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Speaker 1: From Bloomberg News and iHeartRadio. It's the Big Take. I'm

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Speaker 1: West Cassova. Today tech startups are working on ways to

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Speaker 1: get inside your brain. Devices that can interpret signals in

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Speaker 1: the brain and allow a person to move a mechanical

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Speaker 1: hand or a mouse cursor on a screen have been

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Speaker 1: around for a while, but recently brain computer interfaces or

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Speaker 1: bciyes as they're called, have taken a leap. Rapid advances

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Speaker 1: in both medical technology and just plain tech have opened

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Speaker 1: up new possibilities for using small, implanted devices to improve

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Speaker 1: the lives of people with any number of limitations. They

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Speaker 1: plan to look at epilepsy, stroke, dementia, traumatic brain. They

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Speaker 1: want to put chips in or near your brain to

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Speaker 1: treat depression. So there are lots of doctors and scientists

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Speaker 1: thinking very creatively about how to use all of these.

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Speaker 1: That's Bloomberg reporter Sarah McBride. She covers this corner of

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Speaker 1: the tech world, and a little later in the show,

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Speaker 1: I'll talk to her about the growing number of startups

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Speaker 1: looking to bring these devices to market. First, though, let's

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Speaker 1: get a look at one of them ourselves. Doctor Tom

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Speaker 1: Oxley is a neuro interventionist and CEO of Synchron that's

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Speaker 1: a startup that's working on a device to allow paralyzed

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Speaker 1: people to control their iPhones or search the web, or

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Speaker 1: just call up a movie on Netflix with their thoughts.

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Speaker 1: He agreed to give us a tour of his lab

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Speaker 1: in Brooklyn, New York. Synchron's office is typical tech startup,

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Speaker 1: big open room, desks and computers, caches in the corner

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Speaker 1: for collaboration, and free snacks in the kitchen. Across the

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Speaker 1: hall is the lab. It's a large raw warehouse space

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Speaker 1: that's divided in two. On one side, in true startup fashion,

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Speaker 1: we have a pickleball corn which is very popular. The

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Speaker 1: other side is filled with workbenches that are strewn with

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Speaker 1: electronic equipment, and one of them is the device we're

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Speaker 1: here to see. Are we able to see one of

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Speaker 1: the devices? Yeah? Yeah, take you back over right, So

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Speaker 1: this is the device. I'm from a colonial state of Britain,

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Speaker 1: so I use the metric system, So I'm holding about

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Speaker 1: a fifty centimeta lead. The lead on one end has

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Speaker 1: a self expanding stint, which is similar in look to

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Speaker 1: the type of stint that you might have if you

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Speaker 1: have a hot attack. I'm going to try to describe

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Speaker 1: this thing. The stent is an open weave of this

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Speaker 1: whisper thin silver wire about the length of a medium

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Speaker 1: paper clip. There's an array of tiny dots. There's answers.

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Speaker 1: Actually likens them to microphones, and they sit where the

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Speaker 1: wires cross over each other. The device collapses down small

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Speaker 1: enough that it can be inserted through a vein in

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Speaker 1: the neck, and then it expands once it's in place,

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Speaker 1: and the stint is attached to a long coated cable

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Speaker 1: of bundled wire about as big around as a piece

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Speaker 1: of angel hair pasta there's one wire for each dot,

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Speaker 1: and as I understand it, over time it embeds itself

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Speaker 1: within the vessel, which which makes the signal stronger exactly.

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Speaker 1: So think of that like a tattoo. If the cells

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Speaker 1: grow over the system, the ability to record local brain

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Speaker 1: activity is better. Once it's encapsulated in tissue and it

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Speaker 1: stays there and it generates no ongoing well where we're

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Speaker 1: going to prove that it generates no ongoing inflammation. But

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Speaker 1: we feel good about that because there's a long history

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Speaker 1: of decades of the use of stents in the heart

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Speaker 1: and brain, and we're using the exact same materials that

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Speaker 1: have always been used for these systems, so they can

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Speaker 1: live in there like a tattoo for a lifetime safely.

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Speaker 1: And then they on the other end, you'll see a

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Speaker 1: plug and the plug goes into a it's kind of

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Speaker 1: like a AirPod container for the Apple AirPods, but it's

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Speaker 1: thinner than that. Yeah, that's a little bit elongated, and

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Speaker 1: it sits under the skin, so you could feel a

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Speaker 1: little bump in the chest if you had one in

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Speaker 1: your chest. And then the wire runs beneath the skin. Yeah,

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Speaker 1: this is all implanted in the body. And then there

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Speaker 1: is a Bluetooth protocol that sends the information out of

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Speaker 1: the body. So then we get to the external components.

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Speaker 1: And if you imagine there's an external component about the

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Speaker 1: size of an iPhone, I would think of this like

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Speaker 1: a Bluetooth mouse and is able to connect to any

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Speaker 1: device and give control over a system. It does the

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Speaker 1: battery run for years, similar to a pacemaker. Does it

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Speaker 1: require a charging It runs for years. Once the stent

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Speaker 1: is implanted and hooked up, those tiny sensor darts attached

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Speaker 1: to those wires can start listening to the brain signals.

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Speaker 1: So the brain has about eighty billion neurons and each

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Speaker 1: of those neurons has electrons running down a bit of

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Speaker 1: cell tissue, which is called an action potential, and the

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Speaker 1: action potential generates a firing of the neuron. If you

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Speaker 1: were to listen to them, it would sound like a

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Speaker 1: whole bunch of fireworks across the whole domain of the brain.

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Speaker 1: And depending on how close you are to each individual neuron,

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Speaker 1: you can hear activity that relates to certain functions. So

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Speaker 1: the brain is broken into functions, and if you're in

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Speaker 1: any of those domains and you see the brain firing,

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Speaker 1: you can presume that there's some processing of information as

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Speaker 1: it relates to that domain. For us, we can't get

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Speaker 1: down to the individual neurons, but we can hear the

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Speaker 1: firing of populations of neurons, and that looks like changes

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Speaker 1: in voltage. So we literally are recording changes in electron

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Speaker 1: flow that represent activation of brain tissue in real time

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Speaker 1: that's nearby their senses. To record those changes in the

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Speaker 1: flow of electrons, the device needs to be as close

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Speaker 1: to the brain as passable. Synchrome does that by going

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Speaker 1: in through the jugular vein in the neck. Yeah, So

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Speaker 1: one thing that might be worth pointing out is that

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Speaker 1: we are building technology that goes into the veins, not

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Speaker 1: the arteries. So the arteries carry blood into the brain,

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Speaker 1: and if they get blocked, then you're stopping auction getting

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Speaker 1: to the brain. The veins are the drain pipes of

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Speaker 1: the blood out of the brain, and so we're coming

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Speaker 1: up the backside up the drain pipes. So the jugular

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Speaker 1: vein is in the neck, and we move backward to

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Speaker 1: the flow of blood up the jugular vein and we

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Speaker 1: take a turn into what's called the transverse sinus. We

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Speaker 1: take another turn into the superior sagittal sinus, and that

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Speaker 1: is a big pipe that carries up over to the

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Speaker 1: top vertex of the of the brain, and that is

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Speaker 1: where the motor cortex exists. So we actually stop there.

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Speaker 1: And the reason we've done that is because it's it's

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Speaker 1: it's a safe domain to be in. It's a large

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Speaker 1: blood vessel, it's it's got access to the motor cortex.

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Speaker 1: It's quite robust. There are other blood vessels that we're

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Speaker 1: starting to work towards that are going to give increasing

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Speaker 1: access to more motor cortex, but we're staying within that

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Speaker 1: domain to get into the jugular vein. If you just

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Speaker 1: touch your collar bone into your neck just above the

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Speaker 1: collar bone. You're probably touching your jugular vein. So we'd

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Speaker 1: put a little needle in there and then put a

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Speaker 1: wire and then a catheter and then push that up

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Speaker 1: heading upwards and the catheter goes up through the base

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Speaker 1: of the skull into the brain. Actually says it actually

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Speaker 1: isn't that big a deal to get the device in place.

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Speaker 1: The procedure is not performed in the operating room. It's

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Speaker 1: performed in a cath lab. The patients lie down on

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Speaker 1: the table. We don't cut open the skull, use a

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Speaker 1: catheter to slip your way up blood vessels into the brain,

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Speaker 1: and we can deliver all sorts of things. And what

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Speaker 1: we have figured out is how to deliver electronics into

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Speaker 1: the brain. So what does that look like in real life?

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Speaker 1: A patient has the device implanted, and then what are

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Speaker 1: they able to do? What would be an example of

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Speaker 1: something that a person going to do with that ability

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Speaker 1: to metaphorically click the mouse. So on the Apple iPhone,

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Speaker 1: there is a way in which you can start to

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Speaker 1: control the iPhone without having to touch the screen if

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Speaker 1: you have an ability to send command clicks into the iPhone.

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Speaker 1: So we have our patients sending their command functions and

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Speaker 1: we've integrated into the iPhone where they're able to navigate

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Speaker 1: their way and use the iPhone. It's not as fast

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Speaker 1: as what you and I can do with our fingers,

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Speaker 1: but Apple have created mechanisms of accessibility control that allow

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Speaker 1: these types of inputs to work. So that's a really

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Speaker 1: big deal. We're giving our patients back control over the iPhone.

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Speaker 1: We're also working on a Windows platform with a different approach,

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Speaker 1: but the thing that we're realizing is for people who

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Speaker 1: are severely paralyzed, what they primarily want is a stable, robust,

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Speaker 1: easy to use, rapidly responsive system that doesn't fail. And

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Speaker 1: so we have to be careful if we go for

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Speaker 1: two complicated training programs or calibrations, or it very quickly

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Speaker 1: becomes frustrating to use. So we've really got a approach

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Speaker 1: around simplicity and robustness from what we're hearing our patients want.

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Speaker 1: So this enables people to say sounded tax message or

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Speaker 1: to search the web. Well, I mean, once you've got

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Speaker 1: control of your iPhone, you can do whatever your iPhone

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Speaker 1: can do. But the things that are relevant, we think

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Speaker 1: from a patient perspective, things basic elements of what you

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Speaker 1: might call digital activities of daily living, Sending text messages,

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Speaker 1: checking your email, responding to an email, checking your bank

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Speaker 1: account and making a payment, doing some shopping, arranging your medication,

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Speaker 1: joining a call with your physician. All those things can

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Speaker 1: mean that you don't need someone else around you all

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Speaker 1: the time helping you with these things. That's the goal

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Speaker 1: is improving independence. How close is Tom Akley to reaching

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Speaker 1: that goal. We'll talk about that after the break. Now

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Speaker 1: that we have a good idea of how sync RAN's

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Speaker 1: device works, I asked Ham, I actually how close he

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Speaker 1: is to bringing it to market? We have an early

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Speaker 1: version that's in trial with a low number of human subjects.

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Speaker 1: The FDA has approved six subjects in the US, we've

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Speaker 1: done four in Australia, and those are subjects have been

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Speaker 1: improved to receive the device. Yeah. These are people who

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Speaker 1: have severe paralysis, who can't use their hands to control

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Speaker 1: digital devices that you and I have become probably addicted to,

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Speaker 1: so replacing lost hand function due to diseases such as

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Speaker 1: spinal cord injury, stroke als, multiple sclerosis. And how long

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Speaker 1: will the trial last? The formal assessments of safety and efficacy,

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Speaker 1: which is how well the device works, will be assessed

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Speaker 1: over a twelve month period, but the patients keep using

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Speaker 1: the device after that point, and we're learning from the

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Speaker 1: people who are going through lives with paralysis. We're still

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Speaker 1: learning what the needs are. We're in a position now

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Speaker 1: where are looking to be the first company that's going

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Speaker 1: to go through this process in the discussion with the FDA,

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Speaker 1: and it's going to set the scene for the industry.

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Speaker 1: And when does it begin, Well, we are hoping to

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Speaker 1: launch our pivotal study within two years. A pivotal is

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Speaker 1: a phase three study, which generally means that you have

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Speaker 1: to set a outcome which you agree upon is clinically meaningful,

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Speaker 1: is like, it means something that is useful for the

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Speaker 1: patient is going to improve their lives, and you achieve

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Speaker 1: that in the study in a pre specified, controlled manner.

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Speaker 1: The feasibility stage, which is what we're in now, is

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Speaker 1: more about preparing to test certain methods of assessment to

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Speaker 1: know that you've you're on the right track to demonstrating

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Speaker 1: a very clear cut level of impact for the patient.

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Speaker 1: I asked actually where his company fits into this growing

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Speaker 1: universe of tech startups that are all exploring ways to

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Speaker 1: use brain computer interfaces. So firstly, we are within the

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Speaker 1: implantable brain computer interface domain. Within the implantable brain computer

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Speaker 1: interface domain, we are the company that are confined to

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Speaker 1: the blood vessels. So the word intervention is interventional New

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Speaker 1: radiology is the method with which our technology is implanted

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Speaker 1: into the brain. The other companies in the implantable space

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Speaker 1: are removing at least some amount of skull to deliver

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Speaker 1: hardware into the brain. There are pros and cons with

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Speaker 1: being in the blood vessel. The procedure is less invasive

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Speaker 1: in that there's no disruption to the skull. However, we

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Speaker 1: can't get as close to individual neurons in the brain

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Speaker 1: because we stay within the blood vessel. That's bad because

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Speaker 1: we don't get as much information, but it's good because

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Speaker 1: there's decades of evidence to show that existing in the

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Speaker 1: blood vessels over lifetime can be safe and stable. Difference.

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Speaker 1: The challenge for us is with you know, lower data

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Speaker 1: rates coming out of the brain, but with a system

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Speaker 1: that we anticipate to be stable, what does that mean

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Speaker 1: in terms of what the patients are able to perform?

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Speaker 1: You know, if I was to look forward with more

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Speaker 1: the more the user is able to engage with systems.

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Speaker 1: You know, our brains computing powers goes far beyond that

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Speaker 1: of our ability to communicate our current state of our brain,

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Speaker 1: and this technology will use that as a mechanism of

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Speaker 1: overcoming problems that we otherwise can't solve because the limitations

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Speaker 1: of the human body. I mean, ask you some of

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Speaker 1: listeners might be wondering. I know, I am can this

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Speaker 1: thing be hacked? It uses Bluetooth, which is not always

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Speaker 1: the most secure thing. So privacy and security are a

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Speaker 1: big focus for the FDA, and there've been a discussion

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Speaker 1: point between US and the FDA, and I mean, you know, hacking,

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Speaker 1: I don't quite know what that would look like. I

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Speaker 1: guess kind of in the same it would be like saying,

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Speaker 1: can a bluetooth mouse get hacked? That's controlling my computer.

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Speaker 1: So if the computer gets hacked, things can be done.

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Speaker 1: But it's not like your brain can get hacked, because

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Speaker 1: it's really like you're controlling and joystick. The US government's

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Speaker 1: been investing in this space for decades and it's now

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Speaker 1: starting to mature into an industry and we're seeing commercial

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Speaker 1: offerings on the horizon. It's very exciting and I think

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Speaker 1: for patients that just to give you an example of

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Speaker 1: you know what patients need this technology. The patients that

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Speaker 1: we're dealing with right now, they go to bed and

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Speaker 1: that their father, their brother, whoever it is it's in

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Speaker 1: the other room, has a way to call out if

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Speaker 1: there's a problem. So if you are not able to

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Speaker 1: move the muscles in your body, or talk properly, or

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Speaker 1: use a device, how do you call for help? How

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Speaker 1: do you reach out? And there are some systems out there,

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Speaker 1: but I think what BCI has the potential to solve

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Speaker 1: that issue of always being connected when you want to

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Speaker 1: be connected and reaching out using digital systems to engage

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Speaker 1: in your world. And you and I take that for granted.

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Speaker 1: You know, we all sleep with the phone within arm's

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Speaker 1: length away from us, and we wake up in the morning,

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Speaker 1: we grab it straight away. This technology enables people who

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Speaker 1: don't have that use of their hands to engage in

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Speaker 1: a way that you and I take for granted, and

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Speaker 1: that's that's what this is about. I'm actually thanks so

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Speaker 1: much for speaking with me today. Thank you very much.

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Speaker 1: When we come back, we'll hear about other companies that

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Speaker 1: are also working on these brain computer interfaces. As we've heard,

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Speaker 1: Synchron is just one of several tech companies working on

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Speaker 1: these brain computer interfaces. Sarah McBride covers venture capital and

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Speaker 1: startups for Bloomberg, and she's here to tell us what

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Speaker 1: others are working on. Can you tell us a bit

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Speaker 1: about why brain science has taken off so quickly? Well,

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Speaker 1: I think there's something about it that just captures the imagination.

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Speaker 1: It just sounds so futuristic and crazy. But then I

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Speaker 1: think people can imagine the possibilities. Then I think people

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Speaker 1: see that some of this is real. They read about trials.

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Speaker 1: For example, at Synchron, people have synchron devices in their brains,

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Speaker 1: so it seems to be actually happening, and you can

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Speaker 1: imagine a time in the future when there'll be a

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Speaker 1: few thousand people walking around with these things in their heads.

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Speaker 1: How long has this technology been around. The truth is

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Speaker 1: it's been around for years, twenty thirty years, depending on

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Speaker 1: what event you choose. To date it back to there's

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Speaker 1: a company called black Rock Neurotech that's been doing this

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Speaker 1: for decades, but nobody really paid attention to it until

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Speaker 1: Elon Musk came around. And when Elon Musk, who was

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Speaker 1: a track record of getting things done, said that he

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Speaker 1: was going to work on this, everybody started paying attention.

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Speaker 1: But there have been some versions of this used for

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Speaker 1: a long time. When I first heard about it, I

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Speaker 1: thought there's no way anyone would get chips of any

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Speaker 1: sort put in their brain. And then I learned that

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Speaker 1: there are a lot of people who have epileptic seizures

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Speaker 1: who have chips in their brains that try to stop

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Speaker 1: epileptic seizure. There are people with Parkinson's same thing, so

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Speaker 1: I realized, yes, there are certain people who would definitely

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Speaker 1: do this. A lot of the different startups that are

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Speaker 1: working in this area seem to be trying to address

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Speaker 1: medical conditions like Alzheimer's or other diseases, or physical limitations

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Speaker 1: that allow limbs to operate, or other things like that.

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Speaker 1: But are there other people working on things that don't

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Speaker 1: have to do with trying to fix something, but just

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Speaker 1: trying to extend our capabilities as humans? You know, les.

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Speaker 1: I think there probably are people working on that type

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Speaker 1: of thing, but they're keeping very quiet about it because

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Speaker 1: it just sounds so freaky. So I've heard people say before,

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Speaker 1: why don't we just download languages into our brains. I've

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Speaker 1: actually talked with somebody about is that possible, And it

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Speaker 1: sounds like we can't do it now, but theoretically it

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Speaker 1: would be possible. How However, your brain is a little

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Speaker 1: bit like a hard drive. If you downloaded an entire

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Speaker 1: language like Japanese, then there might be limits as to

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Speaker 1: what else you could put in there. Every time Elon

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Speaker 1: Musk talks about this, he mentions crazy things that I think, Oh,

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Speaker 1: that's surely not possible. He has said, oh, I'd like

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Speaker 1: to download music directly into my brain, listen to music

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Speaker 1: play directly into my brain. Or I'd like to cure

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Speaker 1: addiction with neuralink. And every time I heard something like that,

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Speaker 1: I thought, oh, he must be really stretching it now,

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Speaker 1: that can't be true. And then I would go find

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Speaker 1: some very smart people who tell me, well, that's not

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Speaker 1: possible now, but that's not actually impossible. Theoretically we could

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Speaker 1: do that with a device like this. So every time

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Speaker 1: I thought something sounded outlandish when I looked into it,

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Speaker 1: there were actually smart people who told me it wasn't

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Speaker 1: as outlandish as it sounded. Can you tell us some

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Speaker 1: of the companies that are doing this and what they're

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Speaker 1: coming up with? Sure, So there are a handful of

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Speaker 1: players that are pretty advanced, and by advanced, I mean

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Speaker 1: they are either close to getting approval for clinical trials

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Speaker 1: or they have clinical trials in process. One of the

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Speaker 1: companies that already has an early trial in place is Sincron,

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Speaker 1: which you just visited. Brain Gate and black Rock, And

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Speaker 1: this isn't Blackrock the investment bank. It's Blackrock, the company

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Speaker 1: that makes brain Gate. They published the first results of

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Speaker 1: their device in humans in two thousand and six, so

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Speaker 1: that was somebody who could control a click on a

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Speaker 1: computer screen, very simple robotic devices, and then they went

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Speaker 1: on to do robotic arms after that, but that was

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Speaker 1: chips in brains. When Elon Musk started talking about Neuralink,

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Speaker 1: he said he wanted to help people with severe brain injuries,

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Speaker 1: and he specifically mentioned stroke and cancer, lesions and other

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Speaker 1: types of challenges that patients have. Then they seem to

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Speaker 1: have kind of homed in on paralysis and they've also

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Speaker 1: talked about blindness and have they had success in helping

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Speaker 1: alleviate these problems not in people. They're trying to sign

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Speaker 1: up patients right now. They've tweeted about if you ever

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Speaker 1: have any interest in being in a neuralink trial, please

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Speaker 1: register here. That doesn't mean that they're in humans yet,

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Speaker 1: Like that's just kind of building up a database so

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Speaker 1: that once the FDA gives them permission, they could start

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Speaker 1: implanting their devices and paralyzed people or whoever it is.

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Speaker 1: What's another company that you've looked into. The former president

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Speaker 1: of Neuralink, Max Hodak, started a company called Science, and

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Speaker 1: he has a few ex Neuralink people working there. One

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Speaker 1: of the problems they're working on is blindness. And just

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Speaker 1: as synchron wants to use blood vessel as a backdoor

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Speaker 1: into the brain, Maxhodak at Science wants to use the

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Speaker 1: optical nerve as a backdoor into the brain. Precision Neuroscience,

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Speaker 1: founded by another co founder of Neuralink, Ben Rappaport, has

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Speaker 1: said that they plan to look at epilepsy, stroke, dementia,

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Speaker 1: traumatic brain injuries. There's another category of company that might

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Speaker 1: not be considered brain computer interfaces, but they want to

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Speaker 1: put chips in or near your brain to treat depression.

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Speaker 1: There are companies that are already using chips to treat

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Speaker 1: things like epilepsy. So there are lots of doctors and

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Speaker 1: scientists thinking very creatively about how to use all of

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Speaker 1: these So who's funding these companies? Where does the money

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Speaker 1: come from. I've had a number of founders tell me

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Speaker 1: that there's no way traditional venture capitalists would normally fund

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Speaker 1: this type of company and probably wouldn't have backed any

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Speaker 1: of them except once Elon Musk got involved. And now

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Speaker 1: some pretty mainstream venture capitalists are getting involved and funding

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Speaker 1: some of these companies. Also, neuroscientists and doctors who might

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Speaker 1: have gotten into some other type of medicine are now

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Speaker 1: considering working in the field. There are a lot of

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Speaker 1: bright people attracted to it now because of the Elon

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Speaker 1: must kalo, but also mainstream health venture capitalists like Arch

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Speaker 1: for example, is one that's back to a couple of

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Speaker 1: these companies, and it's something where you can also get

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Speaker 1: government grants. And there are a lot of research universities

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Speaker 1: where people are doing a lot of the preliminary work

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Speaker 1: and then starting companies based on what came out of

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Speaker 1: their university lab. When you look down the road, given

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Speaker 1: how fast this technology is changing, what do you see

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Speaker 1: five years from now? What are some of the things

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Speaker 1: that you think will actually be in use by then?

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Speaker 1: You know, honestly, five years from now, I think there'll

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Speaker 1: be a lot more trials. I think there'll be bigger trials,

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Speaker 1: the type known as pivotal trials. I don't think you'll

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Speaker 1: be able to go to your doctor and get a

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Speaker 1: prescription for this the way you could for lasik now.

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Speaker 1: I think maybe in ten years, But five years is

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Speaker 1: I think still too tight a timetable. But in ten years,

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Speaker 1: I think it'll be more like the early days of lasik.

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Speaker 1: And then in twenty years, I think it won't seem

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Speaker 1: that out of the ordinary for people to have some

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Speaker 1: kind of brain implant. Right now. I've talked to patients

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Speaker 1: who are in some of these trials. I had one

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Speaker 1: young woman who was trialing chips for her epilepsy who

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Speaker 1: told me I'm the bionic woman now because she had

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Speaker 1: chips in her brain and she felt very kind of

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Speaker 1: special and unusual. I'm not sure that it will still

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Speaker 1: seem special in twenty years, but five years, yes, and

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Speaker 1: it's still going to be pretty unusual. Sarah McBride, thanks

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Speaker 1: so much for being here. Thank you so much. Wes,

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Speaker 1: thanks for listening to us here at the Big Take.

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Speaker 1: It's a daily podcast from Bloomberg and iHeartRadio. For more

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Speaker 1: shows from iHeartRadio, visit the iHeartRadio app, Apple Podcast, or

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Speaker 1: wherever you listen. And we'd love to hear from you.

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Speaker 1: Email us questions or comments to Big Take at Bloomberg

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Speaker 1: dot net. The supervising producer of the Big Take is

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00:26:40,080 --> 00:26:45,360
Speaker 1: Vicky Bergolina. Our senior producer is Katherine Fink. Rebecca Chassan

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Speaker 1: is our producer. Our associate producer is Sam Gabauer. Phil

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Speaker 1: Degarcia is our engineer. Our original music was composed by

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Speaker 1: Leo Sidrin. I'm West Kasova. We'll be back tomorrow with

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Speaker 1: another Big Take. Down Down, Down, down, Down There