Brain implants to treat epilepsy, arthritis or even incontinence? They may be closer than you think

Oran Knowlson, a British teenager with a severe form of epilepsy called Lennox-Gastaut syndrome, became the first person in the world to try a new brain implant last October, with phenomenal results: his daytime seizures were reduced by 80%.

“It’s had a huge impact on his life and has prevented him from having the falls and injuries he used to have,” said Martin Tisdall, a consultant paediatric neurosurgeon at Great Ormond Street Hospital (Gosh) in London, who implanted the device. “His mother has said how much his quality of life has improved, but also his cognition – he’s more alert and engaged.”

Oran’s neurostimulator sits beneath his skull and continuously sends electrical signals deep into his brain. The goal is to block abnormal impulses that cause seizures. The implant, called Picostim, is about the size of a mobile phone battery. It is charged via headphones and works differently depending on the day and night.

“The device can record and measure brain activity, and that allows us to think about ways in which we can use that information to improve the effectiveness of the stimulation that the children are receiving,” says Tisdall. “What we really want to do is offer this treatment through the NHS.”

As part of a pilot, three more children with Lennox-Gastaut syndrome will be fitted with the implant in the coming weeks, followed by a full trial of 22 children early next year. If this goes well, the academic sponsors – Gosh and University College London – will apply for regulatory approval.

Tim Denison, professor of engineering at the University of Oxford and co-founder and chief engineer of Amber Therapeutics in London, which developed the implant with the university, hopes the device will be available on the NHS and around the world within four to five years.

The technology is part of a growing number of neural implants being developed to treat a wide range of conditions, including brain tumors, chronic pain, rheumatoid arthritis, Parkinson’s disease, incontinence and tinnitus. These devices are more advanced than previous implants because they not only decode the brain’s electrical activity but also regulate it. It’s also a sector where Europe is pitted against the US in a race to develop the life-changing technology.

Amber isn’t the only company working on brain implants to treat epilepsy. California-based NeuroPace has developed a device that responds to abnormal brain activity and has been approved for use by U.S. regulators for people 18 and older. However, the battery isn’t rechargeable and must be surgically replaced after a few years. Other devices are placed in the chest, with wires running to the brain, and must be reattached as a child grows.

When you think of brain chips, most people think of Elon Musk’s startup Neuralink, also based in California. The company has just implanted a brain chip in a second person with a spinal cord injury. The device uses tiny wires thinner than a human hair to pick up signals from the brain and translate them into actions.

The implant was modified after some wires became dislocated in the first person to receive it in January, Noland Arbaugh, who is paralyzed from the neck down. It has allowed him to control a mouse cursor on a computer screen by thinking, which he says feels like a Star Wars Jedi “use the Force.”

Other US companies, such as Synchron, backed by Bill Gates and Jeff Bezos, have also recently implanted brain-computer interfaces (BCIs) in people who cannot move or speak.

But scientists say those implants simply decode electrical signals. Instead, a number of U.S., British and European companies, including Amber, are working on modulating the signals in what are called “BCI therapies” — or deep brain stimulation to treat disease. Amber’s implant is also being used in academic trials for Parkinson’s disease, chronic pain and multiple system atrophy, which causes gradual damage to nerve cells in the brain. The company has also sponsored a first-of-its-kind trial in Belgium to treat incontinence, with promising results.

Another type of technology will enter a human clinical trial within weeks, using the first brain implant made from graphene, the “wonder material” discovered two decades ago at the University of Manchester.

A medical team at Salford Royal Hospital will place a device with 64 graphene electrodes on the brain of a patient with glioblastoma, a fast-growing brain tumour. It will stimulate and read neural activity with high precision, ensuring that other parts of the brain are not damaged when the cancer is cut away. The implant will be removed after surgery.

“We use the interface to determine where the glioblastoma is located and remove it without affecting functional areas such as language or cognition,” says Carolina Aguilar, co-founder and CEO of Inbrain Neuroelectronics, a Barcelona-based company that developed the implant in collaboration with the Catalan Institute of Nanoscience and Nanotechnology and the University of Manchester.

Traditionally, platinum and iridium are used in implants, but graphene, made of carbon, is ultra-thin, non-damaging to human tissue and can decode and modulate very selectively.

Inbrain plans to conduct clinical trials of a similar implant, driven by artificial intelligence, for people with Parkinson’s disease, epilepsy and speech problems caused by strokes.

Prof Kostas Kostarelos, professor of nanomedicine at the University of Manchester, co-founder of Inbrain and principal investigator for the glioblastoma study, says the company aims to “develop a more intelligent implantable system”.

AI-driven devices with 1,024 electrical contacts will “help deliver the best therapy for each patient without neurologists having to program all these contacts individually, as is the case today,” he says.

Inbrain is working with German pharmaceutical company Merck to stimulate the vagus nerve with its graphene device. The vagus nerve is responsible for various bodily functions, including digestion, heart rate and breathing. This can treat serious chronic inflammatory, metabolic and endocrine diseases such as rheumatoid arthritis.

Galvani Bioelectronics, founded in 2016 by Britain’s second-largest pharmaceutical company GSK and Alphabet subsidiary Verily Life Sciences, has a lead therapy aimed at treating rheumatoid arthritis by stimulating the splenic nerve. Galvani has begun clinical trials with patients in the UK, US and the Netherlands, with initial results expected within six to 12 months.

The bioelectronics market, which combines biological science and electrical engineering, is now worth $8.7 billion and is expected to reach more than $20 billion (£15 billion) by 2031. according to verified market research. This area focuses on the peripheral nervous system, which carries signals from the brain to the organs and back. Add brain-targeted neuromodulation and BCI to that, and the total market could be worth more than $25 billion, Aguilar believes.

While neuromodulation companies are making waves in the US with devices aimed at chronic pain and sleep apnea, there is a growing number of startups in Europe. MintNeuro, a spin-off from Imperial College London, working on next generation chips that can be combined into small implants, and is working with Amber. Funded by an Innovate UK grant, the first project is to develop an implant to treat mixed urinary incontinence.

Geneva-based Neurosoft has developed devices in the form of thin metal films on stretchable silicone that, because they are soft, put less pressure on the brain and blood vessels. It targets severe tinnitus, which affects 120 million people worldwide.

Nicolas Vachicouras, the CEO, says: “Although tinnitus often starts with damage to the ears, usually caused by loud noise… it can cause changes in the wiring of the brain and in fact become a neurological disorder.”

Newronika, founded in 2009 by 13 neurosurgeons, neurologists, engineers and other scientists from the Policlinico research center in Milan and the University of Milan, has developed a rechargeable deep brain neurostimulator to treat Parkinson’s disease. It is capable of closed-loop stimulation, which adapts to the patient’s condition from moment to moment, and is still being tested in patients.

“When it comes to delivering therapies to the NHS and distributing them globally, Europe and the UK can go head-to-head with the US,” Denison says. “It’s a fair race and we’re going for it.”