14 September 2016

Cracking the Code on Mobile Brain Monitoring - Nathan Intrator, Neurosteer: NOW #94

Nathan Intrator, Professor of Computer Science and Founder of Neurosteer, talks about the progress his company has made in the development of new ...

Welcome to StartUpHealth NOW!

The weekly web show that celebrates the Healthcare Transformers and changemakers reimagining health. My name is Unity Stoakes and today we are at the Wearable Tech and Digital Health Conference in New York City. We’ve got a special guest, Nathan Intrator, the founder of Neurosteer. He's also a professor at Tel Aviv University for computer science and neuroscience. Stick around. It's going to be great show. It is the duty of leaders to lead, of the creative to create of the daring to do. The free world expects leadership of us, its fate in our fate depends upon our leadership. We are industrious, inventive, restless, with the fires that burn within us. But I say that nothing is easy and the best things are the hardest. And our troubles all our immense difficulties now and in the future can I say be solved if we have the will, the courage.

The future is to those who take it. So, welcome, Nathan, it’s great to be with you here today. I thought we’d start the conversation, you guys are making so much progress at Neurosteer. Maybe give us an update of what's going on, and what's new in your world? First of all it's great to be here. Wonderful to be interviewed by you. Yes, we did work quite a bit last year and developed new kind of applications and a new view of what it is that we're doing. We realize that there's a huge need for minimal conscious cases where patients cannot actually express or show any conscious and the doctors are kind of in the dark not knowing what is going on there what medications what treatment is actually improving the situation, etc. In addition there’s a few possibilities to address

this kind of minimal consciousness. Patients nowadays I don't know if you've.. So this would be someone who maybe is in the hospital unconscious for whatever reason and they're hooked up to your device. Usually Usually a person would suffer some kind of an ischemic event. There was no oxygen coming to the brain for quite a while and that would actually really reduce conscious, cause some damage. We know somewhat about the damage we don't know much. We definitely don't know why it is that some people do recover, why is that others don't recover. Functional MRI or PET are the two devices to look at the brain and try to figure out what's going on, but what we find is that they don't tell us enough. We are trying to develop monitoring specifically for this

for now. To understand if there's a change in the behavior of the subject. Whether it is the result of external stimulation from the environment. For example, the patient went back from the hospital home which sometimes usually increases the amount of simulations. Family, friends and siblings, etc. We want to see effective medications on the patient and there are now a number of medications that can stimulate the brain and can drive the brain sometimes back to recovery. We want to see the effect of those. Of course other stimulations like magnetic stimulation electric stimulation and something that we've been quite in contact with is a hyperbaric chamber which provides a lot of oxygenated brain, oxygenated blood to the brain. About 10 times more than the usual. This extra oxygen

which is the source of life for those neurons actually revives cells. So, in your view, There's so much progress being made in terms of brain monitoring advances that are being made just within consumer wearables that are starting to monitor brain activity. What are you most excited about today with how things are developing? We've heard about several companies, but I haven't seen actually serious mobile monitoring of the brain. This is something that we're working on. There's some competition. There’s a few companies but it's not flooded at all. This area, there's a lot of companies that produce some kind of monitors for specific cases. For example, for meditation, where relaxation can be observed. You've seen some of the concussion monitors. Concussion, Then it's usually a multi-head system.

It's not a mobile to electric system. Ok? And What we feel is that there's a lot of room to grow there. There's a lot of technology to introduce in that field. Technology that will interpret the brain quite a bit both on the cognitive emotional and cases of abnormality of the brain. It’s a fascinating field. How long until we cracked the code on mobile monitoring of the brain as you define it? Cracked the code is a tough one, but providing sufficient monitoring that can actually help patients, this I think is, we are quite close to that. In the next three years or Maybe. Yes. You're optimistic that some of the biggest challenges are being solved? Very optimistic. I feel that there's definitely cases where even if we don't exactly understand what's going on in the brain

we can understand an abnormal brain from a normal one and we can then see when medications or other intervention actually makes the brain look more normal and it turns out that this is then a healthier brain. How would these new tools impact patients? How will they impact everyday consumers? What will be possible? First of all my hope is that people will be monitored in their own environment. At their home, wherever they feel comfortable to be monitored and not have to go to the hospital or to the clinic to be monitored. That of course will improve life quality and keep patients where they really want to be and not in a hospital which is still some kind of cold environment. In the hospital Sorry, I mean at home patients will be monitored in a way that the doctor or the caregiver, the family member,

or of course the patient themselves will be able to see on something like a mobile phone, would be able to see statistics and information and indications on what is going on so the doctors doesn't have to be next to the patient. The doctor can see that medication that he just prescribed over the phone and the person took in the pharmacy is actually working. There is no need to bring the patient to the clinic or to keep the patient in the hospital for monitoring them which of course is extremely expensive. With this monitoring at home I really hope that we can detect problems at the very, very early stage before severe damage is done so that intervention is minimal and of course the cost is minimal and the disruption is minimal. I hope that all this is going to come to the brain just as it came to other organs in our body. What sort of

applications do you see maybe on the prevention side for everyday consumers Will people be wearing these types of monitoring devices as everyday consumers? Maybe not as a patient per se but to monitor other types of things in order to prevent things many years down the line? Absolutely. Look at heart monitoring. In the past heart monitors were just to people that have a certain heart problem, but now people who exercise want to monitor their heart while they exercise, want to protect the heart, to know their condition, to know what's going on if they push the heart to the right limit, etc. Absolutely the same way will happen with the brain. We’ll want to see was I more concentrated now after having coffee in the morning? Did my emotions actually affect me and reduce my concentration

or affect my level of judgment? Things like this. People that will be playing games and will empower the gaming environment with looking at their brain with reading their thoughts and maybe sending them to the to the other players, etc. That could be a whole new world. The VR, the AR will be a huge part of that. I'm glad you brought up VR. Virtual reality, augmented reality. What are the intersections with those very, there's all sorts of funding going on in those environments. What are the intersections with, specifically, the science and technology that you're focusing on and VR and an AR? VR looks like an amazing jump forward in terms of the brain-computer interface. Suddenly we can bring people that are not in the room to appear as if they are in the room

and we can have this kind of telepresence that's a huge leap. But if you ask yourself in terms of brain-computer interface if the computers will be 10 times faster is that really going to improve my communication with the brain? Watson, now from IBM, understands natural language. It's extremely knowledgeable in terms of everything that's going on. "Jeopardy" was an example of that. That is ten times faster. Computers are not going to do anything. However, when we humans have an interaction. The interaction is much more than what is being said. This level of unsaid but through facial expression, through body language expressing emotions between the two people who speak is really what significantly makes a difference today with the communication with computers. When computers can actually read our emotions in real time during the conversation

and respond to those emotions and possibly express their own emotions or express emotions during the conversation then suddenly we would feel that a conversation with the computer is much closer to a conversation with human being and I believe that with augmented reality and virtual reality these things will actually coincide and the emotional aspect will be added to this kind of interaction. What are your thoughts on many of the new consumer technologies? For example the Amazon Echo that are in the home, consumers are interacting with them, you know question-and-answer sort of basis at this point. Do you foresee your technology integrating in those types of platforms in the future? Absolutely. Just as I said we are interacting with computers now more and more. Sometimes we would be sending a message

through “what's up” or any other applications of that kind and we would not know if you're talking with a representative of the company with a computer representative of the company etc. This will happen more and more often and at some point we will have a change in our reaction an emotional change etc. We would like from that representative on the other side to be able to notice that and to be able to respond accordingly. And In that respect that will definitely interact, yes. Wonderful. So, You’re based in Israel. I wanted to learn a little bit more about the ecosystem that is rapidly emerging there. It’s a great ecosystem for entrepreneurs but also for digital health. What's going on over there maybe share a little insight into how the ecosystem’s evolving. It is true.

It's an amazing ecosystem in that respect as well. From kind of the middle way between Tel Aviv to Haifa and all the way to Haifa it's a an ecosystem of heart-related monitoring and treatments. I'm kind of roughly dividing it. From that middle of Tel Aviv to Haifa to Tel Aviv and going all the way towards Be’er Sheva it's an ecosystem of other medical devices. Of course I'm not neglecting cyber issues. That is a big big thing. But, I’m very happy to see that medical devices, monitoring miniaturized sensors is becoming a big thing in Israel and also a lot about the brain. Shimon Peres started this initiative. Several years ago he wanted to make Israel into a brain technology country. Rafi Gidron took that and made it practical and we have now this IBT’s for brain technology and it's beautiful to see

that the ecosystem drawing around there and more and more people are coming to the yearly meetings and more and more companies and entrepreneurs are getting there and trying to invest and incubators around that area are developing. Of course the hospital's very very open with their respect to clinical studies. So it is a beautiful ecosystem. What's your advice to other entrepreneurs maybe just getting started today in digital health. What should they be focusing on, and what lessons learned can you share with them? In the past developing a medical device company was extremely long. Required a lot of financing, much more than expected at the beginning of the company. Then there was FDA and all the other regulations that were tedious. I believe that as we see this progress in shortening the time from the app development to

putting it on the Google store, we will see something like this. Some kind of shortening of time of development of medical devices. Some of them can start as consumer products, can be tested by consumers before they are intended for use by medical doctors. A lot of information and even revenue can be obtained at that path before going into the tedious path of regulatory and approvals and all the clinical studies. But I believe they will become faster as well especially if you're talking about monitoring at home. where monitoring is cheaper and you don't need to bring the patients in the hospital etc. So, I feel that So, a different approach to commercialization, almost. Yes. You don't go just in one path. You may be going in two paths or this one first and the medical path later. I think there's a lot of room

to, to do this. Fantastic. Last question. What you do to stay healthy? I try to think positive. To look at the bright side of life. That turned out to be even scientifically proven to be useful. But, it is really helpful. I try to exercise on a regular basis. Cardio and keep the skeleton in place by keeping the muscles in place. And I definately and I try to be happy. This is good advice. Positive energy and being happy. Great advice for entrepreneurs everywhere. Thank you so much and it's great to speak with you again. I’d just like to add one more thing. If you were going to ask me to have a book to recommend. I do. I’d love to know. Then to continue on the same note of be happy, I'd like to recommend a book of my good friend professor Shimon Edelman

from Cornell. He's a mathematician with a background in psychology and he wrote an interesting book on the happiness of pursuit. The happiness of pursuit. Talking about happiness and the pursuit of happiness and talking about it from a neuroscientist perspective. I think that would be an illuminating book for people to read. Those who are interested in the roots of happiness, what it means to be happy in the brain. We’ll put a link in the show notes for that. That's a great recommendation thank you so much. Thank you so much. Thank you.