March 31, 2016 | March 2016 issue
March 31, 2016 | Several established and startup neurotechnology firms are entering the market for treating dysphagia. Often labeled as the neglected disorder, dysphagia is a neurological condition marked by difficulty in swallowing. Neurotech devices in this space largely rely on neuromuscular stimulation, but future therapies may exploit noninvasive brain stimulation.
The complex process of swallowing involves nearly 50 pairs of muscles and it is the primary means of nurturing the body. Approximately 15 million Americans live with the condition and about 1 million are added each year. According to the Agency for Health Care Policy and Research, about 60,000 Americans die each year from complications associated with swallowing dysfunction.
People living with dysphagia are not homogeneous. It is often a complication from another injury, disease, or condition. Survivors of head, neck, and throat cancer may experience difficulty swallowing. It is also common among stroke and head injury survivors. Then there are those living with degenerative disorders such as Parkinson’s disease, ALS, or MS who may slowly acquire the condition. Regardless of how a person procured the condition, dysphagia impacts the quality of life.
Traditional treatments are oral exercises, diet alterations, and in moderate to severe cases percutaneous endoscopic gastrostomy tube (feeding tube). Seeing the growing need and diverse patient population, neurotech companies are stepping into the ring. DJO’s VitalStim has been on the market for decades. The device uses surface neuromuscular electrical stimulation to aid swallowing. Most recently, the company released the VitalStim Plus system, which combines e-stim with EMG sensors for closed-loop therapy.
Start-up vendors are now emerging in this space. Spectramed Inc. in New York, NY offers the Guardian Way, a similar therapy using electrical stimulation and biofeedback with the additional feature of interfacing with an iOS app for telemedicine. Another young company out of Texas, Ampcare, offers a stimulation device coupled with a head and neck positioning tool for their ESP or Effective Swallowing Protocol system. An Alabama-based vendor, eSwallow USA, offers a surface electrode and small hand-held device to administer treatment.
With this array of start-up activity, there is no doubt that the bigger players will begin to step in to grab some of that market share. Most recently, orthopedics giant Hanger entered this space with their device, called Synchrony OMNIsEMG. This device combines patterned electrical stimulation with biofeedback and virtual reality. The package includes treatment protocols for clinicians to administer to their patients.
On the research front, the application of brain stimulation for treatment of the disorder is under investigation in a variety of laboratories. At the University Hospital of Muenster in Germany, a team of researchers is combining traditional strength training with transcranial magnetic stimulation for patients with dysphagia as a complication of Parkinson’s disease. Researchers at Beth Israel Deaconness Medical Center in Boston are combining swallow training with tDCS among stroke survivors as another modality for treating the disorder.
