Expanding Our Borders

Very often, a new industry can be defined by specifying what fields it does not encompass as well as what is included within its borders. Such was our philosophy when we launched Neurotech Reports in 2001 and has guided our editorial mission as we enter our fifth year of publishing. From the outset, we excluded two sizeable and well established markets: the cardiac pacing and the neuropharmaceutical industries.

Although our market, and our profitability, would have been much greater with the inclusion of these two segments, our position was that neurotechnology—the application of electronics to the nervous system—represented a unique approach to the treatment of neurological diseases and disorders, one that relies on information processing and signal processing rather than molecular and biochemical concepts. Neuropharmaceuticals, by their very definition, did not fit into our definition of neurotechnology. And cardiac pacing, though it controls excitable tissue, involved the cardiovascular, not the nervous system.

We see in this issue, however, that our industry has much to gain by studying, and perhaps annexing, concepts from both the neuropharmaceutical and cardiac device industries. Warren Grill’s article on neural stimulation as a potential treatment for cardiovascular disorders [see p1] reminds us that the nervous system and the circulatory system are connected—literally. Stimulation of the vagus nerve or the greater splanchnic nerve can elicit response in cardiac muscle, much as stimulation of the phrenic nerve or the ulnar nerve produces response in the lungs or skeletal muscle. Surely it would be narrow-minded of us to exclude such neuromodulatory applications just because the end organ is the heart. Given our industry’s background and success at fine-tuning stimulation parameters, the cardiovascular market may well represent a ready and lucrative opportunity for neurostimulation companies.

Our article on NeuroInsights’ report on the neurotechnology industry [see p1] also points up the value of broadening our horizon with respect to neuropharmaceutical products. Though our definition of neurotechnology differs from that of NeuroInsights, there is much to learn from the way neuropharma companies have defined a market, recruited clinician support, and obtained reimbursement. As the report points out, clinical specialists are increasingly calling upon multiple treatment regimens and “polypharmacy” therapies to treat neurological disorders. The opportunity for partnership with one or more drug companies should be appealing to any neurotech device firm. And we continue to believe that neuropharmaceutical therapies that exploit concepts of ion-channel kinetics and membrane electrophysiology are well within the construct of neurotechnology as we have defined it.

Which should make us take heart (and drugs) more seriously in the future.

James Cavuoto
Editor and Publisher