It was our pleasure to host our Cure Panel Talk Show on Health Tech on Tuesday, August 6 2013 @ 5pm ET. Our topic for the show was “Wearable EEGs in Clinical Trials- Now and Beyond” with Advanced Brain Monitoring (ABM). Chris Berka (CEO & Co-founder of ABM), Dr. Ajay Verma (VP, Translational Neurology at Biogen Idec), Gene Davis (VP, Manufacturing at ABM) and Dr. Kamran Fallahpour (Clinical Psychologist and the director of the Brain Resource Center, NY) were our panelists for the show.
Priya Menon (Scientific Media Editor at Cure Talk) was our host and Kimberly Blozie was our co-host for the show.
You can listen to the entire show here-
I’ll be providing a quick summary of the discussion here.
We actually learnt about wearable EEGs in a NYTimes article
that was published on March 27 which mentioned that researchers at University of Edinburgh attached portable EEGs to the scalps of 12 healthy young adults to study the cognitive impacts of green spaces. They asked each volunteer to take a short walk of 1.5miles that included walking through a park and urban congested areas so that they could detect the brain wave patterns as the walk progressed through different sections. The study found that green spaces lessen brain fatigue and we thought this would be something useful to discuss as part of our Nanotech and innovative Health Tech Cure Panel Series.
Q- What is EEG and how are they applied traditionally? What aspects of the technology have recently changed?
Gene – Traditionally, EEG involves a lot of wires and electrodes connected to a big instrument and a screen, sticky gels and removing hair to get good quality signals, and a patient bed. Recent changes to EEG include use of wireless technology, and dry techniques. The biggest change is the aspect of mobility with wireless technology. With our sensor system, you can actually study EEG in a more natural environment. The hardware is easier-to-use, mobile and lower cost. The software enables management and processing of enormous data sets.
Q- Can you throw some light on if EEGs measure emotional states in the individual. As mentioned by Priya earlier, the study reported in the NYTimess used wearable EEGs for detecting changes in brain patterns affected by green spaces. So can EEGs provide specific patterns indicative of depression or anger, compassion or other emotional states.
Gene- That’s something we’re seeing more and more of in research. EEG can tap into giving idea of one’s emotional state broadly but cannot be specific like telling whether one’s experiencing anger or frustration.
Q- Please tell us a bit about wearable EEGs. When were they first developed and how did you all get started? Why is it needed and what does it entail?
Chris- EEG is one of the oldest bio-medical techniques, but it is only in the past 20-30 years that we’ve seen increased processing capabilities, miniaturization of electronics, ability to produce, store, merge and analyze large data-sets. Our area of expertise and interest is in making EEG least/non-intrusive, comfortable, light weight, and easy to use and monitor continuously even while doing daily activities. So on top of advanced sensor technology and miniaturized electronics, we need to layer in very specific algorithms for identifying potential artifacts. When such an artifact is detected, we have alarm systems like telling the person through voice messages that their sensor fell of and ask them to put it back so that we can continuously collect clean data.
Q- How big is the wearable EEG device and how portable is it?
Chris- Our current systems for sleep and for daytime measurements are worn on head, and we have a sensor array ranging from 2 to 32 sensors. 2-3 sensors is all that we need to analyze sleep at night, while a complete system with 24-32 sensors is enough to give you a complete neurological map of the person. What we’ve able to do is develop this system where even a denser sensor array is just 2-3 ounces. You just wear it on your head, and connect it to a computerized system be it smartphone/tablet/laptop or computer in a range of around 30 feet.
Q- How are portable EEGs being used in clinical trials now and how will the value they bring continue to evolve going forward?
Dr. Verma- The field of neurology has suffered from the lack of a reliable brain bio-marker. Once we get a good bio-marker, it is easy like we have numbers for blood glucose and blood pressure, so we treat patients to bring those numbers in the correct range. Portable EEGs can help us get a good brain bio-marker as the concept and technology has made it possible to take EEG to masses. The convenience and ease of use of EEG that ABM technology has offered through their wearable EEGs can’t be under-estimated. As regards to use of EEG in clinical trials, there’s a lot of scope of EEG to look at drug responses in neurodegenerative disorders like Alzheimer’s, Parkinson’s, ADHD, epilepsy, etc. EEG provides a very robust signal for variety of drug classes and thus will be very useful to look for drug responses.
Q- What is your opinion on this innovative health technology – wearable EEGs?
Dr. Fallahpour- We use EEG in bio-marker studies looking at depression populations and drug responses. The advantage with portable EEGs is that it opens the door for research in human-brain interface, clinical applications, etc. There are challenges like teasing out whats’a clear signal and dissecting out muscular artifacts, eye movement artifact, etc., and we’re getting better and better. The future for research and clinical use is quite exciting.
Q- Describe how patients feedback…do they actually change connections in the brain leading to less depression, less stress etc?
Dr. Fallahpour- We’ve done lots of brain mapping using EEG, and we know that there’re certain profiles associated with certain disorders. Like for example, in most ADHD patients, there’s increased flow activity in frontal lobe area, and when exact location and frequency band is figured out, we can design paradigms where in real time, with just a single/double channel EEG, we can measure EEG activity, and teach children how to inhibit or reduce amplitude of waves(neuronal firing in real time) by way of feedback and re-reinforcements and get closer to normal brain activity repertoire. We’ve observed that this model of self regulation by real-time feedback and monitoring works well for number of disorders.
Q- Can you describe how algorithms for automated data analyses work and their role in making EEG viable in clinical studies?
Dr. Ajay-The art of extracting meaningful signals from EEG requires insight into signal analysis, noise, how to clean up noise, knowledge of neurobiology. Its needs a multidisciplinary approach. The sensors and electronics are really advanced, but the analysis is where biggest gains are to be made.
Chris- I’m supported by a team of experts PhDs, electrical engineers, bio-medical engineers, processing and signal detection experts, neuro-scientists, psychologists, clinical psychologists. It takes that entire team to develop algorithms and detect artifacts. We do a lot of work with large databases, where we make sure data is clean, validated and replicable. It’s a great challenge to work with.
Q- What are some of the key goals the regulatory agencies aim to uphold when it comes to EEG in clinical trials?
Dr. Fallahpour- It’s validation, standardization, by publication in peer-reviewed journals, and there need to be number of studies with EEGs done on different days showing that features and elements are standardized. Then there are regulations depending on in which country the data is going to be used. There are specific regulatory bodies and scientific groups looking into this.
Gene- Medical practice norms and requirements are different for different countries. There are also a specific subset of rules and regulations for EEG. You have to go to the specified testing/regulatory body to get your products or services certified and cleared.
Q- What are some of the practical disadvantages you have observed while using wearable EEGs? Outside noise? Criticisms?
Gene- Depending on the study you’re doing, there’s a wide range of issues to overcome including environmental and patient considerations. Other main issue we face is that some people in medical community still believe portable EEGs are part of science fiction.
Chris- One of the first things that comes is privacy concerns not just about health privacy, but also that we’re trying to read people’s minds. Well that’s not what we’re doing and we have to overcome everyone’s concerns and fears.
Dr. Verma- Most of our experience is in clinical trials where we already have people’s consent for using EEG. Our main issues are regarding data robustness and analysis. Some of the older systems of EEG were more susceptible to noise coming from other electronic devices. For us, the quality and integrity of the data is of paramount importance, and that has always been the challenge. But we’re seeing improvements with newer systems like portable EEGs.
I will end it here for this exhaustive panel discussion. I strongly suggest you to listen to the talk to enlighten yourself and to know what the future of brain research, human mind, psychology and behavioral sciences would look like!
A big thanks to all our panelists and our hosts Priya and Kimberly.
- Wearable EEG in Clinical Trial with Advanced Brain Monitoring on The Cure Panel Talk Show on Health Tech
- Wearable EEGs in Clinical Trials- Now and Beyond – Q/A Session with Cure Panelists
- Listen HERE! Dr. Kamran Fallahpour, Director, Brain Resource Center, on The Cure Panel Talk Show on Mental Health
- Discuss Latest Treatments For Mental Health With Dr. Kamran Fallahpour, Director, Brain Resource Center on The Cure Panel Talk Show on 14 May @ 7pm EST
- A Big Shout Out To Our Cure Panel Talk Show Panelists! Listen To The February Cure Panel Talk Show On Multiple Myeloma Broadcast Here!