Y Combinator Startup Podcast - 脑机接口的未来,对话《科学》杂志的马克斯·霍达克 封面

脑机接口的未来,对话《科学》杂志的马克斯·霍达克

The Future Of Brain-Computer Interfaces with Science's Max Hodak

本集简介

YC校友马克斯·霍达克是Neuralink的联合创始人,也是Science公司的创始人,该公司致力于开发可恢复视力的脑机接口。Science已研发出一种微型视网膜植入物,通过刺激眼部细胞帮助盲人重见光明。目前已有40多名患者在临床试验中接受了该治疗,其中包括一位最近十年来首次阅读完整小说的患者。在本期《如何构建未来》中,马克斯与加里讨论了脑机接口的工作原理、工程化大脑所需的条件,以及为何脑机接口可能成为未来十年最重要的技术之一。

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我觉得,第一批能活到一千岁的人,现在很可能就活着。

I think it is very possible that the first people to live to a thousand are alive right now.

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这听起来还是有点难信,因为我觉得生物技术以前进步得太慢了。

It still takes some suspension of disbelief because I think biotech has just been so incremental.

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现在最让人兴奋的是,这些进展再也不像以前那样微乎其微了,

One of the things that's so exciting about what's happening now is that no longer really feels so incremental to

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对我来说是这样。

me.

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我觉得脑机接口,以后我们会发现,它根本不是某个具体的产品。

I think that BCI, we're going to come to see, is not is not a specific product.

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未来会冒出一堆做脑机接口的公司,各自瞄准不同的应用场景,不同的探针在不同地方才有用。

I think there are gonna be a bunch of BCI companies going after different applications where different types of probes will make sense.

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我觉得我们现在真的已经进入起飞阶段了,地球上发生了全新的事情。

To me, it feels like we're firmly in, like, the takeoff era now, like something new has happened on Earth.

Speaker 1

欢迎回来,继续收听《如何构建未来》这一期节目。

Welcome back to another episode of How to Build the Future.

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今天我们请到了一位重量级嘉宾——Max Hodak,Neuralink的联合创始人,也是Science公司的创始人,这家公司是我们见过的最令人兴奋的脑机接口企业之一。

Today we've got a real treat, Max Hodak, the co founder of Neuralink and also founder of Science, one of the most exciting BCI, brain computer interface companies that we've ever seen.

Speaker 1

Max,欢迎来到《如何构建未来》。

Max, welcome to How to Build the Future.

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谢谢你们邀请我。

Thanks for having me.

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Science最近宣布,已经有四十多人接受了你们的首批脑机接口治疗,能帮助失明者重见光明。

So Science recently announced more than 40 people have received one of your first BCI treatments, which gives people their sight back.

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这到底是什么原理?

What is that?

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具体是怎么做到的?

What's happening?

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去年我们完成了一项大型临床试验,今年秋天刚在《新英格兰医学杂志》上发表了结果。

So we finished a big clinical trial last year, which was published in the New England Journal of Medicine in the fall.

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这是一个小小的芯片,只有两毫米见方,植入在眼球后方、视网膜下面,本质上就像一组微型太阳能电池阵列。

So it's a this little chip, a tiny little two millimeter by two millimeter silicon chip that's implanted in the back of the eye under the retina that it's it's this tiny little array of essentially solar panels.

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患者戴的眼镜上装有摄像头,用来捕捉外界画面,再通过激光投影仪把图像投射到眼睛里。

So the patients wear glasses that have a camera that looks out at the world and then a laser projector that projects an image into the eye.

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激光打到植入物上的时候,那个太阳能电池板就会吸收光能,直接刺激它正上方的细胞。

And wherever the laser hits the implant, the solar panel absorbs the light and then excites the cells directly above it.

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这其实是个视网膜刺激器,能绕过已经坏死的视杆细胞和视锥细胞——那些原本让眼睛对光敏感的细胞——只要人是因为这些细胞丧失而失明,就能重新把视觉信号传回视网膜。

It's a retinal stimulator, and this allows us to bypass the dead rods and cones, like the cells that normally make the eye light sensitive, to get a visual signal back into the retina if they've gone blind because they've lost the rods and cones.

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所以我们在欧洲17个中心做了一个大规模临床试验,效果非常显著。

And so, yeah, mean, there's a big clinical trial in Europe across 17 sites, and it was a huge effect.

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我们现在正准备提交审批申请。

So we are submitting for approval now.

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目前还没获得市场批准。

It's approved on the market yet.

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希望今年晚些时候能拿到批准。

Hope to have that later this year.

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对于那些从来没听说过脑机接口的人,到底什么是脑机接口?

For those watching who have never heard of a brain computer interface, what is it?

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那人们现在能用它做什么呢?

And what have people been able to do?

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他们目前能做到哪些事情?

What are they able to do now?

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大脑其实是个超强的计算机,但它被锁在头骨里头。

So the brain is this powerful computer, but it's encased in the skull.

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它可不是能直接跟外界无线连接的。

It is not magically connected to things.

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它就那么几条跟外界连接的通道,靠这些我们才有感觉、才有动作控制。

And so it has these handful of connections to the world, and these give you the senses that you know and the motor control that you know.

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但你不妨想想,我们是不是非得用这些原始通道?有没有别的替代方案?

But you can kind of ask, like, is that so either do we wanna replace these with something else?

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比如虚拟现实,或者《黑客帝国》那种场景。

So for example, like the simulated reality or the matrix use case.

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另一种就是恢复丧失的功能。

Another is restoring lost functionality.

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所以,这就是现在它们的实际应用方式。

So this is, I mean, this is how they're deployed today.

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如果有人失明了,你可以帮他们恢复视力。

So if someone has gone blind, you can restore the ability to see.

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如果有人听不见了,你可以帮他们恢复听力。

If they've gone deaf, you can restore the ability to hear.

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如果有人瘫痪了,你可以帮他们恢复行动能力。

If they're paralyzed, you can restore the ability to move.

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再往下想,就是神经结构工程,这方面我们整个领域其实还没怎么深入。

And then you can think about structural neural engineering, and this is the this is the thing that people haven't really we haven't gotten to as a field as much.

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但你可以想想,大脑到底是怎么处理信息的?

But looking at how does the brain process information?

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能不能给大脑新增一些区域?

Can you add new brain areas?

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有没有办法搞清楚大脑内部到底在发生什么?

Are there ways to understand how the brain is like, what is going on?

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要么用这个来打造更智能的机器,要么用来思考如何治疗抑郁或成瘾这类问题。

Either use this to build smarter machines or to think about how to treat things like depression or addiction.

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我现在特别关注的是,我们主要还是在帮那些有疾病或障碍的人恢复能力。

I'm taken by to what degree right now it's about sort of taking someone who has a condition or a disease, and then bringing them restoring them to capability.

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我觉得AI领域现在也是这么在演进的。

I think that's playing out in AI right now as well.

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以前的电脑根本没法做任何真正的思考,也没有神经元,突然间就冒出了一大堆神经元。

You had computers that had no ability to do any sort of pure cognition, and no neurons, and then suddenly a bunch of neurons.

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而通用人工智能,就是人类能做的事。

And then AGI is what a human can do.

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这其实是一种能力的恢复。

It's a restoration of capability.

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再往后,当然还有更高级的,就是超人工智能。

And then, of course, there's this other thing after that, which is ASI, super intelligence.

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你有没有想过,将来这东西会变成什么样?

Do you ever think about what that might be down the road?

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那脑机接口呢?它用来做什么?

What is that for BCI?

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脑机接口的类型可多了。

There are many types of BCIs.

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它其实会像制药行业一样,形成一个大类。

So it's there it really is gonna be a category like pharma.

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不是说只有一种产品。

It's not it's not one product.

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我觉得不会出现人人都用的那一种脑机接口。

I don't think there's gonna be like the BCI that people get.

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不同的应用场景,得用不同的技术手段。

And there are different modalities that will work for different things.

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我不做超声波方向,但我认为超声波未来有可能做出类似数字版安眠药,或者数字版专注力药。

So for example, I don't work on ultrasound, but one of the things I think will be possible with ultrasound is, like, a digital Ambien or, like, a digital Adderall.

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能不能通过刺激大脑特定区域,让人集中注意力,或者直接催眠?

So can you, like, stimulate part of the brain to cause focus or sleep and things like that?

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要是真能实现,我一点都不意外。

Would not surprise me if that was possible.

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我觉得这种应用更像消费级产品,而且 hopefully 不用开颅手术。

And that could I could see as being more of a consumer application almost, and that won't require brain surgery, hopefully.

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现在高端的超声设备确实得钻开颅骨,但我相信这个问题迟早能解决。

Right now, the the high quality ultrasound stuff does require drilling through the skull, but I think that that will be overcome.

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至于植入式脑机接口,那可是真真正正的大脑手术。

For the implantable BCIs, I mean, this is a very serious brain surgery.

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这一点非常重要,得清楚认识到。

I think that's important to appreciate.

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所以当你想一想怎么把这技术用到人身上、谁会用它时,其实目标群体主要是重度残疾的患者。

So when you think about how do you actually get this into humans and who's gonna use it, I mean, these are gonna be very disabled patient populations.

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你总得权衡风险和收益。

You always look at risk reward.

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所以得从最严重的患者开始。

You start at the most disabled patients.

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即使功能比较基础,也能带来最大的好处。

You get the most benefit for even relatively basic functionality.

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像我就不觉得你我会想去用那些现在市面上的皮层运动解码器,毕竟键盘鼠标用起来已经很好了。

Like, I don't think that you or I would wanna get one of the cortical motor decoders that you might have seen out there today because the reality is that, like, a keyboard and mouse is, like, great.

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它的效率高得多。

It is a much higher performance.

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口语表达的速率能达到每秒40比特。

Can get spoken word is 40 bits per second.

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很多人打字都能达到每秒20比特左右。

Many people can type in 20 ish bits.

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所以每秒10比特的皮层运动解码,根本没法提升你的生活质量。

And so the 10 bit per second cortical motor decode is not going to make your life better.

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现在我可不会为了这个去冒做开颅手术的风险,但等技术更强大了,能更丰富地读取和双向调控更多脑区时,风险和收益的平衡就会变了。

I wouldn't get serious brain surgery for Now as it gets more powerful, and as we are able to produce kind of access richer representations for more of the brain, especially bidirectionally, then you will start to see the risk benefit change.

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我的看法是,健康年轻人短期内根本不会去装这个,但迟早有一天,很多人都会变成患者。

Like my my view on this is not that I think healthy 30 year olds are gonna be getting these soon, but eventually, many people become patients.

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衰老就像是所有东西都在慢慢变差的过程,总有个关键年龄,到了那儿,你就会觉得有必要恢复一些原本拥有的功能;再往后,情况就反转了——那些遭遇严重损伤的人,反而拥有了你都羡慕的能力。

Aging is like the correlate of kind of everything getting worse, and so there's some critical age where it kind of crosses over where it makes sense to have something that will restore some functionality that you had, and then eventually that will kind of cross the origin, and then you'll see people that had something terrible happen to them who now have a capability that you're jealous of.

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那时候,你才会真正看到变化开始发生。

And that will be when you start to see it changing.

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我想问问,那些从来没见过光的人,为什么视神经就没法正常运作呢?

Talk to me about how people who maybe never had sight why was the optic nerve not actually set up?

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这事儿不能在后来补救吗?

Is that not something that you can do later?

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大脑的可塑性在这儿起什么作用?

How does plasticity fit in?

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是不是得趁年纪很小、大脑还很有弹性的时候就用上脑机接口?

You know, do you have to get BCIs when you're incredibly young while the brain is still plastic?

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这些因素到底怎么凑到一块儿的?

Like, how does all this come together?

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神经可塑性这事儿特别有意思,但大家对它的理解常常是错的。

Neuroplasticity is really interesting and really misunderstood.

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早期发育确实有关键窗口期,错过了,有些能力以后就很难再建立起来。

There are genuine critical periods in early development that if you miss them, there are some things that will be very hard to wire up later.

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确实有生来就失明的人,但不是视神经出了问题。

There actually are some cases of patients that were born blind who but it wasn't it wasn't a loss of the optic nerve.

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也不是大脑受损,而是先天性白内障。

It wasn't something in the brain, but they had congenital cataracts.

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他们从出生起视力就模糊,从来没能形成清晰图像,后来成年做了手术矫正,结果根本没用。

So their vision was blurry from birth, and they were never able to really form images who then had this fixed as adults, and that did not work.

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他们的大脑根本处理不了接收到的视觉信息。

Like, this was they didn't their brain could not make sense of the information.

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太混乱了,完全受不了。

It was totally overwhelming.

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有些人只好戴眼罩。

They would wear eye patches.

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其中好几个后来自杀了。

Several of them committed suicide.

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天哪。

Oh my god.

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所以早期发育确实有明确的关键期,错过了就有些事根本做不成了。

And so there is there are clear critical periods in early development where if you miss that, some things are not gonna work.

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不过话说回来,大脑在人的一生中,甚至成年后,可塑性都远比大多数人想的要强得多。

With that said, the brain stays way more plastic throughout life and adulthood than I think is is widely appreciated.

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这让人松了口气。

That's a relief.

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没错。

Yeah.

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要是我在你大脑的几乎任意位置植入一个电极,然后在手术中把你叫醒,再给你看一个闪烁的光——光闪的频率正好对应那个神经元的放电强度——在皮层的绝大多数区域,你几分钟内就能学会控制那个神经元。

If I put an electrode almost anywhere in your brain and then wake you up in during surgery, and I show you a flashing light that is that flashes proportionally to how much that neuron is firing, at least almost anywhere in cortex, within a couple minutes, you can learn to control, like, that neuron.

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所以大脑在有反馈的情况下非常灵活,这也是皮层运动解码器能工作的部分原理。

And so the brain is very plastic under feedback, and this is partly how the the cortical motor decoders work.

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其中一部分是,我们其实是在解读大脑原本用来代表手或手臂的信号。

Some of it is you're decoding what the brain was originally representing in terms of, like, a hand or arm representation.

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但如果你把大脑发出的信号提取出来,再给患者反馈,告诉他们这些信号在做什么,大脑也会反过来适应你。

But also just if you're getting these signals out of the brain and you're giving the patient feedback for, like, what those signals are doing, then the brain also adapts to you.

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所以在最早做这个实验的时候,他们根本没做任何校准。

And so in the first experiments for this, they actually didn't fit anything at all.

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他们只是挑了两三个神经元,或者一小撮,然后把权重固定下来。

They just put took a couple they took two neurons or a handful of neurons and fixed the weights.

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也就是说,当这个神经元更活跃时,屏幕上的光点就往上走。

So it said when this neuron fires more, we're gonna go up the screen.

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当这个神经元更活跃时,光点就往下或往侧面移动。

When this neuron fires more, we're gonna go down the screen and sideways.

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他们把参数定死,然后让大脑自己去摸索、去学习。

They fixed the weights and let the brain figure it out, let the brain learn.

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再说一遍,大脑在反馈机制下非常灵活,完全能做到这一点。

And again, the brain is very plastic under feedback and can do this.

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这真是个震撼的时刻。

What a powerful moment.

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你瞧,我们有两个可以互相学习的系统,而不是靠死板的if语句来控制。

You have a learn we have two learning systems that can learn off of one another instead of a fixed one with if statements on this side.

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完全对。

Totally.

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没错。

Yeah.

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大脑要是能接收到皮层传来的信息,真的特别擅长从中提炼出意义。

And the brain really if you give the cortex information, it is really good at extracting the meaning.

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到了成年以后,我觉得你之所以觉得大脑没那么灵活,是因为它早就跟现实磨合得差不多了。

Now in adulthood, I think one of the reasons that you don't see it as being so plastic is because it has already fit well to reality.

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你可以把它想象成一个能量地形,大脑的状态就像这个地形上的山丘和山谷。

And so there's like, if you think of it as this, like, energy surface and the state of brain states is this like, you've got these hills and valleys.

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在正常发育过程中,对大多数人来说,这个能量地形上会形成一个巨大的洼地。

So during normal development, typically, for most people, there's this enormous basin in this energy surface.

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所以大多数人发育时,都会慢慢滑进这个洼地,然后就稳稳地停在那里,因为已经跟现实完美适配了。

And so for most people, during development, you descend into this basin, and then you're down there, and it's stable because you've fit to reality.

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如果我给你看些怪异的电影,也很难把你从这个状态里拉出来。

And if I show you, like, weird movies, it's not gonna really push you out of that.

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我觉得有一种理论说,致幻剂的作用可能是像退火一样,让这个能量表面稍微收缩一点,让你能接触到其他状态?

You can I think, like, one of the theories of what psychedelics do is they kind of add kind of anneal it, so it kind of shrinks the surface a little bit so you kind of access these other states?

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但一旦药效过去,你又会立刻重新跌回大脑已经适应的那个能量深谷里。

But then when it wears off, you just immediately descend back down into the energy well that the brain had fit to.

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所以即使大脑依然有可塑性,它也陷在吸引子系统的稳定区域里,因此你很难察觉到这种可塑性。

And so even though the brain's still plastic, it is in this stable, like, part of the attractor system so that it doesn't you don't see the plasticity as much.

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但这其实是进化选中的。

But this was selected for.

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这绝对是进化选中的。

And this was absolutely selected for.

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对。

Yeah.

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所以这里其实存在一种张力:可塑性确实一直在持续。

And so there's this tension between there absolutely is ongoing plasticity.

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如果没有可塑性,你就没法学新东西。

If there wasn't plasticity, you couldn't learn things.

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所以啊,你学习新东西、形成记忆的能力,本质上就是这么回事。

And so, like, your ability to learn new stuff is like and have memory.

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说白了,所有的记忆,归根结底都是大脑的可塑性在起作用。

Like, all memory is brain plasticity in many ways.

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我们其实时刻都在经历剧烈的神经可塑性,但它的范围也有明显限制——特别是到了关键发育期之后,大脑各个区域之间的连接就固定下来了。

And so we are constantly experiencing very dramatic plasticity, but there are also clear limits to it, especially in how the modules of the different brain areas end up interconnected past these critical periods.

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我有一大堆问题,说实话。

I have a million questions, honestly.

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我特别好奇的一点是,那个有‘ prima ’体验的人,他的主观感受到底是什么样的?

One of the things that I'm super curious about is, well, what is the qualia of the person who has prima?

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如果用生物混合的方式,那种感觉又是怎样的?

And I'd be curious with the biohybrid approach, what does it feel like?

Speaker 1

会不会就像多了一块屏幕在那儿?

And, you know, is it like having a second screen?

Speaker 1

就是说,有输入和输出吗?

Like, you know, is there an input or output?

Speaker 1

我特别好奇。

I'm very curious.

Speaker 0

对。

Yeah.

Speaker 0

关于Prima,说到可塑性,当病人失明时,大脑其实很想‘看’东西。

So for Prima, actually, on the topic of plasticity, in the time that the patients are blind, the brain the brain wants to see.

Speaker 0

说白了,你所体验的,是大脑构建出来的世界模型,这是一种生成模型,它在主动创造你的现实。

Like, again, you the thing you experience is this world model constructed by the brain, and that is this is this generative model that is conjuring your reality.

Speaker 0

所以当视觉神经没有输入时,大脑还是会拼命想‘看’,于是就加大了内部的噪音。

And so when it's not getting input from the from the optic nerve, it is still trying to see things, so it kind of turns up the noise.

Speaker 0

很多盲人患者都会报告说,他们会有幻觉,或者一些自己脑子里冒出来的感知。

And so blind patients often report, like, hallucinations and these, like, internally generated percepts.

Speaker 0

当你第一次给这些患者打开植入装置,比如用激光激活时,他们会说:‘我看到一道闪光。’

When you first turn on the implant in these patients, like, you hit it with the laser, they'll they'll say, oh, I see a flash.

Speaker 0

但你可以这么做:打开激光,他们看到闪光,同时播放一个声音。

But then you can do a thing where you'll you'll turn on the laser, they'll see a flash, and you'll you'll play a tone.

Speaker 0

重复几次之后,你就不开激光了,只播放声音,他们却说:‘我看到闪光了。’

And you do this a couple times, and then you, like, don't turn on the laser, but you play the tone, and they're like, I see the flash.

Speaker 0

所以在康复的头几个小时里,他们得慢慢学会区分真实感知和幻觉,因为大脑的增益调得太高了,噪音底噪压得太低,光是学会分辨来自视神经的真实信号,就得花点时间适应。

And so for the first couple hours of rehab, they kind of just have to, like, learn to, like, dissociate the real percepts from the phantom percepts because the brain is, like, so it is, like, so turned up the gain, like, turned up turned down the noise floor that just, like, getting learning how to discriminate real information coming in from the optic nerve takes a little bit of rehab.

Speaker 0

PRIMA带来的视觉体验,跟正常视力没什么区别。

The qualia of PRIMA is normal sight.

Speaker 0

是黑白的。

It's black and white.

Speaker 0

视野范围很小,但确实是视觉。

It's only a it's a small field of view, but it's vision.

Speaker 0

更深层的问题是,一个超高带宽的脑对脑生物混合神经接口,它的主观体验到底是什么样的?

The deeper question is, like, what is the qualia of, like, a brain to brain, of, like, an ultra high bandwidth, like, a biohybrid neural interface?

Speaker 0

这个我真的想象不出来。

And that is just like, I don't like impossible to imagine.

Speaker 0

这些设备迟早会造出来,咱们就等着看吧。

Those devices will get built, and we're gonna find out.

Speaker 0

不过呢,现实中还真有一些天然的案例。

But there are some natural case studies.

Speaker 0

加拿大有一对连体双胞胎,说白了就是同一个脑袋,却有四个脑半球。

So there's a pair of conjoined twins in Canada that it's really like one head with four hemispheres.

Speaker 0

特别有意思的是,每个双胞胎自己的两个脑半球是正常连接的,但他们俩之间除了有一根缆线连着丘脑到丘脑,其他地方完全不互通。

And what's really interesting is that the two hemispheres of each of the twins' brains are connected normally, but they're not connected with each other except for this one cable connecting the thalami, like, from the thalamus to thalamus.

Speaker 0

这根巨大的生物缆线,在核磁共振图像上清清楚楚看得见。

There's this big biological cable that you can see on an MRI.

Speaker 0

靠着这根线,他们能共享一些真实的意识体验。

And over this, they can share meaningful elements of their conscious experience.

Speaker 0

目前还没人深入研究的一个问题是:他们某种程度上能透过对方的眼睛看东西,但这会形成新的视野吗?

And one of the open questions that hasn't really been studied in the depth that I would love to see it is when they they can see to some degree through each other's eyes, but does this show up as new visual field?

Speaker 0

我的意思是,这种体验到底是怎么直接发生的?

Like, how is this how do those get experienced directly?

Speaker 0

其实大多数人本来就有两种图像模式。

Like, we already most people have two image modes.

Speaker 0

比如,你有睁眼看到的现实画面,也有想象出来的画面。

Like, you've got your eye open vision, but you also have imagination.

Speaker 0

有些人是想象缺失症,脑子里根本没法生成图像。

Some people are aphantasic, and they don't have internal imagery.

Speaker 0

大多数人其实都有这两种图像模式。

Most people have kind of two image modes.

Speaker 0

那他们是三种还是四种图像模式呢?

Do they have three image modes or four image modes?

Speaker 0

而且他们各自都有内心独白,但还能通过这条通道清晰地交流——他们做过一些任务,根本不用说话,就能默契配合。

Or if they have internal monologue, they they seem to each individually have internal monologue, but they also can clearly communicate over this channel because they've done they've done tasks where, like, they can coordinate without saying anything to do stuff.

Speaker 0

他们自己也清楚这一点。

And they're conscious of it.

Speaker 0

他们自己也清楚这一点。

And they're conscious of it.

Speaker 0

而且他们也不会把这两种体验搞混。

And also, they don't confuse it for each other.

Speaker 0

这跟精神分裂不一样,不是那种‘我听见声音了,这声音是我脑子里自己冒出来的’那种情况。

It's not like with a schizophrenic where it's like, oh, I'm hearing voices, and they're coming from internally generated me.

Speaker 0

他们不会把内心独白错当成外界的声音。

It's misattributed monologue.

Speaker 0

这种事不会发生在他们身上。

That doesn't happen to them.

Speaker 0

他们能清楚分辨出来。

They can tell it apart.

Speaker 0

但他们确实是以某种方式直接体验着这些。

But they're experiencing it directly in some way.

Speaker 0

所以这就引出一个问题:当你看那根电缆时,他们是在用传统方式传递信息,还是说,这根电缆上发生了某种‘现象绑定’——就像大脑左右半球被连成一体、共享同一时刻的体验那样?

And so there's a question of is this like, when you look at that cable, are they sending the, like, information in the classical way, or is this is there an effect of phenomenal binding happening over this cable where it's more like the two hemispheres of your brain that are bound together into one moment?

Speaker 0

这些自然案例告诉我们,这里头可能藏着一些非常有趣的现象,但要想象那种感受到底是什么样,还真不容易。

And so there's these natural case studies that tell us that some really interesting things might be possible here, but it's kind of tough to imagine what it would feel like.

Speaker 1

你给我们描绘一下吧。

Paint the picture for us.

Speaker 1

你知道,你现在就在这儿。

You know, you're here.

Speaker 1

一切进展得特别特别顺利。

Everything goes really, really well.

Speaker 1

五年到十年后,这项技术会发展到什么地步?

Where are we in five to ten years with this technology?

Speaker 0

你觉得能接近正常人的视力吗?就是那种20/20的清晰度。

I mean, do think that you can get to close to native acuity, so kind of like your normal 2020 vision.

Speaker 0

我们现在还没达到,但我能看到一条路,能实现色彩还原,覆盖大部分视野——不过得说清楚,现在还远没到那一步。

We're definitely not there yet, but I see a path to get there and be able to get color and fill in a lot of the field of view, to be clear that it's not where we are right now.

Speaker 0

但我觉得,未来十年内,这完全有可能实现。

But in the next ten years, I think that that's possible.

Speaker 0

再往远了说,我们公司的核心理念,或者说我的看法是:医学可以有两种路径,一种是药物研发,另一种是神经工程。

But beyond that, I'd say that our worldview or my worldview, kind of the motivating idea behind the company, is you can contrast this this like, there's like a drug discovery approach to medicine versus a neural engineering approach to medicine.

Speaker 0

我的意思是,这比视网膜植入物的范围要广得多。

I mean, this is much broader than the retinal prosthesis.

Speaker 0

我们从这个开始,是因为它需求巨大,而且我觉得这是目前最有可能实现、最有价值的脑机接口产品。

We started with that because it's a huge unmet need, and I think it's the most valuable BCI, like, product on the, like, on the horizon that I thought was doable now.

Speaker 0

人类在药物研发上真的不太行。

Humanity just isn't very good at drug discovery.

Speaker 0

偶尔吧,你才能碰上一个有效的。

Every now and then, you kind of find a thing.

Speaker 0

这事儿太神奇了。

It's amazing.

Speaker 0

比如你碰上了GLP-1,或者运气好发现那么几个药,但更多时候,你花十年时间埋头苦干,最后做临床试验,结果却是‘不行’,然后你就不知道该往哪儿走了。

Like, you find a GLP one or you find like, there's every like, there's a handful of drugs that are we were lucky to find, but it's much more common that you spend a decade going down this path, and then at the end, you run a study, the answer is no, and then it's like, where do you go from there?

Speaker 0

为了阻止失明恶化、甚至恢复视力,人们投入了海量研究,但几乎没什么成效。

There's been a huge amount of work that's gone into finding drugs to stop blindness getting worse, or to reverse it and restore vision, to basically no effect.

Speaker 0

有一种基因疗法,每个病人要花一百万美元,但对绝大多数患者来说,效果微乎其微,甚至根本没有。

There's a million dollar per patient gene therapy that has really very marginal, if any, benefit to a very small percentage of patients in the first place.

Speaker 0

在我们的视网膜植入试验中,我们看到,有些患者十年来连人脸都看不见,现在却能看清视力表上的每一个字母。

And with our retinal prosthesis, what we saw in the trial, was we can take a patient who's been unable to see faces for a decade and allow them to read every letter on an eye chart.

Speaker 0

大脑不仅是唯一真正重要的器官,从实际操作来看,我们在改造它方面也远比其他器官更在行。

And so not only is the brain the only organ that really, in some deep sense, matters, we are also just empirically much better at engineering it.

Speaker 0

这让我们对医学的根本认知有了一个彻底的转变。

And so I think this allows a really fundamental reframing of medicine.

Speaker 0

未来十年,你只需要能看见、听见、保持平衡,再有每秒一千比特的运动控制能力——就像你本来那样。

And over the next decade, I think beyond, you only need be able to see, hear, have balance, have a kilobit per second of motor control that is like you.

Speaker 0

我们已经有耳蜗植入,也懂怎么解码运动信号,唯一一直搞不定的是恢复视力,但现在我们真的在突破。

And think we have cochlear implants, we know how to do motor decoding, the thing we didn't know how to do is restore vision, we're making real progress on that.

Speaker 0

我觉得这一切加起来,说明医疗领域正迎来一场根本性的范式转变,可能性比我们想象的大得多。

I think all of this adds up to something that speaks, I think, to the really foundations, like this paradigm shift in what's possible in health care.

Speaker 1

这种东西,我记得十年前,甚至二十年前就看过相关报道。

Something like this, I remember reading about maybe ten, maybe even twenty years ago.

Speaker 1

那时候他们已经能用电刺激视神经,但分辨率低得可怜。

They were able to stimulate the optic nerve with electricity directly, but it was very, very low resolution.

Speaker 1

而且那方法太侵入性了,基本只能在医院或手术室里做。

And it was so invasive that it could probably only be done in a clinical setting or in a surgical setting.

Speaker 0

要让病人看到闪光其实挺简单的。

It's relatively easy to get flashes of light to cause a patient to kind of see these flashes.

Speaker 0

我们管这叫光幻视。

We call these phosphines.

Speaker 0

十年前有个叫Second Sight的公司,他们把电刺激器植入了患者眼睛里。

There was a company a decade ago called Second Sight that had an electrical stimulator that was implanted in the eye.

Speaker 0

手术要四个半小时,眼睛旁边还装了个钛合金盒子。

It was a four and a half hour surgery with a titanium box on the side of the eye.

Speaker 0

他们刺激的是跟我们不一样的细胞层,能让人看到一些闪光——比如病人一看,就能说:‘哎,这儿有几道光。’

It stimulated a different layer of cells than we do, and they were able to get these flashes where, like, if a patient looked at it, they could could say, like, oh, there's some flashes here.

Speaker 0

这儿有几道光。

There's some flashes here.

Speaker 0

这玩意儿是连着的。

It's connected.

Speaker 0

哦,这是个a。

Oh, that's an a.

Speaker 0

他们当时在展示下一个字母,然后就说,这儿也有几个光点。

And they were showing, like, the next letter, and it's like, there's some here.

Speaker 0

这儿也有几个光点。

There's some here.

Speaker 0

这是个h。

It's an h.

Speaker 0

但大脑并不会把这些光点自动拼成一个完整的图像,像在脑子里形成一个字那样。

But it doesn't the brain doesn't assemble together these flashes of light into, like, a gestalt hole that is an image in the mind's eye.

Speaker 0

同样,当你刺激大脑后部的视觉皮层时,也能引发这些光点,有时候甚至能引发很多。

Similarly, when you stimulate cortex, like the back of the head where the visual cortical areas are, you can get these flashes of light, and you can even in some cases get a lot of them.

Speaker 0

但again,这更像是种迷幻的效果。

But again, the brain it's kind of this more psychedelic effect.

Speaker 0

这些光点并不会被大脑整合成有形状的视觉。

Like, this doesn't get assembled together into form vision.

Speaker 0

据我所知,我们的临床试验是史上第一次让人在脑海中形成清晰图像的视觉体验。

And as far as I know, our clinical trial was the first time ever that form vision had been like, had created a coherent image in the mind's eye of a of a person.

Speaker 1

黄斑变性有什么特别之处,让这群患者能实现这种效果?

Is there something specific about macular degeneration that causes this to be possible for this set of patients?

Speaker 0

人失去视杆细胞和视锥细胞的原因有很多。

So there's a bunch of reasons why people lose rods and cones.

Speaker 0

比如黄斑变性。

There's macular degeneration.

Speaker 0

还有视网膜色素变性。

There's retinitis pigmentosa.

Speaker 0

也有些罕见的遗传病,像斯达加特病。

There's some rare, like inherited diseases like Stargardt's disease.

Speaker 0

糖尿病视网膜病变也会导致。

Diabetic retinopathy can do it.

Speaker 0

年龄相关性黄斑变性是最常见的。

Age related macular degeneration, it's the most common.

Speaker 0

所以这在全球影响了两亿人。

So this globally affects two hundred million people.

Speaker 0

其中严重的形式——地图样萎缩,大概有一到两百万人。

The severe form geographic atrophy is is a million to a couple million.

Speaker 0

从这个角度看,需求非常大。

In that sense, it's a big need.

Speaker 0

我们设备的一个优势是,它对导致感光细胞丧失的原因基本不挑。

One of the nice things about our device is that it doesn't we're somewhat agnostic to the reason that you lost the photoreceptors.

Speaker 0

所以我们觉得它对视网膜色素变性、斯格特病,以及其他类似病症也都有效。

And so we we think it'll also work for retinitis pigmentosa, for Stargardt's, for these other indications.

Speaker 0

我们马上就要启动一项针对遗传性视网膜疾病的全新临床试验,患者普遍更年轻。

We're actually just about to start a new clinical trial on uninherited retinal disease, which affects much younger people.

Speaker 0

这其实又回到了药物研发和神经工程这两种不同思路的对比。

And this, again, this goes back to, like, the drug discovery versus neural engineering view of the world.

Speaker 0

如果你想开发一种药,那你得特别关注视杆细胞或视锥细胞里具体出了什么分子层面的问题,而每种病的情况都不一样。

Like, if you wanna make a if you wanna make a drug, then you care a lot about exactly, like, what molecularly went wrong in the rod or cone, and that is different by disease.

Speaker 0

就算你搞明白了这个问题,要怎么解决它还是特别难。

Then even if you figure this out, it's really hard to, like, understand what to do about it.

Speaker 0

在这里,我们其实不关心视杆细胞为什么会出问题。

Here, we don't really care why the rods are coinciding.

Speaker 0

我们只关心能不能把视觉信号重新传回计算机。

We just care that we can get the the visual signal back into the computer.

Speaker 1

我觉得吧,作为计算机科学家,我们平时老在琢磨输入和信号这些事,所以特别着迷。

I guess I'm just very fascinated by obviously, as a computer scientist, we spend a lot of time thinking about inputs and signals.

Speaker 1

而我听到的是,这种思维方式居然真的能从软件迁移到生物系统里。

And then what I'm hearing is that some of that thinking does actually translate from software into wetware.

Speaker 0

我的意思是,大脑其实就是一台计算机。

Well, mean, the brain is a computer.

Speaker 0

这么说可能会惹恼某些领域的专家,但我觉得这话差不多可以字面理解。

It's gonna saying that is gonna get me yelled at by some corner of the field, but I think that you can take that almost literally.

Speaker 0

它的架构跟冯·诺依曼那种电子计算机完全不同,但它确实在处理信息。

It's a very different architecture than a Von Neumann architecture electrical computer, but it processes information.

Speaker 0

信息通过12对脑神经或31对脊神经传入传出,也就是说,所有进出大脑的信息都靠这寥寥几条‘线缆’传输。

It gets information down one of 12 cranial nerves or 31 spinal so all of the information that flows in and out of the brain goes through a small number of cables.

Speaker 0

视神经,我们叫它第二对脑神经。

The optic nerve, we call cranial nerve two.

Speaker 0

前庭蜗神经,负责听觉和平衡,是第八对脑神经。

The vestibulocochlear nerve that carries hearing balance, cranial nerve eight.

Speaker 0

还有31对脊神经,负责把指令传到肌肉,同时把感觉信息送回大脑。

There's 31 spinal nerves that carry commands out to the muscles and sensory information to the brain.

Speaker 0

你可以把这看作是大脑的‘接口API’。

And you can think of that as like the API of the brain.

Speaker 0

只要你能把所有信号都通过这些神经传进去,那大脑就不是神秘地直接连着外界的。

And if you can get all the signals going down those, then that's like the brain is not magically connected to the environment.

Speaker 0

现实到底是什么,其实就是脑神经和脊神经上那些电脉冲的组合。

It is reality is whatever spikes are on the cranial and spinal nerves.

Speaker 0

从这个角度来说,你其实已经拿到了一个清晰定义的接口。

And in that sense, you've got this well defined interface to it.

Speaker 0

然后到了处理阶段,一旦大脑接收到这些信息,事情就变得极其复杂了。

Then with the processing, once it gets this information, it's enormously complicated.

Speaker 0

它构建了我们所体验到的一切。

It constructs everything we experience.

Speaker 0

我觉得很重要的一点是,你要意识到,你感觉自己是真实存在于这个世界里的。

Like, I think it's important to appreciate you experience yourself being in the world.

Speaker 0

你看到墙、房间、灯光,所有这些东西。

You kind of see the walls and the room and the lights and everything.

Speaker 0

但其实你并没有直接体验到它们。

But that, of course, you're not experiencing directly.

Speaker 0

你体验到的是大脑为你构建出来的一个世界模型。

You're experiencing a world model, like, fabricated by your brain.

Speaker 0

不过我觉得,人工智能的发展带来了一个很有趣的现象:神经科学和AI正在走向大融合。

But I think one of the interesting things that's come out of progress in artificial intelligence is we're seeing this big unification in neuroscience and and AI.

Speaker 0

我们实际上从AI研究中学到了很多,多得超出了我原先的预期。

I think we're actually learning a lot from AI research, more than I think we thought we would learn from AI research.

Speaker 0

十年前,我们还以为会是反过来——是AI领域的人从神经科学中学到很多,结果恰恰相反。

I can tell you ten years ago, we thought it would go the other way, that the AI people would learn a lot from neuroscience, and it's really been the other way around.

Speaker 1

我一直很好奇。

I'm always curious.

Speaker 1

你提到那种第二视觉的闪光,那你是怎么搞清楚这个接口的?

I mean, you're mentioning second sight flashes of light, and yet here, how did you figure out the API?

Speaker 1

要是让我来逆向工程,我

If I was trying to reverse engineer it, I

Speaker 0

我大概会先试着测量那些信号。

guess I would try to measure the signals.

Speaker 0

生物学里也是这样吗?

Is it similar with biology?

Speaker 0

测量这些信号真的很难。

It's difficult to measure the signals.

Speaker 0

所以,人机接口的研究和发展,受限于我们记录和刺激这些信号的能力。

So computer interface research and development is limited by your ability to record and stimulate these signals.

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相比之下,神经科学其实挺简单的。

The neuroscience comparatively is actually pretty simple.

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只要你能记录下这些信号,我们很快就搞清楚了所谓的神经表征到底是什么。

As soon as you can record these signals, we've very quickly figured out what we talk about neural representations, what they are.

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第二视觉这个现象特别有启发性。

Second sight's instructive.

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在视网膜里,真正关键的有三层细胞。

So in the retina, there's three layers of cells that matter.

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有大约一亿五千万个视杆细胞和视锥细胞。

There's a 150,000,000 rods and cones.

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它们连接着一亿个双极细胞——叫双极是因为它们两端都连着,再由这些双极细胞连到一百五十万个视神经细胞。

This connects to a 100,000,000 bipolar cells, bipolar because they've got two ends, and that connects the rods and cones to 1,500,000 optic nerve cells.

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我们管它们叫视网膜神经节细胞。

We call them retinal ganglion cells.

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‘神经节’这词听着挺高大上,其实就是指那些伸得很远、连到别处的细胞。

Ganglion is like a fancy word for, like, reaches a far distance and connects to somewhere.

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我们刺激那1亿个双极细胞。

We stimulate the 100,000,000 bipolar cells.

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第二代设备直接刺激那150万个神经节细胞,目的是把信号传进大脑,绕过这100倍的压缩。

Second site stimulated the 1,500,000 ganglion cells, and so they were trying to get the signal into the brain past that 100 x compression.

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其实视网膜在那儿已经做了大量计算了。

And the retina was doing a lot of computation there.

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相机的光线是从前面照进来的。

The eyes of camera light shines in from the front.

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光线就这么打在视杆细胞和视锥细胞上。

It hits the rods and cones like that.

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视杆和视锥细胞里的信息,其实就是一个像素映射图。

The representation in the rods and cones is a bit mapped image.

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就像你把一张图直接铺满整个视杆和视锥细胞层。

It's just like you take the image, you tile it across the rods and cones.

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就这么回事。

And that's what that's what it is.

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是的

Yeah.

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现在这150万个视神经细胞就不是这么回事了。

Now in the the 1,500,000 optic nerve cells, it's not like that.

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如果你直接把图像投射到它们上面,出来的全是乱码。

Like, if you just project an image onto them, you get a bunch of trash.

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因为到这一步,图像已经被压缩成边缘、相对运动、一堆 blob 形状和颜色信息了。

Because at that point, it's already compressed things like edges, relative motion, a bunch of other blobby shapes, color.

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所以如果你刺激其中一个细胞,不会只看到一个像素点。

And so if you stimulate a cell there, you're not gonna get just like a pixel.

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你看到的会是某种边缘模式,比如方向梯度之类的东西。

You're gonna get some edge mode, like direction gradient thing.

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当你激活它的时候,根本没法精准控制——首先我们做不到那么精细的控制,其次我们根本不知道这个编码规则。

And when you excite that, you can't do that selectively because we don't first of all, you just can't do it selectively enough, and we don't know the codec.

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我们根本不知道该怎么正确地设计这种模式。

We don't know know how to pattern it appropriately.

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所以你最后看到的是一闪一闪的光。

And so you end up getting these flashes of light.

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我们研究中偶然发现,如果你用图像刺激双极细胞,人脑里就会出现图像——因为这正是视网膜中你最想保留的关键处理步骤。

It was an empirical discovery of our study that if you excite the bipolar cells with an image, you get an image in the mind's eye, because that is clearly the critical processing step in the retina that you wanted to preserve.

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你们一开始就知道会这样吗?还是试了各种不同的部位才找到的?

Did you know that that would happen, or did you have to try different parts?

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我们创办公司的时候,跟大多数医疗设备或生物技术公司不太一样。他们通常围着某一项资产转,比如一项专利,或者从大学里孵化出来的某个具体技术,又或者是创始人之前做过的东西。

When we started the company, we, I think, were a little bit different than most medical device or biotech companies, because they're often bounded around a specific asset, like a patent or some specific piece of IP that they're gonna spin out of a university or maybe something that the founders have worked on.

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我们不是这样的。

We weren't like that.

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一开始我们其实有好几个想法。

We did we had a couple ideas at the beginning.

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我们是从神经工程的角度来看待医疗健康的。

We had this, like, neural engineering centric view of health care.

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我们当时有个具体的脑机接口探针想法,是做生物混合方向的,但也觉得,短期内最有价值的,还是做个视网膜假体。

We had a specific BCI probe idea in in biohybrid, and we had a sense that the most valuable thing that we could build in the near term was a retinal prosthesis.

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我们觉得时机已经成熟了。

We thought the time was there.

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那时候技术其实都到位了,2021年完全能做到。

Like, the technology was all there that that would be possible circa 2021.

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而且这跟以前我做的东西差别挺大的,所以觉得正好适合我们去探索一下。

And that was also further from stuff that I had worked on before, and so it felt like a a good thing for us to to kind of go explore.

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我觉得我们是从最根本的原理出发的。

I think we took this very, like, first principles approach.

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但在生物学里,你得小心用第一性原理,因为光靠第一性原理是不够的。

And you have to be careful with first principles in biology because first principles are not enough in biology.

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在其他工程领域,这招能带你走很远。

Like, they'll get you very far in many other areas of engineering.

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但在生物学里,你还得搞清楚:进化到底干了些什么?

But in biology, you also have to understand, like, what did evolution actually do?

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这里面的门道多着呢。

And there's a lot of other nuance there.

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但这次我们盯上了视网膜。

But in this case, we we looked at the retina.

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本来大家觉得,这事儿肯定难得多,也有这么点直觉。

There were kind of reasons, intuitions to think that past that would be much harder.

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视网膜里头呢,是个2乘2的矩阵结构。

And so in the retina, you've got this two by two matrix.

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你得做个选择。

You've got a choice.

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要是视杆细胞和视锥细胞都坏了,你是刺激双极细胞,还是刺激视神经细胞?用电刺激,还是用光遗传学那套方法?

So do if you've lost the rods and cones, do you stimulate the bipolar cells or the optic nerve cells, and do you do it electrically or with a technique called optogenetics?

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我们就把这四个方向全都试了一遍。

And we just went and explored all four quadrants of that.

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很快我们就发现,直接刺激视神经细胞根本行不通。

We very quickly figured out that stimulating the optic nerve cells is very difficult for these reasons.

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得给每个病人做上百万个参数的校准,现实中根本做不到。

You end up with this like 1,000,000 degree of freedom calibration that you have to do per patient that can't be done in practice.

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所以我们转向了双极细胞,也就是在压缩之前的研究方向。

And so that led us to the bipolar cells, which was before this compression.

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于是他们问,是用电刺激还是用光遗传学方法来刺激它们?

And so then their question was, do want stimulate them electrically or using optogenetics?

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我们两种都开发出来了。

And we developed both.

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我们自家已经研发出顶尖的光遗传基因疗法,去年秋天还发表了一篇论文,讲的是目前世界上最灵敏的光遗传系统。

And so we have a state of the art optogenetic gene therapy in house, published a paper last fall on on the world's most sensitive optogenetics.

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光遗传蛋白就是一种能被表达在神经元里的蛋白质,能让原本对光不敏感的神经元变得对光有反应。

Optogenetic proteins, these are proteins that you can express in a neuron to make a neuron that is not normally light sensitive responsive to light.

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天啊,真厉害。

Oh, wow.

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但问题是,传统的光遗传蛋白得用强激光才能激活。

But the drawback was that the conventional optogenetic proteins take a bright laser to activate them.

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所以我们找到的这些光遗传蛋白,灵敏度高到连普通办公室的灯光就能激活它们。

And so what we were able to do were find optogenetic proteins that are so sensitive that they're sensitive to indoor office lighting.

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所以这个技术可以用在很多不同的地方,我们还能专门把它用到双极细胞上。

And so this, you could use in very different ways, and then we could target them to the bipolar cells.

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但就算最后能成功,临床转化还得五到七年,中间不知道要踩多少坑。

But that still has, like, five to seven years of clinical translation away if it ends up working, there's a bunch of pitfalls it could run into along the way.

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然后我们还全面调研了一下,看看目前电刺激领域最顶尖的技术是什么。

And then we also just surveyed the world to see what was the state of the art for the best out there in electrical stimulation.

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之前斯坦福十几年前发明过一项技术,后来一家欧洲小公司一直在默默推进,我们一看就觉得这路子对,于是几年前就把他们收购了。

And there was this technology that had been invented at Stanford about a decade ago that a small company in Europe had been kind of developing in the meantime, and we got convinced that that was the right way to go, and so we acquired them a few years ago.

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这一切其实都是从一个宏观视角出发的:如果想恢复视网膜视力,到底该怎么下手?

And this was kind of all from this bird's eye view of if you wanna restore vision in the retina, kind of how would you do that?

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哪些方向最有希望?

What are the promising approaches?

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把范围缩小之后,我们就走到了今天这一步。

Narrow that down, and that brought us to here.

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这太疯狂了。

That's insane.

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这也太酷了。

That's so cool.

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我想聊聊你早期是怎么踏入科技领域的。

I wanted to jump to your start in tech broadly.

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你是一开始就搞生物、软件和工程的吗?

I mean, did you start in bio and software and engineering?

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你是怎么一步步走到今天的?

What was your sort of journey into what you're doing now?

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你现在的事业——让人重见光明,简直太疯狂了。

Which is, I mean, giving people blindsight is the wildest thing.

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观众可能在想:听多了B2B SaaS,可我到底该怎么变成你这样的人?

People watching might be asking themselves, well, hear a lot about B2B SaaS, but, you know, how do I actually become something more like you?

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我确实一直做软件,最拿手的硬技能就是编程。

I was certainly doing software, and my deepest hard skill is software.

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我虽然学的是生物医学工程,但打小就写代码。

I have a degree in biomedical engineering, but I grew up programming.

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所以我做软件的时候,还没碰过任何生物技术呢。

So And I was doing that well before I was doing any biotech stuff.

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我爸妈总跟我讲,我小时候坐在巴诺书店的地板上,哭着要他们给我买一本Visual Basic的书。

My parents tell me a story about how I sat on the floor of a Barnes and Noble and cried until they bought me a learned visual basic book.

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我一直对大脑特别着迷。

I was always interested in the brain.

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我确实深受科幻作品的影响。

I was definitely inspired by science fiction.

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《黑客帝国》对我影响特别大,不只是因为那个全是代码构成的世界听起来太酷了,更因为它触动了我一些根本性的想法。

The matrix had a big impact on me, both because the idea of this, like, world of bits was just so alluring for for a bunch of, like, fundamental reasons.

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你看这个世界,想造点东西真的很难。

Like, when I look around at at the world, like, it's hard to build things.

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空间太受限了。

Space is constrained.

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地球就这么点大。

It's like the Earth is small.

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资源竞争太激烈了。

The resources are intensely contested.

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空间倒是大得很。

The like, space is large.

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光速又慢得要命。

The speed of light is low.

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但在机器里,这些限制全都没有。

Like, you don't have any of those constraints in in the machine.

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所以如果你能模拟一个世界,那里面几乎啥都能实现。

And so if you could simulate a world, kind of anything was possible there.

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但反过来想,如果你真能造出这样一个世界,而且让人分不出真假,那就能得出一个结论:真正重要的,其实是大脑。

But then also, if you then kind of turn that inside out, if you realize that you can build this and that you couldn't tell the difference, then the corollary of that was there must be like the thing that matters is the brain.

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只要你能设计并支撑起大脑,其他所有东西都可以被替代。

And if you can engineer the brain and support the brain, then all the rest of it is replaceable.

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这想法明明这么深刻,可现实里却没人当回事,这让我觉得特别奇怪。

And that just seemed like a fairly deep insight that was not being borne out in the world in the way that it seemed like it should be.

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一部分在于,如果你能给这种意识提供正确的输入环境。

Some of it is if you can surround that consciousness with the correct inputs.

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对。

Yeah.

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这其实也引出了一个问题:意识到底是什么?

I mean, this also gets into questions of what is consciousness.

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大脑是怎么创造出我们的主观体验的?

How does the brain create our experience?

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现在网上有个说法,认为脑机接口只是人工智能的周边话题,说我们得把人和机器融合起来——我觉得这话确实有点道理。

There's this meme out there that BCI is an artificial intelligence adjacent story, and that the goal is to we need to have to merge humans and machines, and I do think that there's something to that.

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但我觉得更直接、更紧迫的是,我把脑机接口看作是与长寿和医疗健康紧密相关的事。

But I think in the more immediate thing here is that I see BCIs really a longevity, like, health care adjacent story.

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如果人工智能的终极目标是造出超级智能机器,那我觉得脑机接口的终极目标其实是造出有意识的机器。也许到最后我们会发现,根本没有任何外部测量能告诉我们某物有没有意识、它体验是什么样的,唯一能确定的,只有你自己的感受。

If the end of the quest of artificial intelligence are super intelligent machines, and I think the end of the BCI quest are actually conscious machines, it might turn out that there's actually no measurement that we can take that will tell us if something is conscious or not or what it's like, and the only thing that you can actually know on that is your own.

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所以如果真是这样,那想研究意识,我们就得靠脑机接口,亲自去‘看见’它。

And so if that's the case, then to study consciousness, we will need to use brain computer interfaces to see it for ourselves.

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等你搞定了这个,就能慢慢理解那里到底在发生什么根本性的物理原理了,不管是全新的物理规律,还是某种涌现现象。

And once you've developed that, then I think that you kind of can understand the fundamental physics of what's happening there, whether that's new fundamental physics or it's emergent in some way.

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但如果你能学会去把握大脑在利用的、宇宙本身允许的那种机制,迟早能造出超级智能又具备意识的机器,而我们能通过这些超高带宽的连接,真正融入其中。

But if you can learn how to build, like, kind of understand whatever the brain is taking advantage of that our universe supports, then eventually, get super intelligent conscious machines that we can be part of through these these ultra high bandwidth connections.

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我觉得,这跟现在大多数人对脑机接口的理解完全不一样。

I think that's a very different narrative than how people usually think about BCI today.

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我的意思是,我们现在才刚起步。

I mean, we're at

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对,才刚开始。

the beginning of that.

Speaker 1

对吧?

Right?

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是啊。

Oh, yeah.

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我们真的才刚刚开始。

We're at the very beginning of that.

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你现在的这个试验,带宽确实还比较低,但以后肯定会大幅提升是肯定的。

The current trial that you have, I mean, it's low it's relatively low bandwidth, but it's going to get much higher bandwidth.

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而且就像做任何事一样,你得先从能跑通的东西开始,而你现在的成果,本身就已经是个明显的突破了。

And then, I mean, like anything, you sort of bootstrap with the thing that works, which I think what what you have is a clear breakthrough as it is.

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再看看个人电脑的革命,谁能想到,今天我们用的这些东西,当初是从Altair里那个小蓝盒子起步的?

And then if you look at the PC revolution, for instance, it's like, could you believe that all of this that we have today started with a little blue box in Altair?

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这确实需要一点想象力,因为生物技术过去一直太循序渐进了。

It still takes some suspension of disbelief because I think biotech has just been so incremental.

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以前虽然也有大进展,但整体节奏太慢了,你花十年做一件事,感觉还是在原地打转。

Like, it's been so like, there's there's been big advances, but at the same time, these time constants historically, I mean, you could easily spend ten years on something that feels very incremental.

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但我觉得现在最让人兴奋的是,这种‘慢吞吞’的感觉真的没了。

And I think that one of the things that's so exciting about what's happening now is that no longer really feels so incremental to me.

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在我看来,我们现在已经真正进入起飞阶段了,地球上发生了全新的事情。

To me, feels like we're firmly in the takeoff era now, like something new has happened on Earth.

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不过也别忘了,这事可不是从2019年或者1999年才开始的。

But I think it's also important to remember that this didn't start in 2019 or 1999.

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这其实从19世纪末就开始了,工业革命刚要爆发那会儿,说白了,人类的生活方式几千年来都没啥根本变化。

This started in the late eighteen hundreds with the Industrial Revolution, Just a few years before the Industrial Revolution really kicked off, I mean, life was more or less unchanged in a fundamental sense for several thousand years.

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那时候的人甚至压根儿就没有‘进步’这个概念。

And they didn't really even have a concept of progress in many ways.

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他们根本没法想象,蒸汽机刚出来后的头十年、十五年,生活会变成今天这样。

And I don't think there's any way they could have imagined the way that their life would have changed over the course of the first ten, fifteen years of the steam engine.

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我现在看未来十五年,感觉就跟那时候一模一样。

And that is how I feel looking at the next fifteen years right now.

Speaker 1

是的。

Yeah.

Speaker 1

我们现在既有电刺激,同时也在做生物耦合。

I mean, so we have an electrical stimulation right now, and then at the same time, you also do have a biocoupling.

Speaker 1

这可不是单纯的电刺激那么简单。

Like, it's not purely just electrical.

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你觉得这是v2.0,还是说,算是下一个前沿?

Would you call it a v two or, like, sort of a next frontier?

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这完全是另一个领域。

So this is a totally different area.

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我的意思是,你或许可以用它来恢复视力。

I mean, the you might be able to use it for vision.

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我们那个电刺激设备PRIMA治不了青光眼,因为青光眼是视神经本身坏了。

So one of the diseases that PRIMA, our electrical stimulator, doesn't treat is glaucoma, which is loss of the optic nerve itself.

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理论上,我们的生物杂交BTI技术或许能用在那儿,但目前我们没往这个方向做。

And so it's possible that you could use our biohybrid BTI technology for that, but that's not what we're doing right now.

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我们在科学领域有三个主要方向。

There are three elements to our pipeline at at Science.

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第一个是视网膜和失明方面的研究,特别是PRIMA植入物。

The first is our work in the retina in blindness, especially with the PRIMA implant.

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第二个是神经接口,第三个是我们的VESL灌注项目。

The second is our work in neural interfaces, and the third is is our work in perfusion with our VESL program.

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说到生物杂交神经接口,核心想法是:既然大脑就是一堆神经元,那大自然会怎么解决这个问题?

The biohybrid neural interfaces, the idea here is, like, if your brain is a bunch of neurons, like, how would how would nature solve this problem?

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我们常常从大自然中找灵感。

Like, we often look to nature for inspiration.

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进化这工程师,比咱们强多了,至少在搞生物方面是这样。

Evolution is a way better engineer than than we are, at least when dealing with biology.

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其实这个想法一开始是来自这样的观察:你的大脑分成两个半球,各自处理世界的不同部分,但你并不会感觉到两个半球、两个半视野。

But I think the intuition here kinda started from your brain is is composed of two hemispheres, and they kind of process different halves of the world separately, but you don't experience two hemispheres or two hemifields, we would say.

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你感受到的,是一个完整的瞬间。

You experience one integrated moment.

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而连接大脑两个半球的,有一条叫胼胝体的神经纤维束。

And this is there's a cable that connects the two hemispheres of the brain called the corpus callosum.

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大概有两亿条纤维。

It's about 200,000,000 fibers.

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我就在想,如果大自然真想造个超高带宽的大脑互联通道,它会怎么搞?要是让你设计一条新的颅神经,你会咋设计?

And I was thinking, like, if nature wanted to build a ultra high bandwidth brain to brain connection, like, what would how did or if you wanted to make a new cranial nerve.

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所以与其搞视神经、前庭耳蜗神经,不如直接整一条‘互联网神经’。

So instead of having an optic nerve or vestibular cochlear nerve, it wanted to have like the Internet nerve.

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那大自然会怎么解决这个问题呢?

Like, how would nature solve this problem?

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它可能会长出一根新的神经。

Is it would grow like a new nerve.

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再弄个新的神经束,末端带个USB接口。

It would have a new fiber bundle with a USB port at the end.

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所以这里的思路是,如果你的大脑里有这么多神经元,那要是我在你的神经元上再培养一些神经元,会发生什么?

So the intuition here is like, if your brain has a bunch of neurons, what happens if I culture some neurons on your neurons?

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在实验室里,你这么做的时候,神经元通常会自己长到一起,连上线,形成新的生物连接。

Do they like when you do that in a lab, the neurons will typically grow together and wire up and form new biological connections.

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所以我们设计的这个设备,会在植入物里提前种上活的神经元——这些是我们专门改造过的、来自干细胞的神经元。

And so we have an approach to the device where we seed the implant with living neurons, these heavily engineered stem cell derived neurons that we've created.

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它们和你自己的神经元有关系吗?

Are they related to your own neurons?

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还是

Or

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不是。

No.

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其实这背后是一个非常深入的研究领域。

So really interestingly, this is actually one of the deep areas of research.

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我们用的是单一细胞系,而这项技术最核心的知识产权就在于,我们让这些细胞逃过了免疫系统的识别。

So we there's it's one cell line, and the probably the single deepest area of IP on this is that we've hidden them from the immune system.

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我们是少数几家能做出相当靠谱的‘低免疫原性’干细胞的公司之一。

So we're one of a a really small number of companies that have, I think, like, pretty convincing what we call hypoimmunogenic stem cells.

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不需要为每个病人单独定制,那样成本太高,耗时也太长。

You don't need to manufacture it per patient, which would be really expensive and take much longer.

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我们把这种经过工程改造的低免疫原性神经元,种在培养皿里,等它们长好后,再整体植入大脑。

We've got this hypoimmunogenic stem cell derived engineered neuron that we load into the device in a dish, and then that kind of gets stuck there, and then you engraft this onto the brain.

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我们根本不会把任何电线插进大脑里。

So we don't we don't place any wires into the brain.

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也不需要对你的大脑进行基因改造。

We also don't need to genetically modify the like, your brain.

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其他一些想法,比如用光遗传学或者超声波,都需要做基因治疗,改造你脑里的神经元,但这就像是单程票。

Some of the other ideas out there, for example, using optogenetics or things like ultrasound, this requires using a gene therapy to genetically modify the neurons in your brain, which, first of all, that's like a one way door.

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一旦出问题,后果可能非常严重。

And if it goes wrong, that can go really wrong.

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而我们不一样,我们只改造了移植进去的细胞,其他什么都没动。

Whereas here, because we're adding the only thing that has been edited are the graft cells that we add.

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就算这些细胞最后死光了,你的情况也不会比原来更糟,基本上跟没治一样。

And if if those die off, then, like, you're really not worse off than you were before for the most part.

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但好处是,它们有可能在大脑里不断生长,形成遍布各处的生物连接。

But it comes with the potential of growing throughout the brain, forming biological connections all over the place.

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我们在动物模型里已经看到这种效果了。

And I mean, that's what we've seen in in the animal models.

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不过在人身上还没试过。

That's not in humans yet.

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你看过詹姆斯·卡梅隆的《阿凡达》系列电影吗?

But have you seen James Cameron's Avatar movies?

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当然了。

Definitely.

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就是那些外星人脑后的那种长辫子,你知道吧?

Like, you know the ponytails that the aliens have?

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我脑子里想的其实就是这个样子。

That's how I think about it, basically.

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就像一条全新的颅神经,末端还带着个接头。

It's like it's a big new cranial nerve with a connector at the end.

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我觉得那个‘阿凡达’里的辫子,其实就是对我做的这种生物混合神经接口最直白的比喻。

I think that's actually the avatar queue, I think, is a pretty direct reference for how I think about our biohybrid neural interfaces.

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你之前不是说,咱们得找个‘USB接口’吗?

So earlier, you were saying sort of this how do we find a USB port?

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当然,外星人那种形态,就是一种体现。

I mean, obviously, an avatar, that's one of the manifestations in the blue creatures.

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视神经,某种程度上就像个接口。

The optic nerve, in a way, is like a port.

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然后说到Neuralink,你当初联合创办它的时候,那东西是要直接进入大脑的,根本没什么明显的接口。

And then jumping to Neuralink, when you were cofounding it, that sort of enters the brain, and then there is no not necessarily an obvious port.

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你是怎么想这个问题的?

How do you think about that?

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你到底往哪儿接?它是怎么工作的?

Where do you attach, and how does it work?

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从Neuralink那儿,你学到的哪些东西对现在有帮助?

And what did you learn from Neuralink that was useful here?

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很多东西都

A lot of

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我从Neuralink学到的,说白了就是一场终极的创业博士训练。

what I learned from Neuralink was just the In many ways, was the ultimate startup PhD.

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更多是关于怎么去运作一个技术上特别复杂、需要跨学科团队和完整基础设施的公司。

And so that was more about how you execute a technically complex company that requires this type of multidisciplinary team and infrastructure.

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我特别想知道,那时候你们的V1版本是什么样的?

I'm very curious from those days, what was the v one?

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然后就是假设,接着是结果。

And then there's a hypothesis and then the outcome.

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而到目前为止,科学上的结果已经非常非常棒了,当然还没完。

And then here, the outcome is very, very awesome with science so far, not done, obviously.

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当你想到大脑的时候,我记得当初对我来说简直太神奇了。

When you think about the brain because I remember it being totally magical to me.

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比如说,大脑到底在干什么?你怎么可能理解它?

Like, what is like, how do you even understand what the brain's doing?

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它到底在用什么‘语言’交流?

Like, what is like, what language is it speaking?

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那么复杂到不可思议的事情,我们该怎么去理解它呢?

How do we understand what's going on there that seems, like, impossibly complicated?

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从信息处理的角度来看,我觉得大脑里充满了我们称之为‘表征’的东西。

The way that I would think about, like, the brain from this information processing perspective is the brain is full of these these things that we call representations.

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比如,它能形成对手部活动的表征。

And so you can have a representation of, like, hand activity.

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所以大脑里其实有个类似几何对象的东西。

So there's, like, a like, a geometric object in the brain.

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比如你记录一些神经元的活动,当手指张开时,某个神经元会放电。

Like, if you record from some neurons, then when your finger is is, like, held open, a neuron will be firing.

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而当手指握紧时,另一个神经元就会激活。

When it's closed, another neuron will be firing.

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几乎每一个可能的状态,都有对应的神经元在负责。

There's neurons that kind of correspond to every possible state here.

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在初级运动皮层——很多脑机接口公司都从这儿取信号——它通常只隔一到两个突触就连到肌肉了。

And often in primary primary motor cortex, which is where many of the other BCIs companies record from, primary motor cortex is a couple synapses, often two synapses from the muscle.

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所以信号从头顶的皮层一路传到脊髓,再从脊髓跳一次突触到肌肉。

So it projects all the way from the top of the head down to the spine, and then there's another synapse from the spine out to the muscle.

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因此初级运动皮层里的这种表征特别好理解,因为它直接对应我们能直观理解的东西,比如手的状态,尤其是关节力矩。

And so the representation that you get in primary motor cortex is kind of easy to understand because it looks like like, it directly corresponds to things that we can easily reason about, like hand state, and specifically often joint torques.

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我有时候会拿大语言模型做个小实验,比如挑一个神经元作为起点。

One of the things that I like to do sometimes with the LLMs is I'll pick like a neuron to start from.

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比如说视网膜神经节细胞。

For example, like the retinal ganglion cell.

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然后我会想,好,往前推一个突触。

And I'll be like, okay, go forward one synapse.

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那和它相连的都有哪些细胞呢?

Like, what are all of the cells that we're connected to?

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我再选一个,接着说,好。

I'll pick another one and be like, okay.

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往前推一个突触。

Go forward one synapse.

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那这次又连着哪些细胞?

Like, what are all the cells that we're connected to?

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就这么一步步地把大脑的通路走一遍。

Just kind of kind of walk through the brain.

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每一代模型,你做这种推演的能力都会更强。

And each generation of model, your ability to do this gets better.

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但你注意一点,当你靠近输入或输出端的时候,比如肌肉、耳蜗毛细胞、视网膜神经节细胞、视杆或视锥细胞,这些情况下,我们觉得这些表征是具体的,因为它们对应的是我们生活中很直观的东西——比如颜色、图像亮度、声音频率,或者肌肉控制。

But one of the things that you see is that when you're close to, like, an input or an output, like a muscle or a cochlear hair cell or a retinal ganglion a rod or cone, like, in these cases, we think of the representations as being concrete because they correspond to things that are intuitive for us, like colors and image intensities, or frequencies of sound, or muscle control.

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但一旦你往大脑更深处走,这些表征很快就变得特别抽象了。

But as you go deeper into the brain, it very quickly kind of blows up into these very abstract things.

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大脑里有个地方叫下颞叶皮层,它里面有个区域专门处理脸的表征,旁边紧挨着的就是物体的表征,就像两张地图并排放着。

And so there's a part of the brain called inferotemporal cortex where the representation that it has is a map of face like a map of objects or a map another way, right next to it is a map of faces.

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我们可以沿着这张物体空间的图谱,也就是大脑对各类物体的神经表征,一路往上走。

We can go up this map of object space, this neural representation of general objects.

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在某个点上,

There's one point.

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你可以把它想象成一长串数字,其中某个位置就对应着一个花瓶。

You can think of it as a long list of numbers, and there's some point in that that's like a vase.

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某个位置对应的是埃菲尔铁塔,

There's some point that's like the Eiffel Tower.

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某个位置则代表一辆车。

There's some point that's a car.

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有一个点代表一个人。

There's some point that's a person.

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有一个点代表斑马。

There's some point that's like a zebra.

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当你在这个流形上移动时,就能感知到任何可能的物体。

And as you move around in this on this, like, manifold, you get kind of the percept of any possible object.

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那里有数百万个神经元,正在表征大脑能识别的所有可能物体的空间。

And there's millions of neurons there that are representing this, this space of possible objects that the brain could be identifying.

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听起来像潜空间。

Sounds like latent space.

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没错,它就是

It is a

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潜空间。

latent space.

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对极了。

Exactly.

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所以现在人工智能和神经科学之间正在发生一场巨大的融合。

And so there's this huge unification going on between AI and neuroscience.

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最有趣的一点是,当你训练AI模型——比如图像模型或者语言模型时,模型内部产生的表征,跟大脑里实际观察到的表征非常相似。

And one of the most interesting things is that when you train AI models, like like image models or and even language models, the representations that you get inside them look a lot like the representations you see in the brain.

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太神奇了。

Fascinating.

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这其实是个明显的线索,说明AI研究者们

And so this is like a real hint that the AI people I

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没错,这确实很棒。

mean, that's really good.

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他们走对路了。

Are on the right track.

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是的。

Yeah.

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不是的。

No.

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我的意思是,说AI只是随机鹦鹉或者高级自动补全,这种说法根本就是外行话。

I mean, the the whole idea that, like, there's these things that are, stochastic parrots or glorified autocompletes, like, these people just don't know what they're talking about.

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很多神经科学家转去做AI了,因为他们本质上还是在搞神经科学,只不过用模型做起来方便多了。

Many people in neuroscience have gone over to AI because they're basically still doing neuroscience, but it's just way easier to do it on the models.

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听起来对你来说这是个好消息啊,说明确实存在某种潜在空间映射,科学就像是通往大脑的API。

It sounds like it's very good news for you in that, like, there is actually some kind of latent space mapping, and then the job of science in terms of being sort of like the API to the brain.

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完全没错。

Totally.

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就是这么回事。

Exactly.

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这完全有可能。

It is entirely possible.

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你从大脑里记录下来的神经活动,其实也是一种潜在表征。

The neural activity that you when you record neural activity from the brain, this is just another latent.

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如果你能把这种活动翻译成另一个模型,那我们就能做出特别酷的东西。

And if you can translate this into another model, then you can do, we think, really cool stuff with that.

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所以你现在有输入了,之前你提到过,早期的脑机接口实验主要是在搞清楚

So you have input now, and then you earlier were saying I mean, a lot of the earlier BCI experiments involved figuring out

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比如运动控制。

like motor.

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对。

Yeah.

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运动解码是个特别经典的任务,实现方式其实有很多。

So motor decoding is kind of this very classic task, and you can do it in any number of ways.

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但人类第一次实现光标控制或键盘控制,那是在90年代末。

But getting cursor control or keyboard control in a human, that was first done in the late '90s.

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所以我觉得现在好多脑机接口公司都在做这个,就是因为咱们已经确定它肯定行得通。

And so I think a lot of the BCI companies are doing that now just because, like, we know it definitely works.

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毕竟有真实患者的需求,说白了就是个电子工程问题。

You know, there's some patient need, and it really is just like an electronics problem.

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只要你能把电子设备做得足够小、功耗足够低,不会产生太多热量,能顺利缝合皮肤,那就是一大突破。

Like, if you can shrink the electronics so that they're small enough and low power enough so that they don't dissipate a lot of heat so that you can close the skin, then that is like a big advance.

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我认为这正是Neuralink真正做成的第一件事。

And that I think is really the first thing that Neuralink has done.

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以前也有设备能做这种运动解码,但都需要一根线从头皮穿出来。

There were prior devices that could do that type of motor decoding, but they required a connector coming out through the scalp.

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只要皮肤是开着的,就容易让感染顺着线往里钻,那可就麻烦大了。

And as long as the skin is open, there's a risk that, like, an infection will climb down that, and then you're gonna have a really bad day.

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所以能把皮肤缝上特别关键,但以前这事儿特别难,因为得把电子元件做得足够小、足够省电,才能完全植入体内还不发热。我觉得让这成为可能的关键,是所谓的‘智能手机红利’。

So being able to close the skin is really important, but that was really difficult because it required really efficient electronics that were small enough to fully implant and also were power efficient enough that they wouldn't get And so I think the thing that made this possible is what we call the smartphone dividend.

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单靠脑机接口自己搞不定这事,但苹果、三星这些公司砸了巨资把这类电子元件做出来了,我们才能用上。

BCIs couldn't have done this on its own, but Apple and Samsung and others have poured epic amounts of money onto making these types of electronics exist in the world so that people like us can use them.

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而且你作为生物混合体,确实有明显的优势。

And then it feels like you have a really significant advantage around being a biohybrid.

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我的意思是,这些难题通常都跟长期用电刺激脑细胞有关。

I mean, are all these issues famously about sort of trying to electrically stimulate brain cells for a long period of time.

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是的。

Yeah.

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我的意思是,这里其实有不同的产品类型。

I mean, I think that there are different products here.

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说白了,这正是我做这件事的原因。

I think that on the like, on the one hand, I mean, that's why I'm doing it.

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我觉得这主意不错。

I think that's a good idea.

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但另一方面,有些人一看就觉得,哎,现在你得对付一个活体细胞了。

On the other hand, I think some people look at this, and they're like, that is now you have a cell to deal with.

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你把一个设备,加上了一大堆生物成分。

You took a device, and you added a bunch of biology to it.

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我觉得我们对这个已经有不错的把握了。

And I think we have a good handle on that.

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这正是我们这么做的原因,但确实有得有失。

That's why we're doing it, but there's definitely a trade off there.

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我觉得脑机接口,最终我们会明白,它不像药物那样是个具体的产品。

And I think that BCI, we're going to come to see is not is not a specific product in the way that, like, pharma is not a product.

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我觉得未来会涌现出一大批脑机接口公司,各自深耕不同的应用场景,不同的电极探针方案都会找到合适的用武之地。

I think there can be a bunch of BCI companies going after different applications where different types of probes will make sense.

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而生物混合技术这种方案,其实只有在那些最高端的场景里才是真的刚需。

And I think biohybrid in particular is only really necessary for some of the very highest end things.

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反过来讲,要是想用它满足其他大量重要的医疗需求、落地其他重要应用,难度会高很多;和其他方案比起来,它要实现规模化的社会影响,节奏肯定会更靠后一些。

And on the flip side, it will be harder to deploy for many other important medical needs and important applications along the way, And we'll probably be a little backloaded relative to some other things in that scalable impact.

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刚才你提到科学研究里还有第三个方向,就是和血管相关的那个技术?

So earlier, you're referring to there's a third part of science, which is vessel.

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你再多讲讲这个吧,感觉你在这件事上用到了好多

Talk more about that, because it feels like you're applying a lot of

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最开始的

the first

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第一性原理思维,正是这套思维帮你做出了现在这个突破性的成果。

principles thinkings that got you here to this thing that is also pretty groundbreaking.

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其实这个项目是我们目前所有项目里规模最小的。

So this is our smallest project.

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现在有个领域叫体外灌注。

So there's this field of perfusion.

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你可以把它想象成一种人工心肺机。

You can think of it as they're kind of like heart and lung machines.

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大概十年前,我读到《柳叶刀》上的一篇文章,才第一次意识到这个问题——讲的是波士顿一个17岁少年,正在等肺移植。

And I I was first clued into the need here about a decade ago when I read an article in in a medical journal called The Lancet, which was this case study of this 17 year old living in Boston who was waiting for a lung transplant.

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在等移植的这段时间,他靠ECMO系统维持生命。

And while he was waiting for this lung transplant, he was being kept alive on an on an ECMO circuit.

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ECMO是体外膜肺氧合的缩写,说白了就是人工心肺机。

ECMO is the sacrum for extracorporeal membrane oxygenation, and this fancy word for, like, heart lung machine.

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他的心脏没问题,但肺彻底坏了,全靠这个机器吊着命。

And in his case, his heart was okay, but his lungs had failed, and so this was keeping him alive.

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等了一段时间后,他被诊断出出现了并发症,不再符合移植优先条件,结果被移出了移植名单。

And after a while on the transplant list, he was diagnosed with a complication that made him no longer a priority recipient for donor lungs, and so they took him off the transplant list.

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这篇文章其实探讨的就是一个伦理难题:我们该怎么对待他?

And so this article is kind of about the ethical dilemmas of, like, what do we do with him?

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是的。

Yeah.

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但他还活着。

But he's alive.

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因为他啊,正在打游戏呢。

Because he's, yeah, he's playing video games.

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他在写作业,跟朋友一起玩。

He's doing homework, hanging out with friends.

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如果我们关掉机器,他马上就会死。

If we turn off the circuit, he will immediately die.

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可别这么做啊。

Well, don't do that though.

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另一方面,他每个月花掉五十万美元的重症监护费用。

On the other hand, he's consuming a half $1,000,000 a month ICU sweep.

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所以这篇文章里,医生们提到,他的家人和朋友从他的存活中得到了安慰,但这引发了公平性的争议。

And so there are these quotes in this article from the doctors being like, his family and friends derived benefits from his continued survival, and how this raised fairness questions.

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因为如果我们长期支持他,那为什么不对所有人这么做呢?

Because if we support him for a longer period of time, then why don't we do this for everybody?

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我当时就看到了这一点。

And so I saw this.

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我觉得这些问题问得真好。

I'm like, those are great questions.

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我得找到这些问题的答案。

I need answers to those questions.

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因为技术和实际能落地的经济性之间,明显存在巨大鸿沟,不知为啥。

Because there seemed to be this big gap between what was technically possible and what was economic to deploy for some reason.

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说白了,这正是当创始人的本质啊。

I mean, that's exactly what being a founder is about.

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对。

Yeah.

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所以我看到这个之后,想到有个叫PubMed的医学文献数据库,我就意识到,要是我在上面搜‘ECMO伦理困境’,能跳出好几页结果。

So I saw this, and I there's this database of medical literature called PubMed, and I realized that if I searched PubMed for the phrase ECMO ethical dilemma, there were multiple pages of results.

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所以这根本不是个例。

So this was not like a one off.

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我翻了那些文献,发现里面经常提到,ECMO 不该被当成所谓的‘通往无处的桥梁’,很多医生其实都在劝家属别在重症情况下考虑这个,因为一旦用了,就会陷入进退两难的境地——然后怎么办?这简直是个道德难题。

And when I looked at this literature, there it was often a lot of it was talking about how ECMO shouldn't be used as a as a, quote, bridge to nowhere, and how many doctors were basically trying to discourage families from even pursuing it in these critical care cases, because it would create this bridge to nowhere, and then what do we do, and it creates these dilemmas.

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后来我问过一些医生,那是很久以前的事了。

And then I went and asked some doc this was a long time ago.

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差不多十年前了。

This was almost a decade ago now.

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我就问,为啥不能把它当成最终方案呢?

Like, oh, well, why don't we consider it a destination?

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这就是他们用的词。

That's the phrase.

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就是‘终点疗法’,而不是‘过渡疗法’。

It's like a destination therapy versus a bridge therapy.

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要是这技术本身还不够成熟,还得再改进呢?

What if the technology just isn't good enough yet, and it needs to be improved?

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确实得改进,这点没得说。

It needs to be improved, definitely.

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但那根本不是我得到的回应。

But that wasn't even the response that I got.

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我得到的反应是大喊大叫,还砸东西。

The response that I got was just shouting and throwing things.

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我当时就觉得哪儿不对劲,可那时候我也没能力去深究。

And so I was like, something feels wrong here, but I wasn't really in a position then to pursue it.

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但这件事一直在我心里,我觉得这里面藏着一个特别重要的共通点。

But this was always a thing that was kind of I saw that there was a really important unification here.

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其实,同样的核心技术已经彻底改变了器官移植领域。

It also the same fundamental type of technology has really transformed organ transplantation.

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那边他们管这叫NMP,常温机械灌注,不是ECMO,但道理是一样的。

So there, they call it NMP, normothermic machine perfusion, rather than ECMO, but it's the same idea.

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二十年前,要是你得做肾移植或者肝移植,车祸要是半夜三点发生的,手术也得在四五点赶紧做。

So twenty years ago, if you needed a, like, a kidney transplant or a liver, if the car crash happened at three in the morning, the surgery would happen at four or five in the morning.

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但现在,手术都能安排在下午,甚至第二天了,美国超过百分之七十五的肝移植现在都用这种灌注技术。

But now it gets scheduled for, like, the afternoon or the next day, and over seventy five percent of liver transplants in The US use this type of perfusion technology now.

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但现有的设备,价格高达五十万美元。

But, like, the the systems that exist for this are, like, $500,000.

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只能靠私人飞机运送。

They can only be moved by private jet.

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有个业内大公司,结果发现他们的私人飞机物流业务,比医疗设备业务还大。

Like, one of the big companies in this space, it turns out that their private jet logistics business is bigger than their medical device business.

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很明显,这中间还有很大的工程优化空间。

And it just there was just clearly an engineering that could refine this.

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所以我们想,要是能把这技术优化到,能像托运行李一样,把肾脏直接送上联合航空的航班,运到东海岸,那该多好。

And so we looked at this, we thought, well, what if you could refine this to the point where you could check a kidney as luggage on a United flight to the East Coast?

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或者,要是能做出一个设备,让那个17岁的孩子能背在身上带回家,而不是像他那样,根本没换氧合器的滤芯,一周后血栓堵死了,人就没了。

Or what if you could make a thing that that 17 year old could have brought home as a backpack instead of just what they did in his case is they stopped changing the oxygenator filter, and a week later, it clotted and he died.

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事实就是这么发生的。

And that's what happened.

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还有其他问题,比如怎么把皮肤好好缝合在脑部植入物周围。

There are other problems here, like being able to close the skin around the brain implant.

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还得让连接血液回路的管子能和皮肤长在一起,不然容易感染。

You also need to make it so that the tubes that connect the blood supply to the circuit, the skin can heal to it, so that's not an infection risk.

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不然就得天天小心翼翼地清洁。

Otherwise, you have to clean it very carefully.

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总的来说,科学突破指明的方向,和实际在做的事,差距大得离谱。

But just overall, there's this huge gap between, like, clearly, like, where the scientific breakthroughs, like, were put were pointing and, like, what was being done.

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我觉得很多人没意识到,其实要当个‘缸中之脑’,技术上早就做到了。

Like, I think I think that people don't appreciate is that in many cases, like, there's like, if you you wanna be a brain in a vat, like, this basically already exists.

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你完全可以把一个临终病人在ICU里维持生命,几乎无限期地撑下去,但那生活质量简直惨不忍睹。

Like, you can keep a like, an end life, like, patient alive in an ICU almost indefinitely, but this is very poor quality of life.

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所以病人常常主动要求撤掉这些设备。

And so patients, like, ask for that to be withdrawn.

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没人想躺在病床上,浑身插满管子,就剩个脑子还醒着。

Like, nobody wants to be basically like a brain in, a hospital bed connected to tubes.

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你得让人能过上高质量的生活。

You need to be able to provide a high quality of life.

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所以你需要一种让人能真正接受、能长期用的东西。

And so you need something that people can live with.

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如果你能恢复视力、听力、平衡感、运动控制,让人能重新走出去、做点事儿,那才叫真本事。

And I think to see this, if you can get vision, hearing, balance, motor control, the ability to be out in the world and doing things.

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我突然意识到,这其实提供了一种全新的视角,来重新理解医学的根本问题。

I just saw this very fundamental way to reframe the problems of medicine here.

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所以就像我说的,虽然现在有好几个不同的项目,但我觉得——

And so that, like I said, at science, even though there's these several different projects, I

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在未来十年里,它们本质上就是一个项目。

really see them as one project over the next ten years.

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我本来是搞工程的,讲究第一性原理,现在这词儿老跟马斯克挂钩了。

So started as an engineer, first principles thinking, which often now is quite associated with Elon Musk.

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Neuralink 是怎么起步的?

How did Neuralink start?

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你是怎么认识他的?

How did you get to know him?

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那这整件事是怎么凑成的?

And how did all of this come together?

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我第一次见你的时候,你还在做Y Combinator,那是好多年前了,也是我第一次在YC工作的时候。

Because I first met you when you were doing Y Combinator many years ago, my first stint at YC.

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2016年初的一个晚上,我收到了山姆发来的一封邮件,标题是“一个疯狂的问题”。

So I got an email one night in early twenty sixteen from Sam, subject line crazy question.

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大概就是说,马斯克要创办一家脑机接口公司。

Be like, Elon's starting a brain computer interface company.

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那该找什么人来牵头运营这家公司呢?

Like, who should who should run it?

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我当时还以为他们会同时咨询很多人呢。

And I assumed they're talking to a lot of people.

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我第一反应其实是想到了我在麻省理工的几个朋友,我那时候还觉得,这些人都厉害得很,(很适合)。

And my first reaction was actually I I had some friends at MIT that I thought I'm like, well, these guys are really smart.

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你该去跟他们聊聊。

You should talk to them.

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但一小时后,我突然反应过来。

But then an hour later, I was like, wait a second.

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于是我回了邮件,问他:我能跟你聊聊吗?后来萨姆就把我介绍给了埃隆。

And so I emailed him back, I'm like, can I And Sam introduced me to Elon?

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那时候埃隆自己早就有了这个想法,也已经想好了公司名字——Neuralink。

And Elon was going around, he'd already had the idea on his own that he wanted to start a company, and he had the name Neuralink.

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我觉得他当时也从好几个人那儿听到了我的名字。

I also think that he heard my name from enough people that he was talking to at the time.

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2016年下半年,有一群人时不时聚在一起,每周碰一次面,慢慢就发展成了Neuralink。

And over the second half of 2016, there was just this group of people that was kind of some degree ever shifting that would meet once a week or so in the evening, and that snowballed into Neuralink.

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最初那批人里,好几个都是我在杜克大学认识的。

And of the initial group, a bunch of them were people that I knew from Duke.

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比如蒂姆·汉森,那个最早提出缝纫机点子的人,他跟我同在一个实验室,就在杜克。

So Tim Hansen, the guy who had originally had the sewing machine idea, he was in the lab that I came from at Duke.

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他当时是个研究生。

He was a grad student.

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我那时候还是本科生,在他实验室干活。

I was an undergrad working for him.

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后来他和我们另一个朋友去找了UCSF的一位教授,还有那边的一个合作者。

And then the professor that he and and one of our other friends had gone to at UCSF, and then a collaborator there.

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所以当时就那么一小撮人。

So was kind of a very small community.

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刚开始聊电脑和人脑连接这事儿,感觉怎么样?

What was that like initially to talk about the idea of connecting a computer to a human being's brain?

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埃隆比大多数人更早、更清楚地看到了AI的走向。

Elon, I mean, he saw what was coming in AI much more clearly than many other people much earlier.

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我觉得这事不可能跟人类割裂开,必须得融合,这一点对他来说再明显不过了。

And I think the implications of this can't be a separate thing from humanity, and that needs to merge somehow, I think that implication was just very clear to him.

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所以真正驱动他的,是怎么让这技术帮人类升级,而不是被甩在后面。

And so that was the genuine motivating factor of how do we make it so that this allows us to upgrade humanity rather than get left behind.

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我的意思是,你看看地球的自然历史,这根本不是什么空想。

I mean, if you look at the natural history of Earth, it's not like this is a totally speculative thing.

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人类早就统治了整个星球,连我们最亲近的近亲都得关在玻璃箱里,怕它们灭绝。

Humanity has totally dominated the planet, and we keep our closest living relatives in glass boxes so they don't go extinct.

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所以历史上,更聪明的物种往往意味着更大的危险。

And so there's a real history here of greater intelligence being very dangerous.

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一开始并没有什么具体的技术构想,但那种驱动力是实实在在的。

Like in the beginning, there wasn't a specific technical idea necessarily, but there was that motivating force.

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后来我们就想,把能找到的最聪明的人聚在一起,再给足资源,做任何该做的事,最后大家达成共识,就是你现在看到的这种薄膜聚合物细丝。

And then the idea was we'd pull together the smartest group of people that you could find and enough resources to do whatever made sense, and eventually got consensus around what you see now thin film polymer threads.

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你就是个绝佳的例子——从纯软件背景跨界到硬科技,现在真正在做能商业化、具有突破性的研究。

You're one of the best examples of someone who came from a pure software world and then went into hard tech and now is actually doing real breakthrough type of research and work that is also commercializable.

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看节目的人里,说不定也有不少人正走在类似的路上。

The people watching, they might be on a similar track.

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以你现在的见识,回过头来,你会对2016年的自己说些什么?

Knowing what you know now, like, what would you tell to the sort of 2016 version of yourself?

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我觉得有两件事。

So I think there's two things.

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第一件是我做了的,第二件是我没做的。

The first is, like, the thing that I did, and then there's the thing I didn't do.

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我做了的就是,我特别清楚自己想要什么,然后就一直很主动地去追求它。

The thing that I did, I think, was I had I had a a clear sense of what I wanted, and then I was very high agency towards that.

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上大学的时候,我就知道自己想搞脑机接口。

When I was in college, I knew that I wanted to work in brain computer interfaces.

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我所在的杜克大学有个特别棒的实验室在做这个,我花了点功夫,硬是想办法挤了进去。

There was a great lab that was doing that work at Duke where I went, and I was pretty persistent in figuring out how to place myself into that lab.

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那个实验室在医学中心。

It was in the medical center.

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他们一般不收本科生。

They didn't usually take undergrad.

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花了点时间,我才终于进去了。

They were like, took me a little while to get in there.

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最后我发现,可以通过化学系的独立研究项目偷偷溜进那个灵长类神经科学团队,算是走后门吧。

Eventually figured out that I could sneak in by taking an independent study in the chemistry department that would be a backdoor into this primate neuroscience group.

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但其实,我在大学里学到的大部分东西,都是在那个实验室里搞出来的。

But then really, most of my education in college happened in that lab.

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所以我从小就开始编程,最拿手的硬技能是软件,但从2008年起,我就一直在搞灵长类脑机接口和闭环神经解码这一块。

So yeah, I grew up programming, and my deepest hard skill is software, but I've been doing primate brain computer interface, closed loop neural decoding stuff, since 2008.

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所以啊,你要想做成这种事,光有决心和坚持还不够,关键得先知道自己想往哪儿走。

And so that was just like, you had to be pretty high agency and persistent in trying to follow through on that, but that only works if you have a sense of where you wanna go.

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所以第一点,就是得搞清楚自己到底想要什么。

And so the first is like, figure out what you want.

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我没做的事呢,是大学毕业后我创办了一家公司,叫Transcriptic。

The thing I didn't do was my so after college, I started a company called Transcriptic.

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那是个机器人云实验室,说白了,我在大学时也在合成生物学组干过,那时候得每三个小时就去按一次‘酶标仪’的按钮,连着三天,就为了拿个数据。

It was a robotic cloud laboratory, so the idea was mean, I also, in college, had the experience of working at a synthetic biology group, where I needed to go press a button on a device called a plate reader every three hours for three days to take a measurement that I wanted.

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我当时就想,搞软件的谁会这么干啊?

And I was like, in software, this doesn't we wouldn't do this.

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这明显说不通啊。

This just clearly doesn't make sense.

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我们早就该自动化了。

We would automate it.

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那时候AWS刚冒头,云计算也开始火起来了。

This was also the time when AWS was just emerging, and cloud computing was becoming a thing.

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我觉得特别明显:没必要每个研究员都自己搞个实验室,花几百万买设备,还得每隔三小时去按个按钮。我们应该建一个中央化的机器人云实验室,给科学家们开放API,让他们在网上就能跑实验。

And it seemed very obvious to me that instead of every researcher having their own lab and spending millions of dollars for all their equipment, and then needing to press these buttons, what we should build is a central robotic cloud laboratory that expose APIs that scientists can use to run experiments over the internet.

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我干了这事,筹了不少钱,2017年卸任CEO后去了Neuralink。

I did that, raised a bunch of money when I stepped down as CEO in 2017 to join Neuralink.

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那公司年收入都有好几百万美元了。

It had millions of dollars in revenue.

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我觉得我们当时已经做到了一个很有希望的起步阶段。

I felt like we got it to kind of an early promising point.

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但之后这十年,那个愿景一直没实现。

And then since then, over the last decade, that promise was not fulfilled.

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那真是地狱模式。

That hard mode.

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那简直是一场苦熬。

That was like a slog.

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2012年到2016年那会儿,我特别有共鸣本·霍洛维茨那篇《挣扎》。

That era from 2012 to 2016, I strongly identified with Ben Horace's essay, The Struggle.

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我现在觉得,我早该去给像埃隆这样的人打工,那能让我瞬间开窍,真正看懂这个游戏怎么玩。

And I think the thing that I should have done earlier is go work for somebody like Elon, because that just so dramatically leveled up my ability to do this and know how the game is played.

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你经常会看到一些特别有潜力的孩子,心里就想:我要自己干。

I think that often, you'll see these really promising kids who are just like, I'm gonna do it myself.

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我才不给谁当员工呢。

I don't wanna work for anybody else.

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我要自己创业。

I'm gonna start my own company.

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我要硬扛过去。

I'm gonna plow through it.

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有时候这样也行得通。

Sometimes that works.

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我有什么资格说三道四呢?

Who am I to say?

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但我可以告诉你,创业这事儿,说白了靠的是口耳相传。

But I can tell you that very often, startup like, running a startup is an oral tradition.

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历史上确实有过那么几次,一群特别厉害的人从零开始摸出了门道。

There have been a couple of nucleating times in history where, like, a really remarkable group of people have kind of figured it out from scratch.

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我觉得PayPal就是这么个例子。

Like, I think PayPal was like this.

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但除此之外,几乎都是靠口耳相传——从硅谷那几个少数文化圈子里传下来的经验,你要是20岁就搞明白了,跟26岁、28岁才明白,人生轨迹能差出十万八千里。

But almost always beyond that, it's like it's an oral tradition that you pass down from one of this handful of Silicon Valley cultures that can make a huge difference on the trajectory of your career to get that right when you're 20 versus when you're 26 or 28.

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科学领域接下来也会这样,听起来你已经拉起了一支特别牛的团队。

Well, science is the next, and it sounds like you're assembling You've already assembled a really accomplished crew of people.

Speaker 1

这些年我们从创业里学到的一点是,只要一件事真成了,资源和聪明人就会源源不断地聚过来。

And then what we've learned from startups over the years is that once something works, more and more resources, more and more smart people sort of come together.

Speaker 1

再放眼一看,我们真希望在你目前所处的这些领域里,这样的事能越来越多地发生。

And then zooming out, that's what we really hope happens a whole lot more in exactly the spaces that you're in right now.

Speaker 1

所以科学听起来现在正是一个特别值得投入的方向。

So science sounds like one of those places to go to right now.

Speaker 0

这确实挺酷的。

It's pretty cool.

Speaker 0

对。

Yeah.

Speaker 0

我觉得自己特别幸运,能做这份工作,因为这根本是个跨学科的难题,要突破它,得靠各个领域顶尖的人才通力合作。

I definitely feel pretty lucky that I get to do this, because it's such an interdisciplinary problem, and to innovate on it, you need all these different areas and really great people in each of them.

Speaker 0

但与此同时,今天你能做到的事,几年前根本不敢想。

But at the same time, it's just the the things that you can do today were unimaginable a few years ago.

Speaker 0

而且说实话,我觉得我们团队绝对是这个领域里最强的。

And and, I mean, I think that I think we have the best team in the field.

Speaker 1

那接下来的十年、二十年,科学和脑机接口会往哪儿发展?你怎么看?

So next ten, twenty years of science, BCI, I guess, where do you see this going?

Speaker 1

那你最期待的是什么?

And what are you most excited about?

Speaker 0

我现在有个‘事件视界’,定在2035年。

I have this, like, event horizon at 2035 now.

Speaker 0

以前年轻的时候,我总为自己能看透未来感到自豪。

Like, when I was earlier in my life, I always kind of prided myself on the ability to see the future.

Speaker 0

再往后几年的事儿,我还能有点儿感觉。

And that is the next few years, I think, I have a sense of.

Speaker 0

但到了2035年,我就完全看不清了,像被一层墙挡住了。

But, like, by 2035, it's just like imp there's like, I can't see past it.

Speaker 0

我觉得第一批能活到一千岁的人,现在可能就活着,而且人数可能比你想象的多得多。

Think it is very possible that the first people to live to a thousand are alive right now, and I think it might be many more people than you think.

Speaker 0

不可能就地球上一两个人而已。

It's not gonna be like one or two people on Earth today.

Speaker 0

地球现在确实处在巨变之中,但这种时刻历史上不是第一次发生,只是这一次特别剧烈。

Earth as a whole is at a not not unique, like, these moments in history have happened all the time before, but right now, it's a time of exceptional change.

Speaker 0

这会受到正在发生的科技变革的极大影响,尤其是脑机接口和人工智能这两条并行的线索。

This is going to be really, really influenced by the technological changes that are happening, and the twin plot lines of brain computer interfaces and artificial intelligence.

Speaker 0

人们开始意识到,人工智能是真的存在了。

People are beginning to get that artificial intelligence is real.

Speaker 0

但它的价值还没被市场真正认可。

It is still not priced in.

Speaker 0

大家还是没完全领会它的分量。

People still don't appreciate it.

Speaker 0

我同意。

I agree.

Speaker 0

但他们根本没意识到脑机接口即将带来什么、能实现什么,这两条线虽然并行,但完全是两回事。

But they really don't get what's coming in and what's possible with brain computer interfaces, and those are really parallel, but very distinct stories.

Speaker 0

未来,智能将广泛普及,只要有人有能力和意愿去使用它。

Intelligence is gonna become widely available for those that have the agency to deploy it.

Speaker 0

我对这一点总体上还是很乐观的。

And I am generally pretty optimistic about that.

Speaker 0

我的PDOM也不是零,但也没到50%,就是没那么高。

Like, don't my PDOM is pretty it's not zero, but it's not 50%.

Speaker 0

远低于那个水平。

It's well below that.

Speaker 0

是的。

Yeah.

Speaker 0

我不确定我们能不能彻底治愈所有疾病。

I don't know if we'll have cured all disease.

Speaker 0

说实话,我绝对不会说2035年之前就能根治所有病,但我相信那时候会出现全新的治疗路径,彻底改变我们对人类处境的理解。

In fact, I definitely wouldn't use that term, wouldn't say we'll have cured all diseases by 2035, but I think that there will be new lateral options that totally reframe how we think about the human condition on that timescale.

Speaker 1

而且会彻底重塑计算机和人类之间的互动方式。

And totally reconfiguring basically that sort of interface between computers and humans.

Speaker 0

对,还有人与人之间的互动。

Yeah, and humans and each other.

Speaker 0

在很多情况下,脑机接口其实就是脑与脑之间的接口。

A brain computer interface is equivalent to a brain to brain interface in many cases.

Speaker 0

这直接带你进入一个全新的领域。

This takes you to totally new territory.

Speaker 1

马克斯,非常感谢你来参加我们的对话。

Max, thank you so much for joining us.

Speaker 1

谢谢你为未来做的一切,我们都很期待你接下来的创作。

Thanks for building the future, and we can't wait to see what you build next.

Speaker 0

谢谢,加里。

Thanks, Garry.

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