Neuralink Human Trials: Inside the First Human Implant Success

The boundary between biological thought and digital action has officially blurred. In early 2024, Neuralink, the neurotechnology company founded by Elon Musk, achieved a historic milestone by implanting its brain-computer interface (BCI) into a human patient. The subsequent demonstration of the patient playing online chess and video games using only his mind marks a pivotal moment in medical science and assistive technology.

The First Patient: Noland Arbaugh

The first participant in Neuralink’s “PRIME” study is Noland Arbaugh, a 29-year-old man from Arizona. Arbaugh was left paralyzed from the shoulders down following a diving accident eight years prior to the surgery. His condition, quadriplegia, limited his ability to interact with digital devices to using a mouth stick (a stylus held in the mouth) or relying on caregivers.

In January 2024, Arbaugh underwent surgery to receive the Neuralink N1 implant. In a livestream on the social media platform X (formerly Twitter) in March 2024, he revealed his new capabilities to the world. He described the ease of use, comparing the control of the computer cursor to “using the Force” from Star Wars. He simply stares at a spot on the screen and imagines the cursor moving there, and the system responds.

Capabilities Demonstrated: Chess and Civilization VI

The primary breakthrough demonstrated during the trials was the level of precise control Arbaugh achieved. Previous BCI technologies often required arduous training and offered clunky, slow responses. In contrast, Arbaugh demonstrated fluid control in complex environments.

Online Chess

During the livestream, Arbaugh played a game of online chess. He was able to move pieces across the board seamlessly. While playing chess might seem simple, the cognitive load required to plan a move and the motor intent required to drag and drop a digital piece are distinct neural processes. The N1 chip successfully decoded these intentions in real-time.

Strategy Gaming

Perhaps the most impressive feat was his ability to play Civilization VI, a complex strategy game. Before the implant, Arbaugh required extensive assistance to play such games. With the implant, he reported playing the game for eight hours straight. The chip allowed him to navigate menus, select units, and map out strategies without physical fatigue, though he did have to stop eventually to recharge the implant.

The Technology: Inside the N1 Implant

To understand the magnitude of this trial, it is necessary to look at the hardware involved. The device, known as the N1, 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 once the incision heals.

Key Technical Specs:

  • 1,024 Electrodes: The device uses 1,024 electrodes distributed across 64 ultra-flexible threads.
  • Thread Thickness: These threads are thinner than a human hair, which minimizes damage to the brain tissue.
  • Wireless Data: Unlike older BCI models that required a port in the skull and wired connections to a computer, the N1 transmits neural data wirelessly via Bluetooth to an app that decodes the movement intent.
  • The R1 Robot: Because the threads are so fine, a human surgeon cannot insert them. Neuralink developed the R1 Robot, a surgical system designed to insert the threads into specific regions of the motor cortex while avoiding blood vessels.

Challenges Encountered: The Retraction Issue

The trial was not without complications. In the weeks following the surgery, Neuralink reported a hardware issue where several of the electrode-bearing threads retracted from Arbaugh’s brain. This retraction meant fewer electrodes were recording neural data, which initially reduced the speed and accuracy (measured in bits per second) of the cursor control.

Rather than performing a second surgery to replace the threads, the Neuralink engineering team solved the problem through software. They modified the recording algorithm to be more sensitive to neural population signals. They also improved the techniques used to translate these signals into cursor movements. According to Neuralink, these software updates not only recovered the lost functionality but actually improved Arbaugh’s control beyond his initial post-surgery performance.

The Goal of the PRIME Study

The current phase of testing is called the PRIME Study (Precise Robotically Implanted Brain-Computer Interface). It is operating under an Investigational Device Exemption (IDE) awarded by the FDA in 2023.

The primary goals of this study are threefold:

  1. Safety: To verify that the N1 implant and the R1 surgical robot are safe for human use.
  2. Functionality: To demonstrate that the device can reliably read neural spikes.
  3. Utility: To prove that the system allows people with quadriplegia to control external devices effectively.

While the current focus is on cursor control and digital independence, Elon Musk has stated that future iterations, such as “Blindsight,” will aim to restore vision to the blind, even in cases where the optic nerve is damaged.

Comparison to Other BCI Competitors

Neuralink is not alone in this space, though it garners the most media attention.

  • Synchron: This company has also successfully implanted BCIs in humans. Their approach is less invasive; they insert a device called a “stentrode” through the blood vessels into the brain, avoiding open skull surgery.
  • Blackrock Neurotech: A long-standing player in the field, their “Utah Array” has been used in research settings for nearly two decades to allow paralyzed patients to control robotic arms and computers.

However, Neuralink distinguishes itself with the high channel count (1,024 electrodes) and the fully wireless, cosmetic nature of the implant.

Frequently Asked Questions

How does the patient charge the device? The N1 implant is powered by a small battery that is charged wirelessly from the outside. The patient wears a specialized hat or charging coil over the implant site for a few hours to recharge the battery.

Is the surgery dangerous? All brain surgery carries risk, including infection, bleeding, or tissue damage. However, the R1 robot is designed to mitigate these risks by detecting and avoiding blood vessels during the insertion of the threads. The procedure is designed to take only a few hours.

can healthy people get a Neuralink chip? No. Currently, the trials are strictly limited to patients with severe physical impairments, such as cervical spinal cord injury or amyotrophic lateral sclerosis (ALS). Regulatory approval for elective or “enhancement” use in healthy individuals is likely many years or decades away.

What happens if the device breaks? This is a critical part of the ongoing study. If a device fails, explantation (removal) or replacement strategies must be developed. The current trial aims to test the longevity and durability of the implant in the harsh biological environment of the human body.