As a long time reader who is deeply interested in neurotech I loved this post! A few thoughts
1. You are 100% correct in saying that many of the results from companies like Neuralink or BlackRock Neurotech can be done without touching the Central Nervous System, with simple devices like the Mouthpad. This is something I quickly realized a few years ago when I was doing research on Neuralink. I'm conflicted on whether or not to count this as a point against Neuralink. On one hand, products like Telepathy weren't made to help locked-in users move a cursor but were made as a stepping stone to advance the company towards a "Holy Grail" device that lets humans merge with AIs. This focus on the "Holy Grail" is why things like the butcher number matter - though killing a few thousand neurons now doesn't really matter, eventually we'd want to scale from just a few thousand channels to hundreds or even millions of channels and it won't do to be killing a significant portion of the brain's total neurons. On the other hand, the company had a top tier team, billions of VC funding, and a decade to work with, and hasn't delivered better outcomes than a tonguepad / eye-tracking device could accomplish. Though to be fair, they are now working on a device that will attempt to restore vision in blind patients.
2. Though Nudge's approach of using Low-Intensity Focused ultrasound is a few orders of magnitude less precise than Forest Neurotech's approach, it not only several orders of magnitude more precise than basically every other non-invasive neuromodulation method, but is the only non-invasive neuromodulation technique that can reach deep into the brain. Why is this significant? You mentioned that using deep brain stimulation (an expensive and invasive procedure that involves physically inserting electrodes next to the desired target region), on theorized depression circuits, researchers burned tens of millions of dollars to achieve null results. With a Nudge-like device using LIFU, it would be possible to run such trials with a fraction of the time and cost, due to Low-Intensity Focused Ultrasound's non-invasiveness and relative safeness. A Nudge-Like device will significantly reduce the barriers to not only run such studies, but to map the entire brain.
3. You're definitely right about the market need for many modern neurotech devices. On one hand you have the medical grade devices from companies like BlackRock/Neuralink/Synchron/Precision Neurosciences, which serve a desperate but small population. As you've mentioned before, many of these people could be served equally well with a device that interacts with the Peripheral Nervous system instead. On the other hand you have the "Wellness" devices that are often just not very good.... There are so many EEG companies that are forever reaching but falling short of Product Market Fit. I don't know much about the Kernel Flow but it doesn't sound like a hyper successful consumer product. Yet, there are companies that have seen a lot of success in this space like Mouthpad and CNTRL-Labs, and two others whom I think will do VERY well in the consumer market if the product works: Orbit and Prophetic.
Anyways, loved the article. Your writing is some of the best on substack.
The Meta Neural Band was released commercially at the end of September, 2025, as the main controller for the Meta RayBan Display smartglasses. 8-channel EMG; 18h battery life, on-device ML for gesture decoding. Band only available for purchase as a set for $799, but a replacement band is $199 (for cost reference).
Meta has ongoing academic collaborations (CMU, Utah, ...) supporting accessibility applications for various patient groups, including those with spinal cord injury. Preprint hot off the press: https://www.biorxiv.org/content/10.64898/2026.01.09.698484v1
I am cohosting this meetup! Looking forward to seeing you all!
As a long time reader who is deeply interested in neurotech I loved this post! A few thoughts
1. You are 100% correct in saying that many of the results from companies like Neuralink or BlackRock Neurotech can be done without touching the Central Nervous System, with simple devices like the Mouthpad. This is something I quickly realized a few years ago when I was doing research on Neuralink. I'm conflicted on whether or not to count this as a point against Neuralink. On one hand, products like Telepathy weren't made to help locked-in users move a cursor but were made as a stepping stone to advance the company towards a "Holy Grail" device that lets humans merge with AIs. This focus on the "Holy Grail" is why things like the butcher number matter - though killing a few thousand neurons now doesn't really matter, eventually we'd want to scale from just a few thousand channels to hundreds or even millions of channels and it won't do to be killing a significant portion of the brain's total neurons. On the other hand, the company had a top tier team, billions of VC funding, and a decade to work with, and hasn't delivered better outcomes than a tonguepad / eye-tracking device could accomplish. Though to be fair, they are now working on a device that will attempt to restore vision in blind patients.
2. Though Nudge's approach of using Low-Intensity Focused ultrasound is a few orders of magnitude less precise than Forest Neurotech's approach, it not only several orders of magnitude more precise than basically every other non-invasive neuromodulation method, but is the only non-invasive neuromodulation technique that can reach deep into the brain. Why is this significant? You mentioned that using deep brain stimulation (an expensive and invasive procedure that involves physically inserting electrodes next to the desired target region), on theorized depression circuits, researchers burned tens of millions of dollars to achieve null results. With a Nudge-like device using LIFU, it would be possible to run such trials with a fraction of the time and cost, due to Low-Intensity Focused Ultrasound's non-invasiveness and relative safeness. A Nudge-Like device will significantly reduce the barriers to not only run such studies, but to map the entire brain.
3. You're definitely right about the market need for many modern neurotech devices. On one hand you have the medical grade devices from companies like BlackRock/Neuralink/Synchron/Precision Neurosciences, which serve a desperate but small population. As you've mentioned before, many of these people could be served equally well with a device that interacts with the Peripheral Nervous system instead. On the other hand you have the "Wellness" devices that are often just not very good.... There are so many EEG companies that are forever reaching but falling short of Product Market Fit. I don't know much about the Kernel Flow but it doesn't sound like a hyper successful consumer product. Yet, there are companies that have seen a lot of success in this space like Mouthpad and CNTRL-Labs, and two others whom I think will do VERY well in the consumer market if the product works: Orbit and Prophetic.
Anyways, loved the article. Your writing is some of the best on substack.
Thank you so much for the informative comments and kind words!! I'll check out Orbit and Prophetic, I hadn't heard of either of those companies before
The Meta Neural Band was released commercially at the end of September, 2025, as the main controller for the Meta RayBan Display smartglasses. 8-channel EMG; 18h battery life, on-device ML for gesture decoding. Band only available for purchase as a set for $799, but a replacement band is $199 (for cost reference).
Meta has ongoing academic collaborations (CMU, Utah, ...) supporting accessibility applications for various patient groups, including those with spinal cord injury. Preprint hot off the press: https://www.biorxiv.org/content/10.64898/2026.01.09.698484v1