Neurotech Veterans and Newcomers Discuss Past and Future at 2021 Leaders Forum

Staff report

About 120 neurotechnology industry professionals attended the 20th anniversary Neurotech Leaders Forum earlier this month—roughly half in person and half on-line. The two day event, which took place in San Francisco, CA, was produced by Neurotech Reports, the publisher of this newsletter.

Neurotech Reports editor James Cavuoto opened the conference with a look back at the first Neurotech Leaders Forum in 2001, when the industry was just beginning to emerge. He then informed attendees of some of the key events of 2021.

Warren Grill, the Edmund Pratt School Professor of biomedical engineering at Duke University and a former senior technical editor of this newsletter, delivered the keynote on the first day. He discussed the four Ps involved with realizing the potential of neurotechnology: promises, principles, products, and pitfalls. He compared the success rate and development time for new drugs with new neurotech devices. “Pills cannot save us,” he said, citing a quote from the former CEO of GSK, who downplayed the likelihood of success of new drugs for neurological disorders such as pain, depression, and anxiety. The main advantages of neuromodulation approaches over drug interventions is selectivity in space as time, and the ability to grade and tune the neuronal activation.

Grill discussed the key approved indications for implantable neurostimulation systems, such as SCS, SNS, and DBS systems, cochlear implants, and phrenic nerve stimulation systems, noting that most of these came out of academic research institutions.

The key challenges confronting the industry include long and expensive product development cycles, expensive product approval cycles, the requirement for a team of highly trained specialists, and dependence on third-party reimbursement. He cited examples of neuromodulation products that did not pay sufficient attention to what is being stimulated and how it engages the therapeutic mechanism, in particular, VNS neuromodulation for heart failure. In several cases, the dose that was delivered in failed trials was inappropriate, he said. He also stressed the importance of understanding the different functions of different nerve fibers within a nerve such as the vagus nerve.

“To realize the great potential of neurotechnology, we need to pay heed to the principles of stimulation,” Grill concluded. “This is going to give us tremendous opportunity to develop new products that can be readily be translated.”

Dave Anderson, president of Medtronic’s neuromodulation business, delivered the keynote on the second day of the conference. He described three key vectors for therapy optimization and advancement. These include adaptive therapies, personalized medicine, and a “new frontier” of applications. “The converegence of closed-loop therapies, data-enabled therapies, and new disease targets, is helping our products become adaptive, smarter, and more personalized,” he said.

Anderson cited examples of closed-loop approaches in SCS and DBS devices, highlighting the uses of evoked compound action potentials in use at Medtronic and Saluda. “Historically, devices were data-poor,” said Anderson. “But now we have multiple new sources of information that can help guide therapy optimization.” These sources include EMG, evoked potentials, accelerometers, and LFPs.

The conference included several panel discussions devoted to key issues confronting the neurotechnology industry. A session discussing recent and potential neuromodulation exits moderated by NBR senior consulting editor Jeremy Koff featured Amy Kruse, a general partner at Prime Movers Lab, Paul Grand, the CEO of MedTech Innovator, and Mike Thomas, senior commercialization office at In-Q-Tel, which works closely with DARPA and its fundees.

Grand noted that he was an entrepreneur before he became involved with venture capital and his accelerator, which he launched in 2013. He started eight companies, including several in the neuro space. “Our mission is to bring these technologies to patients with the maximum value possible,” he said.

Kruse was a scientific co-founder at a startup involved with applied neuroscience for human performance before joining Prime Movers, which was the largest investor in the startup.

“We are a deep tech venture investing firm,” she said. We look for breakthrough science that has the potential to impact billions of lives, and we take that pretty seriously. So we have a lot of scientists and engineers on staff that not only help source and diligence the deals, but really lean in with the companies that join our portfolio.” Kruse said Prime Movers tends to write 2 to 5 million dollar first checks, with the opportunity to follow on with a 10 to 20 million dollar series.

A session devoted to neuromodulation battlegrounds featured industry veterans Victor Pikov, formerly with GSK and Galvani and now CEO of startup Medipace, and Saluda vice president Dan Brounstein, formerly at Spinal Modulation and St. Jude Medical.

Brounstein predicted that innovation in the pain space would continue to accelerate and that the SCS market is currently fragmented with many implanting physicians distracted. Pikov cited the markets for sacral nerve and tibial nerve stimulation as key battlegrounds. He described three types of neuromodulation vendors who made it through the PMA approval process: first movers such as Medtronic and Abbott, followers, which have some distinguishing features, and tech-driven companies such as Saluda who present some disruption to the market.

Other panels at the conference were devoted to the psychiatric disorder market, wearable systems, neurosensing and data analysis, and reimbursement.

Neurotech entrepreneurs who presented at the conference included Braingrade, Neuronoff, WISE Srl, Panaxium, Inscopix, and Bionic Vision Technologies. Cirtec Medical was Platinum sponsor, while MST was the Gold sponsor.


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