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NeuroBionics

NeuroBionics

Endovascular Brain Stimulation

Andrew Kuzemczak
April 29, 2025

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Welcome to the 5 new subscribers who have joined Future Human since our last edition! Join 170 other leaders in tech, medicine, and finance learning about the future of human health:

Trying to build more in public (clearly).

Hi friend,

Welcome back to Future Human! I hope you enjoyed the 10th edition last week all about AI in pathology. If you are a pathologist, I hope it only inspired you more and did not strike any fear into your soul. Your job is still safe. We have too many trust issues to let AI take over that quickly. I thoroughly enjoyed jumping into Paige and exploring the space over multiple days.

Fun update! Here at Future Human, we have brought on two research associates. Welcome Isabelle and Nick! I considered the idea of seeking research assistance when I drafted the plan for this newsletter in 2024, but I did not expect to be in this position so soon. We are still small, but there is a lot to do. Isabelle and Nick reached out at the same time to help, so I jumped on the offer. They are now not only gathering data on any healthtech topics they are most excited about, but soon will also be helping with general improvements in our marketing, collaborations, branding, and other things random Instagram influencers tell you they do.

Future Human is only 3 months old, but the conversations it has allowed me to have and people it has brought into my life have been a blessing. I aim to return it all in the form of entertaining content to keep you in the loop on what the future of health and medicine holds.

Okay, now onto edition #11.

The brain is a sensitive space for most. I would venture to say most would allow tools and wires into their kidney sooner than their brain. As neuroscience evolves, however, we find that it is taking a tried and true path to accommodate this sensitivity—one of minimal invasion.

So with that, let me ask you:

If tuning up your brain could boost your memory, mood, or focus, would you let a wire be threaded through? And would the width being no thicker than a strand of hair nudge you closer to yes?

The Story

Up until this week, the youngest companies we have written about were founded in 2017 (Hemotune, Cleerly, and Paige). Today, we are going to break massively from this and see how it works.

I tend to keep close tabs on the entrepreneurial ecosystem and spinout activity within universities like MIT, Stanford, Yale, and Harvard. Given their historical record, I know each year I should hear about ~1-2 startups coming out of a lab or incubator somewhere that shows promise. That was exactly the case last year when I got a TechCrunch notification for a young team spinning out of MIT with a technique to deliver the future of deep brain stimulation. Founded in 2023 by MJ Antonini and Nicki Driscoll, two postdoctoral researchers working within the Anikeeva lab, NeuroBionics applies next-gen fiber technology to develop less-invasive options for neuromodulation therapies.¹

The fibers they were working on in lab were far from the standard interventional catheters we in medicine know well. Their ultra-thin, multifunctional fibers are not just compatible with the body’s soft tissue, but also equipped with electricity emitters to activate specific cells and channels to deliver genetic components or therapeutics.

The young postdocs, having seen family members suffer from mental illness and neurodegeneration, thought (like any good entrepreneurs) that they could take this tech farther to reach more people. From depression and bipolar disorder to epilepsy and Parkinson’s, they knew a minimally invasive intervention could change the minds (literally) of millions.²^,³

While in the MIT lab, they secured 3 patents, meaning the university remains a stake holder in the company which always makes things interesting. That stake, however, did not stop them from breaking into the market and attracting investors rapidly. Just in January, they announced their $5 million Seed round led by Dolby Family Ventures with Future Ventures, GreyMatter Capital, and 4 others participating.

Queue the obligatory investor support quote:²

“NeuroBionics is pioneering a revolutionary technology that will transform how we treat complex neurological disorders. Their endovascular platform tackles the critical need for more accessible, effective therapies.”

Steve Jurvetson, Co-Founder at Future Ventures

So we have a young team, two massive brains, an even more massive medical need, and a few million dollars—what can go right?

The Tech

I have written a number of times now in Future Human about the paradigm shift in medicine to minimally invasive surgery (MIS). It is a regular topic of discussion especially in cardiology with the cardiac surgeons and cardiologists practically launching campaigns against the other over whether a TAVR (transcatheter aortic valve replacement) or SAVR (surgical aortic valve replacement) offers better outcomes (SAVR seems to win, but TAVR is getting closer).

For the neurosurgeons and neurologists, however, I am the first to admit my limited knowledge of the space (read: I prefer the engine of the car, not the electronic control unit). That said, I love this newsletter because it forces me to become knowledgable for the week, so let’s dive in.

The current on-market solution for neuromodulation is deep brain stimulation (DBS). Few can deny its impact, but all must acknowledge that it requires patients to undergo surgery awake with drills burrowing into one’s skull.

DBS involves surgically implanting electrodes into specific brain regions to deliver electrical impulses, helping manage symptoms of neurological disorders like Parkinson's disease and tremor. Once electrodes are placed directly into the brain tissue, a pulse generator is implanted under the skin to control the stimulation.

Deep brain stimulation (DBS) is approved by the United States FDA for the treatment of tremors, dystonia (involuntary muscle contractions), Parkinson’s disease, and treatment-refractory obsessive-compulsive disease (OCD). As with any promising technology, research continues to expand the label. Studies are ongoing to understand DMS’s value in addiction, autism, anorexia nervosa, and anxiety.⁴

With open-brain surgery on one side, NeuroBionics now has a much easier sell. The startup utilizes hair-thin, flexible bioelectronic fibers that can be delivered endovascularly—that is, through the bloodstream—eliminating the need for the surgery. Once navigated to the target area within the brain's vasculature, these fibers can deliver precise electrical stimulation through the vessel walls to modulate neural activity. They call it “evSTIM”. Although I could not confirm from our research, it seems that the goal is to build the system into a permanent implantable that continues to modulate as needed. These next-gen delivery wires are also crafted from carbon nanotubes instead of traditional platinum and iridium oxide (read: MRI compatible and degradation resistant).

evSTIM:¹^,⁵

Consider this the clinical face of the endovascular neuromodulation device
The device is adjustable for blood vessel sizes and can both stimulate and record nerve impulses
The stimulation is powered by a small implantable battery (already on the market) with a lifespan of 5-10 years
By 2030, NeuroBionics aims to apply the device to humans and seek FDA approval

IO Fiber:¹^,⁶

Consider this the research-only version of the device
The research wire integrates:
- An optical channel that can send light into the brain and activate specific neurons, collect light signals from the brain, and record neural activity based on fluorescent signals
- A microfluidic channel that locally delivers drugs or viral vectors for medication testing or transfection
- The system also offers standard connectors for most lab tools, so one can connect devices like infusion pumps

The opportunity to modulate is not just limited to electricity and medications. Neurons also produce and receive complex chemical signals that one can interact with to generate certain responses. The NeuroBionics team has its work cut out for it to combine neural recording, electrical stimulation, drug and gene delivery, and voltammetric recording of neurotransmitters within an individual fiber, but they are already offering an exciting option against brain surgery.

The Market

As the brain proves tougher to medicate (recall: Biogen’s controversial data and withdrawal of Aduhelm for Alzheimer’s⁷), companies are turning more to hardware to address our neurological conditions. The global brain implant market is currently valued at $2.12 billion, growing rapidly with a CAGR of 11.1% through 2032.

As discussed earlier, the hardware is far from perfect. Current metal or silicon probes often leave scars after implantation in addition to the direct brain access site scars. As companies continue experimenting with new artificial materials whose stiffness matches the brain soft tissue better, NeuroBionics stands as one of the only teams to look to carbon nanotubes.⁸

The deep brain stimulation (DBS) market is expanding, so lets cover the classic incumbents that could not pass up a good patient population.

The largest companies in the DBS space are Abbott, Boston Scientific, and Medtronic.⁹

Abbott:
- The Infinity device has a non-rechargeable battery that lasts five years
- Liberta RC has a rechargeable battery that lasts 37 days (longest of any available rechargeable DBS system)
- Both are otherwise the same, even operating with Apple iOS software
Boston Scientific:
- Vercise Genus R16 has a rechargeable battery
- Vercise Genus P16 is non-rechargeable and lasts three to five years
Medtronic:
- First DBS device to be FDA approved for Parkinson’s (1997)
- New Percept gained FDA approval in 2020
  - First self-adjusting DBS system available for use (changes stimulation in response to brain signals)

Now with the giants out of the way, let us look to the exciting startups.

Synchron:¹⁰^,¹¹
- Another team developing endovascular neuromodulation tech, with a focus on brain-computer interfaces rather than stimulation (also happens to be the subject of my most popular LinkedIn post ever)
- In December, Synchron announced a $75 million financing round that included the investment firms of Bill Gates and Jeff Bezos
- 2020 - FDA granted Synchron the Breakthrough Device designation
- 2021 - first company to receive an Investigational Device Exemption from the FDA to conduct trials of an implantable BCI in humans
- Remain focused on a different patient population— patients with severe paralysis seeking communication via type or text
Amber Therapeutics:¹²
- Not really following the ‘minimally invasive’ trend—fully implantable PicostimTM System targets the pudendal nerve with a device that can both stimulate and sense physiological responses
Neurovalens:¹³
- Developing a noninvasive device to be worn over the head, and deliver electrical impulses
- Focused on improving sleep

“There’s roughly about 2,000 interventionalists who can perform these procedures. It’s a little bit more scalable, compared to, say, open-brain surgery or burr holes, which only neurosurgeons can perform.”

Peter Yoo, Senior Director of Neuroscience at Synchron

It must also be said, that although NeuroBionics is not diving into the brain-computer interface field, it is certainly benefitting from the enthusiasm built by Elon Musk. Putting current events aside (I am writing this in April, 2025 during the peak of DOGE-mania for our readers in the future), Musk and Neuralink have brought a lot of attention to the industry. Government investment in neuroscience (from DARPA and NIH’s Brain Initiative) has been steadily rising to $3 billion since 2014.¹⁴

The Sick

Writing about a space as broad as ‘neurological conditions’ makes writing this section concisely quite the challenge. Approximately 3.4 billion people worldwide are living with some neurological disorder. I am not going to stand here (sit?) and tell you NeuroBionics is going to help nearly half the world. To keep it reasonable, I will look at the indications that NeuroBionics has mentioned as serious possible targets. Let us begin.

Nearly one million people in the U.S. are living with Parkinson's disease (PD). This number is expected to rise to 1.2 million by 2030. PD is the second-most common neurodegenerative disease after Alzheimer's disease.¹⁵ Globally, 10 million individuals are living with PD. Symptoms are unique to each person, but most of us are aware they can include tremors, slowness of movement, limb stiffness, difficulty swallowing, and imbalance. Patients will often respond well initially to Levodopa (precursor to dopamine meant to smooth out movements). Unfortunately, over time patients can develop Levodopa-induced dyskinesias (LID), which are involuntary movements as a side effect of the medication. In many cases, when the medications fail to control motor-fluctuations or worse make them more severe as a side effect, patients turn to DBS. NeuroBionics may soon be there new next option (hey, no need to cut your skull open).

Obsessive-compulsive disorder (OCD) is often a long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions), and behaviors (compulsions) that they feel the urge to repeat over and over.¹⁶ Lifetime prevalence of OCD among U.S. adults is 2.3% and of those individuals, half have serious impairment. For a less invasive approach, patients can turn to cognitive behavioral therapy (CBT) to manage their obsessions. From there, many try selective serotonin reuptake inhibitors (SSRIs), but doses need to be higher than that used for depression. Third line therapy includes DBS—reserved for patients who fail medications and intensive CBT. With a minimally invasive, endovascular approach, however, we could see NeuroBionics evSTIM become what percutaneous interventions (stenting) is to statins—the clear next step.

Finally, depression is currently being researched for DBS.¹⁷ An estimated 3.8% of the global population experience depression—that is 280 million people. At the moment, psychological therapy is the first line therapy, with antidepressants available for combination therapy. Although the FDA has not approved deep brain stimulation for the treatment of depression, several clinical studies have shown that it can be used safely and effectively.¹⁸ Assuming the approval follows the positive results in the years to come, we may be able to skip over traditional DBS entirely and offer endovascular stimulation with NeuroBionics first.

The Economy

It may seem like a logical assumption that more minimally invasive interventions will cost the patient and the healthcare system less than an invasive surgery. Well, I am here to tell you it is unfortunately more complicated than that. Remember earlier when I said SAVR has better outcomes than TAVR for valve repair—there in lies the problem. Sure, a minimally invasive option (e.g. stenting a coronary artery) is immediately more affordable, but it must sustain the same quality of outcomes as the surgical option to remain cheaper. It, unfortunately, does not always end up that way.

In the great cardiac surgery vs. interventional cardiology debate, data has been shockingly clear that stents overtime can become more expensive as the vascular patency does not hold up as well as a coronary artery bypass graft.

Now, it is a long stretch to say endovascular brain stimulation will follow a similar path as stents (benefit not holding up overtime), but it is a valuable trend to consider. NeuroBionics will have to demonstrate robust and sustainable neurological benefit with longterm savings to displace the incumbents in DBS.

Parkinson’s alone came with a total economic burden of $51.9 billion in the US in 2017. As with most neurological conditions, Medicare bears the largest share of medical costs, as most patients are over age 65.¹⁹ OCD comes with a similarly high burden, driving 6% of the cost for all mental illness treatment in the US.²⁰

Then, we come to depression. With depression affecting people of all ages and backgrounds, it is no surprise that it imposes the most significant economic burden on the U.S. economy. The societal economic burden of major depressive disorder (MDD) was estimated to be a staggering $333.7 billion in 2019. This comes from a combination of healthcare costs (38%), household costs (24%), presenteeism (13%), and absenteeism (11.5%).²¹

As for deep brain stimulation, procedures in the US can range from $50,000-$100,000. Specific region, hospital, surgeon’s expertise, and postoperative care explain the variance.²² Although we do not know what endovascular brain stimulation would cost from NeuroBionics, we could extrapolate that it would price like most percutaneous interventions—60-70% the price of the invasive option (e.g. stenting costs ~$6,000 while CABG costs $10,000+). If NeuroBionics can show durable neurological response in human patients in the years to come, that minimally invasive evSTIM may just compete as the standard of care for any of the above conditions.

My Thoughts

To dedicate your life to ‘sparking’ happiness, focus, and improved memory in others is a cause that rivals any obsession no matter how noble. MJ and Nicki are moving at a fiery pace thus far, and I expect it to only intensify in the coming years as the technology is validated. Neurology patients and their families will only push harder for better therapies than those that are already available.

With continued execution on the path of minimal invasion, the NeuroBionics team has much success ahead of them.

To more lives saved,

Andrew

I always appreciate feedback, questions, and conversation. Feel free to reach out on LinkedIn @andrewkuzemczak.