Brad Smith, rendered mute by amyotrophic lateral sclerosis (ALS), is speaking again—this time through a coin-sized brain implant. Surgeons embedded Neuralink’s experimental N1 “Link” device, equipped with 1,024 electrodes, directly into his motor cortex. The device translates his thoughts into movement, allowing him to steer a digital cursor and trigger AI-generated speech—entirely with his mind.

Smith is the first person with ALS, and only the third human overall, to receive the device. His message, “I am typing this with my brain,” was shared publicly in a tweet from Elon Musk, who confirmed Smith’s role in Neuralink’s initial human trial. “It is my primary communication,” Smith added.

Neuralink’s implant, about the size of five stacked quarters, replaces a portion of the skull and interfaces directly with brain tissue. During the procedure, a precision surgical robot inserts 64 ultra-fine polymer threads—each loaded with electrodes—just a few millimeters into the brain, carefully avoiding blood vessels to minimize trauma. Unlike competitors such as Synchron, which uses a less invasive vascular route with only 16 electrodes, Neuralink’s approach aims for higher fidelity by tapping directly into the brain, despite the increased surgical risk.

The device sits invisibly under the scalp and transmits data wirelessly to a nearby computer via Bluetooth. That data—electrical patterns from Smith’s motor cortex—is decoded in real time by Neuralink’s algorithms. When signals from imagined hand movements proved weak due to ALS progression, engineers pivoted to monitoring tongue movement attempts, which produced stronger, more consistent signals. By focusing on these, Smith gradually learned to control a computer interface using his thoughts.

From there, the team built an “accessibility stack” tailored to his needs: a predictive keyboard, shortcut macros like copy/paste/undo, and a custom chat interface powered by Grok 3, a large language model. The system can even vocalize messages in a synthesized version of Smith’s voice recorded before ALS took it away. “It keeps me in the conversation,” he said—though the AI sometimes takes creative liberties, like suggesting a bouquet of carrots for a horse lover.

Despite the promising results, hurdles remain. The device is still in its early-feasibility phase. It must complete a pivotal trial and secure FDA premarket approval—an intensive process that typically takes years. Early challenges have also emerged: Neuralink’s first human recipient, quadriplegic Noland Arbaugh, lost signals from most of his electrodes within weeks. The company now inserts the threads deeper into the brain to reduce such signal loss due to brain movement.

Still, the promise of a high-bandwidth brain-computer interface that restores real-time communication to people with paralysis is closer than ever—and Brad Smith is living proof of what’s possible.

By Impact Lab