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https://www.wsj.com/articles/how-brain-computer-interfaces-could-restore-speech-and-help-fight-depression-11662129229


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HOW BRAIN-COMPUTER INTERFACES COULD RESTORE SPEECH AND HELP FIGHT DEPRESSION


NEUROSURGEON EDDIE CHANG, A LEADER IN A TECHNOLOGY THAT TURNED THE BRAIN SIGNALS
OF A PARALYZED MAN INTO WORDS, ENVISIONS FURTHER ADVANCES IN THERAPEUTIC
IMPLANTS

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EDDIE CHANG IS A NEUROSURGEON AND BRAIN-COMPUTER INTERFACE PIONEER AT THE
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO WEILL INSTITUTE FOR NEUROSCIENCES.

Photo: Carolyn Fong for The Wall Street Journal
By
Daniela Hernandez
Sept. 2, 2022 10:33 am ET

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Already, brain-computer interfaces have helped to control epileptic seizures and
decrease tremors in patients with Parkinson’s disease. The next wave will tackle
even more complex applications, like restoring speech and regulating mood.

Eddie Chang, a neurosurgeon and brain-computer interface pioneer at the
University of California, San Francisco Weill Institute for Neurosciences, is
among those at the forefront of that work. In July 2021, he led a groundbreaking
study, funded in part by Facebook, that translated the brain signals of a
paralyzed man into words on a screen.

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The amount of research in brain-computer interfaces, or BCI, has been growing
steadily in recent years, according to federal online database Pubmed. In 2021,
there were almost 600 studies, compared to roughly 340 in 2016. Fueling some of
this activity are the availability of more powerful computers, improvements in
artificial intelligence, and the further miniaturization of devices that can be
implanted into the brain. Investors, entrepreneurs like Elon Musk and tech
giants like Meta Inc. are getting in on the action as advances in hardware and
software have made decoding the human brain seem less insurmountable.

Federal investments in neuroscience have also played a part in the field’s
upswing.



Dr. Chang says the aim is to decipher the brain activity that underpins complex
human behaviors, like speech and emotions, in an attempt to develop therapies
that could help people who can’t speak or who suffer from neuropsychiatric
conditions like depression and anxiety.

That promise also comes with some peril, such as the potential of further
erosion of privacy as BCIs give direct access to the brain and the processes
that underlie thoughts.

Dr. Chang spoke to The Wall Street Journal about where the field is going, his
work on restoring speech and improving mood, and whether the experimental worlds
of BCI and psychedelics could one day collide.

WHY SPEECH?

Speech is really special. [It’s] just one of the unique and defining behaviors
we have as a species. And so it’s been quite exciting to be trying to understand
how the human brain processes such a unique behavior.

WHAT MAKES THAT DIFFICULT?

One of the biggest challenges is trying to translate electrical signals. The
brain uses [electrical signals] as its own language for communication. That
language has its own logic, its own code. And the true challenge is to
understand how that code works.

DR. CHANG SHOWS A BRAIN-COMPUTER INTERFACE. HE PAIRED THE TECHNOLOGY WITH AI TO
HELP PARALYZED PATIENTS COMMUNICATE.

Photo: Carolyn Fong for The Wall Street Journal

HAS TECHNOLOGY MADE THAT CHALLENGE EASIER?

The signals that we are interpreting—they look nothing like what we’re trying to
decode, like words. They look like squiggles on a screen. And the patterns are
so complex. A lot of our work now leverages computer-science advances in
artificial intelligence and machine learning because they are very, very
powerful ways of pattern recognition. So the kind of stuff that you use for Siri
or Alexa.

HOW DO YOU SEE THE TECHNOLOGY EVOLVING?

Ten to 15 years ago, the state of the field was at the level of trying to decode
vowels, for example. What has been really incredible over the last five years is
how much progress has been made from moving beyond just individual sounds to
trying to decode words. And it’s still really at its very beginning. The first
project that we published on this last year really focused on a vocabulary of 50
words. Our current efforts are towards two endeavors. One is to expand the
vocabulary beyond our [Weill Institute’s] 50-word vocabulary while also having
high accuracy.

The second thing that we’re trying to do is move from essentially trying to say
a word and having a word appear on the screen to synthesizing words that you can
hear. So the goal is for someone who’s paralyzed not to just think of a word and
have it appear on a screen for writing things out, but for actually synthesizing
those sounds. And that turns out to be a very, very difficult and big challenge
because of the complexity of producing words audibly [for] a very large
vocabulary. For a small number of words, it’s very doable now.



Another area that we’re really excited about is not just hearing words, but
actually controlling [an avatar] of the face that is not only speaking, but
actually making the movements that you normally see when you’re talking to
someone in person. The reason why we think that that’s important is that it will
help the learning process for someone [who’s paralyzed] to essentially feel like
the brain computer interface is part of the way that they speak because it feels
more natural.

HOW IS THAT DIFFERENT FROM TURNING TEXT ON A SCREEN TO WORDS YOU CAN HEAR?

Speech synthesis to us is not just the words themselves, but the nuance of
creating the full richness of voice, like intonation and rhythm, in real time.
For example, “Sally went to the store.” To change that from a statement to a
question, all I’ve done there is increase the pitch of my voice on the last
word. It’s the same words, but what that does is that changes the meaning. So
we’re trying to tap into that as well.

YOU’RE ALSO WORKING ON SYSTEMS THAT CAN HANDLE MULTIPLE LANGUAGES. CAN YOU TELL
ME ABOUT THAT?

Part of what we’re trying to develop is technology that is cued by the patient
to switch from one language to another. So the probability of one word following
another word in English is very, very different than their sequences in Spanish.
As a person switches between two languages, we’re looking at ways that the
machine can detect that and continue to communicate in multiple languages. I’m
excited about it because it’s just another step in making the technology more
usable and more practical for people and allowing them to really express who
they are.

DOES THAT MAKE IT MORE COMPLICATED?

It’s much, much more complex because you don’t want the two to be confused. It’s
not like there’s the part of your brain that is Spanish and a different area
that’s processing English. For people who are bilingual, it’s coming from the
same area. And having a computer figure that out is tricky.

ARE THERE SIGNATURES THAT, TO THE MACHINE, SUGGEST THAT A PERSON IS TRYING TO
SPEAK IN ONE LANGUAGE VERSUS ANOTHER?

So that’s actually a fascinating question and I don’t have the answer to that
yet. We’re definitely getting to territory of work that’s under way now.



HOW ARE YOU USING BCI TO HELP PATIENTS WITH MENTAL-HEALTH CONDITIONS?

We’re really interested in trying to understand what is going on when someone is
processing emotions normally, and what the signals look like in people who have
depression and don’t have normal regulation of their mood. Our hope is that by
understanding these electrical signaling patterns that we can use them as
biomarkers, as ways to understand when and what parts of the brain are involved
when someone is having depressive episodes. And then the second thing, which is
far more important, is to use that information to intervene and to regulate some
of these areas so that someone feels more normal, like they aren’t in
incapacitating depression.

DO YOU SEE A WORLD IN WHICH YOUR LANGUAGE AND MOOD PROJECTS COLLIDE?

I haven’t connected these two projects but I do think that there’s potential.
We’re talking about different brain areas and essentially different computer
algorithms to understand and decode them. But a lot of the hardware has a lot of
overlap. I do think that in the coming decade, there will be a lot more
device-based medical therapy, and that we’ll be able to interact with the brain
and integrate [neural] recordings from different parts of the brain.

SHARE YOUR THOUGHTS

How do you see brain-computer interfaces being used in the future? Join the
conversation below.

PSYCHEDELICS ARE ANOTHER CLASS OF EXCITING EXPERIMENTAL THERAPIES IN MENTAL
HEALTH. DO YOU THINK THERE WILL BE CROSSOVER BETWEEN THAT FIELD AND YOURS?

I do have a feeling that those worlds will combine. They’re very complementary.
[Psychedelics are] primarily a chemical approach. We’re exploring this
complementary signal, which is the electrical signal. The brain uses both
heavily and they are related directly. As we start to understand the signaling
changes that occur with things like psychedelics or psychiatric medications in
general, I think there’s a lot of potential.

WOULD YOU GET A BCI FOR YOURSELF, NOT AS TREATMENT, BUT FOR AUGMENTATION?

I personally wouldn’t. There are so many things that I wish I were better at.
But I personally really respect who I am as I am right now.

IS THAT BECAUSE OF PRIVACY? WHY THE HESITATION?

Part of the hesitation is that there are risks. We’re talking brain surgery. The
second thing is that we’re still very much in the learning phase. We’re really
far from any kind of scenario where I can imagine it being for augmentation.
There’s also an ethical line. I’m not supportive right now until we have a much,
much better regulatory ethical framework around this.

This interview has been condensed and edited.

Write to Daniela Hernandez at daniela.hernandez@wsj.com


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