Start up of the month is on hold for this month (and possibly next) while I finish finals. In the meantime, I took a couple of days off for the Royal Society of Medicine (RSM) 10th Innovation Summit, followed hot on its heels by WIRED Health.
At both events the star of the show was the vagus nerve. Its a long nerve originating from the brain stem that wraps itself around the carotid artery in the neck and travels down to the abdomen. Its a highway for the parasympathetic nervous system which is responsible for our ‘rest and digest’ state – the opposite of the sympathetic system’s ‘fight and flight’ state. What I didn’t realise is that this nerve is hugely involved with our immune system. At the RSM Dutch rheumatologist Professor Paul-Peter Tak presented an implantable device that stimulates the vagus nerve to treat rheumatoid arthritis. It activates the parasympathetic system which suppresses inflammation in the joint cartilage. Just a couple of minutes of vagal nerve stimulation a day and the patients tested so far can throw away their pills.
Bacteria on the brain
At WIRED Health Professor John Cryan took things one step further. If you didn’t know already, our bodies are about 99% microbe. We’re colonised by constantly shifting populations of millions of bacteria called the microbiome. Cryan’s research at the University of Cork has found that the microbiome in our guts (and probably everywhere else) actually affects our mental health. Remarkably, changing the microbiome of mice significantly altered their social behaviour and response to stress. How? The vagus nerve again. They found that severing the vagus nerve actually stopped the effect. It seems to be a kind of highway, connecting mind and body. Interestingly vagus nerve stimulation is already approved in the UK for treatment resistant depression. As Cryan put it “What happens in vagus, doesn’t just stay in vagus.”
The winner of the Bupa Startup Stage, Neuroelectrics, are consumerising another kind of stimulation: tDCS, or transcranial direct current stimulation. tDCS has been around for a long time and has been proposed to help treat problems from depression to neuropathic pain. The evidence however has always been a little mixed – a systematic review came out last year that found little-to-no evidence tDCS had any effect on the brain.
Consumer tech for those in need
One theme that arose at WIRED health was how consumer technology often drives solutions that those with disabilities have been waiting on for years. Lama Nachman from Intel presented her work improving Stephen Hawking’s assistive communication device. The mobile revolution has given rise to advanced predictive typing tools, such as Swiftkey, which would have hugely improved Hawking’s quality of life decades ago. Similarly, Geoff McGrath revealed that McClaren have been using sensors and machine learning to gain insights into the human body long before the technology was applied to medicine. Gad Amit, the designer behind the Google Ara phone, pointed out the power of consumer driven healthcare. Sensors and wearables are becoming better, faster, smaller and sexier. If it was up to your doctor, you’d be carrying a fax machine around on your wrist. And while the revolution has begun with fitness and wellness, the application to improve the lives of those suffering from disease is just beginning.
But how long will it take? New technologies are arising every day, but the speed at which they are adopted into formal healthcare systems is less than impressive. Jaan Talinn, founding engineer of Skype and co-founder of the Centre for the Study of Existential Risk gave an insightful talk about what makes the adoption of technology so slow in healthcare. Poor feedback loops, he argued, were the answer. In software development feedback loops are critical to the evolution of a system. Aviation also has strong feedback loops. An airplane falls out of the sky and everyone scrambles to find the cause, learn from it and implement the changes. But an airplane-load of people die from medical errors every day in the US and there are few systems in place to learn from the mistakes. If a system can’t learn from it’s mistakes change is high risk.
Open source science
We are also now seeing an interesting difference in development timescales. At the RSM we heard from UCL’s Professor Geoffrey Raisman, who told us about his 50 year journey to repair spinal cord injuries. At WIRED Health Sonia Trigueros, Director of the Oxford Martin Institute for Nanomedicine also spoke of a 30 year endeavour to bring cancer targeting nano-particles into clinical practice. In contrast, the speed at which new innovations in digital health are now arising is astounding. Of course these are extremely different areas but I think the difference doesn’t just lie in the nature of the problem. Part of the struggle for Raisman was convincing the then insular and conservative academic world of his revolutionary new Pathway Hypothesis. That alone took 20 years. In our new hyper-connected world, hungry for innovation and new insights one hopes this will be faster. At both events we heard from two groups opening up the development of their technology: Oxford Nanopore have an Access Programme allowing the development of their USB sized DNA sequencer for different industries. And Micreos have completely open-sourced their new anti-bacterial endolysin technology Staphefekt in the war against antibiotic resistance.