A perfectly timed brainwave

(Stuttgart/Tübingen) – Psychiatrist Dr. Brigitte Zrenner and neurologist Dr. Christoph Zrenner have found a way to personalise transcranial magnetic stimulation for patients and boost its effectiveness. This technology, which has been in use for decades, utilises strong magnetic fields to stimulate specific areas of the brain. The researchers have now invented “bossdevice”, an instrument that ensures this stimulation is applied at precisely the right time. To get their invention onto the market, they founded sync2brain GmbH. Along with the company’s CEO, Dr. Ramona Samba, they hope that both stroke patients and people suffering from depression and obsessive-compulsive disorder will soon benefit from this new technology. The story of sync2brain is just one of many successful StartUp Stories in the STERN BioRegion.

Illustration of the bossdevice.

sync2brain bossdevice.

Copyright: Shalynn Crawford

The USP – what is the innovation?

TMS involves stimulating key areas of the brain by using an external magnetic coil to apply an electrical current for fractions of a second. However, because the brain is highly dynamic and constantly changing, it has not previously been possible to respond in real time to the activity and connections in the different parts of the brain. Although an EEG measures excitability states in the brain and records them in oscillating curves, these oscillations last mere milliseconds, and scientists haven’t had the computing power and algorithms they need to get the timing exactly right. Previously, stimulation has been applied at a set rate that does not necessarily “catch” the right point of oscillation. Studies have, however, shown that there is a specific point at which this stimulation is particularly effective. It is similar to a swing – it only achieves the pinnacle of oscillation when it reaches its highest point. sync2brain GmbH has developed the “bossdevice” tool so that scientists can target this point with precision. Switzerland-based Speedgoat GmbH manufactures the real-time computer that provides the computing power. US company MathWorks, meanwhile, supplies the all-important software platform. “bossdevice” is thus able to analyse the real-time raw data feed from the EEG in less than three thousandths of a second during treatment and identify the patient’s personal pattern. It synchronises the stimulation with the precise state of the brain and makes the TMS much more effective. The development by sync2brain therefore represents a genuine revolution in brain stimulation therapy.

Milestones – what next?

bossdevice RESEARCH is already available on the market, although the device is only licensed for use in research. bossdevice MEDICAL is to be certified in the coming months, meaning that hospitals and clinics will then be permitted to use it. As is the case for so many other medical devices, the certification process represents a bottleneck. sync2brain has already found the relevant “notified body” that will carry out the necessary assessment as stipulated by the Medical Device Regulation (MDR). The MDR is the EU regulation that manufacturers must abide by if they wish to market medical devices in the EU.

A major multi-centre stroke study involving 130 patients has also been initiated and is being led by the Department of Neurology at University Hospital Tübingen. What’s more, CAMH is involved in a major Canadian study on the psychiatric application of TMS in the treatment of OCD (obsessive-compulsive disorder). It is only a question of time before bossdevice secures its MDR certification for Europe and is certified by the FDA in the USA. However, certification is not the only obstacle that sync2brain has to overcome. Doctors and health insurance companies also need to be persuaded that it is worthwhile trying something new. CEO Dr. Samba expects to see the first positive results from the studies before the end of the year. The long-term goal is to establish the bossTMS therapy as a standard treatment for strokes, depression and other neuropsychiatric conditions. It is a brainwave that many patients will ultimately benefit from.


Further information

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