Hiroto Yamamoto, Team Neurit“Neurodetector" - Finding the minds of patients with disorder of consciousness”
What is a Neuro Detector?
This device has been developed towards an accurate diagnosis of locked-in patients for their bettercare and rehabilitation.
The unmet medical need that we focused on is the misdiagnosis of the locked-in state as a vegetativestate. A vegetative state is the first persistent form of consciousness with loss of cognitive functions.
These patients still have their eyes open while having sleep and wake cycles. Martin Pistorius, wasa patient who was diagnosed as vegetative at the age of 12. But in fact, he was conscious and locked
inside his own body for 13 years. Martin was luckily discovered later by a therapist and he received
proper rehabilitation. After his miraculous recovery, he revealed his unspoken experience of being
locked in with his artificial voice. He said that people abused him physically, verbally, and sexually.
His mother turned to him and told him that he should die. Some studies like Martin's even show thatup to 43% of patients diagnosed as vegetative are reassessed as having at least some level ofconsciousness such as the locked-in and minimally conscious states.
. So, these Locked-in state patients have healthy sensory and cognitive functions, but they're often
misdiagnosed because they have severe motor dysfunctions.
[Our vision]
Our vision is to take these patients back to the social world by directly detecting cognition. By
allowing them to mentally respond. We believe that this accurate diagnosis is the most importantfirst step for these patients to re-socialize. Because unless these patients are found out, they will not
get sufficient support and appropriate rehabilitation for them to be socialized.
[Our technology and strength]
We focused on a signal called the event-related potentials (ERP) that reflects an instant change ofattention. This signal typically requires long-term recordings of over 50 trials to get a legitimate signal.
We have been developing an ERP-based communication aid "Neurocommunicator®" for patientswith severe motor deficits, who could be in a locked-in state when the disease is progressed. Thissystem has been verified by clinical trials with over 40 subjects mostly ALS patients who typicallyhave healthy cognitive functions. These core technologies of Neurocommunicator were used for thedevelopment of Neurodetector.
The raw data of the ERPs obtained are multivariable and very difficult to analyze. However, by using
our pattern matching algorithm, we can use these ERP waveforms to determine whether the subjects
succeeded in responding to the cognitive task or not. And by doing so, we can calculate an individual
score called Task Success Rate, which will eventually be the biomarker quality tasks. We are still at
the development stage for this, but we will be using the database of healthy patients to diagnose
disorders of consciousness for patients with stroke and trauma. The database of healthy patients canbe referred to diagnose new patients into different levels of consciousness, from truly vegetative tolocked-in. If a patient could conduct these tasks with the mind switch, as successful as healthy
patients, that means the patient is in the locked-in state, with high consciousness levels.
We have obtained 11 patents in Japan. 5 of which are also taken in the US, 1 in the EU. Comparing
our technology with the other advanced technologies, the main point we would like to stress out isthat the Neurodetector stands out in terms of locked-in detectability, which means the sensitivity
for accurate diagnosis. Therefore, we can test the amount of communicability the patient has. Ourtechnology is also superior for decoding speed, convenience, independence of eye movement, price,and market size. We believe that these will also be factors that will affect our promotion sales in thefuture.
[Estimated Market Size]
In Japan there are about 700,000 patients and 2.5 million in the US. Our estimated market size forour service for the first year is about 120 million yen, and we estimate to sell our devices to about
100 hospitals in Japan, who have these patients. The serviceable available market is around 750
million yen per year, and hopefully sold to 626 big hospitals around the time that may need thisdevice.
[What we are looking for]We look for HVC Kyoto to get advice about clinical evaluation, obtaining funds and making
connections with partners for clinical evaluation. Our team is very small so we look for new members
for business management and perhaps medical approval.
[Q & A]Q.
You explain about the Locked-in State but can you explain about your technology itself? So what isyour technology and why you can use your technology for these symptoms?
A.
The strength of our technology is the ability to conduct to analyze raw data of the brain waves thatis ERPs effectively. These signals are very small, like five micro-volts. And they are very difficult to
extract from the chaotic raw data of our various signals. But our technology allows us to specificallytake out these signals and use them as a virtual switch for internal decisions, that is, the Mind Switch
for the locked-in patients to respond to others. And since these patients have healthy cognitive
functions, by detecting their cognitive ability, we can tell if the patient is whether if they are in avegetative or lock-in state.
Q.
How many points you put on your headgear to take the signals?
A.
Our headgears have 8 electrodes around the top of the head.
Q.
It's an interesting program and project. And if you want to expand the use of this headgear todifferent disease or states, I was thinking about ADHD, for example, like kids with ADHD mightoverreact to certain signals. And I guess this can be a good diagnosis tool. Just as a suggestion, but
you might want to consider about that.
A.
Thank you for your suggestion. We are also interested in it. The application might be a good use-casefor device. And we are thinking of other options right now.
Q.
What is the way of differentiate the healthy vs negative patients? Can you explain how did you comeup with this? This graph and this distribution? Or what is the key parameter showed in your device
to come up with this? Just allocation?
A.
The cognitive task has several trials, and we can calculate the score of how well they can do by MindSwitch. We only have the results about distribution from 40 healthy subjects, and still have toconduct clinical trials to confirm our hypothesis. The average score of healthy subjects was about

77%. If the score of a tested patient is close to this average. He/she could be in a locked-in state. If
the score is lower, the state may be minimally conscious or truly vegetative. This logic is still ourhypothesis, and needs to be verified.