Modern treatments for depression have evolved over the last few decades.
Historically, it wasn't that long ago that hospitals were performing lobotomies on patients, but today it seems like the stuff of horror movies: a highly invasive, damaging brain tissue, and relatively primitive procedure.
Since the 1940s, a common treatment has been electroconvulsive therapy, which induces seizures and has dramatic effects on the brain's overall functioning, sometimes with serious side effects, which also sparked fears.
UK – February 12: Electroconvulsive Therapy (ECT) machines were used to send timed electrical currents through the brain, inducing violent convulsions and seizures. It was thought that in this way patients with severe mental disorders could be “shocked” back to life. The therapy has always been controversial, but it is still occasionally used, primarily to treat severe depression. (Photo by SSPL/Getty Images)
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More recently, there's a non-invasive treatment called transcranial magnetic stimulation (TMS), which was invented in 1985 and received FDA approval for severe or treatment-resistant depression (TRD) in 2008. In this method, a doctor places a helmet on your head and aims a magnetic coil at your brain to stimulate deep cortical areas associated with mood disorders.
The challenge with TMS is that it requires patients to visit the hospital daily for weeks or even months, which can be difficult for patients suffering from depression. Additionally, TMS machines are only found in larger cities, making the treatment unavailable to patients in rural and smaller cities. Finally, TMS machines can only stimulate the brain; they cannot sense it and provide feedback to patients and doctors on whether the treatment is working.
Now, that evolution has taken a new step with something called BCI, or “brain-computer interface,” which solves three limitations of TMS: compliance, access, and feedback.
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BCI is a specialized medical accessory that can be used to send precise pulses to help treat depression.What's more, the device can sense brain signals and use an AI-based “mood graph” to make the right kind of small adjustments in the brain to bring patients out of severe depressive episodes.
Its developer, Inner Cosmos, calls its BCI “a digital pill for the mind.” The wearable device, about the size of a dime, delivers precise micro-stimulation similar to TMS, but without the need for weeks of hospital visits or the need to operate traditional hospital machines — a game-changing change in the time, effort and cost of delivering care and accessing treatment.
Depression patients who have tried antidepressants more than once without success and are prescribed TMS will be able to try the Inner Cosmos BCI as part of a clinical trial, as the device is approved as an IDE by the FDA in 2022. (Full disclosure: I have known the CEO and founders for years and serve as an advisor to Inner Cosmos.)
By managing the delivery of these mental stimuli in new ways, Inner Cosmos and its BCIs hope to modernize the therapy from an office-based treatment to something that can be cheaply and easily administered at home via an app, analyzed by AI and monitored remotely by a psychiatrist.
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This stimulation approach has led to some preliminary progress for patients in clinical trials, with 24 months' worth of data already collected from two patients.
For both patients, the Inner Cosmos device provided better results than their previous TMS treatment scores.
In a major milestone in depression treatment, Inner Cosmos announced that a recent patient who was initially severely ill experienced complete symptom relief over several months after treatment with the Inner Cosmos device. The patient's Montgomery-Osberg Depression Rating Scale (MADRS) score dropped from 30 to 5, indicating an 84% improvement in depressive symptoms.
CEO Meron Gribetz and the device
Melon Gribetz
The company also implanted a third patient this month in an effort to expand its data pool and further demonstrate the device's safety.
Interestingly, the technology that makes Inner Cosmos Therapy possible is the same technology behind many AI and machine learning projects: the shift to big data, smaller hardware, and larger language models (and other forms of AI/ML) has brought such innovation to every area of our lives.
This is great news for people with depression, and for us ordinary people, it shows what's possible when we push the limits of a technology. It's interesting to think about AI not just as a general force, but as part of an investigation into how we use it in real-world use cases that impact us for the better.
In some ways, the human brain is like the ocean, or the moon, or a distant planet: what we know about it is limited, and it has a “dark” or unexplored side to it. Technologies like this allow us to gain greater therapeutic knowledge about how our most complex organs work, and AI is a key driver, perhaps the most important driver, of these life-saving and life-enhancing modalities.
IC Devices
Melon Gribetz
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