Neurotech startup Augmental has raised a $4m seed round to commercialize their wearable interface for people living with motor impairment and limited hand function.
The “MouthPad” offers an unprecedented and convenient alternative to a brain-computer interface, or BCI, that circumvents the need for brain surgery by enabling users to control a mouse cursor using their tongue, breaths, head gestures, and soon, voice.
It’s the brainchild of two engineers, Tomás Vega and Corten Singer, who met as undergraduates at Berkeley and reunited in Cambridge to found the company at the tail end of Vega’s graduate work at MIT in 2019. Over the pandemic, they formed Augmental and relocated to San Francisco, where they recently upgraded their garage-based R&D hub for a new office space that includes a clean room for commercial-grade manufacturing and distribution.
The novel form factor belies Augmental’s importance to the future of neurotech markets. Their progress over the coming years represents a crystal ball for the success or failure of companies like Neuralink, Synchron, and many others in the crowded field of implantable BCI.
To understand why, let’s look at product functionality, the state of the market, and the growing, global commercial ecosystem in BCI.
A Simple Goal: Augmenting Autonomy
Augmental operates under a banner known as “Assistive Technologies.” AT includes tools to help with typing, speech, smart home functionality, as well as wheelchairs, semi autonomous robots, prosthetic or robotic limbs and some stimulation devices. Estimates vary but analysts have pegged this at a $20 billion annual market opportunity that is growing quickly as our technophile society ages.
New Mobility recently published a close-up on several AT tools, and included both the MouthPad and its early impact on end user Keely Horch, a 19 year old living with quadriplegia. From the article:
“The MouthPad embeds a tiny touchpad in a dental-safe resin retainer, Bluetooth-enabled, for the tongue to manipulate like a finger would. At first it was a challenge grasping the relationship between tongue, touchpad and screen, but now Horch forgets the device is even in her mouth and uses it for five hours a day, controlling her cell phone and more easily editing the papers she dictates with voice recognition, which works alongside the MouthPad without a hitch. Settings are customizable, and she right-clicks by drawing air through her lips: It’s sip-and-puff without the straw.”
Each MouthPad is custom-printed based on dental scans from a national network of over 90 partnered centers across the US. Augmental’s operation is becoming scalable now, after three years of working closely with nearly 100 people living with various disabilities such as spinal cord injury and neuromuscular disorders to design and develop a product that works intuitively.
Investors backing the vision include SCI Ventures, Murata, Revere Partners, LivEdge Capital, Fen, Carao and Tesserakt, as well as individuals from Andreseen Horowitz’s Scout Fund and a group of Angel Investors that include notable consumer electronics experts such as Eric Migicovsky and Nirav Patel, as well as Neuralink’s Head of Next Gen, Joey O’Doherty.
Horch, an engineering sophomore in college, uses the MouthPad to play games with her brothers and participate in class, stating, “I was able to unmute myself and raise my hand and type questions up…I was able to use different software, like graphing, and it was really helpful for visualizing things.”
Comparable to Tomorrow’s BCI, Available Today
Analysts are confident that BCI will be a $400 billion market in 20 years, but they can’t measure how much digital autonomy is worth today for people who can’t move their hands.
Augmental’s users who can move their head and neck can use head-tracking for cursor control, and perform clicks and other gestures with tongue movements. Those with more limited mobility can use tongue gestures alone for cursor control, clicks, swipes, etc.
How does the Mouthpad compare to implanted BCI? With a pricepoint in the low four figures (currently $1,500 through the company’s early-access program) it is a magnitude of order more affordable than the estimated range of $30,000 to $60,000 for implanted BCI. Moreover, by circumventing surgery of any sort, users avoid possible complications, from infections to difficulties upgrading the device.
Critically, the functionality is comparable. Vega shared that their “Bits Per Second” test, which is one technical measure of controlling a mouse cursor with BCI, clocks in at 7.85 BPS for their top-performing quadriplegic user. Compare this to 9.51, which was Neuralink user Noland Arbaugh’s top score at the time of this writing.
Most importantly, the device is available for use today. 2024 represents a breakout year for Augmental. In addition to their seed round and new office, they have crossed $100k in direct sales, published user testimonials and brought on world-class engineers and experts to expand the range of actions available to MouthPad users, including building a voice-based UI for whisper speech, and eventually fully silent speech.
Moving forward, the question is not whether the MouthPad is capable of helping people. It’s how Augmental can scale growth until qualifying their device for insurance reimbursement, which would expand access to hundreds or thousands of people seeking greater digital autonomy.
The Foundation For Success
The complexity of delivering affordable innovations into “the disability market” cannot be understated. As Augmental navigates the broken roads experienced by people living with serious motor impairment, they’ve entered the cottage industry of AT. Finding Reimbursement for novel devices involves a whack-a-mole quest through departments of rehabilitation, vocational programs, state Medicaid offices, county level disability support offices, and the like.
Despite the challenges, the number of Mouthpad users has grown to 50, with as many devices in production. MouthPad users live across 28 states, and the waitlist for the device has surpassed 3,000 people.
In the background, the company is pursuing a submission to the FDA for virtual control of electronic wheelchairs, which would qualify them for CMS reimbursement down the road. Meanwhile they are helping candidates access grant funding to pay for MouthPads and have forged alliances with nonprofits to promote and sponsor device purchase. Augmental is planning an in-house team to develop and cultivate relationships with these key institutions to broaden onramps to access by meeting patients in existing communities nationwide.
One such nonprofit is BCI Pioneer Ian Burkhart’s foundation, which has sponsored a handful of MouthPads for users in Ohio. In April, Burkhart, who was implanted with a research version of Blackrock’s interface in a clinical trial that ran from 2014 to 2021, shared his experience of navigating health coverage and income caps for disability programs with The Atlantic: “The salary (an end-user would) have to make to cover both expenses and in-home care out of pocket, though, is much more than most jobs pay. A lot of people don’t have the opportunity to make such a giant leap. The system is set up to force you to live in poverty.”
An affordable, risk-free BCI could change the conversation around value and productivity. What if enabling success in the classroom or the workplace is comparable to the cost of a new phone, rather than a new car? For now, philanthropy represents a stop-gap to drive access. It makes sense then, that SCI Ventures, born from the Christopher and Dana Reeve Foundation and operating as a strategic venture philanthropy, led Augmental’s seed round.
In a conversation with me this summer, SCI Venture’s Managing Partner Adrien Cohen described Augmental’s approach as “extremely elegant,” adding “I’ve seen the impact it’s had on users’ autonomy and independence. In a few minutes, you’re controlling your laptop, using your phone without assistance, without a caretaker. It’s a mindblowing innovation that needs to exist in the world.”
The challenging opportunities facing Vega, Singer, and their team of ten engineers and designers could reveal several promising paths for Augmental in the coming months:
- Big Tech: Augmental’s progress in launching a functional wearable control interface while developing a speech-based UI could open the door for strategic partnership opportunities. A corporate interest like Google, Amazon, Meta, OpenAI, Samsung, or any of a dozen other multinational conglomerates who frequent expos like CES might soon be keen on accelerating Augmental’s work as a way of understanding the BCI market, integrating in-home applications, developing use cases beyond disability (hands-free control in manufacturing, industrial applications, driving, agnostic integrations with all leading AR/VR headsets), leveraging large language model apps, or exploring other collaborations.
- Global Partnerships: With founders educated at Berkeley and MIT, Augmental represents an American innovation story, ready for expansion. Will the coming years see the MouthPad expand globally? From Canada to Mexico and the UK to India, Korea, Japan, and Australia, the proliferation of well-funded research centers, dedicated academic laboratories, non-profit accelerators, and other flavors of public-private R&D shops prioritizing neurotech and BCI means the possibilities of trans-oceanic collaboration are closer than ever.
- iBCI Alliances: With hundreds of patients enrolled in registries, but only precious few slots available for investigational FDA trials, it makes sense from the outside (i.e. from the patient and family perspective) for a Neuralink, Synchron, Blackrock, or ONWARD to partner with Augmental. The latter even shares an investor in SCI. But any of these companies could strike up a potential win-win opportunity to provide MouthPads to folks on the registry as a way of improving their quality of life immediately, while more closely understanding the lives of end-users in the real world.
What’s in it for the BCI companies? It comes down to competitive strategy.
In a recent article, Burkhart, Jen French, and colleagues discuss the opportunities and gaps in building Assistive Technology. These include co-development of products and standards designed with end-users in mind. Beyond calling for tech companies to do the right thing by engaging people with lived experiences (including those who might not be eligible for implantation), they call for closer consideration of how inclusive design could attract cause-driven funders and improve adoption of frontier technologies, while facilitating scale-up through crowdsourcing.
There are many BCI companies emerging, but few functional wearable control interfaces out there, ready to use and scale today. So, where can commercial leaders and investors find a revenue-generating, low-risk market opportunity to help people living with disability today, while generating unique insights on user preferences, habits, requirements, limitations, and ideas that could differentiate BCI roadmaps and strategy?
The answer might be right under your nose.
