Some Future Day

Marc Beckman: Chad, it's wonderful to have you join me on some future day. How are you?
Prof Chad Bouton: I'm great and it's great to be here.
Marc Beckman: Chad, um, you're one of these rare people who have really committed their life towards research and it's pretty remarkable. I looked at, um, a lengthy timeline of accolades, achievements, and awards, and just to highlight a few, um, in 2010.
You were recognized in the United States Congress for your work in neural prosthetics. In 2007, you were, um, awarded the R& D 100 award for development of improved methods for decoding human brain activity. In 2000, you received the R& D 100 award for the development of a cancer detection system. it kind of like brings us through this process of you building a career on, research and concepts and commitment.
But if we go back in time, what was the true impetus behind your commitment, your lifelong commitment to research of this nature?
Prof Chad Bouton: Well, first of all, none of those, milestones would have ever been reached without, the incredible teams that I worked with, uh, all of the people involved in those studies and those research programs, and so it's just been an incredible journey, because of all of those folks, and, and the patients I'll talk about too that we've worked with, but for me personally, yes, I, I did have an incident in, in a terrible, uh, incident back when I was finishing graduate school, where, I had, uh, a traumatic brain injury and two, uh, subdermal hematomas and, uh, had to be, uh, you know, taken, uh, rushed to the hospital, uh, received two, life saving operations through that, throughout the night and, um, Yeah, and I was just extremely lucky and I was able to recover.
I had speech issues, expressive aphasia as it's called, couldn't say but two words. I went through speech therapy, physical therapy. Uh, and many months of, just working, through to recover and, uh, not a day goes by now where I don't, think about how lucky I was
Marc Beckman: I'm just curious, like, expressive aphasia, explain that a little more. So you, were you, capable of understanding when people were talking to you, but then you couldn't respond to them? Is that?
Prof Chad Bouton: Yeah, the memories are very fuzzy, but I understand from my family that, uh, I could, really understand, but I couldn't express myself. So, and in fact, I thought I was saying, you know, And I thought I would just repeat the same uh, two words over and over. And the strange thing is, those two words were, Thank you.
And so I would say, you know, thank you this, thank you that. And I thought I was having a completely normal conversation. And um, I was, yeah. And that's, that's something that affects unfortunately, many people, either after a brain injury or, Uh, uh, it could even happen after a stroke, but these, it, it, just imagine not being able to express yourself.
Yeah. So this is something, um, that's become very important to me along with other traumatic type injuries.
Marc Beckman: So, Chad, how frustrating is that to the person that's suffering from expressive aphasia? Is it, is it almost like you're in a, like in, in your own prison of sorts? Like what,
Prof Chad Bouton: It is, it can be, and there's also locked in syndrome, uh, where, and that can come, you know, after a number of conditions, but where you can't speak at all, either you've had, say, a brain stem stroke, or, or you've had, uh, you might actually have a motor neuron disorder, uh, ALS, Lou Gehrig's disease, for example, can leave you without the ability to speak.
Uh, I've worked with a number of folks. Uh, one woman who had a, had a brainstem stroke could not, speak at all and she had to use a piece of plexiglass with letters on it and, and, you know, we would move it around and watch her eyes to see what letters she was looking at. So had to painstakingly spell out, you know, words and sentences.
And. Uh, no, it's, it's, it's just, it's life changing. It's extremely difficult, and to not be able to just, you know, talk to your loved ones and friends and in a, in a more fluid way. And, and a gentleman who had ALS, uh, was also involved in one of our studies. And, um, he, um, you know, he really struggled, uh, and could only blink his eyes.
And even that was an effort. And, but I remember one day when his son came and jumped in his lap. and kind of was cheering him on, in this new, uh, study and experiment we were doing, uh, with, and we'll get into this, but we put a tiny chip, into his, motor area of his brain so that he could just think about moving the cursor on the computer screen, and spell words out a little more quickly, and man, that was incredible.
And he was able to talk to his son and his family.
Marc Beckman: So Chad, is it fair to say then that you specialize in bioelectronic medicine? is that the proper term of art?
Prof Chad Bouton: Yes, that is definitely an emerging field that we've been a part of. And there's also another adjacent field or even an overlapping field called neuromodulation or neurotechnology. all involve stimulating, the nervous system, and doing it in a very natural way. to promote positive outcomes, and recovery. And so, for example, we can stimulate areas of the brain to help somebody, overcome the effects of a stroke.
we can also stimulate the spinal cord to help someone, regain movement or even the sense of touch after an injury. so the sky's the limit and, it doesn't have the side effects, that many drugs have.
Marc Beckman: So, Chad, I, I know that, um, as we go deeper into this discussion, we're going to cover neurons and neural pathways quite a bit. Would you mind taking a second just to explain to my audience what a neuron's function is and what a neural pathway is, please?
Prof Chad Bouton: Absolutely. So, our brain has 87 billion neurons. And the spinal cord actually has 10 million neurons. And then we have these neural pathways throughout our entire body. So from the tips of our head to the tips of our toes, everywhere, in the body, you will find, you know, nerve endings, neural pathways, and What these, uh, these neural pathways do is they allow messages from the brain, uh, you know, travel to different parts of the body to, you know, move and cause, even to control organ function or even help digest food, uh, believe it or not.
but the other fascinating thing is that, uh, All of these different nerve endings will pick up sensory information, so it might be the sense of touch, might be again organ function, how things are being processed in our body, even digestion can be monitored. We don't, we don't feel some of these things, some are visceral or you just don't feel them, part of the, even part of the autonomic Uh, system as it's called, like regulating your heartbeat, even your breathing rate, uh, and we don't have to think about those things.
But then we have the ones, of course, we think about like movement and touch and whatnot. So, it's fair to say that the nervous system is controlling and monitoring, Everything happening in our brains and body. And so what happens when you have an injury, or a stroke or a neurodegenerative condition, that can start to cause effects in your nervous system and lead to just devastating, consequences in terms of, um, you know, a patient's, uh, you know, daily lives.
Marc Beckman: so you're running, the Neural Bypass Lab at Northwell Health here in, in New York. can you explain? What the mission is of this, I think, very specialized, very, uh, amazing group of, um, scientists, researchers and surgeons and doctors, like what's the vision for the Neural Bypass Lab?
Prof Chad Bouton: yes, it's an amazing group. I'm lucky to come in every day and work with everyone here, and the group ranges from neuroscientists to biomedical engineers to electrical engineers to neurosurgeons to epidemiologists. I mean, you know, you just go, you know, this goes on and on and all of the. Occupational therapists, physical therapists, our nursing staff, everyone is involved in this because it goes from creating this neural bypass, this technology that I'll explain, all the way through Uh, to doing clinical studies that involves putting, uh, different types of devices in different areas of the brain or even on the body, uh, and we're stimulating these different pathways, and we have to, work through this continuum and have this multidisciplinary, uh, team, and everyone has to be able to kind of Speak these different languages with each other.
So when, when we hire, we look for people that have, multiple areas of expertise, uh, and can really, cross a couple of different disciplines and, and enjoy doing that, right? We really make sure anybody coming in to the group, has that ability. It really enjoys that environment, the team environment, because this, what we're doing is not, uh, absolutely would not be possible without, uh, this kind of team approach.
Marc Beckman: So it's like the core mission of, of your lab to, to restore movement and sensory feedback, like at the heart, is that really what we're talking about?
Prof Chad Bouton: Yeah. So let me get into that. So our, the mission is really about restoring independence. Okay. And we leave it at that broader level because it might involve restoring movement and the sense of touch. Those are two, devastating, conditions when you lose the sense of touch or you lose the ability to move.
Uh, the two leading causes, by the way, of paralysis and the loss of these functions are stroke and spinal cord injury, and what's even more surprising is that a little over half of the folks that have suffered a spinal cord injury are quadriplegic or tetraplegic, uh, and that it surprises most people, and that means that now they, uh, really not only cannot walk and, and move around very easily, you know, easily without, uh, obviously powered wheelchairs, but they also can't feed themselves.
They can't groom themselves. It's a, you know, really impacts everything in your daily life. And then the sense of touch has the personal aspect of not being able to feel hold a loved one's hand. You know, you can imagine, um, the impact there, but then there's a lot of functional things. You can't button your.
I'm here to talk about the importance of a shirt without tactile sensation, the sense of touch at your fingertips, because you have to be able to notice and feel the edge of the button. You have to be able to really guide it through the buttonhole. It's, uh, even, uh, we had a woman who had a car accident who struggled to, you know, operate.
you know, the zipper, uh, on her, you know, pants or shorts, you know, and just getting dressed was a major challenge. And,

Marc Beckman: really independence.
Prof Chad Bouton: the independence, right? And now, we expand that because we have studies now involving. Paralysis, loss of movement, restoring the sense of touch, and now we've started another study that involves folks that have had a stroke, and we are working to increase their independence, allow them to really do things for themselves.
I've met so many incredible patients through the years, and the recurring message and comment I've heard now over and over is, I don't want to ask for help.
I just want to be able to do things without having to ask for help.
Marc Beckman: it's just so poignant. Um, when you reference the study or the studies plural, are these reports that our viewers could take a look at with, the National Library of Medicine? I noticed that there's one study that you're focused on called Restoring Motor and Sensory Hand Function in Tetraplegia Using a Neural Bypass System.
So is that connected directly to your lab?
Prof Chad Bouton: Absolutely. If you go to clinical trials, dot com and you search, for, either, either my name is the, is the principal investigator or PI, as we say, uh, or, or you put in the term, uh, neural bypass, that will bring up, uh, these studies.
And there's two, that are listed on that website with all of the details. and, uh, it's exciting because, we are underway and we're still, uh, recruiting in some cases there and you can look at that information, and find out, uh, kind of what some of the enrollment criteria are as well.
Marc Beckman: Chad, I'm curious. So is, um, is it fair to say that your group, your lab is working towards trying to end paralysis? I know that's like far out and I know I'm being very lofty here and I'm sorry to like throw that big one at you. But
Prof Chad Bouton: No, it's fine. It, it, no, absolutely. So restoring independence and yes, now we can kind of go down, uh, into restoring movement. It comes in, in, there's two ways you can do it. One is you can create what we call a neural bypass. And you mentioned, you know, this, this term, this, what is a neural bypass?
Bypass, I think, is an important question to tackle here. And so that your viewers can understand, you know, what is this, this approach? What does it really mean? It means, uh, literally bridging signals from the brain to the body or directly to the muscles so that someone who is paralyzed can think about movements that perhaps they haven't been able to do in years, uh, but be able to now Do those movements again, activate those muscles and have their thoughts driving that.
Right. So they're not, uh, waiting for anybody to help them. They're actually able to do things for themselves that we, in 20, uh, 2000 and and 14, we demonstrated the first, what we'd call a one-way neuro bypass, where, uh, we had one chip. Implanted in the motor area of the brain, uh, we literally routed those electrical signals, uh, that's the way the brain works, so it's electrochemical.
So, you talked about neurons, every time you think about movement, uh, a thousands, even, even millions of neurons will start to become active in the motor. The Modern Hotelier, David Millili, Steve Carran, Stayflexi, CRM, CEO, LodgIQ, Dr. Elizabeth Haas, Pierre Gervois, AIG. What is that? What is the person thinking about?
So are they wanting to open their hand or move a certain finger or close their hand? And we've developed over these years, demonstrated it for the first time in 2014, and then published it later. fortunately, uh, in, in nature in 2016, uh, we were very lucky to do that. and we found, we found that, uh, it was possible someone could think about moving their hand again.
We could decode those signals, send signals back to the muscles, and, a young man named Ian Burkhart was able to move his hand again, pick up a, a cup, and take a drink, uh, all by himself without having to ask for help. And it was incredible. But that was a single, what we call a single neuro bypass, a one way neuro bypass.
Marc Beckman: so I'm curious, like when you, when you talk about like decoding the information that the individual is thinking and then Sending it back to basically activate that intention. is the information then running through the neural pathways and is the information, if so, is that information then taking on a, a different format, like what is it that your message kicks in?
Is it, is it like you're triggering a chemical reaction? Are you sending a message in a way that the body doesn't normally have internally like in an artificial way, um, like how does that work exactly? And
Prof Chad Bouton: no, it's even simpler than that. So what, what happens in the case of a spinal cord injury, or even, even a stroke is that the signal, often will, depending on where the, the damage has occurred or the stroke event, You know, we will see that the signal can be kind of started and it will originate, but then it gets blocked at some point.
So let's take the spinal cord injury, for example. Often people will, either from a diving accident or a car accident, they will end up with an injury at the base of the neck, and that's what we call the You know, C5 or cervical fiber, 4 to 6, kind of in that range that causes paralysis from about mid chest down.
So it's an issue where the signal starts out, everything is great, then it comes down and it can't get past the injury. Okay, this can happen even with a brainstem stroke, for example, it gets blocked. Now, but by us intercepting the signals, we, yes, we do have to kind of transform them a little bit. We basically amplify them.
We send them to the computer. We digitize them, so we turn them into ones and zeros, and then we use what are basically forms of AI, machine learning algorithms, or AI, To, uh, decipher, uh, and how do we do that? It's like learning a language, say you learn a new foreign language, you're, you're in a new country, and, and somebody will point to different things and say what the correct words are, and you use association, right, to learn, to learn the language.
Uh, well, it's similar. We look at the patterns. While we're asking the person to attempt or visualize moving their hand or different fingers, even, and we then use AI to recognize the correlation, the patterns that correspond with those attempted movements. And so it, and for, after years of development, we've been able to do this very consistently, and then the computer translates.
So there's kind of a translation of language there where the computer says, okay, now. I know they want to open their hand, but I need to know what muscles to stimulate, nerves and muscles, but we really target specific muscles. And in your, in your arm, uh, there are dozens and dozens of muscles that control all the different finger movements and wrist movements, and even the twisting and we call it pronation supination of the form, very complex.
But, but the computer and the algorithms that we've developed to these AI methods can translate. The signals so that it knows how to stimulate the muscles. Now we do a lot of mapping too of the muscles to find out where exactly you need to stimulate to get the movements. But once it's, uh, once the bypass is incomplete, uh, the neural, bridge, if you will, or neural bypass, can, can do this in a fraction of a second.
So someone can think about moving and do it again.
Marc Beckman: So in the case with Ian, with your patient, Ian, just to, um, break it down and in almost lame in layman terms, for sure. the idea was how do we, give this patient the ability to think about using his hand to hold onto a cup, right? It was that, that's the concept. So in order to do so, typically for someone like me, I have a neural pathway, a road, where that message is going from point A to point B.
And when it hits point B, I can hold the cup. But for Ian, it was different. The pathway is typically A to B, but B hits a dead end. That roadway is closed. So what you're doing is using technology and artificial intelligence to say, we'll get to B, but first we need to go down the pathway, make a left turn, hit C, and then that will take you to B.
Is that, is that, and then his hand could hold,
Prof Chad Bouton: that's exactly right. So we do, we take an off ramp, And we pick those signals. We do a little bit of, you know, deciphering. Okay, what, what are the intentions? this is that thought driven or intentions. Uh, once we know that, then we kind of get back on the on ramp and, uh, we know what we need to do and, and take the message, uh, all the rest of the way to the muscles.
now, one of the problems, that we ran into, uh, and we always have this issue, right? We run into problems and then, and then we, we work, we work to solve them. So, we had a session one day. We're, Ian, and we're going to talk about some other patients too, but Ian said to us one day, you know, I can't feel this cup.
He said, I, you know, I'm thankful I'm moving and I can do things, but I just want you all to know I can't feel this cup. And it's a very strange, um, you know, uh, feeling sensation. It's a, it's a weird situation to be in. He said, it's because I can't, if I close my eyes, I can't even figure out where my arms are and let alone feel this cup.
And that's a loss of what we call proprioception and touch. And so, so that's. That's when we realized we, we need to do better. We need to do, we now need to have, uh, a bridge or a bypass going in the other direction. And that led into some new, some new areas and some new studies down
Marc Beckman: So that, is that the, is that where you came up with this concept of a double neural bypass? So that's when you're, you're hitting both movement and sensory feel.
Prof Chad Bouton: You got it. Yeah, absolutely. And, and what was interesting is, so we, we started to realize, okay, we're going to need to have this two way, you know, this double neural bypass. And during the pandemic, we, we were looking at a lot of old data and, you know, we wrote some new papers and we made some, some additional discoveries and came up with some new ideas, which were not only could we make a two way bypass and attempt to restore touch and movement, but why not try to stimulate, uh, and we were talking in the beginning about this a little bit, right?
Stimulate another pathway that might promote some plasticity, as we say, or some, strengthening of connections, or maybe even helping reverse some of the damage, uh, or at least the effect of, of the injury. And so we, we created this double And we spent a few years and the, the team, you know, the incredible team I mentioned, uh, spent the, uh, years developing this.
We spent a lot of time in the lab, designing the technology, developing and building and testing. but we figured out a way to run the signals in the reverse direction. So we pick up. Touch information, at the skin with these tiny little, you know, sensors, and we can pick up, uh, kind of that information about when someone's touching a cup or even holding somebody's hand.
And we'll, we'll talk about, uh, we'll talk about a personal moment here in a minute. but we basically then said, let's, we can take those signals, run them back into the computer, and then we could, uh, send a signal into the brain, this time, into the brain and stimulate what's called the sensory area, somatosensory, the primary area right below or right behind the motor area, right above your ear.
And if you stimulate the brain, you can cause someone, even if they're paralyzed without the sense of touch, you can cause them to, start to feel some sensations again, even in their fingertips.
Marc Beckman: Chad, I noticed that you were pointing to the right side of your brain. Is that a right hemisphere?
Prof Chad Bouton: It's actually the opposite, right? So it would contralateral as we said, so opposite sides. So right side, if I put a chip in the right brain, you know, this sounds like science fiction,
Marc Beckman: No, I want to hear it. Yeah. Yeah.
Prof Chad Bouton: Yeah, but if you put these tiny little chips, and they have, uh, they have a hundred or so electrodes, so we've put in now, I'll tell you about a recent study and a big breakthrough where we put in over 200 electrodes, tiny little chips, there are only a few, literally smaller than, than the size of my, you know, pinky fingernail, and these tiny little chips, can stimulate these areas, and if you stimulate on the right side of the brain, you will, uh, Feel it on the left side.
So we always, you know, the right side controls the left side of the body and vice versa. And so, yes, you can, you can now, uh, not only allow somebody to move their fingers. but you can pick up the information on the sensation and stimulate the brain. It doesn't feel completely natural. a new participant, named Keith Thomas, that, uh, we just enrolled, um, a year before last.
has been a part of our study to look at the double neural bypass and to demonstrate, uh, and he's been making some breakthroughs, but able to get signals going in both directions, uh, and I can tell you about his story as
Marc Beckman: Well, let's get into it. I think, you know, Keith Thomas is really a fascinating story. It's, you know, it's obviously heartbreaking, but what you've done to transform his life is just incredible. It's my understanding that he was paralyzed in a pool related accident in the summer of 2020. and then, and then, you know, after that paralysis, How long did it take for him to, um, connect with you and your team?
And, and like, what was his condition like when you met him?
Prof Chad Bouton: when we met Keith. We learned about his story and his injury and he was just with some friends and, um, you know, dove into a swimming pool right at where the shallow end transitions into the deep end. And, uh, just misjudged that transition or didn't see it and, um, you know, went in head first and ended up having to be, life flighted to the hospital.
But we're able to connect with Keith a couple years after his injury, and, he learned about our study and we explained to him that we're working on restoring both movement and the sense of touch, which he of course had lost both, uh, in on both sides of his body from about mid chest down.
And of course did not, uh, could not feel, uh, in his hands and arms, uh, and couldn't move, his hands or arms either. But when we met, Keith and we enrolled them into the study. We immediately set to set off to do the stimulation of key targets, you know, spinal cord at the cervical levels. We call it the back of your neck at the base and we also started to plan you know, this operation to put in tiny chips in his motor and sensory areas.
Uh, and that involved doing, you know, MRIs and, and, you know, Keith was doing a lot of, lot of work coming in to these sessions, receiving stimulation, getting scans of his brain. but after, uh, just a few, you know, just after several months, we started to notice Keith was already getting a little stronger.
when we met Keith, uh, he couldn't even lift his arms but an inch or two off of his wheelchair armrests.
And so, if he had an itch, uh, on his face, he couldn't reach up and scratch it. That's how, you know, difficult his, situation was. And had to ask for help, for everything. And what happened several months into the study was that after stimulating, Uh, his, his pathway, if you will, or his, uh, spinal cord at the base of the neck.
We've saw that he was getting stronger and in fact, after just again, you know, this first phase of the study, we saw over a hundred percent increase in arm strength and his bicep strength and ability to lift his arms. And now he's able to lift both arms up and reach and scratch his face, uh, if he needs to, or even, you know, even, uh, you know, say, uh, wipe his mouth.
or, you know, even feed himself if we, uh, help him with his grasping, which I'll, I'll talk about in a second. But, but that first phase and those first improvements were, were dramatic. And it was extremely exciting to see that.
Marc Beckman: So Chad, just to be clear, when you talk about the first phase after a few months, you're talking about, after surgery, right? This is after you, you, you, he did the surgery and you embedded the chips.
Prof Chad Bouton: Well, not, not even. So it's a common, so let me now walk you through. We did the first phase before surgery where we started to see Uh, his strength improvements in some of his gross motor, some of his arm strength. What we found out after the surgery, and this was, you know, took a number of months to plan and do all the imaging of his brain and make sure we were going to place these chips exactly where they needed to go.
But the other exciting thing that happened after surgery, uh, was that, uh, not only did he get better and better at, at different types of arm movements, but we focused on his, uh, right. So all of the chips in his case went into the left hemisphere, uh, his left motor and sensory areas. And we were able to quickly decipher his signals.
He could think about now opening and closing his right hand. Uh, in his case, that is where, again, we focused all of our energies and. I, I won't forget this moment, his sister, came in, to the lab one day and, we had kind of set up things where, Keith was able to, open his hand, for the first time and his sister reached out and, and held his hand.
and Keith could not only open his hand, but he could feel her hand when she squeezed it. And so those signals were, rerouted, literally now in the other direction. We stimulated, uh, with these tiny electrical impulses in the brain, and he felt his sister's hand. For the first time in three years since his, uh, injury.
Marc Beckman: How did he react
Prof Chad Bouton: well, uh, well, we
Marc Beckman: on a human
Prof Chad Bouton: We all, Keith got, he became emotional and, and, and so did, uh, all the rest of us in the lab. And it, it was an incredible moment. He was, he was very, He was very emotional and, um, talking to him afterwards as well, he said it was just the first time, you know, since his injury, he was able to feel family members and he talked about that, just, you know, being able to feel the hand of a family member, um, you know, it's just, it's just been a huge step forward, um, you know, now he's, you know, And now, you know, he's, he's combining movements and, uh, this new sensation.
And we've continued to see improvements in additional sensation, that's happening, down now in the wrist area. And even occasionally in the hand area, when we. Turn off the bypass. So this is what's kind of fascinating and was one of our goals was that we would promote lasting changes that we call this plasticity, right?
And if we can strengthen connections between neurons as you mentioned in neurons or strengthen neural pathways Over time, it may be that we can start to turn off certain parts of the bypass and let him use his own natural regain strength or even sensations in this case. So, so far, we've already seen improvements.
We're going to be tracking that over the next 6 to 12 months and, and, uh, But things are definitely heading in the right direction. And, and the, the, the dream and the mission, of our lab would be that, uh, we can combine these assistive technologies, to help them do things and, and gain more independence, but then also promote some strengthening in certain areas as well.
We're not claiming we have a cure for paralysis yet. No one has cured,
Marc Beckman: Are you saying that the body is relearning to use those pathways that, um, that were essentially shut down as a result of the paralysis? Is it, is there a regenerative piece of it? What's actually happening, Chad?
Prof Chad Bouton: That's a great question, Mark. It's It's really, we believe, a combination. So by stimulating these pathways electrically and because they, these pathways work, you know, uh, with the electrical impulses and, and, and what we call a neurotransmitter, messaging, the idea is that.
Uh, there's an old expression, uh, that a famous neuroscientist, uh, said, which was, well, he said something similar, but it was paraphrased as neurons that fire together wire together. and, that is not exactly, uh, what he said, but it's, it's again, a paraphrase, but the idea is that if you stimulate neurons at the same time, they believe they're communicating, and they'll actually strengthen their connection with each other.
And so, we're stimulating the brain and the spinal cord now at the same time. And we're trying to strengthen and reconnect those pathways, or at least strengthen the ones that were damaged. Uh, it turns out that in most spinal cord injuries, uh, or even in some of these cases, Welcome back to the Modern Hotelier Podcast.
I'm your host, Revin. I'm joined by my co host, Dr. Steve Carran. And we're going to talk about how to get started with the Modern Hotelier Podcast. So, I'm joined by my co host, Revin. And I'm joined by my co host, Revin. And I'm joined by my co host, Revin. Uh, you can allow somebody to regain function. Now, regeneration has been demonstrated in some of the laboratory work that's been done.
We're, when you're in a study like this, we're not able to go in and, and, you know, and, uh, dissect his spinal cord, obviously, and take a close look that we'd love to be able to do, but we can't do that. But we do believe, based on what we've seen in some other, Studies and previous work, uh, that we are strengthening connections and potentially even causing regeneration.
Marc Beckman: Wow, that's pretty wild. And Chad, could I have to ask you, like, are there other forms of therapy that are happening concurrent, or would you say this um, positive reaction or these positive results are are exclusively because of your efforts?
Prof Chad Bouton: Well, so we think that, the efforts in 2014, uh, were, were a big step forward because. we did this, we, we demonstrated that someone, uh, can regain movement, uh, using this, uh, neuro bypass, technology. Then we, other groups started to, try to do studies building, you know, on that and that was just incredible to see, and now there are multiple groups.
that are trying to create these kinds of bridges, but we believe that our efforts last year were the, is, was the first effort to, to restore movement and the sense of touch with a two way community. type of bypass in an actual human hand, not, not a robotic hand, not a robotic arm, but actual hand of the patient and the study participant.
And so that's important. Uh, I I've even heard directly from some of our past participants, uh, you know, that they would much rather, of course, move their own bodies. Um, they think robotic technology is, is, is incredible, but they'd really like to move their own limbs and regain some of that independence we talked about.
Now, this all builds, this all builds on, on years of research and, and, you know, we're standing on the shoulders of other giants in the field that did early work, uh, even going back into the 60s, 70s, 80s, where, uh, first a single wire was put into the brain, uh, then it was a group of wires and we've had, incredible researchers, uh, that have paved the way, uh, but we've really tried to now see if we can, reconnect or, or strengthen these pathways and promote plasticity at the same time while still, creating a, a powerful assistive type technology.
Marc Beckman: Chad, who were some of those early researchers, like, just, I think it's worth to give them the credit,
Prof Chad Bouton: Oh, John Donoghue uh, I worked with him early, early on and on, uh, what was called the BrainGate program, Leigh Hochberg. oh my gosh, there's a long list of people. and, um, uh, Phil Kennedy. I mean, there's, uh, Andrew Schwartz, you know, and, yeah, there's a, it's a long list, but just a lot of incredible folks, have been working in this field, You know, and now we're really just trying to keep moving it forward.
And now, if you think about it, I mentioned AI, and if we're able to implant tiny chips in the brain, and we call these, you know, brain computer interfaces, or BCIs is another term we use. If you can put tiny chips in the brain, Uh, and you can connect the brain to a computer in the way we've done, way we have now.
You can link BCIs with AI, and, and yes, that sounds like it could be a scary thing to be linking our brains to a computer and then having, uh, the ability to interface with AI. Uh, or regenerative AI, yes, you can think about scary scenarios, but right now, we see all the positive, potential benefits, uh, and the impact it can have on the, in the medical space.
We're already demonstrating some of that now, right, by restoring movement, touch, and other types of function, but now imagine, uh, one day, if someone has, A neurodegenerative condition like Alzheimer's, for example, and you want to help, help offset or counteract the cognitive decline. This, we don't know how to do this yet, but we are trying to understand the science and develop technologies where it might even be possible to.
have augmentative, you know, augmentative intelligence, if you will, or reversing, cognitive decline. we already know if you stimulate certain areas in the brain, uh, people can, will do better on certain types of. And, you know, it's kind of like, uh, I like to give the analogy sometimes of taking a shot of caffeine, you know, we're electrically stimulating, but it is a form of stimulation to the brain.
But if you do it in the right way, it can have a lot of benefits.
Marc Beckman: what is artificial intelligence, what, what is the role in this instance? I assume it's, it's mainly generative AI, is that fair to say?

Marc Beckman: what I was getting, what I want to get at, Chad, is like this idea, I've been struggling, not struggling, but researching a little bit about right hemisphere and left hemisphere brain thinking and like what their functions are. And there's this, one individual that I've been fascinated with that's, coming out of Europe.
And his argument is that we don't really function anymore in a way that is broken out, left brain thinkers versus right brain thinkers. It's actually, we use both hemispheres and hemisphere, he's thinking or describing as more transactional in nature, more of like a road map. And I think in many ways that mimics generative AI.
It's like the predictive nature of math. It's algebra. Whereas on the right hemisphere, it's a little bit broader. It's the deeper ecosystem and it's even maybe even emotions and creativity and uh, humanity, right? Like what makes us people? So I'm curious, like, I'm, I'm just thinking back to what I've been reading as it relates to that dichotomy.
And I'm thinking from, in your mind, would we be able to, and I know this is going beyond your research, but like, do you think that we would be able to use chips to stimulate the right hemisphere, this, this, broader part of creativity, right? Like, so you could have a person who's. who's stimulated, and thinking in a way that is predictive as it relates to being hyper intelligent or hyper creative, but it doesn't mean that they're going to sink back to the emotional connection of what the current events are.
I, I often talk about like Bob Dylan and songs of rebellion, right? So think about this, right? We can, we could today have generative AI build out a beautiful song of rebellion for us and it will be perfect. However, it doesn't have the ability. to do what Bob Dylan did in activating his right hemisphere in understanding what the 60s were like as it relates to social justice and war and the emotion and everything that went into it.
It could certainly kick out the beautiful words with generative AI and, and use terms of art that highlight a rebellious spirit, but can it capture humanity?
Prof Chad Bouton: that's the big question. So when we think about combining brain computer interfaces with generative AI, we, we have to think about, We have to look at the possibility of rerouting signals from one part of the brain or left side of the brain to the right side of the brain.
Yeah, absolutely. It's technically feasible. Will we understand how to not only decode, but encode? So that's the reverse. So we have to, we can maybe understand the, the activity and figure out that someone's thinking about a certain type of, you know, movement or whatnot. Uh, we can even have someone imagine sensations, by the way, and we can actually tell, uh, what they're thinking about, uh, you know, They can just imagine sensations and we can transmit them not only back to them or to their body, we can transmit them to someone else's brain.
So not just left or right, but someone else's brain. Okay. But that's another whole other topic. Uh, but, but yeah, it, it is possible, uh, to, to strengthen pathways. In fact, a lot of disorders are an imbalance in these pathways. So even, you know, we talk about depression, we talk about, OCD even. Uh, so some of the deep brain stimulation studies have found that.
Uh, you can help get those pathways, uh, kind of in better balance if you stimulate in certain nodes, uh, or certain locations in the brain. But, but let's get back to the personal, right, the problem with, uh, AI right now is that you can always kind of tell, um, and maybe that's a good thing so far, but you can kind of tell there's the lack of, emotion or that subtle, those subtle cues that we pick up on as, as humans, right?
And you talk about bringing in context and memories of different decades. And, I think human, only humans so far can really. Tap into that and evoke emotions. Um, and, and that's where, um, it's gonna be interesting to see where things go, with generative AI, but, but maybe, maybe linking, brain interfaces with AI in, in a way where.
And I, I, there's a lot of ethical discussions that still have to happen on all of this, but would that help, uh, AI become more human, if you will, if we could record from a human brain, use that in combination with AI or use that to help train AI to be more human? Yeah, I, you know, it's, there's a lot of, lot of questions, a lot of ethical questions around that.
Is that possible? I actually. Believe one day that is possible. I don't think it's a question of if anymore. It's a question of when and, you know, for me, we like to stay very focused on, again, the medical, and the very positive, effects and impacts we can have, but we have to carefully think about, too, what's, what could happen if someone were to, you know, You know, go down the wrong road with this kind of technology, but, but yes, the emotions, uh, yeah, are, are something that are truly still human.
Marc Beckman: Yeah, it's very human and, and the interconnectivity of it all, right? Like our environment and our family and, and, you know, nature, it's all part of what makes us who we are and what we are. So, you know, the math calculation that's fueling generative AI is, very deliberate, but unfortunately that's just not the way the world
Prof Chad Bouton: No, no. In fact, we, we make errors. Humans make errors all the time. We get overly emotional, right? At times we, we, and it turns out that that's actually how we learn. it wouldn't be possible, and that's why we're creative, is because, and can create things, is because of these random fluctuations in neural firing, as we call it, or the pulsing of the neurons, that is built in and absolutely allows us, um, to discover, learn, get better at things.
And, and actually is what allows the whole plasticity idea, right? And let me give you a simple example. So, you watch a baby, Sitting there when they're, you know, just a few months old and let's say they're, trying to learn even how to reach out and to grasp something, right? If you ever noticed the fingers are kind of randomly moving and jiggling and their bodies are moving and jiggling in a random, it's because The randomness of the neurofirings is, is stronger and higher in the beginning stages until we learn how to do these movements and learn how to control these things and things get dialed in.
and if we didn't have the, and we still have those random fluctuations happening again, it's what, you know, when you all of a sudden, ah, I have an idea, you know, because literally you had, these random fluctuations finally occurred in a certain way. That cause certain areas of your brain, to fire at the same time, connect in a certain way, and to give you, you know, this new idea that you didn't have yesterday.
If we were always firing exactly the same predictable way, we would never have, you know, these, these new ideas and these, uh, and the ability to, say, get better at skills. You know, it takes, they say it takes three, four hundred, movements or say you're trying to learn how to play tennis. It takes three, 400 type of iterations before you even start to dial in that, that new skill.
it actually takes even more than that, but no, it's all possible from these random fluctuations of what's makes us human. It makes us imperfect. but those imperfections are then used to create new things.
Marc Beckman: Chad, how many patients have, um, gone through this surgery now?
Prof Chad Bouton: Well, okay, so, uh, when we started many years ago, actually we started, 20 years ago, 2004, I was, involved in the first chronic implant of, an electrode or a chip, uh, that had, about a hundred tiny, tiny little electrodes. That was, the First, implant that was there for a long period of time, incredible step forward, and then we, and then we've seen about, I've been involved with, quite a few, studies, and patients now, but a total around the world, it's over 40 now, it doesn't sound like a large number, but, but the number is climbing, and, uh, And now you, you hear about Neuralink and some new companies, that, uh, are getting involved in this space and it's taking off, really taking off.
Marc Beckman: So, you know, it's interesting that you bring up Elon Musk's Neuralink. Where do you think that's going to go? Do you think that, concept will help accelerate the affordability and create more ubiquity with this technology?
Prof Chad Bouton: Yeah, so, I think that what's great is that we are seeing this large infusion now, or investments, uh, in new companies. that are really looking to accelerate the developments, and, and help, help people use this technology. Now the FDA, uh, will continue to focus on the risk benefit ratio, right?
They're going to look at, okay, this involves brain surgery, okay? This is not a zero risk, type of procedure, so we have to look at the benefits. And the FDA is not going to allow, you know, next year, uh, a company to just come out with a chip for the brain to surf the internet for any, any common person, right?
They're going to say, no, we have to weigh it against the benefit. It needs to be, really used for, uh, someone who has a medical condition and that's the initial priority. Okay. So this is all going to evolve, you know, over time, but, but the investment, the Finally, seeing these large investments and these new companies is super exciting because, you know, 20 years ago, we were trying to fund ourselves and, you know, scrape money together to do these studies and help people who are living with paralysis or loss of touch or other ALS, for example.
And so now it's super exciting. one of the challenges is. is developing the body interface too. So we're seeing this huge development in terms of brain interfaces, but the body interface is a big challenge because if we can tap into the brain and decipher, you know, someone wants to move their hand, well, how do you actually stimulate the muscles?
So there was nothing available out there, and so we developed that technology here in our lab, and then we even have now spun out another company, uh, It's called Nuvotion, and Nuvotion is a company that is focused on developing the brain body interface, so you can now have these light, thin, wearable patches on the skin that So, are super thin, super flexible, that can stimulate muscles and even different targets, like say, uh, even the spinal cord, and by stimulating these targets, based on, uh, the intentions of the user, uh, we call that, uh, that causes, or creates what we call a thought driven therapy, uh, type of, approach, and so someone recovering from, say, a stroke can think about, okay, I want to move this hand again.
and it stimulates, stimulates the hand. Now, this, this body interface, technology, can be used with any brain computer interface or any brain, type device. agnostic to which device. but the fascinating thing is it also has built in AI, to allow someone, to initiate a movement.
And the AI figures out, oh, they're trying to reach for, say, this cup that I have on my desk. And if they reach for that, I can help them finish the movement. So even in this other mode, where it doesn't even have to have a chip in the brain, this wearable device can use sensors that it has to pick up the intentions, use AI to then, Uh, infer, Oh, they're reaching.
I'm going to stimulate the muscles, help them grab the cup and take a drink. And that's a game changer because that can be used, in the millions of people that suffer, injuries or strokes every year that have, uh, Partial paralysis or that are even just trying to, you know, go through physical therapy and regain movements and get stronger where those are the cases where they may not need a chip implanted or want to have a chip
Marc Beckman: Right.
Prof Chad Bouton: So we've been developing both
Marc Beckman: Is, is Nuvotion's product available on the marketplace yet?
Prof Chad Bouton: Nuvotion is hoping, uh, within the next year or so, to have that product, enter, the market and become available. We, Nuvotion is actually in the process of going through the regulatory, pathway. Uh, and working closely with the FDA. So, we're getting, very close.
Marc Beckman: I mean, I have to imagine that when you get into the regulatory scheme and those conversations with, with both platforms that you just discussed, because it's so multidisciplined, because like your lab, for example, has such a diverse range of, of expertise for each individual. How FDA understand like this blending of Um, Compute with Artificial Intelligence and Neuro Networks, and it just goes on and on and on.
Like, it must be such a complicated process for you and your colleagues, frankly, all over the world to explain to organizations like the FDA as to, like, why this is going to be safe and why we need it as, you know, as a community.
Prof Chad Bouton: Yeah, that's actually a great, another great question and, and you, you just touched on a super important topic. We, and in fact, I just had a conversation with, someone at the FDA that, that I've known for years. and interestingly enough, they were coming back from a meeting that's, was about what's called a community, collaborative community.
They call them CCs. that, where the brain interfaces and even body interfaces was part of the whole discussion. And what we find is that The FDA, for many years now has, has hired, uh, biomedical engineers, and, you know, with various master's, PhDs, et cetera, to help with exactly this problem, right?
And so now there are experts at the FDA, that in some cases even did their own, uh, all so much for joining us today, and we'll see you next time. Devices to the market. yeah, it's, the FDA got criticisms or some criticism over the years of not moving fast enough and not accelerating some of the technology that now they've really been trying to do that.
And
Marc Beckman: That's encouraging. Chad, I, I would imagine also, like, I, I know that there's always, like, this tension between, religion and science, um, and, and I would imagine at some point, if not already, but at some point, your, uh, vision will probably be, um, uh, addressed by the religious community too, right? Like, we're creating these, um, Bionic people, right?
We're creating these hybrid individuals and that's not what nature has really, you know, subscribed for us.
Prof Chad Bouton: yeah, you know, it's, it's, we actually have not, had a lot of, reactions like that. And I, we kind of thought we might, you know, in the early years.
Marc Beckman: You will.
Prof Chad Bouton: I think that, yeah, right. And there's always going to be someone that, that believes, you know, we shouldn't. We shouldn't mix the human body with technology like this, but, for the vast majority, of, of, of folks out there that, that read about our studies and research and, and comment on it, are very positive because I think they see that we're, at least we are very focused in our group on, Very pressing, dire situations and pressing medical needs.
So we always look at the unmet needs, they call them. And these are, these I think are what's going to keep us heading in the right direction with this technology. Now, does it mean someone, some other group? Somewhere with, with, you know, ill intention, you know, might go down the wrong path. Okay. Yes, that is possible.
And we need to be really, really watching out for that and guard, safing against that, uh, safeguarding against that. But I think that, um, you know, so far the response has been super positive because we are really, really looking at the folks that really need this. It's again, that risk benefit ratio. And with the good thing with, um, this whole approach is that, as someone who's interested.
Uh, we'll only move, it's up to them, if they want to move forward, it's, it's, it's all, you know, uh, you know, voluntary, it's all, uh, after very long conversations, uh, and if someone wants to, you know, uh, be a part of a study, it's obviously always up to them, always up to them.
Marc Beckman: so Chad, I have, um, a, uh, basically a way that each guest finishes the show with me and I'd love to, uh, bring it to you. Um, this show is named Some Future Day and basically what we do is we predict the future. I start the sentence and then my guest finishes it. So are you game?
Prof Chad Bouton: Yeah, I'm game. Is it just one question, we going
Marc Beckman: just one question and you need to come up with a big answer, baby.
All right, here we go. In some future day, artificial intelligence and the mind will become,
Prof Chad Bouton: one?

Marc Beckman: wow,
Prof Chad Bouton: I think it's, I think it's possible. One. Yeah, exactly. Exactly. And, and there have been others that have. predicted this could happen. I, and I've been thinking more and more about it, in recent years. And I think, and again, I try to think about all the positives. When you can enhance somebody's quality of life, then you're doing a good thing, okay?
If you can help somebody be more independent, you can help with quality of life, and you can't ask for much more. how we do that still has a lot of questions, a lot of, challenges ahead of us, presents a lot of challenges. But, but again, when we're doing what we're doing and trying to help people, Increase their quality of life and increase their independence.
and we're doing it with a team approach and we are having these conversations about always doing it in an ethical way and safe in a very, very safe way. You know, then I think we head down the right path. I think one day looking way out into the future, let's say we, we figure all of that out. the mind has no limits.
The human brain really has no limits because think about it. We, we, We're, we're creative by nature. We talked about why and how, right? So we're creative. We're always thinking of new ideas. We conceived AI that came from human minds. And now, and how do we train AI? Now, you know, how do we train, uh, AI networks?
It's through, right now, surfing, using information that we have that are from human experiences, right? What's on the internet, et cetera, and our data sets that we produce. Now, at some point, AI will produce more data sets. It's already
Marc Beckman: We're there. Yep.
Prof Chad Bouton: Right. And now the question is, will they diverge? Will it go into what you call a divergence where AI is training itself?
And, and that's, of course, the big question. But, but I think, um, I think in the, uh, in at one point, Someday in the future, it will become very hard to separate the human mind from AI, where one begins and where one ends. Right now, we're already, we're already connected to our phones almost 24 7, you know,
Marc Beckman: Chad, thank you so much for, um, joining us today and thank you so much for all of your great work. As you know, it means a lot, to me. It's really been fascinating to, to, um, spend some time and learning from you. I really appreciate it. All
Prof Chad Bouton: you're very welcome and it was great talking to you and I think we covered some, some, uh, a lot of territory and, uh, it was fantastic.