Focus on Epilepsy

Localization of the focus of seizures is a critical task in the treatment of epilepsy, as NBR senior technical editor Warren Grill points out in his article on page 1 of this issue. As such, this task represents a significant market opportunity for vendors of neurosensing systems and neurosurgical tools. Whether the information obtained in the localization task is used for presurgical planning or is used in conjunction with a neuromodulation device to target therapy, the more accurate the information, the better the likely patient outcome.

Currently, there are several neurotechnology system manufacturers who provide equipment used for neurosurgical planning or epilepsy intervention. These include Integra Neurosciences, which makes cortical strip and grid electrodes, depth electrodes, and connectors; Natus Medical, which manufactures EEG systems for surgical applications; and Electrical Geodesics, Inc., which makes dense array EEG systems.

One of the most promising vendors in this market is Nexstim Oy, the Finnish manufacturer of navigated brain stimulation systems. The company’s eXima NBS device combines transcranial magnetic stimulation with sterotactic navigation and electromyographic sensing for both cortical mapping and neuromodulation applications. The company is currently conducting a clinical comparison of NBS versus direct cortical stimulation with 14 patients in Europe. Preliminary results from the study show agreement between the mapping data obtained by NBS and cortical stimulation.

A key component in all of these systems is the data processing hardware and software that analyzes the biological signals and endeavors to make sense of it all. In our view, there is considerable room for future enhancements in data and image processing to give neurosurgeons and neurologists more powerful and more precisely localized information on functional activity in the brain as well as pathological activity. A number of established and emerging neurotech firms are developing advanced algorithms for detecting and predicting epileptogenic activity. These include NeuroVista Corp., Cyberonics, and NeuroPace.

While epilepsy currently represents the most immediate market opportunity for neurosensing tools such as these, there are several other applications that stand to benefit from the same technology. In particular, stroke recovery and traumatic brain injury are ripe market opportunities for systems that can precisely locate areas of neuronal damage in the brain and help clinicians devise therapeutic regimens incorporating cortical plasticity to restore lost functions.

We are optimistic that advances in neurosensing technology will not only continue to enhance treatment for epilepsy, but also spill over to other neurological diseases and disorders.

James Cavuoto
Editor and Publisher



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