Neuralink tests brain implant approach that leaves protective layer intact

Neuralink, a company developing brain-computer interface (BCI) devices aimed at restoring independence to people with paralysis caused by conditions such as amyotrophic lateral sclerosis (ALS), has tested a new implant approach in which electrode threads were inserted through the dura without cutting it open. The dura is the tough protective membrane surrounding the brain.

In a post on X, the company said eliminating the need to cut the dura “takes one of the most delicate manual steps out of the procedure,” which “potentially means a safer, more repeatable surgery, and a real path to scaling” the technology to more people who could benefit.

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BCIs aim to restore digital control

ALS is a neurological disease that causes progressive muscle weakness, ultimately leading to paralysis of most voluntary muscles.

BCIs are an emerging technology that can use electrodes, or tiny sensors, implanted in the brain to detect brain activity. This activity is then interpreted by a computer, enabling people with paralysis to perform tasks they can no longer do physically, such as communicating or using a computer.

Beneath the skull, the brain is covered by a thick, leathery membrane called the dura. This membrane helps cushion and protect the brain, but during brain surgery it can pose an obstacle for surgeons — both because it’s hard to insert objects through the leathery surface, and because the covering makes it difficult for surgeons to see blood vessels and the brain surface beneath.

As such, in previous procedures involving implanted BCIs, devices have typically been placed by removing or cutting a hole in the dura. But although cutting through the dura gives easier access to the brain, it also makes the procedure more invasive and adds a delicate surgical step.

According to Neuralink, the new approach allows the device’s threads to be implanted directly through the dura, eliminating the need for this step. Neuralink said this could simplify the surgery and make the procedure safer and easier to perform consistently.

In a video describing the procedure, Neuralink engineers were able to penetrate the dura by making the implantation needles slightly thicker, so they could go through the layer without bending or breaking.

Robot guided threads through intact dura

The team also developed new imaging methods that allow the surgical robot to visualize blood vessels and the brain surface through the intact membrane. Prior to testing the approach in people, the scientists conducted hundreds of experiments using artificial dura and brain mimics in laboratory settings.

The first-of-its-kind transdural procedure was performed in May as part of the CAN-PRIME study (NCT06700304), which is running at the University Health Network (UHN) Toronto Western Hospital, in Canada. It was done by Andres Lozano, MD, PhD, who leads the neurosurgery team at UHN’s Toronto Western.

Within an hour of the procedure, the participant who received the BCI was able to use the device to move a cursor on a computer screen. The participant is recovering as expected, the company noted.

“It’s the most cutting-edge version of this surgery that we’ve ever performed,” said Matthew MacDougall, Neuralink’s head of surgery.

In addition to CAN-PRIME, Neuralink is running additional clinical trials to test its BCI technology in people with paralysis caused by ALS and other conditions. PRIME (NCT06429735) is recruiting at sites in Arizona and Florida, while GB-PRIME (NCT07127172) is enrolling people in the U.K., and UAE-PRIME (NCT06992596) is seeking participants at a site in Abu Dhabi.