Neurotechnology Could Be The New Frontier In Medicine

By Marco Bafan, Nerac Analyst

With brain-related illnesses affecting more than 2 billion people worldwide, a $120 billion neurotechnology industry is rapidly developing new technologies that address shortcomings in traditional pharmaceutical-based treatments. Attacking such disorders as Parkinson’s, Alzheimer’s, anxiety, depression, epilepsy, stroke, and traumatic brain and spinal injury, newly developed neuromodulation devices are changing the practice of medicine.

As a result of technological advances and increased understanding of central nervous system, neurotechnology has become one of the fastest-growing emerging technologies. Neurotechnology is a broad category that can be divided into three sectors:

• Neuropharmaceutical, with revenues of $101 billion in 2006 and 13 percent growth annually;
• Neurodevice, with revenues of $4.5 billion in 2006 and 20 percent growth annually;
• Neurodiagnostic, with revenues of $12 billion in 2006 and 11 percent growth annually.

Overall, neurotech industry revenues rose 10 percent in 2006, according to NeuroInsights, a neurotechnology market and investment research firm. Tremendous market opportunities for neurotechnology exist, and companies developing these technologies are experience high growth and attracting new investment. According to various market research studies, 2006 venture capital investment in neurotechnology rose 7.5 percent to $1.666 billion.

Why Neuromodulation Devices?
In neuromodulation, electrical impulses regulate larger areas of the nervous system affecting multiple neurons. Electrical stimulation in neuromodulation causes lesioning of specific regions of the nervous system, or infusion of substances into the cerebrospinal fluid. This can ultimately alter nervous system function and relieve pain and inflammation, as seen in surgically implanted spinal cord stimulators, or as external devices such as trancutaneous electrical nerve stimulators.

Many experts in the industry predict that in the next 10-15 years, neuromodulation can become the gold standard treatment for many chronic diseases and neurological disorders. There are two ways to explain that.

First, many chronic diseases such as depression, brain injury, and various neurological disorders remain under-treated. They are refractory or resistant to many existing pharmacologic therapies. Thousands of patients are without immediate solutions through existing medications, especially in cases of stroke and other brain-related injuries. One explanation could be simply that pharmacologic approaches and treatments usually have systemic effects on patients and may be unable to target specific neural networks and organs.

Second, with brain and CNS electrical-chemical systems, an electrical approach to treatment may be a more logical and effective approach. Neuromodulation devices can deliver therapies more accurately and efficiently by electrical stimulation of specific neural networks and regions. Using rechargeable devices or multiple independent current sources can enhance the efficiency of these devices and ultimately improve patient outcomes by relieving pain or helping with motor recovery.

For instance, the Eon Rechargeable Neurostimulation System, a technology that Texas-based Advanced Neuromodulation Systems developed, uses a device that is implanted in the hip area. Similar to cardiac pacemakers it sends mild electrical pulses to leads near the spinal cord to treat the chronic pain.

Besides spinal cord stimulation devices, other advanced neurological devices are already making an impact in the medical device industry. These include deep-brain stimulators for movement disabilities and VNS systems, which have been in the market for a while to treat epilepsy and depression. In fact, it’s been over 10 years since FDA approved Cyberonics’s VNS therapy for treatment-resistant epilepsy and depression where pharmacological approaches were not as successful. VNS therapy is different from other treatments as it improves over time and is sustained long term.

Understanding the Challenges
With advances in technologies and an aging population as market drivers, better engineering designs and improved usability and miniaturization are making significant gains. Furthermore, as complexity increases, an important strategy for the future should be in investing in clinical studies that can confirm the efficacy and safety of these products and technologies.

This can be challenging considering how these devices work. Gathering data would be crucial for both patients and physicians to ensure that patients, as well as physicians, have multiple options for treatment, which is ultimately the result of a better understanding of how these technologies actually work. A better understanding of the underlying science in neuromodulation can offer patients hope where other treatment options like physical therapy or drug therapy have been ineffective.

Knowledge is the key. For instance, it is now understood that brain injuries or related neurological disorders are not necessarily irreversible. The brain can indeed heal itself and targeted neurodevice therapies can enhance this healing process through electrical stimulation.

While adoption of these neuromodulation devices can take time and require special training for physicians, the role of regulatory and reimbursement landscape should not be overlooked either. Fortunately, with the approval of some of these devices, like VNS therapy systems, it is clear that the FDA has recognized the progress in neurotechnology devices along with the tremendous clinical benefits these devices can offer. However, establishing more standardized safety and evaluation protocols, as well as determining the appropriate treatment dose and modality for various disorders, can facilitate and speed up the approval process.

Market Potential & Future
Over 450 private and public companies currently are developing technologies or researching treatments for central nervous system disorders. While many research studies are directed towards new drugs and medications, a few companies are specifically focusing on developing devices and technologies that particularly address brain-related injuries and illnesses, which happens to be the largest unmet medical market. This burden is accelerating as the population ages. These factors are also creating unprecedented demands for treatments in various age-related diseases like Parkinson’s, Alzheimer’s, stroke and many other drug resistant neurological disorders. It is hoped that neurotechnology and neuromodulation devices can make a difference and save lives. Perhaps they can indeed revolutionize the practice of medicine in the near future.