Neural Signals Executive Comments on Market for Phrenic Nerve Stimulation

Philip Kennedy, president of Neural Signals, Inc. and a pioneer in cortical control of neural prostheses, comments on NBR editor James Cavuoto’s publisher’s letter “A Breath of Fresh Air,” published in the March 2003 issue of Neurotech Business Report.

I read with interest your editorial on the stimulator. This is an area I have been very interested in since an ALS patient of mine died. We tested her phrenic nerve latencies and found they were normal, yet no one would give her the phrenic nerve pacemaker she would have accepted (she refused a ventilator). “Not proven,” they said. “Medicare won’t pay.”

We since tested a 10-year vented ALS patient and as expected his phrenic nerve latencies were prolonged. We are testing others as they come along to see if the ALS patient who is going downhill and has to make a decision about a ventilator might prolong his independence from a ventilator for some time, maybe for ever. In ALS, only skeletal muscle is affected. Diaphragm muscle is not well characterized in humans, and is probably not all skeletal.

Bottom line: I suspect the ALS population are candidates for the PNS also! You lament the small market in your editorial. In addition to the 125,000 quadriplegics in this country, there are 30,000 ALS patients of whom in any one year about 5,000 are about to make their ventilator status decision. Ninety percent elect to die! Yes, 90 percent. If we could offer them more dignity, would not a higher percentage choose to live?

The market is bigger yet. What about the axonal neuropathies or the GBSs who never recover? They live on vents. Oh, and multiply by 10 for the world’s population who could benefit from neurotech devices.
Let’s quit apologizing to the venture vultures who make us believe we will never be a business. My vision is that neurotechnology will be up there with the genomics industry, not just for ameliorating disease states, but for expanding the memory and computational ability of the human brain.