Ex.plaura

Brain Platform

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Precision Medicine x Neuroscience  

Our brain platform utilizes novel sensing technology, 3D mapping, and artificial intelligence to deepen our understanding of the brain and unlock personalized brain care

Interview with Dr. Sumeet Vadera

We Empower physicians to make the best possible treatment decisions

Dr. Vadera is a neurosurgeon at University of California, Irvine (“UCI”) Health who specializes in both adult and paediatric epilepsy and uses a range of surgical technologies including robot-assisted intra-cranial surgery.

How it Works

Intracranial Electrodes

  • Cortical electrodes: grid and strip electrodes

  • Subdural electrodes: depth electrodes for use with anchor bolts for stereo-EEG

  • Hybrid electrodes: novel proprietary design combining cortical micro-strips with depth electrodes

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We are developing minimally invasive, flexible, and light-weight sensors for recording high-resolution EEG activity.

 

Propriety thin-film technology drastically improves surgical implantation and minimize brain tissue damage.

Neuraura Advantage:

  • Shorter surgery times and faster patient recovery

  • Improved brain coverage

  • High fidelity EEG data for rapid and easy diagnoses and precise treatments

  • Reduced clinical burden and healthcare costs

Hardware for continuous recording of brain activity

  • Better patient experience by enabling ambulatory care at-home or in-hospital

  • Ability to collect "real-life data"

  • Reduced hospital costs

Wireless EEG Monitoring

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3D Brain Mapping

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Visualization software that presents the brain data traces and displays a 3D map of the electrical activity within the brain

  • Cloud-based storage to access the brain data anywhere, anytime

  • Accelerated clinician review of data

  • Greater surgical and treatment confidence

  • Unlocks personalized brain care and neuromodulation treatments

Clinical Applications

Epilepsy

EEG: Regular and high-density scalp EEG are used for the diagnosis and characterization of seizures; intra-cranial EEG is used as a pre-assessment tool for surgical resection of epileptic foci [i]. 

Neuromodulation: 

  • Vagus Nerve Stimulation ("VNS")

  • Responsive neurostimulation (“RNS”) 

  • Deep Brain Stimulation DBS

  • Transcranial magnetic stimulation (“TMS”)

  • Transcranial alternating current stimulation (“tACS”) [i]

  • etc.,

[i] Davis, Patrick, and John Gaitanis. "Neuromodulation for the treatment of epilepsy: A review of current approaches and future directions." Clinical Therapeutics (2020).

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Migraine

EEG:

Scalp EEG is often used to eliminate other potential causes of migraine symptoms but there is no established test for migraine [i]. 

There is some research evidence of changes in excitability in the occipital cortex of migraine sufferers during the interictal period [ii].

Neuromodulation: 

  • Peripheral Nerve Stimulation (“PNS”) [iii]

  • Single-pulse transcranial magnetic stimulation (“sTMS”) [iv]

  • rTMS [v]

  • Anodal and cathodal transcranial direct current stimulation (“tDCS”) [vi]

  • etc.,

1. https://migraine.com/migraine-diagnosis/electroencephalogram/#:~:text=Because%20there%20is%20no%20specific,causes%20for%20the%20migraine%20symptoms. 

2. Ayache, Samar S., and Moussa A. Chalah. "Transcranial Direct Current Stimulation and Migraine—The Beginning of a Long Journey." (2020): 1194.

3. https://www.neuromodulation.com/migraine

4. Bhola, Ria, et al. "Single-pulse transcranial magnetic stimulation (sTMS) for the acute treatment of migraine: evaluation of outcome data for the UK post market pilot program." The journal of headache and pain 16.1 (2015): 1-8.

5. Kumar, Saurabh, et al. "The effects of repetitive transcranial magnetic stimulation at dorsolateral prefrontal cortex in the treatment of migraine comorbid with depression: a retrospective open study." Clinical Psychopharmacology and Neuroscience 16.1 (2018): 62.

6. https://neuromodec.com/what-is-transcranial-direct-current-stimulation-tdcs/

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Stroke

EEG: Scalp EEG is used for stroke diagnosis and can identify patients with large acute ischemic stroke [i].

Neuromodulation: 

  • Repetitive transcranial magnetic stimulation (“rTMS”) [ii]

  • Deep Brain Stimulation ("DBS")[iii. iv]

[i]https://journals.lww.com/ajpmr/Abstract/2014/05000/Effects_of_Repetitive_Transcranial_Magnetic.8.asp 

[ii]  https://www.nature.com/articles/s41598-020-75379-w?utm_source=other&utm_medium=other&utm_content=null&utm_campaign=JRCN_1_LW01_CN_SCIREP_article_paid_XMOL

 

[iii] Cooperrider, Jessica, et al. "Cerebellar Neuromodulation for Stroke." Current Physical Medicine and Rehabilitation Reports 8.2 (2020): 57-63.

4. Elias, Gavin JB, Andrew A. Namasivayam, and Andres M. Lozano. "Deep brain stimulation for stroke: Current uses and future directions." Brain stimulation 11.1 (2018): 3-28.

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Alzheimer's ("AD")

EEG: EEG rhythm abnormalities are more frequently seen in AD than other subcortical forms of dementia[i],

Neuromodulation: 

  • DBS of Papez or medial limbic circuit [ii]

  • DBS of nucleus basalis of Meynert (“NBM”) [iii]

  • rTMS and tDCS [iv]

[i] Tsolaki, Anthoula, et al. "Electroencephalogram and Alzheimer’s disease: clinical and research approaches." International journal of Alzheimer’s disease 2014 (2014).

[ii] https://www.neurologylive.com/view/neuromodulation-holds-promise-in-alzheimer-disease 

[iii] https://www.neurologylive.com/view/neuromodulation-holds-promise-in-alzheimer-disease

[iv] https://www.neurologylive.com/view/neuromodulation-holds-promise-in-alzheimer-disease

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Parkinson's ("PD")

EEG: A recent study of scalp EEG in a small sample of PD patients showed differentiated wave forms in PD patients and changes in these waveforms when patients were on / off medication [i].

Neuromodulation: 

  • Focused ultrasound thalamotomy [ii]

  • DBS of subthalamic nucleus or globus pallidus internal [iii]

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Psychiatry

EEG: Scalp EEG studies have identified higher right than left parietal asymmetry in alpha band power as a potential bio-market for PTSD[i].

Scalp EEG has been shown to be effective at screening and diagnosis of Alcohol Use Disorder [ii].

Depression: A number of EEG bio-markers for depression have been identified including K-Nearest Neighbour (“KNN”) and the power of the theta waves [iii].

Neuromodulation: 

  • tDCS of the prefrontal cortex (“PFC”) in an attempt to modulate executive control of fear responses in PTSD [iv]

  • DBS of the NAcc is thought to disrupt to deplete / inhibit dopamine and have shown evidence of reducing the urge / cravings to drink [v]

  • Transcranial magnetic stimulation (“TMS”) has been approved for depression [vi]

  • etc.,

[i] Butt, Mamona, et al. "The electrical aftermath: brain signals of posttraumatic stress disorder filtered through a clinical lens." Frontiers in psychiatry 10 (2019): 368.

[ii] Mumtaz, Wajid, et al. "A review on EEG-based methods for screening and diagnosing alcohol use disorder." Cognitive neurodynamics 12.2 (2018): 141-156.

[iii] Cai, Hanshu, et al. "A pervasive approach to EEG-based depression detection." Complexity 2018 (2018).

[iv] Gouveia, Flavia V., et al. "Neuromodulation strategies in post-traumatic stress disorder: from preclinical models to clinical applications." Brain sciences 9.2 (2019): 45.

[v] Salib, Anne-Mary N., et al. "Neuromodulatory treatments for alcohol use disorder: a review." Brain sciences 8.6 (2018): 95.

[vi] Holtzheimer, Paul E., and Helen S. Mayberg. "Neuromodulation for treatment-resistant depression." F1000 medicine reports 4 (2012).

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Epilepsy as an Initial Clinical Application

Epilepsy is one of the most common neurological conditions, affecting approximately 1% of the world population. 

 

For 1/3 of patients, the drugs are not effective. It has been medically proven that surgery is the best option for most of these patients. However, only 3,000 epilepsy surgeries are conducted each year in the US due to the lack of high quality data required for successful surgery and the difficult / risky patient journey.

Epilepsy patients undergo intra-cranial monitoring as part of the protocol for surgical resection of brain tissue to treat seizures.  These patients are often therefore the subjects of research into the electrical workings of the brain.

Neuraura will gain access to unique electrophysiological data sets from epilepsy patients where there is the potential for transformational impact across disease states and treatment modalities based on advancing our understanding of the electrical workings of the brain. 

We are devoted to enhancing the surgical process, optimizing patient outcomes, and deepening our understanding of the brain