Deciphering BCIs

by James Cavuoto, editor

The market for brain-computer interfaces continues to expand, with new players and new financing being announced almost weekly. As we report in our article on page 1 of this issue, some of the earliest competitors in this space are engaged in a race to accumulate new human participants in an effort to position themselves as a market leader, even though meaningful revenues are years away for most of these firms. Other players have chosen to compete on the basis of bandwidth, which is to say, the amount of brain data that can be transferred per unit of time, much the way Internet firms jostle for superiority among consumers.

But the battle for superiority in the BCI market will hinge on a host of more complicated factors, not least of which is the positioning that each firm chooses and the target applications it pursues. Initially, almost all of the major players in this market—and by major we use the arbitrary indicator of firms that have raised in excess of $100 million—have targeted severely disabled user populations such as high-level spinal cord injury or ALS. The progress that has been demonstrated to date with users of BlackRock, Synchron, and Neuralink implanted devices has been remarkable and emotionally and financially uplifting for the industry as a whole.

But it is obvious that there are just not enough of these individuals to support six or seven firms with valuations of several hundred million or even billions of dollars, even if every one of them chose to get implanted, which is far from certain. In our view, a much greater market opportunity exists in applications such as psychiatric disorders, vision and speech restoration, and stroke neurorehabilitation.

Like it or not, the term BCI has become a powerful buzzword in the last few years, much like the term AI has (and yes, we’re planning a session on the “AI-Driven BCI Revolution” at our upcoming Neurotech Leaders Forum, so we’re not an innocent party). But that gets us to the subject of defining BCIs. Much ink and conference minutes have been expended debating what should and shouldn’t be included in a definition of BCI. Last year, a commentary in Nature authored by Jacob Robinson and colleagues argued for an application-based taxonomy: “Any technology that records brain activity and processes it on an electronic device, or any technology that stimulates brain activity based on computations performed on an electronic device, regardless of whether the technology is implanted or not.” The authors would also create subcategories for “communication and movement BCIs” and “therapeutic BCIs.” An alternative definition put forward by the BCI Society distinguishes BCIs from other forms of neurosensing.

But we see the world a little differently. The technologies and the applications for implanted BCIs and for implanted DBS systems (and for that matter implanted epidural stimulation systems) are converging so rapidly that there will soon be no appreciable difference. After all, a closed loop DBS system, or NeuroPace’s RNS system, already perform brain sensing and Neuralink and others have made it clear that their devices will incorporate brain stimulation. So whether it’s called BCI, DBS, RNS, or some other term, an implanted brain device is just that—a neurotech device. That’s actually good news for BCI startups because they can now point to an existing multi-billion market and startups can cite medtech giants like Medtronic, Abbott, Boston Scientific, and others as potential exits to investors. We have no doubt that each of these neurotech heavyweights is eyeing the BCI market very carefully. The implanted brain device market will segment into several different categories based on target indication and clinical specialty.

For noninvasive neurotech devices that record from or stimulate the brain, a similar segmentation will occur, with the addition of a rapidly growing consumer neurotech market. But as has been the case with pain stimulators, the economics of commercialization, reimbursement, and distribution channels will be markedly different between implanted and noninvasive devices, and the investment, supplier base, and marketing ecosystems serving them will be as well.