A Better Brain Chip Than Elon Musk’s?
With money from Jeff Bezos and Bill Gates, scientist Tom Oxley’s startup has a less invasive device that could entice more patients than Elon Musk’s Neuralink.
Shortly after 2 a.m. on a Saturday in a midtown Manhattan sports bar packed with Aussies, Dr. Tom Oxley was feeling stunned. The underdog Brisbane Lions, his longtime favorite Australian rules football club, was up 73 to 27 against the Sydney Swans going into the second half of the championship match.
“It’s a good start,” Oxley acknowledged, clad in his typical game-day fit, a maroon, blue and yellow Lions jersey.
Most days and nights, Oxley, 44, is holed up in Brooklyn’s Navy Yards at the headquarters for Synchron, the brain chip startup he founded with backing from the likes of Jeff Bezos and Bill Gates. But he stole away whenever he could in September to watch the Lions unexpectedly advance in the playoffs. In a later conversation, Oxley would liken his fandom for the Lions—which started when he attended games with his father—to a startup’s “scrappy bootstrap mentality.” He added: “It’s also quite Australian to relish the underdog.”
That’s a useful mentality for Oxley to carry back with him to Brooklyn. Within the burgeoning race to design and commercialize brain chip implants, Elon Musk’s Neuralink has the same status as the Sydney Swans do within Australian rules football: Both are attention-consuming favorites. And yet there’s Oxley and 12-year-old Synchron, which has raised about $145 million.
The company’s device targets patients with amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, or stroke and spinal cord injuries who experience significant paralysis. It helps them control computer screens with their thoughts. Chief Commercial Officer Kurt Haggstrom estimates that the U.S. market includes up to “millions” of people. Morgan Stanley—which expects such brain devices to become available in 2030—projected last month that companies will generate more than $500 million in collective revenue each year in the U.S. from selling these implants by 2036.
Could Synchron pull off a Brisbane Lions–type upset over Musk? Certainly no other company is better positioned to do so. Synchron is further along in the Food and Drug Administration’s approval process than most other commercial brain chip companies, and it has installed its device in 10 people, the first of whom received it in 2019. (Neuralink implanted chips into its first patient, and then another, earlier this year.)
Importantly, unlike Neuralink, Synchron’s device doesn’t require open brain surgery, which could make it easier to commercialize. Instead, doctors feed it into the brain through a patient’s jugular vein. At all times the chip remains inside the blood vessels. It’s not a quick, prosaic type of outpatient surgery, but it’s not as risky as sawing open someone’s skull. The strategy mirrors a broader change in medicine, and that approach is what most investors point to when asked how the company can compete with Musk.
“The shift in most surgical procedures is towards more and more of these minimally invasive intravascular procedures,” explained Alex Morgan, a Khosla Ventures partner.
When I asked Oxley about the competition between Synchron and Neuralink, Oxley said he is “honored” to be considered a Musk rival. “I’ve revered him for a long time, and I’ve looked up to him,” said Oxley, who drives a Tesla. (His board has jokingly suggested he give up the car—lest Musk listen in.) “He’s shifted the way that we think about things in a positive way in areas that needed shifting.”
Asked why investors give him money instead of Musk, Oxley has a simple response: “Because people like their skulls…that’s probably the best reason. Because I think the ultimate solution is going to be: People want to have their bodies disturbed as little as possible.”
Musk has taken notice of Synchron, too. Two years ago, around the time Synchron implanted its first U.S. patient with its device, Musk called Oxley out of the blue one weekend, and they talked for an hour about how to gain access to different parts of the brain, Oxley recalled. Musk’s approach was to remove a substantial portion of the skull and replace it with an electronic embedded titanium shell, while Oxley contended that there were ways of getting there without touching the skull, he said. (Musk didn’t respond to requests for comment for this story.)
The conversation ended with what appeared to be a funding offer. Musk “basically said to me if I am capital constrained in that endeavor to achieve that goal—especially towards a whole brain interface—that he would like to be helpful,” Oxley said. The investment never materialized.
Underpinning Oxley’s 12-year devotion to building Synchron are his formative experiences as a physician. He points to a harrowing stint early in his medical career on a ward for Lou Gehrig’s disease “They would come there to die,” he recalled. Until recently, Oxley still saw patients at Mount Sinai Hospital, doing about 50 procedures a year to treat patients who had suffered strokes, ruptured aneurysms and other “life-threatening brain explosions,” such as hemorrhages.
The roots of his fascination with the human brain lie in his interest in Friedrich Nietzche, the 19th-century German thinker whose own brain deteriorated from syphilis, and other philosophers. As a young man, Oxley became “obsessed” with figuring out how the human brain can ask itself deep, reflective questions. “What happened in us that was different from other animals? What was it about the making up of the brain that generated consciousness, that made us ask these questions, that then started to lead us down this pathway of self discovery?”
A few days before the big game, Oxley and I met in Synchron’s industrial Brooklyn Navy Yard office. There he showed me the newest iteration of the company’s device, the Stentrode, gingerly withdrawing the tiny gizmo—slightly longer than the spring of a ballpoint pen—from a hefty aluminum briefcase.
Researchers have been testing brain chip implants in humans for roughly two decades, and some have attained impressive results beyond controlling cursors on computer screens. Paralyzed patients have been able to control robotic arms with certain implants in academic experiments. But virtually all these devices have involved cutting through the skull and piercing electrodes into patients’ brains with wires dangling out of their heads.
To avoid all that, Synchron’s approach is to feed a needle and tube through the jugular vein all the way to the top of the brain. The Stentrode is then pushed through the tube into the brain, where it expands and mounts onto the wall of the superior sagittal sinus, a blood vessel close to the brain’s motor cortex—the movement command center. Any brain signals the Stentrode detects are sent down through an electrical wire that runs back through the vein and plugs into an iPod Shuffle–size receiver sewn into a person’s chest. Batteries last 10 years, similar to those in a cardiac pacemaker.
That receiver transmits commands via Bluetooth to a patient’s computer or iPad, allowing them to access text messages and control other applications. Once the Stentrode is installed, patients go through calibration exercises, with Synchron staff instructing them to think about moving different parts of their body.
Synchron’s Stentrode isn’t the only such device people with paralysis can use. Eye trackers have been hot spots for innovation in recent years. Apple, for example, revamped its eye-tracking features in its latest iOS update. Still, eye trackers can be tiring for some patients, and selecting things on the screen can be finicky given that it requires people to stare at one spot for a certain amount of time. Plus, the most severe states of paralysis, like locked-in syndrome, limit even eye movements.
Hiding electrodes inside blood vessels as opposed to lodging them in the brain has limitations. The sensors don’t detect electrical signals with the level of strength or detail Neuralink does, which Oxley acknowledges. But that doesn’t phase the Synchron investors I spoke with. “The fact that you get any signal at all is kind of amazing,” said Bob Nelsen, managing director of prolific biotech investing firm Arch Venture Partners, which led Synchron’s Series C two years ago. He suggested that advances in other parts of technology could help the company better analyze and understand the signal the sensor does get.
Synchron is currently developing a new version of its Stentrode, which, by Oxley’s estimate, can detect brain activity “about 10 times better” than the version implanted in the first 10 patients. He doesn’t know what that will mean in terms of functionality but suggests it could mean adding more-nuanced controls for computer screens.
In the long run, Synchron’s hope is to weave multiple, sensor-laden wires into different blood vessels around the brain to detect a much wider array of brain activity.
“The brain does different things in different regions,” said Oxley. “And if you ram a million electrodes into a tiny region, that whole bunch of neurons—they’re all doing the same thing.”
After about an hour of Oxley’s show-and-tell with the Stentrode—and a professorial lesson on brain anatomy—it seemed like an apt time to ask him why he committed himself to all this.
“I’m not religious—I don’t know why we’re here—but it seems to me the best way that you could spend your life is answering some of the mysteries and changing the way that we understand things in a way that helps us as a species move forward,” he said, leaning back in his chair after a long pause. “I chose the brain because it was the biggest mystery I could think of.”
Oxley frequently launched into these philosophical tangents, at one point sharing with me reflections from Carl Jung’s “The Red Book,” which was engrossing him in late September. Asked where all his ruminations come from, Oxley pointed to his father, a former diplomat who shaped his upbringing with strong opinions and “intellectual aggression.”
Oxley spent part of his childhood in Switzerland, where his dad represented Australia at the U.N.—at one point chairing a precursor organization to the World Trade Organization—before the family moved back Down Under. At the dinner table, his father would regularly grill him and his sisters on politics, culture and international affairs. The impromptu exams instilled a mentality of “Don’t open your mouth unless you absolutely know what you’re talking about,” Oxley recalled.
Eager for some distance from his diplomat father’s interests, Oxley decided to pursue medicine. “I figured if I move into a domain that was totally away from his expertise, he wouldn’t pound me to the ground with intellectual dogmatism.”
Oxley attended medical school in Australia, graduating in 2005, and pursued residencies in both internal medicine and psychiatry. He was particularly interested in the latter after watching two friends experience psychotic episodes, one from a psychedelic drug, the other from schizophrenia. But Oxley was shaken when a patient committed suicide. He grew frustrated with not being able to understand the biological mechanisms behind psychiatric conditions. Around the same time, he began reading about brain computer interfaces.
Oxley took a year off from training in 2010 and traveled through 35 countries, ending his tour in the U.S. There, he met Colonel Geoffry Ling, a neurologist who founded a biotech arm of the Defense Advanced Research Projects Agency. Oxley impressed Ling and his team with an idea of using blood vessels to reach the brain. Weeks later, he had secured $1 million from DARPA to begin research back home in Australia.
To build some of the earliest prototypes of Synchron’s devices, he recalls going through the hospital trash to find disposed devices that had been used to remove brain clots. In one instance, a nurse reported him after seeing him pulling devices from the garbage, but he had approval from one of the doctors, so he kept doing it. After sterilizing them, Oxley would tinker with them and hook up sensors to them manually.
Oxley finished his doctorate in neuroscience in 2015 and then moved to New York for an interventional neurology fellowship at Mount Sinai. He continued doing lab research in Australia remotely. The fellowship had him working 100 hours a week, but he would use the time difference with Australia to his advantage, managing the lab at night in New York. In 2019, Synchron implanted its chip in the first of four Australia-based patients, each of whom was able to use the device over the course of a year without any serious side effects.
Oxley cites 2020 as the most painful period for building the company. Synchron had nearly $20 million in funding to that point, mostly from government grants, but was running out of cash. Meanwhile, Oxley was hitting a wall with investors. He grew frustrated when they turned him down, citing concerns about market size and whether Medicare might pay for the device.
“What happens is, you go and meet really smart people, and then they say no, and they say no in a million different ways,” he said.
Khosla Ventures eventually found Synchron while searching for patents related to brain chips that didn’t require removing part of the skull, and the firm led a $40 million funding round in 2021. Morgan, who led the deal, said Oxley has always been laser focused on patient outcomes. And his philosophy interests, in Morgan’s view, are emblematic of many successful entrepreneurs and executives.
“Pick the Charlie Mungers the world or the Jeff Bezoses—they actually wrote a lot about a general philosophy of the world and life,” Morgan said, attributing some of those individuals’ financial success to an “insatiable curiosity.” In 2022, Synchron implanted its chip in the first of six patients in the U.S. and raised another $75 million from Arch Ventures. Earlier this year, the company finished the first of two major FDA clinical trials, showing that the device was safe.
Still, the road to getting the chips approved and making any meaningful revenue remains long. Before Synchron starts the second trial, which will have to demonstrate that the device sufficiently helps patients, the company is planning another small trial for the newer version of the Stentrode.
Haggstrom, the chief commercial officer, anticipates it will take three to five years to begin selling the devices widely, in line with Morgan Stanley’s estimates. He acknowledged total customers in the first year after an FDA approval will probably be “more in the hundreds.” At an estimated price point of $60,000 to $100,000 per device, getting insurers on board will be another big hill to climb.
Oxley, 12 years into his journey, seems as energized as ever. “I’ll flip into complete, absolute nihilism if I don’t feel like I’m doing something that’s really worthwhile, and I couldn’t think of anything more worthwhile or more important than doing this.”
Deep down, he also hopes the Stentrode may one day be able to counter memory loss, an issue that has become more personal to him since his dad was diagnosed with Alzheimer’s disease five years ago. He acknowledged that such a capability is still a long way away.
“It kind of is a bit frustrating that I’ve been so close to neurology—and I’m working in it day in, day out—and nothing I’ve done is going to help at all with him,” he said.
Back at the sports bar around 3:30 a.m., the crowd had begun to clear out as the Lions crystallized their blowout victory. They won 120 to 60, and several Swans fans came up to Oxley to offer their congratulations.
As Oxley looked up at the TV for another 15 minutes watching his team collect the trophy, he picked up the phone and dialed his folks back home in Melbourne, eager to share the moment with them. “I’m watching at a pub in New York,” he told them. His father came to the phone. “Hey, Dad, what do you think?” Oxley asked. “Are you watching?” Indeed he had been.
