Another first look: brain-computer interface helps depression sufferers

All right, how do I introduce you? Mayeron Griffiths, you started a meta augmented reality company long before Mark Zuckerberg bought the name from somebody or copied it or took it over. Thank you for coming.

Thanks ever. Thanks for inviting me.

You're a real pioneer in this industry. A lot of people don't know you because they didn't see your early work. Because it was early.

Right.

And it's hard to make it in this world when you're early and you don't have enough money to compete with an Apple. Right.

Of course.

I remember I told you the night you got $200 million that you're fucked.

And I was like.

And you still came in. Visit me again.

So thank you. No, Robert, we have a legacy. And thank you so much for inviting me. I mean, this is my baby right now. Coming back to my roots, I'm a neuroscience guy, and early on I realized the brain is a computer and the computer is a brain. One day they're gonna merge. Right? That was the early understanding. And so everything I do is about predicting, inventing, and kind of designing the market forces that make that great merger happen. And this is really the first brain chip that I think can really scale because you hear a lot about brain chips online that are so invasive, they require you to open a big piece of your skull, cut your dura, shove electrodes in so that you can interact with the computer. But the value prop isn't there yet because you have to be super paralyzed or you have to be. There's all sorts of strong limits. What?

There's side effects.

There's side effects.

It's expensive.

It's expensive. You can die. Like if you get a hemorrhage or infection, if you're in the brain with electrodes. So we created the least invasive bci, and it goes on the outside of the bone, on top of the bone. And it's a 30 minute outpatient procedure. And it is really a cool piece of tech. So it sits over your brain networks that govern your cognition. Basically, we're starting by helping severely depressed patients that don't react to drugs. And people don't know this, but depression is a cognitive disorder. It's when your rumination gets so strong, that's your default mode network of the brain, that your cognition gets impacted and you can't focus on the outer world. So depression is a cognitive disorder. And what we do is we stimulate and we're like a pacemaker for your cognition. We sit there over the center of the cognitive network, listening. When it's decreased and then we. And for depressed patients, it's decreased. And then we stimulated back into health. And the mystics knew 3,000 years ago that mental health is all about the balance of your inner world and your outer world. So depressed people are really stuck in their head in that default mode network because of the trauma, because of the. You know, you get hit by a car, God forbid, and you're thinking, oh, that bastard that cut me off in traffic. The voice in your head that ruminates gets so strong, steals your prefrontal cortical resources away from your ability to focus on the good things in our lives, on this kind of conversation, on a good walk on a beach, whatever.

I have a different problem. I have x.com running on that screen behind me.

Yeah, and you need your cognition intact for, like, the 90,000 companies that you're processing over there. I couldn't even look at that. Certainly not without our chip to help me focus on it. But, yeah, I mean, basically, that's what we're doing. We're like a new type of pharma company. The device that we're building is estimated to be 400% more effective than drugs without the side effects. So people that take antidepressants, 50% of men, will lose their libido, mental fog, fatigue, suicidality. When we switch cocktails, it's because we're blasting the whole brain with chemicals, and then you get the side effects. But if you can very precisely pinpoint the side effect of the depression network and rebalance it, then you have a whole other story. So that's what it is. And it starts with depression, and then it goes to everything. Obsessive compulsive, ptsd, all these other disorders that are fundamentally what we call networkopathies. Imbalances of brain networks, which modern neuroscience is saying, that's what depression is. It's not a chemical disorder the way we thought. It's a network imbalance. So this thing gets embedded, and it is a pacemaker for these networks. And then you have another cool gadget. This is the magnetic power pod that goes on top of the hair. You can see magnetically. So your scalp will be between these two, and this powers that. And it pulls the data from the implant, okay, the data about your depression, and it sends that up to the cloud. Your AI algorithms are processing it and building your baseline so for what your mood looks like. And then it gets sent to your psychiatrist. And your psychiatrist now can see your accurate mood graph. And then when you're dipping, they can remotely, like a Tesla over the Air Update send you the latest FDA approved prescription to this device. Right. This is the one that sits on your hair for 10 minutes a day when you're having coffee at home. And you get that information on it and it programs the implant. So that's the future of prescriptions, right? Instead of going to CVS and getting this piece of paper, taking a half day off work, taking a drug that was invented 50 years ago, waiting six weeks to know if it even works, you may lose your libido. Get mental fo. None of that. That's the old world of Pharma, this thing. 30 minute outpatient procedure. You're in the hospital, you're out of there right after and for the rest of your life. Your depression is managed on your iPhone.

And here's my son who's autistic. Hey, hey, Milan, you're on video.

And we're looking, we're looking to, you know, help all sorts of, all sorts of mental, you know, imbalances or.

Now how much does this, how do I get one of these? Let's say I have depression and I have.

So you join our clinical trials. We have, we have the very first clinical trial in a new depression stimulation device in almost 20 years. The FDA gave us the first ID approval in almost 20 years since vagus nerve stimulation. So for 20 months we've been collecting data from a few humans and we've basically shown that our device beats in terms of efficacy. It's early data and it's small numbers, but it gets people out of their depression faster. Faster and lower than transcranial magnetic stimulation. Tms. Wow. TMS is this helmet that you got to go to the hospital for a full month to basically daily get stimulation. And then it's almost, it's 80% efficacy or 100% response rates. Nearly. It's an amazing technology, but only 1% of the market can actually go there for a month to the hospital. These are the least motivated patients. So this is like tm.

Hold on a second. Because my son is stimming right now.

Yeah.

And it's the first time I've had him stimming in an interview. He goes around and he claps and he.

Right.

And what's he doing right now? And what is. Because he's autistic, he's special needs, he's in the middle of the spectrum. Right. He's not going to be Bill Gates. So he's not a high functioning autistic. He's, he's, he has fairly interesting issues. Right. Almost as non verbal when we first learned about him, the doctors thought he would never talk. He obviously is talking now. So he's a miracle child to us, but. Right, but what is this technology going to do in the future for him and for other people who have different mental conditions that keeps them from being, you know, as smart as you are?

Well, I would.

As social as you are.

Social. Social as I am. Better. What I would say is like this.

Because he is smart, he knows more about old Godzilla movies than you do, I bet.

Exactly. Exactly. That's why I would be very careful to say, speak about intelligence, which is very multifaceted. What I would say is TMS, that helmet that you go to the hospital 30 days to get people out of depression, is showing great promise. And data when stimulating areas of the brain, for example, the ventromedial prefrontal cortex, which is the area that helps you identify and appropriately react to social cues. So folks with autism simply have it either overstimulated or under stimulated. And so they can also be. That particular node of that network can rebalance, be rebalanced with tms, and there's great data. The problem is, you know, we don't want to have to invite people that need help to forget for a full month to the hospital. They won't go. So what we're doing is, you know, we're creating TMS to go. Basically, this device. This device is bioelectrically equivalent and superior to tms so that, you know, people can come to the hospital for 30 minutes, get this thing popped in, and have a better than TMS machine in that then gets governed by this. So I'd like to show you the next step of our journey today.

All right.

So this is the patient's mood graph. The first thing that they're going to see when they open our device is what their mood was accurately over the last few days. You can see the patient forgot to stimulate on Tuesday, so we didn't get data. Then on the bottom of it, you see the prescription from the psychiatrist. One dose per day, next session, last session, expiration dates. So safety balance. And then on the top, we're gonna hit connect to pod. And you're gonna see the stimulation pattern changing in this animation, showing you. Okay, now my iPhone is connected to the implant. Okay.

Yeah.

Through Bluetooth or through Bluetooth low energy Bluetooth. And so you have your battery levels. You can increase or decrease the intensity of the stimulation depending on what your psychiatrist allows you to do. I mean, in this case, the psychiatrist locked it because they didn't want to Create safety bounds. But for some patients, you'll be able to move it up and down. If you're a little bit more blue that day, you might get the ability to go a little bit higher. You can change the duration and move it up and down as well. And then when we're ready. Okay. We're going to slide to turn on the stimulation.

Yeah.

So now you're actually going to see the pattern change again. This is on your hair for ten minutes a day. And on the device, you can see your real brain networks registered to an fmri. That's what we want to do in the future, showing you how your network is getting rebalanced. It's going through the stimulation. You can even do a meditation session while you're waiting. Right.

You might have to put on a Vision Pro and do some meditation. The Vision Pro, by the way, and the Quest 3 have great meditation apps.

Absolutely.

Help relax you.

Absolutely. And so that's what we think. Meditation and, you know, healing from depression go hand in hand. So that's why having a meditation session, either here or in the Vision Pro, while you're stimulating and rebalancing your brain networks can be an empowering feature. And then you finish, you got your stimulation for the day. You got your mood graph. You see on Tuesday that it's actually a, you know, increased mood. This is the first accurate mood graph in history that is being built. Okay. Traditionally, in order to get an accurate mood graph, you need a certain resolution of brain sensing called high Gamma frequency at 75-105Hz. Now, to get that, you need to do a full craniotomy. Open the skull, put stuff on top of the dura mater protective sheath around the brain. Super invasive. That's what all the BCI companies are doing, these major craniotomies. But we've created. We have an amplifier.

Thousand wires on your brain.

Exactly. We're not going to do that in this case. We're wirelessly interacting with your brain. And inside of the device is the best amplifier in the industry. And it's about 10 times lower noise floor than any other amplifier that is commercially available. And in those devices that you had implied you mentioned, and the reason for that is we want to be able to keep that 75-105 Hz resolution, which is the requisite resolution for an accurate mood graph or any other mental health condition you want to try to track. Okay. But without cutting into the skull. Without cutting the inner table of the skull, because the moment you cut into the inner table of the Skull patients can, you know, there's a small chance that they can actually die, and we want no chance of that. So when you're on top of the bone, it's more like LASIK surgery. Okay. And it's more like, you know, it's like a nose job. We take less bone out than a nose job. Okay. So it's safe. Wireless interaction with the brain is the future. That's the BCI that will really pick up. And this is the first incarnation of that. And we're going to bet you have.

FDA approval for this and patents and all the things.

We have, all the good stuff. Some of the good stuff. I mean, we have the first IDE approval, investigation, device, exemption approval from the FDA for a new depression stimulation device in 20 years. Almost. Vagus nerve stimulation was the last novel thing that was done for depression. For stimulation where it's more invasive, you have to cut that. You put a device in the chest, you have to cut the coronary artery and shove electrodes up that. And then you're interacting with the vagus nerve and you're rebalancing brain networks indirectly through the peripheral nervous system, through the. Through the outside of the brain. And so over the last 20 years, neuroscience has found out what the spots you could stimulate in the brain are, and we figured out how to do it through the skull. So the convergence and the confluence of technologies allows for this, which is the smallest neurotechnology device that we're aware of in terms of a full system that has closed loop. And this device sits over the network, sensing your level of cognition. And if it's low, it stays. Stimulates it right back into balance. And one more feature that's kind of cool is, remember I mentioned it's bioelectrically equivalent or superior to a TMS machine, because that's the best scores in the industry are tms. And that's one of these large electrodes is equivalent to a TMS machine. So you may ask, why do we have four of them? And that is because we want to create the most personalized medicine experience in history, whereby we actually all brain stimulation devices traditionally have an oval or some kind of a linear round shape that when they pulse electricity, it hits the cortex at that. At that shape. But our brain networks are nonlinear. They're shaped in all sorts of weird ways. The shape of your gyrus is angled in particular ways. How do I create a wireless stimulation that maps to your specific shape of your gyrus and the cortical physiology of your network? Well, that's what beam steering and shaping is about.

Got it.

So you have four of these TMS machine like things, and with anodal cathodal gains, you can actually stimulate the brain in a more personalized way far more than a TMS machine.

I have a feeling there's some AI running inside.

There's a lot of AI.

A lot of AI.

There's so many levels of it. And I don't want to throw around that word lightly, but there's the mood graph that it gets personalized to you by studying your own mood and knowing when you're dipping relative to that. So you have to build a baseline. There's a whole lot of AI there. And there's this understanding of how do I create stimulation patterns that even the best psychiatrist could have predicted has the best efficacy. And of course, the AI will do a much better job eventually. So we see AI this is like the future of psychiatry because a psychiatrist sits there at home. Normally, if a psychiatrist wants to see 100 patients like your son and others, they have to like, block out a whole month. Well, a week, let's say aggressively. Okay.

Yeah.

So they block off a week and they meet them one by one and the patient says, I feel X. And a lot of times the patient doesn't actually know accurately what they're feeling because their brain is foggy or because they have these issues.

I was on some of this antidepressant medicine and my wife was being driven insane. I didn't have. I didn't know what was going on. But my wife said, you got to get off this drug. Not good for you.

Yeah.

And so it's. It, it takes. This is what is so frustrating, being a depression patient. Right. You have to go through, find a psychiatrist who will work with you, who understands you, and then start, you know, working on treatments.

And sometimes it takes, you know, months to find them.

Months, years, sometimes.

And, you know, you see them once and then they're backlogged after Covid by, by so many months.

You need to give them a couple months because it takes a couple months for the drug to really start working. Right. Right.

There's so many latencies inside of this. The world we're in right now is again, in order to do this, I have to wait three, four months to find the psychiatrist, get there. Then I have to take a half day off work, get this piece of paper, go to CVS, get a drug, by the way, SSRIs. These drugs, even the modern ones, are a spin off of a molecule that was created 50 years ago. So we're using 50 year old tech, basically. And then over six weeks, you're maybe gonna know if it works. 50% of men will lose their libido at that time. You know, people will get mental fog, fatigue and suicidality. Often when they're switching or testing, 50% of people will have, well, it will not work for. So they'll have to try another drug and go through this process again. So that's the past of psychiatry. And the future of psychiatry, we believe, is you go to your doctor in 30 minutes, you pop one of these things under your skin and for the rest of your life. First of all, not only do you take out the side effects that I mentioned, because you're precisely stimulating the center of the network instead of hitting the whole unintended parts of the brain, which creates side effects, but you're also increasing the efficacy dramatically. TMS has been shown to have 465% higher efficacy than drugs.

Wow.

465% higher for treatment resistant depressed patients, 17% for drugs versus 79% for TMS. So, I mean, you'd think, why isn't the whole world going to TMS? Well, because only 1% of the world of depressed patients can access and go through a whole month in the hospital. Right. It's just so hard. So we said, let's take TMS, make it to go, make it super easy. 30 minutes in. And I think at that point you don't really take drugs. I mean, initially we're going to go after patients that drugs don't work for. And they're what we call treatment resistant patients. Yeah, right. These are the patients that will do electric shock therapy, or tms. But does this help you with addiction?

Because a lot of alcoholics are depressive.

Thank you. Yes. First, there's comorbidities between addiction and depression, and so they'll be that way. There's a direct way this helps with addiction. For nicotine cessation, TMS is actually approved as the way to fix it. So. And later on, other forms of addiction, alcoholism and others, are in the pipe. So TMS is the solution for addiction that for many forms of addiction, as we're starting to see in our, in the early clinical trials, again, early data, but really good data. And so, okay, in the future, this device becomes not only for depression, it can expand to anything TMS can do. So now you have an addiction prescription, digital prescription, we call it. You might have a autism prescription. And we envisage a world where if you have both, both of these indications, you Might put one in one part of the brain that governs your depression and keeps you in balance and another in another which might have autism sort of modulated as well and provide balance for and, and, and, and wow. Addiction. And so look, this is, this could go a lot, a lot of different ways.

Right, because you have like I toured San Quentin prison. A lot of people in prison have, you know, killed somebody. Right. Well, that's because their brain isn't the same as yours and my brain.

Correct. They have oftentimes and again, controversial topic, so I can't speak about it neuroscientifically, but I will say that oftentimes people reach desolate situations, either homelessness or you know, other incarceration due to, there's a lot of comorbidity with schizophrenia, for example. Right. There are other mental disorders that lead you sometimes they have increased the chances of you ending up in these kinds of situations. So can we help society at large by helping people remain more balanced? Especially if they're in situations where society kind of pushed them there, they didn't have much of a chance to not be imbalanced mentally because they've been bombarded with anxiety from poverty for so long that their brains became tired and then they became depressed or they be, you know, or it reached out other disorders. Can we support them with the best technology there is so that they don't have to use 50 year old drugs? You know, can we help them not have to find fancy psychiatrists that they'll never find anyway and not just get thrown into jail or thrown into mental institutions? Yes, we can. And that's really the mission.

Wow, this is a crazy new world that's coming.

Isn't is it is. And interestingly enough, if, if we play our cards right, it's a more peaceful, joyous and present world because all of these network disorders that we listed on our conversation today are fundamentally holding you back from being present and you know, clear minded. When, when you're talking with, with another person or trying to be present with a loved one or walk on the beach or your work, you know, you have to be focused and present. And when you're brain is out of balance, either you're anxious and you're in a state of fear or you're depressed, which means you're tired, your brain is in a depressed level and you're focused in the rumination and not on the outside world. Or your obsessive compulsive disorder, which TMS is also approved for, which means you're obsessively worried about going out to the outer world and all sorts of things. These are all addiction, et cetera. These are all holding you back from being present with your loved ones, with yourself, with your. With your work, with your mission, whatever that may be. So the world that we can build with technology by keeping the brain balanced in this way is a world where those states of joy, presence are more easily accessible. And that's my passion.

What's the name of this?

This is called inner cosmos. The universe within. You talked to me about the Vision Pro and looking at the universe outwardly and playing around inside of it. The next frontier is of course, the universe within. The most complicated organ in the known universe that we know of is in our cranium. We seek to, using the science of TMS and other proven neurostimulatory principles and data, go area by area of the brain and help people get out of disorders. It's an exploration, it really is. It does feel like space exploration, but inward. So that's inner cosmos. And yeah. Last thing is how I got started. I, like you, was diagnosed with the, you know, in my case it was ADHD, childhood ADHD. I was 10 years old, almost getting kicked out of school. And I. My mom scoured the earth, Jerusalem, in this case, to find the best neurologist she could possibly find. Took many months. The neurologist never looked at me, never made eye contact, just looked at their pad, at my symptoms, said, here's a pill, a magic pill. If you take it, it'll fix your problem. And just don't tell anybody about it lest it affect your reputation. That's all he told me. And I never saw him again. And I took this magic pill called Ritalin. And within a year I was the head of student council. And within a couple of years, I was one of the top students in my school. And then I got into Columbia University. Thank you. Ritalin. It gave me the superpower of a lot of, you know, cognitive force and attention. But something really confusing happened to me every year as I was going through this. Less and less friends, I lost my friends. And I didn't know why I was more successful, but I was losing my friends. And that really confused me. So by the time I was academically safe at Columbia, I said, I'm gonna kick this drug that has all the side effects. It's blasting my whole brain with dopamine that can't be sustained. Sustainable, right. And I'm going to study the brain. And what I learned was that when you blast your brain with dopamine you're hitting an area called the ventromedial prefrontal cortex. We spoke about it earlier in the context of autism, and I was losing my ability to identify and appropriately react to social cues. It's as if you're momentarily in a state of neurological autism. I mean, it's not an accurate diagnosis, but I had difficulty interacting with humans. This is what people call the zombie effect of these drugs. And so I was like, I'm out. But then something really crazy happened. 25% of the student body at Columbia, some of the most focused people in the world started taking, asking me for my stash of Ritalin, and I'm like, what the heck is going on here? Right? These are so focused people. They are willing to accept the side effect of being less social and give up a part of their humanity. For what? For what reason? Second year this happened. 40% of people started popping these pills around me in school. 50%. It was growing exponentially. And I realized after reflecting on it years later, these were the first three years of Facebook spreading through campus. People could not focus. They could not stay present.

See, this X is behind you, right? It's distracting.

It's distracting.

And it's kicking out a lot of dopamine watching that.

Exactly, exactly. Because our brains haven't evolved for it. Right. Our brains evolved in the monkeys. In your cranium, there's a monkey, like savannah, like cognitive processing. Right? Because 99% of your, 0.9% of your evolution, you're in the jungle trying to find your next source of food, your next mate, and avert danger. That's not a lot of cognitive bandwidth. That's actually pretty narrow straw you're sipping through. But that X screen behind there, we read two to three books of audio visual information a day in the modern world. So the gap between cognitive, you know, ability, our human ability, and modernity's requirements for cognition is so vast that it's enough, in my belief, this is my personal belief, to make a billion people on the planet depressed and another billion people anxious. You know, they're thinking about their body image relative, you know, to their friends in Facebook as teens. They're getting blasted by WhatsApp messages 24 hours a day. You know, we used to have nine to five jobs, and that's when our brains were stimulated. And then they could wind down. You can't wind down anymore. You know, so, like WhatsApp, Instagram, all of these technologies, they're taking away our presence, our ability to sit there and focus and be present and so we're building this device for the childhood version of me, you know, and, and all the people in the world who can't focus, like those kids at Columbia. Basically the world is losing its cognitive, you know, acumen on some level. And, and, and I wanted to find a way to solve that for myself without having to get all the give up, my friend, circle the side effects, because it's not, it's not just Ritalin for adhd where you give up a part of your humanity for antidepressants. Like you said, you have emotional blunting, basically a side effect. So you don't feel the lows as bad, but you also can't feel the highs, the high states of joy and creativity. So you're blunted in that way. You're giving up a piece of your humanity. And in anxiolytics, benzos, it's a whole other. So each one of these are kind of doing a deal with the devil. You here, give me a superpower and I'll give you part of my humanity. But when you actually stimulate the brain precisely, which over the last 30 years, humanity has discovered how to do, and this device is kind of the, we think of it as the iPhone of that we're collecting all the best sensors and ways to simulate precisely without cutting into the skull or the brain, then you can actually start to play these brain networks like a piano and help people stay in balance and help defend them against this overload of cognition.

Now, if I had this, would I stop being interested in looking at X?

No, on the contrary, you'd just be able to be more present with it. You wouldn't get tired. As you told me, after half an hour of looking at that, you wouldn't get tired. You'd be able to actually open more tabs on that. And the quality of presence that you'd be able to offer each one of those, you know, links is much higher. And most importantly, and this is probably a take home message, when your child comes in and wants some attention and you know, and Maryam comes in and wants to have a discussion, you're able to like segregate and shut that off for a moment and be present here and not be exhausted and not be drained and you can really be with them. And that's the ultimate power of being able to modulate the cognitive control network. Okay, first we're getting people out of depression because they're the people with where their cognition is most impacted. It's tired, basically. But eventually we're going to be able to help people Stay more present in the world. Maybe people with ADHD, maybe people with autism, maybe people with PTSD.

We can talk for hours. We've already gone 30 minutes and it's.

Oh really? That felt like five.

Interesting topic, right? You know, it's crazy.

Yeah. Thank you.

Where did we learn more about this? And I, I'm going to have more of you on Twitter. Spaces or X Spaces.

Oh, sure, sure. Anytime, anytime.

So that we can go more in depth. Because this whole genre of devices requires a lot more understanding. Right. Because most people don't understand their brain, how it works. I don't. You've taught me more in an hour about how my brain works or how my son's brain work then I've learned in other places. So thank you. Where do I learn more?

Inner Cosmos IO So that is our website and we're gonna have a lot of news coming out in the next few weeks. Really. We've been implanting these in humans and showing results that are so exciting to be able to, so promising to be able to share initial small numbers. But it's, it's, it's getting life changing. It's getting, it is, it is really helping people's lives. And so I'm excited and we'll, we'll stay tuned.

Well, thanks for coming. Thanks for coming hanging out with me.

Absolutely, man. Thank you. Since the meta days, man, that's when we did our job.

You're always doing weird things, pioneering things for the human brain.

Absolutely. Step by step will help a lot of people.