Stephen Ryu, a neurosurgeon and key figure in the Stanford Neuroprosthetics Lab joins Tjaša Zajc on Faces of Digital Health to demystify brain–computer interfaces (BCIs): how they work, why invasive systems outperform non-invasive ones, realistic use cases (motor control and speech), timelines and durability, safety and MRI trade-offs, cybersecurity, business models, and what Paradromics is building as a high-bandwidth BCI platform. Throughout, Stephen separates science fact from sci-fi, stressing near-term potential to restore communication and movement for people living with paralysis, while noting earlier-stage areas like mental health and pain. What we cover: - Invasive vs. non-invasive BCIs, and why electrode proximity to neurons matters for performance - Decoding motor intent and speech: training, language considerations, and LLM-enabled synthesis - Safety, surgery, and durability (why 10-year implant lifespans are a meaningful target) - MRI/CT compatibility trade-offs (and parallels to pacemakers/DBS) - Cybersecurity realities (what BCIs can not do today) - Business models, regulation, and reimbursement paths for medical-grade BCIs - Paradromics’ differentiation: a high-bandwidth platform designed to scale across use cases - Future indications: pain, sensory restoration; earlier stage: mental health biomarkers - The human impact: restoring connection for people who can’t move or speak Chapters: 01:37 How BCIs work; signals, decoding, invasive vs. non-invasive 07:13 Surgery basics, risks, and why proximity boosts performance 09:36 Decoding speech & language considerations 13:31 What’s most advanced today: motor + speech 14:58 Mental health: biomarkers and why it’s early 17:48 Longevity, MRI/CT limits, realistic replacement intervals 21:16 Patient perception: fear, performance, and value vs. alternatives 25:04 Paradromics’ platform & high-bandwidth approach 29:22 Platform use cases by brain area (motor, auditory, etc.) 31:18 Cybersecurity: risks today vs. sci-fi 32:35 Business models, regulation, and access 36:42 Trials landscape; Paradromics’ timeline 37:53 Biggest concerns: hype vs. reality 39:50 Three things everyone should know about BCIs 42:10 Potential in pain management 44:41 Role of AI/ML in decoding and assistive apps 46:36 Final thoughts www.facesofdigitalhealth.com Newsletter: https://fodh.substack.com/