The ‘hairnet’ that could save us from brain disorders

ElMindA is one of the World Economic Forum’s 2015 class of Technology Pioneers. The company’s sensor-filled helmet, resembling a hairnet, detects and maps patterns of brain activity. CEO Ronen Gadot discusses the potential for applications in diagnosing and treating brain disorders, developing drugs and enhancing well-being.

How does ElMindA’s approach differ from other ways of measuring the brain, like fMRI scans?

One analogy is to think of the difference between mapping roads and mapping the flow of traffic along those roads. Knowing in general terms, for example, which location in the brain is associated with pain doesn’t tell you exactly what’s going on in the brain of a particular individual who’s experiencing some kind of pain right now. And even if you can map that individual’s brain activity, it’s still another level of challenge to be able to do that robustly and reliably enough for physicians to have confidence in using the results in their daily clinical practice. That’s the aim of the brain network activation (BNA) technology we have been developing since 2006.

When you think about it, the brain is the only part of the body that physicians have to try to treat without being able to measure its function directly. If someone suffers a knock to the head, like a concussion, we have to try to diagnose how serious it is with simple tests like asking them to follow a moving finger or based on symptoms alone. Or if someone’s suffering from depression, we ask them about their symptoms and behaviour and try to rate their problem on a scale. It’s a bit like asking an orthopaedic doctor to diagnose a broken arm just by symptoms and feeling without using an X-ray.

The aim is not only to enable physicians to diagnose problems, but also to treat them. If we can use electrodes to identify the brain activity associated with a particular patient’s experience of pain, attention deficit or even memory loss, for example, then could we use the same electrodes to apply electrical stimulation to the brain in a way that modulates or contradicts those dysfunctional pathways? We did some proof of concept studies on this question on severe chronic pain with Harvard Medical School that had very promising results – over half of patients with severe fibromyalgia pain reported at least a halving of their pain levels, with significant improvement in their quality of life.

If two individuals suffer identical injuries, how much similarity and difference is there likely to be in how their individual experiences of pain show up in their BNA maps?

One of the challenges in brain research is that the brain is very plastic; it changes over time, so there are differences not only between individuals but within the same individual over a period of years. Ideally, you would want to do a baseline test of a particular person every year or so, to map out their individual brain function, and then if that person suffers some kind of brain problem you would have a point of comparison for how they, at that point in their life, would normally process information.

So understanding personal and interpersonal differences is very important, but interestingly there are also enough similarities between individuals’ brain function for us to make deductions even if we don’t have a baseline for an individual. For that purpose, we need a big database of brain function of individuals of different ages, genders and phenotypes. Over the last decade we have collected and analysed over 10,000 individuals’ data to understand what the similarities are – for example, we will study women aged 20-24 and look for the common denominators, then compare them to men of the same age group or women who are older. That allows us to characterize the similarities and understand whether a particular individual’s BNA map is falling within or outside an expected range.

So your biggest challenge is not developing the hardware that measures the brain waves, but the software to interpret them?

Absolutely. Relatively speaking, the hardware is not much of a challenge at all – there are lots of ways of measuring the electrical or magnetic fields emanating from the brain. These brain waves are, in essence, measurements of the way our brain encodes information, and the big challenge is to decode it, to make sense of it. Our core competence is software, sophisticated algorithms and big data analytics that decode meaningful clinical information from brain waves, however they are measured. And to do that in clinically meaningful ways, we rely heavily on partnerships, with leading medical centres, pharmaceutical companies and other industry players.

What are the BNA maps currently being used for and what is in the pipeline?

Head injury recovery was the first application we saw as a “low-hanging fruit”. It’s become a major public health issue among athletes in the United States, particularly in high school and college contact sports like football or hockey, but also with high-profile incidents such as the clash of heads between German and American players in the FIFA Women’s World Cup tournament earlier this year. BNA maps are already being used by physicians to monitor recovery and to tell if and when brain functioning has returned to normal, which is a challenging task when you don’t have a way to look into the injury itself. A second hit to a brain which has not yet fully recovered can lead to irreversible brain damage and devastating consequences.

Another application already in use is to assist pharmaceutical companies with drug development. In the very early stages of research, BNA maps can help understand whether a novel molecule is affecting the brain in the expected ways. In later stages, BNA maps can help answer questions such as what is the right level of dosage to optimize treatment. This could save millions of dollars in clinical trials and accelerate drug development – it takes on average 10 years and $1 billion  to bring a brain-related drug to market.

As for future applications, as many as 2 billion people are thought to be suffering from some kind of brain disorder: from child developmental issues like autism or ADHD to neurological and psychiatric disorders like depression, anxiety or pain to neuro-degenerative diseases of ageing like Parkinson’s and Alzheimer’s diseases. Just recently we received a major grant for a consortium we put together of industry and academia to study new ways to measure and treat neuro-modulation depression, Parkinson’s disease and ADHD. There are huge possibilities for BNA maps to improve how we diagnose and treat all kinds of problems with the brain, and to transform billions of lives. There is great potential to do well by doing good in this field.

Is there potential not only to address dysfunctionality, but also to enhance functionality?

We could indeed see BNA maps being used for wellness apps. You could imagine sitting at home, putting on a cap and measuring the networks responsible for your creativity, or attention, or memory, and then applying some kind of neuro-modulation that will enhance the functioning of those particular networks. The ability to interact with our own brains could become as important a part of well-being as our current efforts to manage, say, our cardiovascular health.

The human brain is a complicated thing – there are about 100 billion neurons connected in over 1 trillion connections, and everything we do is a function of the electro-chemical firing of those networks – but our understanding is growing quickly. As the Nobel Prize-winning neuropsychiatrist Eric Kandel recently said, we have learned more in the past five years than we have in the whole of history up until now. And we are only at the tip of the iceberg. There is so much still to learn.

Full details on all of the Technology Pioneers 2015 can be found here. 

Author: Ronen Gadot, CEO, ElMindA, a World Economic Forum Technology Pioneer.

Image: A woman walks past a display of a brain slice of patient “H.M.” at the press preview for the MIT 150 Exhibition at the MIT Museum, celebrating Massachusetts Institute of Technology’s 150 year anniversary, in Cambridge, Massachusetts January 7, 2011. REUTERS/Brian Snyder