Neuromodulation Professionals Come to Vancouver for INS 2024

Staff report

May 2024 issue

Pain physicians, neurosurgeons, neurologists, and neural engineering professionals assembled in Vancouver, BC last month for the 16th World Congress of the International Neuromodulation Society. At the meeting, Giancarlo Barolat, a neurosurgeon and spinal cord stimulation pioneer, received the Giants of Neuromodulation Award.

The conference featured a preconference workshop devoted to Innovations in Neuromodulation and co-moderated by NBR editor James Cavuoto, INS president Marc Russo, Ashish Gulve from James Cook University Hospital in the U.K., and Philippe Rigoard a neurosurgeon at the Poitiers University Hospital in France. The full-day session featured several tutorial sessions targeted at neuromodulation industry startups, as well as presentations from several emerging companies in the space. These included Presidio Medical, Spark Biomedical, RebrAIn, Aurimod GmbH, and Lungpacer Medical.

Aurimod CEO Stefan Kampusch described the Austrian firm’s novel percutaneous auricular VNS device called VIVO, which is targeted at chronic pain. The device stays on the patient’s pinna for a period of seven days. He said the therapeutic effect can often be observed in one week. Kampusch explained the analgesic effect of aVNS, which he said results from afferent modulation of vagal brainstem nuclei, which leads to expression of endogenous opioids and activation of the cholinergic anti-inflammatory pathway.

Lungpacer CEO Doug Evans explained that diaphragm muscle atrophy can occur rapidly in hospitalized patients and that patients on a ventilator experience added cardiac strain. These considerations point up the need for the company’s AeroPace system, which Evans described as a “personal trainer” for the diaphragm.

RebrAIn co-founder Emmanuel Cuny described the company’s technology, which simplifies the surgical treatment of Parkinson’s disease and essential tremor. Their software-based service integrates AI-guided targeting into the surgical workflow. The company received a €3.7 million seed investment from Karista and M Capital.

Spark Biomedical CTO Alejandro Cavalin offered advice to neuromodulation startup firms seeking to commercialize their new technology. He advised them to seek out investors familiar with bring a new medical device to market. He also cautioned startups to be thoughtful about their early funding rounds. Too much initial money may dilute the funders to the point it’s no longer staying for later rounds, he said.

Greg Bruce from battery vendor Resonetics gave an in-depth tutorial on power sources for implanted medical devices. He said that batteries are a mission-critical component and should be one of the first pieces to be considered in the design process. The advantages of lithium-ion batteries over other chemistry are higher energy, better storage, low self-discharge, and no memory effect. New technologies coming down the road include piezoelectric, fuel cells running off sugar, and metal oxygen batteries running off oxygen in the body.

Katherine Neuenfeldt from Presidio Medical addressed the issue of what third-party payers want from medtech startups. She reminded the audience that for SCS reimbursement, all three legs of the stool are necessary: coding, coverage, and payment. Some of the reasons that some SCS technologies and patient populations are not covered today have to do with limitations of the submitted data, such as an open-label design, small sample size, and lack of blinding.

In the opening plenary session, Robert Levy, editor-in-chief of the journal Neuromodulation: Technology at the Neural Interface gave well documented overview of the role of the placebo effect in neuromodulation. “Part of the mechanism of action is the placebo effect,” he said. Jeffrey Rogers from IBM’s Thomas J. Watson Research Center gave a talk on the subject Big Data and AI in Neuromodulation.