Mark Jackson reclines in bed and controls a simple video game using pure thought. Across from him on a laptop three blue circles drift on a plain background. When one circle turns red, it becomes his goal. He pilots a white circle toward that target. Should the white orb touch a blue one, the level resets. To move left, Jackson imagines clenching his right fist once. For rightward movement, he visualizes that same clench happening twice in rapid succession, much like clicking twice rapidly on a mouse.
Over multiple tries, Jackson, a 65-year-old living with paralysis, demonstrates remarkable skill. On this day he hits 14 out of 15 targets. He has perfected timing so well that he previously scored a flawless 15-for-15 stretch. That level of accuracy is no accident. He has spent weeks training with the system implanted in his skull. Practice sessions have sharpened his ability to blend concentration, pattern recognition and neural decoding into precise, near-instant commands.
That ability stems from an experimental brain-computer interface implanted into Jackson’s brain by a startup called Synchron. Unlike devices that require a large opening in the skull, Synchron’s implant employs a wire-mesh stent inserted through blood vessels. The system interprets signals from Jackson’s motor cortex to execute actions on his laptop and, soon, other electronics. In addition to gaming, he can compose text messages, draft emails and complete online purchases, all by thinking selected motor intentions rather than moving any muscles.
His experience with the implant forms part of an early study involving ten participants: six in the United States and four in Australia. Surgeons at the University of Pittsburgh performed Jackson’s operation roughly two years after the company began its first human trials down under. With this device he regains features of daily life that ALS, the disease that paralyzed him, had stolen. The trial aims to prove the concept works safely in people such as Jackson before it expands into larger studies.
Jackson’s journey to this point began five years ago in Georgia, where he worked at a wholesale floral business, arranging bouquets and fulfilling orders—his ideal occupation. He initially assumed a pinched nerve had caused neck pain and hand weakness. In January 2021, specialists at a major medical center delivered a harsher verdict: amyotrophic lateral sclerosis, a condition that destroys nerve cells over time and gradually strips away a person’s muscle function.
His physician at Emory University invited him into a clinical trial for an experimental ALS medication. Jackson joined immediately and remained hopeful about a positive outcome. By December 2022 he could no longer type or lift crates of flowers, forcing him to leave his job. He moved in with his brother outside Pittsburgh and confronted the disease’s toll. “The loss of mobility, the loss of independence that goes with this disease,” Jackson says, “it’s a lot to take in, it’s a lot to process.”
When the drug trial ended in mid-2023, Jackson looked for other ways to regain autonomy. A new feasibility study testing Synchron’s brain-computer interface at the University of Pittsburgh had just opened its enrollment. Jackson signed up in July. He passed screening exams six weeks later and entered the operating theater for a procedure lasting about three hours. Surgeons threaded a flexible stent, the size of a matchstick, through his jugular vein up into a vessel beside his motor cortex.
During that same session, they placed a rectangular processing unit beneath his collarbone. It captures electrical activity from the stent’s electrodes and transmits data through infrared light to an external receiver. That paddle-shaped sensor rests on his chest, sending signals along a cable to a translator box beside his bed. When he powers the system, two green lights appear over his shoulder, indicating that internal and external components are linked.
After the surgery, Jackson had to wait months before the parts began talking reliably. Swelling at the implantation site and distance between internal and external modules caused interference. He feared the signals might never stabilize. “There was a lot of anticipation,” Jackson recalls. In October 2023 the connection finally took hold. The first clear transmission lifted a huge weight, turning weeks of anxiety into relief and opening the door to training sessions.
Learning to use the interface involves imagining simple movements so the system can map them to distinct neural patterns. Patients think about opening or closing a fist hundreds of times as software powered by artificial intelligence learns to decode those signals. When a patient cannot physically move a limb, the motor cortex neurons still fire during an attempt. That intention registers in the data, providing the neural commands required to operate a cursor or select an icon.
A rival approach from another startup involves drilling into the skull. Elon Musk’s Neuralink cuts a circular flap in the bone and replaces it with a coin-shaped device that feeds dozens of ultra-fine threads into brain tissue. Neuralink has implanted its system in seven volunteers so far, some of whom left the hospital the next day. Direct-brain penetration risks tissue damage and bleeding, whereas Synchron’s method carries the danger of blood clots or stroke. All implants bring a threat of infection.
Even with lower overall investment—Synchron has raised about $145 million versus more than $1.3 billion for Neuralink—it has advanced toward routine human use more rapidly. Backers include Amazon founder Jeff Bezos and Microsoft co-founder Bill Gates. Musk reportedly considered contributing when Neuralink experienced delays. The team behind the stent device continues adding features, making it compatible with consumer technology already on the market.
Last year Synchron introduced a conversational assistant powered by OpenAI so that users can compose messages or ask questions by thought alone. It then added support for Apple’s mixed-reality headset, which Jackson uses to watch movies and explore virtual environments. An integration with Amazon Alexa followed, giving people the power to control smart-home gadgets with neural commands. Earlier this year the company rolled out a Bluetooth link protocol so the implant can pair automatically with iPhones, iPads and headsets.
Looking ahead, Synchron is preparing a pivotal trial slated to begin in 2026, involving up to fifty participants. That study must demonstrate safety and functional benefit on a scale large enough to satisfy regulators and insurance providers. Synchron’s founders hope this will move the device from an experimental prosthetic into an accepted therapy for people who have lost communication or mobility.
Tom Oxley, Synchron’s chief executive and cofounder, embarked on this work decades ago. He graduated from medical school at Monash University in Australia in 2005 and proceeded into internal medicine training before specializing in brain conditions. During a rotation in a clinic for ALS patients he found the experience harrowing. “It was extremely intense,” Oxley says. Those months implanted the desire to create tools that could reclaim lost function for patients like the ones he treated.
During a subsequent rotation in the rural region of Mildura, Oxley met cardiologist-in-training Rahul Sharma. Over homemade Indian meals they debated how heart surgeons were shifting from open-chest operations to navigating catheters through blood vessels. Oxley began to wonder if a similar approach could record neural activity from inside the vascular system. By placing electrodes on stents, they might capture brain signals without cutting through skull and tissue.
In 2008 Oxley encountered a landmark article in the journal Nature detailing experiments at Brown University and Massachusetts General Hospital. Researchers had inserted a Utah array, a 4-by-4-millimeter grid of 100 microscopic metal spikes, into the brains of two paralyzed volunteers. The spikes recorded neuron firing as the subjects thought about moving a cursor or robotic arm. One participant, Matthew Nagle, managed to check email, play Pong and draw shapes on a screen. Oxley recalls, “At that moment, I got excited about BCI.”
With that insight, Oxley and Sharma sketched their concept of a stent-based interface. After finishing his fellowship in 2009, Oxley cold-called the Defense Advanced Research Projects Agency to pitch the idea. A program manager saw its potential for soldiers who had lost limbs and offered $1 million in seed funding. Two years later the pair launched SmartStent, a venture soon rebranded as Synchron, to develop their first prototypes.
Over the next several years the startup secured another $5 million from the Australian government plus $4 million from DARPA and the Office of Naval Research. They brought on biomedical engineer Nicholas Opie, who had worked on artificial-vision research, to refine the design of the Stentrode. Animal studies followed, including sheep implants by 2012. In 2019 the first human patient in Australia received the device, laying the groundwork for the Pittsburgh study. Neuralink did its first surgery in January 2024.
Investor Vinod Khosla, whose firm backed Synchron, sees a clear advantage in adopting a vascular approach. More cardiologists around the world possess the skills to place stents than neurosurgeons who can perform complex brain surgery or operate specialized robotics. That could open up implantation at hundreds of hospitals instead of a handful of elite centers, speeding deployment to patients who need it.
The trade-off is signal fidelity. With only 16 electrodes embedded in the stent’s metal scaffold, the system samples neural activity at a distance from individual neurons. Experts refer to this as a “stadium effect”: from inside you hear individual voices, but outside you perceive the roar of the crowd and general shifts in intensity. Kip Ludwig, a professor of biomedical engineering, asks, “How much resolution do you really require to restore basic functions for a patient?”
Neuralink’s system carries more than a thousand electrodes across 64 flexible threads, providing high-resolution data. Yet that level of complexity may be excessive for everyday tasks such as moving a cursor or selecting items on a screen. “The minimal viable product is the ability to navigate and select on an iPhone. That’s what we think is going to be the basic use case,” Oxley says.
He envisions a future where microstents placed throughout the vascular network grant access to extensive regions of cortex. “We believe that opens up 10 times more brain coverage,” Oxley notes. With multiple Stentrodes arrays wired into a single system, users might handle devices with ease and perform intricate sequences of commands.
As Synchron plans its larger trial, it must define how to quantify success. Leigh Hochberg, a neuroscientist at Massachusetts General Hospital and Brown University who coauthored the 2006 BCI study, emphasizes the novel nature of these tools. “They are providing the opportunity to restore functions that no other device or approach is yet able to restore,” he says. At present there is no standard outcome measure for evaluating neural prosthetics.
Regulatory approval in the United States will hinge on showing that benefits justify any risks. After that, insurers will assess whether to cover the device for eligible patients. In many ways a brain-computer interface resembles an advanced assistive gadget more than a traditional drug or surgical implant, prompting questions about reimbursement and long-term support.
Industry groups and agencies are already developing frameworks for assessing neural devices. Scales that measure a person’s daily capabilities or quality of life might be tailored to capture gains linked to mental-command control. Those metrics will guide future trials and shape the standards for emerging brain technologies.
Jackson regards the concept as life-altering. “I can see down the road where this would give someone their independence,” he says. For now he must connect an external cable from his chest to the translator box whenever he wants to use the system. Twice each week Synchron’s clinical engineer, Maria Nardozzi, visits for calibration and training. A next-generation design will link the implant wirelessly, freeing users from physical tethers.
Until that upgrade arrives, Jackson relies on speech-recognition software for most tasks. “If I’m being honest, that’s the easier route,” he confesses. Systems such as Siri or Alexa work well for many commands, yet they struggle with niche functions or apps that lack voice modules. An example came when he tried to send money via Venmo: there was no voice-input option for the required payment note.
Rahul Sharma, Synchron’s medical director, points out that voice interfaces still miss simple requests and exhibit lag. “The voice assist technology is nowhere near where it needs to be,” he says. A brain interface can carry out commands directly and discreetly. “If there are other people in your environment, you may not wish to be sharing what it is you are trying to do or express out loud,” he adds. For some patients who lose speech entirely, a neural link may be the only way to communicate.
Jackson considers himself among the first explorers of the technology. He tests new programs as Synchron releases updates and uses Apple’s Vision Pro headset regularly to watch films and visit distant landscapes in virtual reality. Unable to travel physically his mind can roam the peaks of the Swiss Alps or the lush canopy of a New Zealand rainforest.
Yet he longs to return to the arts. A painting of two yellow fruit warblers, which he drafted at age 20, hangs framed above his bed. His mother preserved the work over decades. Jackson had hoped to spend his retirement creating oil paintings and refining his style on large canvases.
He recognizes that ALS will progress relentlessly. He may lose the slow control he still has or develop cognitive issues that prevent him from operating the device. Statistics show a life expectancy of two to five years after diagnosis. Among the ten participants in Synchron’s study only Jackson and one other remain active users; the rest discontinued as their condition advanced or they passed away.
In his early days with the disease Jackson discovered woodworking, carving small bird figures from blocks of basswood. A red cardinal perched on his nightstand recalls the hobby he cannot pursue now. He dreams of future systems linked to robotic limbs: “If there could be a way for robotic arm devices or leg devices to be incorporated down the road,” he says, “that would be freaking amazing.” Neuralink and other groups are exploring prosthetic control now, but current robotic arms offer slow, jerky motion.
Fine-motor tasks like carving intricate wood patterns remain out of reach for today’s interfaces. Jackson makes do by browsing art collections and exhibits through mobile apps. He imagines a tool that would translate his creative impulses directly onto a digital canvas, drawing lines at the speed of thought.
Even with its limits, the brain-computer link offers capabilities he once believed impossible. He can open web pages, send texts and control onscreen elements with no hands, no voice and no muscle beyond an intention. The system interprets that intention and delivers action.
“There’s a reason why this is pretty groundbreaking technology,” Jackson says.