Neuralink’s First Human Patient Controls Mouse with Thoughts

The boundary between human biology and digital technology has just become significantly thinner. Neuralink, the neurotechnology company founded by Elon Musk, has successfully demonstrated that its first human patient can control a computer cursor using only their mind. This milestone marks a critical step forward in the development of brain-computer interfaces (BCIs) aimed at restoring independence to those with severe paralysis.

The First Patient: Noland Arbaugh

For years, the concept of controlling devices with thoughts was largely confined to science fiction or restricted to academic laboratories. That changed in January 2024 when Noland Arbaugh became the first human to receive the Neuralink implant. Arbaugh, a 29-year-old former athlete, was paralyzed from the shoulders down following a diving accident eight years prior.

Following the surgery to install the device, which Musk has named “Telepathy,” Arbaugh made a full recovery with no reported ill effects. In a livestream demonstration on X (formerly Twitter), Arbaugh showcased his newfound ability to play online chess and the strategy game Civilization VI. He described the experience of moving the cursor as intuitive, noting that he simply imagines the cursor moving to a specific spot, and it happens. He likened the capability to using “The Force” from Star Wars.

How the N1 Implant Works

The technology powering this breakthrough is the N1 implant. It is a cosmetically invisible device, about the size of a large coin, that replaces a small piece of the skull. The sophistication lies in how it connects to the brain.

The N1 features 1,024 electrodes distributed across 64 ultra-flexible threads. These threads are incredibly thin—finer than a human hair—which makes them impossible for a human hand to insert. To solve this, Neuralink developed the R1 Robot, a surgical system designed to insert these threads into the cerebral cortex with micron-level precision.

Once in place, the implant functions through the following steps:

Recording: The electrodes detect neural spikes, which are the electrical signals neurons use to communicate.
Processing: The N1 chip aggregates these signals inside the device itself.
Transmission: The data is transmitted wirelessly via Bluetooth to an external app on a computer or smartphone, which decodes the intention of movement.

Overcoming Early Challenges: The Retraction Issue

While the initial results were promising, the trial did encounter technical hurdles. Several weeks after the surgery, Neuralink engineers noticed a decrease in the amount of data being received from the device. This resulted in a drop in bits-per-second (BPS), a metric used to measure the speed and accuracy of cursor control.

The cause was mechanical. Some of the ultrafine threads had retracted from the brain tissue. The human brain is not static; it pulsates with every heartbeat and shifts during movement. This movement caused some electrodes to pull away from their targeted neurons.

Rather than performing another surgery to replace the threads, the Neuralink team solved the problem through software. They modified the recording algorithm to be more sensitive to neural population signals. This update improved the way the system translated neural firing rates into cursor movements, effectively restoring and eventually surpassing Arbaugh’s initial performance levels.

The PRIME Study

This implantation is part of Neuralink’s PRIME Study (Precise Robotically Implanted Brain-Computer Interface). The FDA gave clearance for this trial in May 2023. The primary goal of the study is to evaluate the safety of the implant and the surgical robot, as well as the initial functionality of the BCI for people with quadriplegia.

The study is open to patients who have limited or no ability to move both hands due to cervical spinal cord injury or amyotrophic lateral sclerosis (ALS). It is expected to take approximately six years to complete, involving regular check-ins and data collection to ensure the device remains safe for long-term use.

Comparisons to Other Neurotech Companies

While Neuralink captures the most headlines due to its high-profile founder, it is not the only player in the field.

Synchron: This company has already implanted devices in multiple human patients in both the U.S. and Australia. Their approach is less invasive. Instead of open brain surgery, Synchron inserts a stent-like device called the “Stentrode” through the jugular vein, pushing it up into a blood vessel near the motor cortex.
Blackrock Neurotech: A veteran in the space, Blackrock has had its “Utah Array” devices in patients for years. Their technology has allowed patients to control robotic arms and even feel sensations through prosthetic hands.

Neuralink distinguishes itself with a higher channel count (more electrodes) and a fully wireless design, whereas many older systems require a port physically connected to the head.

Future Applications

Elon Musk has stated that “Telepathy” is just the first product. The long-term roadmap for Neuralink is ambitious. The next targeted product is “Blindsight,” which aims to restore vision to people who are blind, even if they were born without sight, by bypassing the eye and stimulating the visual cortex directly.

Beyond medical restoration, the company’s stated mission includes the eventual symbiosis of human intelligence with artificial intelligence, though clinical applications for paralysis remain the strict focus for the foreseeable future.

Frequently Asked Questions

Is the Neuralink surgery painful? The brain itself has no pain receptors. However, the surgery involves an incision in the scalp and removing a portion of the skull. Patients are under general anesthesia during the procedure. Noland Arbaugh reported being released from the hospital the day after surgery.

How much does the Neuralink implant cost? There is no public commercial price yet, as the device is still in the clinical trial phase. Early estimates suggest the surgery and device could cost around \(40,000 to \)50,000 initially, with costs likely dropping as the technology scales and insurance coverage is negotiated.

Can the device be removed or upgraded? Neuralink designs the N1 to be upgradeable. The implant replaces a piece of the skull and sits flush with the head. If a newer model becomes available, the previous device can theoretically be removed and replaced, though any surgery involving the brain carries inherent risks.

Who is eligible for the current trials? The PRIME Study is currently looking for individuals who have quadriplegia (limited or no function in all four limbs) due to spinal cord injury or ALS. Participants must be at least 22 years old and have a consistent and reliable caregiver.