One day last October, sitting in the courtyard of his house in China’s Henan province, Dong Hui decided to see if he could hold a pen to write. 

Dong, 39, had sustained spinal cord injuries in a car accident six years earlier that left him paralyzed from the neck down. Slowly but determinedly, he wrote his name, “Thank you,” and then the date. This was the result of an 11-month-long rehabilitation enabled by an implant in his brain. Before that process, Dong could move his arms slightly but wasn’t able to use his fingers.

“I couldn’t believe I was able to write again. I was so excited I even missed a stroke in my name,” he told MIT Technology Review on a video call. 

In November 2024, Dong became one of the first people in China to be given an invasive brain-computer interface (BCI) through brain surgery. He had signed up for a clinical trial with the device’s developer one month after seeing on TV how a BCI had apparently enabled another paralyzed Chinese man to hold his granddaughter. 

This March, the implant Dong uses became the first invasive BCI product in the world to be approved for use beyond clinical trials. It’s now available to some patients with paralysis in their limbs due to spinal cord injuries. We spoke to a range of experts to understand why the device was able to reach this global milestone, what makes this moment so significant, and what to expect next. 

A world first

Dong’s brain implant is a coin-size device called NEO. It was developed by Neuracle Technology, a Shanghai-based startup, together with researchers at Tsinghua University in Beijing. 

During a procedure that took just over an hour and a half, the device’s sensors, which collect Dong’s brain signals, were placed on his dura mater, the tough outer layer of tissue that covers and protects the brain. The signals are transmitted to a computer by an implant placed on Dong’s skull. The computer then translates the signals into commands for a soft robotic glove Dong wears during the 2.5-hour training sessions he completes each day to help him learn to grab. 

Dong started his rehabilitation around a week after surgery. “On the ninth day of my training, my right hand successfully grabbed a ball without the glove,” he says. “That was a miraculous moment.” 

Now he continues with his training at home. He wants to be able to control his hands better in order to put on clothes, eat, and do other daily tasks without troubling his aging parents. 

A growing number of people with traumatic injuries in China are now poised to tread a similar path thanks to NEO’s recent approval. According to China’s National Medical Products Administration, the bureau responsible for drug supervision, the product is suitable for patients between 18 and 60 who have paralysis in all limbs due to spinal cord injuries but still have some residual function in their arms. 

NEO beat several other BCIs to approval, including one from Neuralink, a California-based company founded by Elon Musk. Since October 2023, Neuracle has conducted 36 clinical trials using NEO, including the one on Dong. Thirty-two of them took place in the space of a few months in 2025, with the details about one of the four first in-person trials published in a preprint paper last July. Neuracle did not reply to a request for comment from MIT Technology Review.

One reason for NEO’s fast approval could be that it has a “relatively less invasive” design than counterparts such as Neuralink’s N1 brain chip, says Avinash Singh, a BCI researcher at the University of Technology Sydney. NEO’s eight sensors sit on top of the brain’s protective membrane while Neuralink’s N1 chip directly penetrates the cortex, the outermost layer of the brain itself. Neuracle’s device faces fewer regulatory constraints because it presents a lower risk of hemorrhage, glial scarring, and long-term signal degradation, Singh says.

China’s strong support for its BCI industry also means that NEO was put on an expedited regulatory pathway; in comparison, the approval process of the US Food and Drug Administration can take several years, Singh adds.

A big boost for BCIs

NEO’s approval is hugely important for the global BCI industry, says Wang Shouyan, a neuroscientist at Fudan University in Shanghai who was not involved in research or trialing for NEO. Even though research and development on BCIs has taken place for several decades, most of it happened in the lab. The news means that BCIs are now ready for large-scale manufacturing and clinical use in China, Wang says. 

For Dong, however, it means something much more personal. “Now, it will be able to help not only me, but also thousands and thousands of other patients suffering from spinal cord injuries in China who are tortured by despair each day,” he says of NEO. “It will bring them hope and change their lives.” 

Days after NEO was approved, China started incorporating it into the country’s health insurance system by assigning it a unique code. This is one of the first steps toward a future where eligible Chinese patients pay a certain percentage of the BCI’s price if they need it during their treatment.

The growth of China’s BCI industry is expected to accelerate thanks to the government’s policy support and financial backing. The country’s latest five-year plan, published on the same day Neuracle received its approval, lists BCI as one of six key industries important to China’s future tech competitiveness, alongside quantum technology, humanoid robots, and others. Several Chinese startups, including NeuroXess and StairMed, have already worked in the field for many years. 

“China’s decision to double down on becoming a global leader in the field owes in part to what these companies have already accomplished,” says Meicen Sun, an information scientist at the University of Illinois Urbana-Champaign who studies information and technology policy. 

But, Sun says, the biggest advantage China may have is that Chinese people, particularly patients like Dong, tend to welcome this technology and are genuinely enthusiastic about it. In comparison, in the US and Western Europe, testing technologies on human bodies elicits an “ick factor,” triggering concerns and even resistance, she says.

Cooperation in a cold climate 

NEO has become the world’s first invasive BCI to go commercial, but scientists interviewed by MIT Technology Review caution against comparing Chinese and US efforts through the lens of a race. 

A race implies an endpoint, but it is hard to say where that is for the development of BCIs, says Nick Ramsey, a neuroscientist at Radboud University Nijmegen in the Netherlands. Also, the US and China have fundamentally different visions, Sun says. The US is primarily concerned with being the first to do something and achieving state-of-the-art performance, while winning to China means capturing more consumers and using technology to deliver solutions on a societal scale. 

“Being exceptional and being accessible are two diametrically opposed definitions of winning,” Sun says. 

In fact, neurotechnology has emerged as a rare tech sector where US-China collaboration is still happening despite geopolitical tensions. The US company Axoft,  based in Cambridge, Massachusetts, says it has teamed up with a Chinese company and a hospital in Shanghai to test its BCI on four patients in China and has plans to expand its trials in the country. 

Looking forward, China’s BCI industry is expected to speed up its growth over the next five years thanks to strong government support. “There is no comparable national-level ambition or coordinated map elsewhere in the world at the moment,” says Singh.

More BCIs are also in the pipeline for domestic approval in the country, including Beinao-1, developed by the Chinese Institute for Brain Research in Beijing and its affiliated startup, NeuCyber NeuroTech. The device, which sits on the dura mater, is designed to help those who have movement and speech difficulties due to spinal cord injuries or amyotrophic lateral sclerosis. These candidates could get the green light as early as 2028, Singh says. 

The alert was raised on May 5. Four health-care workers in the Ituri Province of the Democratic Republic of the Congo had died from an unknown illness within four days.

Rapid response teams were sent to investigate, and tests at a research center in Kinshasa revealed the culprit: the Bundibugyo virus, one of the viruses that cause Ebola. Suspected cases of the disease have snowballed in the last few weeks. By May 24, the WHO had estimated that 223 people had died from the disease. There were over 900 suspected cases. Today’s figures are likely to be higher.

A couple of weeks ago, I covered the hantavirus outbreak aboard a cruise ship. Three people sadly died, but the outbreak itself was kept under control. There have been no further deaths, and passengers have been safely repatriated. The picture for Ebola is far bleaker. And there are several reasons why.

The most obvious is the disease itself. Ebola is a severe disease with an average 50% fatality rate. Previous outbreaks have resulted in thousands of deaths. (Hantavirus also has a high fatality rate, but it doesn’t usually spread as easily between humans.) 

Between 2014 and 2016, an Ebola outbreak in West Africa caused more than 11,000 deaths. A more recent outbreak, which took place between 2018 and 2020, caused 2,299 deaths before being brought under control with a vaccination campaign.

But those outbreaks were caused by the Zaire virus, which has a different genetic sequence. There is no vaccine for the Bundibugyo virus. We don’t know if the two vaccines approved for Zaire might also work for Bundibugyo. There’s a concern they might even make things worse by interfering with a person’s immune response to the virus.  

Scientists are working on potential Bundibugyo vaccines. But the most advanced efforts are still months away from clinical trials. There are no specific antiviral treatments for the virus, either.

So to control the outbreak, health-care workers are trying to stop the spread of the disease. Ebolaviruses can be transmitted to humans by animals including fruit bats, chimpanzees, and gorillas. They can then spread between people via contact with bodily fluids such as blood or vomit.

That’s why the virus is often spread among family members, to health-care workers, and during some burial services. The WHO advises isolating people who have the virus in treatment centers. It also recommends safe burial measures that limit physical contact with the deceased, for example. Communities need to be informed about the virus and how it spreads, and health professionals should be on hand to diagnose cases and track them.

That’s all easier said than done in an era of misinformation. Some members of the community even doubt whether the disease is real. There have been three attacks on health-care facilities in the region in recent weeks.

Last week, two treatment centers were burned down. The first incident occurred after relatives of a deceased man were prohibited from retrieving his (infectious) body. As a result of the second incident, 18 suspected cases reentered the community.

A couple of days later, a group of men unleashed gunfire at Mongbwalu General Hospital, which was also treating people with Ebola. They were demanding the bodies of their deceased relatives.

There are more causes for concern when it comes to the spread of the virus. The Ebola outbreak is thought to have originated in Mongbwalu, a high-traffic mining hub. People who caught the virus in Mongbwalu are thought to have sought care in neighboring districts. And the wider province borders both South Sudan and Uganda. So far, Uganda has reported seven confirmed cases and one death. South Sudan’s health ministry has said it will strengthen surveillance, but no cases have been reported in the country so far. 

Violence in the region is making it much harder to contain the spread of the virus, too. Conflict involving multiple armed groups, including deadly attacks on civilians, has hampered humanitarian and health-care efforts. Poor infrastructure and damaged roads make matters even worse. Food insecurity is ravaging the region as well—this year, nearly 10 million people in the region face acute hunger.

Together, these factors are making it “nearly impossible” to isolate people with Ebola and trace others who have been in contact with them, WHO director general Tedros Adhanom Ghebreyesus said in a statement earlier this week.

The dismantling of US aid programs hasn’t helped either. US government funding for international health projects has steeply declined since the start of President Donald Trump’s second term. These cuts have harmed disease surveillance systems, according to the International Rescue Committee, a humanitarian nonprofit.

“Funding cuts have left the region dangerously exposed,” Heather Reoch Kerr, the organization’s country director for the Democratic Republic of the Congo, said in a statement. “Years of underinvestment and recent funding cuts have left many health facilities without adequate protective equipment, surveillance capacity, or frontline support needed to respond quickly and safely.”

The US has mobilized emergency funding for the outbreak, and a spokesperson for the State Department has argued that none of the administration’s actions have hampered the Ebola response. But health experts counter that the damage has already been done.

On May 17, the WHO declared the Ebola outbreak a public health emergency of international concern. In a statement on Wednesday, Tedros described the situation as “a catastrophic collision of disease and conflict with the Ebola outbreak in Ituri province outpacing the response.”In an online appeal to residents on Wednesday, ahead of an in-person visit, Tedros pleaded for a ceasefire and commended the spirit of community members. He also acknowledged the steep challenges they face. “You are already carrying so much: malaria, hunger, insecurity, and the daily struggle to keep your families safe,” he wrote in French. “And now Ebola. It’s not fair, and I won’t pretend otherwise.”

This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.