25 Years Old: Mirror box therapy with a VR twist
In 1993, Dr. Ramachandran invented a new therapeutic approach to treat phantom limb pain using a mirror box. The device worked as follows: the patient would place the sound limb in the box on the mirror side, while the affected limb was hidden in another compartment. Looking at the mirror reflection of the sound limb, the patient would imagine this to be the phantom limb and execute movements to help relieve the perceived pain.
Today, MindMaze, a Swiss-based startup, has developed and sold a virtual reality device that applies similar principles as the mirror box to help alleviate phantom limb pain.
50 Years Old: Google invests in technology from the 60’s which seeks to substitute the senses
In 1969, Dr. Paul Bach-y-Rita published a paper in Nature on a new device for the visually impaired. The device allows patients to “see” by converting an image, captured on camera, into a vibrational pattern that can be received as substitute stimulation. Normally, an image is captured by the eyes and focused onto the retina which produces the visual signal. This signal is then transmitted by the optic nerve to the occipital lobe for further processing and interpretation. In fact, information from all sensory organs follow a similar trajectory in which external stimuli are converted into electrical signals to be processed by the brain. With this in mind, Dr. Bach-y-Rita realized that perhaps malfunctioning eyes could simply be replaced by another sensory organ. Following his publication on visual substitution, Dr. Bach-y-Rita began to tinker with methods of substituting sensory organs. In one example, he developed an idea to use tactile stimulation as a means of sending information to the brain.
After weighing numerous options, Dr. Bach-y-Rita concluded the best option for sensory substitution would be stimulation of the tongue. He created a company and began development on a device for commercial use. The device, called the BrainPort V100 Vision Aid, allows patients to “see” by converting light stimulus, captured on camera, into 400 electrical signals relayed on the tongue’s surface. Through training, these signal patterns can be interpreted to provide information about the visual stimulus. The BrainPort V100 Vision Aid allows for reading and object recognition.
While his venture nearly failed in 2005, Dr. Bach-y-Rita was given the chance of a lifetime to present his idea to Eric Schmidt of Google as well as other venture capitalists. As a result of this pitch, the BrainPort V100 Vision Aid raised 2.5 million dollars in funding from Google and has since acquired FDA approval and commercialization licenses.
70 Years Old: Same tests, different platform
Since the 1930’s, neurologists have applied cognitive assessments in the treatment of neurological disorders. As many of these illnesses diminish cognitive function, doctors can use these assessments as a diagnostic tool and method of tracking disease progression. In particular, these diseases may affect attention, focus, and memory. All of these characteristics can be measured through cognitive tests, but it is important to note the arduous nature of conducting these evaluations. First, patients are required to visit a doctor or hospital, where they risk contracting illnesses. Furthermore, in the past tests were tedious to execute as they were paper-based and used stopwatches to track time. As critical as these evaluations are for treatment, they can be inconvenient for patients and doctors alike.
Fast forward to present day and these hassles can be avoided with the help of computers. Electronic tests reduce the amount time clinicians spend administering and scoring assessments. In addition, patients can now perform cognitive assessments from the comfort of their own homes using their smartphone or tablet. Companies, like Savonix, have developed neurocognitive assessment apps which can accurately measure a variety of cognitive functions. Perhaps in the future test scores on cognitive assessment apps will be sent directly to the patient’s doctor, further simplifying the diagnostic process.
90 Years Old: Improving on an old standard
The first electroencephalogram, abbreviated to EEG, of a Homo sapien was reported in 1929 by Hans Berger, a German psychiatrist.
Since its inception in 1929, the EEG has remained relatively unchanged. For optimal recording the electrical resistance between skin and electrodes must limited as much as possible; to achieve this, electrodes are kept tightly in place by a cap or gels. It takes approximately 30-60 minutes to precisely position each electrode. Furthermore, due to the high volume of cables required for recording and transmitting electrical signals, patients are asked to remain still for the duration of the procedure.
(Credit: BioSemi, g.tec)
In recent years researchers have been working to improve EEG technology. While many have sought to improve signal acquisition in existing electrodes, more recently there has been a push to create a mobile EEG system using dry electrodes. Notably, these dry electrodes require no gel or cables. The California-based company Zeto has developed a new EEG device using dry electrodes and a wireless transmission system for patients with epilepsy. Zeto applies tripolar electrodes to minimize noise. The company’s aim is to provide medical-grade quality at maximum convenience; they are currently seeking FDA approval for their exciting venture.
100 Years Old: Looking to old drugs might the way of the future
Due to improvements in diagnostics and societal awareness, more and more children are being recognized as falling on the autism spectrum. Unfortunately, there is still no effective pharmaceutical treatment for autism spectrum disorder (ASD).
Recently, a drug called suramin was repurposed with the intent of treating ASD. After being tested on an ASD mouse model with success, the drug was shortly after given to children. Researchers randomly assigned participants into experimental or control groups. Children in the experimental condition received 20 mg/kg of suramin through intravenous injection, while control groups were injected with saline. Children were assessed using the Autism Diagnostic Observation Schedule-2 (ADOS-2) score, Expressive One-Word Picture Vocabulary Test (EOWPVT), Aberrant Behavior Checklist, Autism Treatment Evaluation Checklist, Repetitive Behavior Questionnaire, and Clinical Global Impression Questionnaire. While improvements were not seen in all assessments, the authors concluded the suramin treatment had a modest, but noticeable, effect.
Remarkably, suramin was originally developed in 1916 to treat trypanosomosis, more commonly known as African sleeping sickness, and onchocerciasis. Its beneficial effect for children on the autism spectrum was unintended, but with continued validation and research, suramin could become a promising option for ASD communities. The field of drug repurposing has become highly appealing as it becomes more difficult to develop new drugs and too costly to risk their failure in clinical trials. By repurposing an already approved drug, pharmaceutical companies can help patients faster with lower financial risk.
There are huge opportunities available for neurobusinesseses using classic technologies
As stated previously, it has become a new trend for researchers to apply their innovative spirit to find new purposes for old therapeutics. In the world of neurotechnology, polishing up and improving an existing system could lead to new business ventures. There likely many technologies from the past that could have practical and commercial uses today. Sometimes to move forward, we need to look back.
- Bach-y-Rita et al., 1969. Vision Substitution by Tactile Image Projection. Nature, 8; 221 (5184) 963-964.
- Collins, B. W.-Y.-R. (1970). Seeing with the skin. Attention, Perception & Psychophysics.
- Naviaux et al., 2017. Low-dose suramin in autism spectrum disorder: a small, phase I/II, randomized clinical trial. Annals of Clinical and Translational Neurology, 4(7): 491-505.