Medical News

The Neuro Revolution: How Brain Science is Changing Our World Zack Lynch with Byron Laursen. St. Martin’s, $25.95 (256p) ISBN 9780312378622

Neuroscience entrepreneur Lynch, founder of a global trade association and a market research firm, is a futurologist with his feet on the ground. After an eight-year struggle to diagnose a painful back injury, Lynch's condition was pinpointed by a full-body MRI scan; the experience convinced him that emerging tools will improve our “control over the mental environment” in the same way we've managed the physical environment. Examining emerging tech, Lynch reports on lie detectors like a portable system for rapidly scanning and detecting involuntary facial tics, and a developing method called “brain fingerprinting.” Emerging marketing techniques include functional MRI scanners for focus groups, allowing researchers to look directly at the brain of the subject, rather than depend on verbal responses. Lynch predicts that brain scan information will improve performance, and may become vital to professionals like stock brokers and specialized military forces; he also sees mental face-lifts attaining the popularity of cosmetic surgery. The exciting news is tampered by warnings that such devices could also be used for “cultural or economic bondage.” Lynch is passionate, knowledgeable and fully engaged with the world of neurotechnology, and his overview makes absorbing material. (July)

Here is the 45 minute follow up debate. Poor title, we should have discussed neurodevices in depth but there only so much time and bandwidth.

Enjoy this 15 minute interview!

Adaptation of pacemaker technology has led to major advances in neurodevice development, allowing for stimulation of discrete brain areas and nerves for the treatment of Parkinson’s, essential tremor, epilepsy, and even obsessive–compulsive disorder. Novel device platforms for neuromodulation will allow for less invasive and more responsive therapies in the future.

Optogenetics, for example, is an emerging field combining optics and genetics to probe neural circuits on the millisecond time scale. In early development, delivery of genes tied to cell-specific promoters has been used to make certain neurons light sensitive. Then highly targeted light-emitting hardware such as fiberoptics is used to activate or deactivate that specific cell type. One startup in this area is developing an optogenetic neuromodulation system that may one day enable the blind to see. Leveraging this technology will yield entirely new levels of control over specific cell types in the brain, making it possible to treat illnesses that emerge as a result of malfunctioning neuronal circuits. Another exciting example of the future of neurodevice development relates to the development of conducting polymer nanowires, which will make it possible to monitor and modulate individual brain cells. The wires can be threaded through the circulatory system into the brain, without the need for invasive brain surgery. They do not block normal blood flow or interfere with the exchange of gases and nutrients through the blood vessel walls.

Looking forward, it will be possible to connect an entire array of nanowires to a catheter tube that could then be guided through the circulatory system into the brain. Once there, the wires would branch out into tinier blood vessels until they reached specific locations. Each nanowire would then be used to record the electrical activity of a single nerve cell or small groups of them. Nanowire sensors could greatly improve doctors’ ability to pinpoint damage from injury and stroke, localize the epileptogenic zone(s) of seizures, and detect the presence of tumors and other brain abnormalities. Beyond that, nanowires that could deliver electrical impulses have the potential to transform the entire field of neuromodulation, dramatically expanding the potential scope of treatable conditions. (more in the Neurotech Industry 2009 Report)

If you are in Canada tomorrow evening, watch me on The Agenda at 8pm with Steve Paikin where I'll be talking about my forthcoming book, The Neuro Revolution and neuroenhancement.

While I spent Monday on a special working group at the National Institute of Neurological Disease and Stroke reimagining the Small Business Innovation Research Program in Rockville, Maryland, Tuesday was full of 10 separate meetings up on Capitol Hill lobbying for the National Neurotechnology Initiative. In the morning I met with the staff of Senators Burr, Greg, Bingaman, and Merkley in their offices while the afternoon was spent talking with Representatives Dingell, Markey, DeGette, Burgess, Sarbanes, and Space. Progress.

Dozens of private companies are currently developing or commercializing neurodrug delivery methods and devices that will bring life to old and new compounds alike. These technologies include:
Implantable devices: Implantable pumps bypass the blood– brain barrier (BBB) and deliver highly accurate amounts of drugs to specific sites in the brain or spinal cord.
Expression systems: A French company is circumventing the BBB using encapsulated cell technology (ECT), a polymer implant containing cells that provide continuous, long-term release of the therapeutic protein to the brain or eye.
Receptor-mediated transport: Receptors that transport nutrients
to the brain from the blood can be tricked into transporting therapeutic chemicals, peptides, and proteins across the BBB. Insulin, transferrin, and lipoproteins, for example, cross the BBB by facilitated transport, and can be combined with therapeutic proteins or other molecules to promote access to the brain [10].
Cell-penetrating peptides: During the past decade, several arginine-rich peptides have been described, such as SynB vectors, which allow for intracellular delivery and BBB transport. The mechanism for this transport is unknown. A Swiss company is using cell-penetrating peptides to develop treatments for stroke and myocardial infarction.
Focused ultrasound: Some research shows that focused ultrasound can temporarily open the BBB in a targeted area for a window of time. A seed stage company is working to commercialize this technology and improve it for use in humans.
Nanoparticle formulations: Nanoparticle formulations refer to
therapeutics encapsulated in nanoscale particles that can pass the BBB. Although there is great interest in using nanotechnology to improve neuropharmaceutical delivery to the brain, it will take some time to overcome challenges of this platform, including the need for intravenous delivery, manufacturing, and clearance by the liver.

Brain and nervous system illnesses are exceptionally difficult to research and diagnose, partly because changes in the local environment of the brain are difficult to assess within the confines of the skull. Although diagnostic tests for diseases like cancer and diabetes are common and can use samples from blood, urine, or tissue, diagnostic tests for many brain-related illnesses are only beginning to emerge.

Neuroimaging is revolutionizing the diagnosis and treatment of brain-related illness. It is difficult to imagine treating patients with brain tumors, cerebrovascular disorders, or epilepsy without current imaging tools. Several decades of neuroimaging research have contributed enormously to our understanding of structural and functional differences in people with neurological and psychiatric disorders. For example, PET scans have been shown to be 93% accurate in detecting Alzheimer’s disease about 3 years before the conventional diagnosis of ‘‘probable Alzheimer’s”. Imaging now offers
insights into the mechanisms of action of drugs used to treat schizophrenia and the causal mechanisms that may be at the root of many disorders. Diagnosis of mental illness and differential treatment selection is one of the most difficult aspects of psychiatric treatment, yet this is where neuroimaging will add tremendous value in the years ahead.

On the neurofeedback front, Omneuron, a private company, in conjunction with Stanford University, is using real-time functional MRI (rtfMRI) to train patients in pain management techniques by monitoring the ongoing activity of their brains. Within a 13-minute session, patients can learn to control activity in different parts of their brain and alter their sensitivity to painful stimuli, allowing them to better control pain. Patients watched their brain’s level of activity as seen by rtfMRI and were trained to decrease pain intensity through mental exercises, such as focusing on a part of the body where they did not have pain. In years to come, rtfMRI has the potential to add an entirely new treatment option for a whole host of brain-related illnesses including depression, addiction, and dementia.

We have released our fifth annual comprehensive investment guide and market analysis of the global neurological disease and psychiatric illness markets. The 480-page report enables investors, companies and governments to identify opportunities, calculate risks and understand the dynamics of this continually changing market.

Specific findings from The Neurotechnology Industry 2009 Report show that in 2008:

- 2 billion individuals worldwide suffered from a brain-related illness
- Over 550 public and private companies participated in neurotech worldwide
- Venture capital investment in neurotechnology fell 22% to $1.44 billion
- More than 250 venture investors were involved in neurotech financings
- Global neurotech industry revenues rose 9.0% to $144.5 billion
- Neuropharmaceuticals recorded revenues of $121.6 billion and 9.3% annual growth
- Neurodevices recorded revenues of $6.1 billion and 18.6% annual growth
- Neurodiagnostics recorded revenues of $16.8 billion and 3.7% annual growth
- The annual economic burden of brain-related illnesses is over $2 trillion

The Neurotechnology Industry 2009 Report: Drugs, Devices and Diagnostics for the Brain and Nervous System comprehensively tracks pipelines and products in development globally to help guide strategic business development and investment decisions in neurotech.

The 2009 report provides an in-depth look at more than 16 brain and nervous system disorders and treatments in development at over 550 public and private companies, including: Alzheimer's disease, addiction, ADHD, anxiety, depression, epilepsy, migraine, mild cognitive impairment, multiple sclerosis, obesity, pain, Parkinson's disease, schizophrenia, age-related macular degeneration, sensory disorders, sleep disorders, stroke and traumatic brain injury. Corporate financing, market activity, growth drivers and global industry conditions that make up the obstacles and opportunities facing the industry are fully assessed with detailed insights.

The brain has extremely limited capabilities to repair itself, but new strategies are emerging to improve the brain’s ability to regenerate lost neurons and to facilitate the incorporation of implanted stem cells into brain circuitry. There are currently at least eight private and three public companies developing neuroregeneration cell transplant therapies. More than $450 million in venture funding has been invested in companies working on cell replacement and stem cell therapies for brain and spinal cord disorders.

There are significant challenges to overcome when considering the use of implanted cells for neurological diseases. For example, inducing a cell to differentiate into a skin cell or a liver cell is likely to be easier than inducing it to form precise connections with another area of the brain. The chemical signals for forming the appropriate connections in the brain may be present only during certain times of development. Additionally, the character and connections of these new cells must be stable. Despite these complexities, stem cell therapies offer the potential for outright cures to some
neurological diseases.

Recently, we have seen progress in bringing these treatments into human trials. A California company has been in clinical testing of fetal stem cells to treat Batten’s disease since 2005 and expects to complete their Phase I study in early 2009. In December 2008, they received FDA approval to begin trials in a second disorder, Pelizaeus–Merzbacher disease (PMD), a fatal brain disorder that affects mainly young children. In February 2009, the first embryonic stem cell trial for spinal cord injury treatment was also approved. These are slow and precautious steps, centering on untreatable disorders, but cell-based therapeutic candidates for amyotrophic lateral sclerosis, Parkinson’s disease, Alzheimer’s disease, and stroke will soon follow.