Recognizing the Patient

by James Cavuoto, editor

May 2023 proved to be a busy month for the neurotechnology industry, as evidenced by this largest issue ever of Neurotech Business Report. If one theme stands out among the several groundbreaking studies and commercial developments this month, it is the importance of developing personalized therapies that are tailored to each patient.

As we report in our coverage of the American Psychiatric Association meeting in San Francisco [see article, p16], new neuromodulation therapies for disorders like major depression are achieving better results because device vendors and clinicians are able to customize a treatment regimen to the individual characteristics of each patient. And as we report in our vendor profile this month, SCS manufacturers such as Nevro are making use of artificial intelligence and big data to optimize stimulation paradigms for patients with chronic pain.

But in order for this strategy to work best, developers of new device therapies need two things: an understanding of the mechanism of action by which a particular therapy exerts its effect, and a signal or biomarker that indicates how well the therapy is working.

And that’s why we’re so encouraged by the the recent work of Prasad Shirvalkar and colleagues at UCSF in identifying brain circuits that are indicative of the perception of pain [see article p1]. Studies like this will not only help personalize neuromodulation therapies to individual patients, or to classes of patients, they can also go a long way toward helping clinical trial sponsors select the most appropriate participants to maximize the probability of a successful trial.

Gone are the days when neuromodulation vendors could get away with delivering the same stimulation parameters to everyone.

This point was brought home by the blogger and Parkinson’s disease patients advocate Benjamin Stecher, who recently took part in a NIH-sponsored workshop along with researchers in that field. “All of our disease modifying therapies aim to paint all or most of us with the same PD brush,” he wrote. “We must begin to treat those diagnosed as individuals, and embrace the tough reality that it is likely that there are dozens of factors contributing to each person’s individual disease if we are going to make progress.”

Clearly, the more we understand about the underlying cause of a particular neurological disease or disorder, the better able we will be to develop personalized therapies that are best for each patient.