Bringing Stimulation to the Surface

The deep brain stimulation market segment continues to be one of the most promising areas of the neurotechnology industry. Even as this segment matures, however, several research teams and commercial firms are looking at an alternative technology that may make DBS obsolete some day and that is epidural cortical stimulation. As Neurotech Business Report senior technical editor Warren Grill points out in his article this month [see p1], cortical stimulation has many advantages over DBS, not least of which is the potentially simpler surgical implantation ­procedure.

Both Neuropace and Northstar Neuroscience are looking at applications for cortical stimulation and vendors like Cyberkinetics Neurotechnology Systems have made progress implanting recording electrodes in the cortex.

The prospect of a wide base of products and technologies for cortical stimulation appeals to us for more reasons than patient comfort and surgical simplicity. Leads and electrode arrays implanted on the surface of the brain are much more accessible, both physically and in terms of signal processing, than DBS leads. We envision a new synergy between neurosensing and neurostimulation applications that this movement to the surface would enable. It’s also conceivable that once implanted, surface electrode arrays would be in a position to perform multiple applications as new stimulation regimens and neurophysiological mechanisms are uncovered.

Eventually, as progress in technologies such as transcranial magnetic stimulation (TMS), source localization, and microelectrode fabrication reaches new levels, there may be an opportunity to migrate some of the industry’s success with epidural cortical stimulation to surface stimulation delivered through devices worn on the head.

It continues to be our belief that to the extent the neurotechnology industry can generalize the use of stimulation devices and techniques to treat a multitude of applications, the field will be in a position of explosive growth. Cyberonics Inc. has given us a small taste of that phenomenon by successfully migrating its vagus nerve stimulation technology from epilepsy to psychiatric disorders. Though the process of obtaining market approval has been arduous for Cyberonics, the potential payoff from the depression market alone seems to make it all worthwhile.

We suspect that Wall Street will also look favorably on any developments that hasten the expansion of existing neurostimulation devices to new markets. Medtronic’s purchase of Transneuronix for $260 million [see article, p1] offers one more example of the wide web of opportunities that are available to entrepreneurs and investors in this field.

We look forward to reporting on more successes in future issues.

James Cavuoto
Editor and Publisher



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