.

Elon Musk’s long-term vision is to develop interfaces for brain machines that will connect people with computers. Electrodes would affect signals in the brain to enhance human properties.

Elon Musk. Photo: Susan Walsh

Among other things, he has talked about the concept of “conceptual telepathy”, where it would be possible for an individual to think of a series of complex concepts and transfer these thoughts directly to someone else. There’s a bit left there.

Today, electrodes in or outside the brain are used primarily for treatment and rehabilitation. It is an active area for research and technology development.

Where is the brain technology in Sweden today and what is the next step? To answer this, Ny Teknik has spoken with the startup company Flow Neuroscience and researchers Jens Schouenborg and Elaine Åstrand.

Headset for depression

People with depression have lower activity in parts of the brain’s prefrontal cortex, studies show. With the help of a technology called transcranial electrical stimulation, tDCS, one can increase the activity in the area. It can alleviate the negative symptoms.

This is the starting point for Malmö-based Flow Neurosciences product. It is a headset with associated app that is used to treat mild to moderate depression.

– It is a huge market and there are many who need help. We see ourselves as a complement or alternative to medication for depression, says neuroscientist, electrical engineer and co-founder Erik Rehn to Ny Teknik.

The company’s proprietary headset resembles a thick tiara. It has electrodes on each side. With the help of a built-in current regulator, weak direct current is sent between the electrodes, which stimulates the brain.

The current is two milliamps. For those who wear the headset, a treatment should thus not feel more than a “slight tickling” or “itchy”.

By using the headset for half an hour five times a week for the first three weeks and then once or twice a week, people with depression can have milder symptoms.

Erik Rehn, electrical engineer and co-founder of Malmö-based Flow Neuroscience. Photo: Flow Neuroscience.

Flow Neuroscience headsets have been approved as a medical technology product in the EU since 2019 and may be sold directly to consumers.

– There are a plethora of different techniques for brain stimulation. The technology we use has gained momentum in recent years precisely because it is so safe to use and works for home use, says Erik Rehn.

What we see today is just the beginning of the development of techniques for brain stimulation, says Erik Rehn.

– We see a potential to develop more precise methods, which hit exactly the right place in the brain, and at the same time an opportunity to, with the help of technology, increase our understanding of diseases such as depression, says Erik Rehn.

Flow Neuroscience product is based on non-invasive brain technology. This means that you do not need to operate on anything in the brain. Invasive brain techniques, which Neuralink among others looks at, open up other possibilities.

– What is difficult about that idea is how to solve the problems that exist with implants. They are associated with great risks, says Erik Rehn.

Implantable electrodes

Jens Schouenborg is a professor of neurophysiology at Lund University. Since 2006, he has led the work at the university’s Neuronano Research Center.

His job has two different tracks. One is about developing technology to investigate how the brain works. The second track, which takes place in collaboration with its own company Neuronano AB and clinical researchers, is about developing new, effective treatments for pain and neurodegenerative diseases (ie diseases that slowly wither the nervous system) such as Parkinson’s.

Jens Schouenborg, Professor of Neurophysiology, Lund University. Photo: Mikael Risedal / Press photo

In both cases, the development of biocompatible, implantable electrodes that do not interfere with the normal signaling of nerve cells is central.

When work at the center started in 2006, there were electrodes for implantation. But they were also associated with major problems. In animal experiments, the electrodes triggered tissue reactions that encapsulated the components and destroyed tissue.

– The electrode technology was so primitive that many sensitive mechanisms in the brain could not be studied, says Jens Schouenborg.

This problem should be largely solved after 15 years of intensive research and development.

Jens Schouenborg and his research group have developed very thin, flexible electrodes with extremely little effect on brain tissue. They are based on micrometer-thin conductors of gold or platinum (iridium), with insulation on the outside.

– Minimizing foreign body reactions is a big deal. This means that we can now register activity in a tissue that is much less affected than before and thus we get a much more authentic situation, Jens Schouenborg explains.

Clinically, the electrodes will be used for, for example, “Deep brain stimulation”, DBS. It is a method that is used today mainly in the treatment of Parkinson’s. It involves operating electrodes deep into the brain to provide symptom relief when no medication is helping.

Using brain technology for pain, Jens Schouenborg considers it a very promising area.

– There are many people who walk around with pain and who are on sick leave because of it. It is associated with high costs to society. And at the same time we have many cases where it is not possible to affect pain at the end of life with, for example, morphine.

The human brain is complex and there is still much we do not know about it. Photo: Illustration: Science Photo Library.

Jens Schouenborg explains that by using a cluster of electrodes, the precision of the technology can be refined. Once the cluster of electrodes has been implanted, you test which of the electrodes are most effective for treatment, and select those that do not work as well. In this way, the risk of side effects is also significantly reduced.

– However, microelectrodes can only send out very small currents. They must not have a higher voltage than any volt. It also means that they must be very precisely positioned. It is a challenge, but also a problem that we have basically overcome with the help of gelatin technology, he says.

The electrons are embedded in gelatin which dissolves after implantation. The brain’s enzymes then break down the gelatin.

An earlier challenge has been that the electrodes can move. The small movements that our heart rate, our breaths and head rotation cause can cause electrodes to lose contact with the nerve cells they are to be attached to.

– You need a sufficiently stable technique to be able to communicate with the right nerve cells for a long time, at the same time as the movements and micro-forces that arise can make tissue irritated and inflamed. There have been really big difficulties, which we are now seeing solutions for, says Jens Schouenborg.

The closest thing to hand is to use the implants for Parkinson’s and pain. Since the technology can be adapted to all kinds of structures in the brain, it can also be shown that it works against other diseases that break down nerve cells, and be interesting for the treatment of, for example, epilepsy and narcolepsy. But future studies will show.

Although Jens Schouenborg and Elon Musk seem to have different goals with their brain technology, Lundaforskaren sees the Tesla founder’s company Neuralink as a possible future competitor.

– Neuralink has been around for four, five years and has very large resources. In the long run, this may therefore mean that we face tougher competition from the company, says Jens Schouenborg.

At the same time, he sees a benefit in the fact that more and more people are interested in, researching and developing brain technology. This can lead to significant improvements, including in the treatment of severe neurological diseases.

– We have barely scratched the surface in terms of our understanding of the brain. The technology that is being developed now can give a clear push forward.

Neural learning and rehabilitation

We are far from Neuralink’s vision. But brain technology has already made it possible to train cognitive functions such as attention and working memory. For example, people with memory difficulties can receive training that strengthens their memory.

This is an area that researcher Elaine Åstrand at Mälardalen University is taking a closer look at. She is also researching the rehabilitation of stroke patients, where the goal is to give them the ability to move back.

– Stroke patients with the most serious symptoms are very disabled and may therefore have difficulty undergoing physical therapy. With the help of technology, they can train themselves to imagine a movement and get feedback from the motor areas of the brain, which can have a rehabilitative effect, she explains to Ny Teknik.

Elaine Åstrand, researcher at Mälardalen University. Photo: Mälardalen University

This type of feedback can allow a patient to regain movement in, for example, an arm, control a robot arm or an exoskeleton.

The first critical part of making technology work is to read brain activity in a good way. This can be done, for example, with the help of electrodes attached to the scalp or, where the benefit is judged to outweigh the risks, implanted electrodes.

– Traditionally, you have only read one region of the brain at a time, but it is really a pattern of activities that take place in the brain and need to be extracted. It is a challenge, and much more research is needed in the area, says Elaine Åstrand.

Then you need a way to read the information from the registered brain activity. In her research, Elaine Åstrand has used algorithms to find structures in the activity and extract characteristic features.

The third and final part is the feedback, which reflects the activity of the brain. The researchers’ algorithms here try to read the information that the brain provides in a correct way. For example, if the user or patient is looking at a ball on a screen and should try to make it move, this is what the technology should understand.

– The algorithms look for the relevant activity that is linked to what you imagine. This can create the signal needed to get a hand, or a robot arm, to open, says Elaine Åstrand.

An important part is the study object’s or patient’s own experience of the exercises.

– If you do not get the feedback you are looking for, try to find strategies to solve that problem. It will be a neural learning. This is what we want to do, to train until you get the changes in brain activity that you want and that last long-term, says Elaine Åstrand.

More on Flow Neuroscience

Flow Neuroscience has developed a headset for depression with an associated app. Malmöbolaget does not state figures on the number of users, but at the end of 2020 it was reported that 30 percent of the users recovered from depression.

Source: Flow Neuroscience

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