digital phenotyping

Since 2010, the Sharp­Brains Vir­tu­al Sum­mit has been bring­ing togeth­er neu­ro­sci­en­tists, entre­pre­neurs, and prac­ti­tion­ers with a mis­sion to improve men­tal health­care, brain per­for­mance and gen­er­al well-being.

As we get ready to host our next col­lec­tive brain­storm­ing next week, let us share some key themes from our last Sum­mit, since they helped shape the Agen­da for this one.

In 2017, the gathering’s tone was gen­er­al­ly optimistic–given the explo­sion of sci­en­tif­ic and tech­no­log­i­cal break­throughs, start-ups and investments–but impor­tant eth­i­cal con­cerns were also wide­ly discussed.

1. The Need is Very Real, Very Large and Largely Unmet

Dr. Tom Insel, a well-known sci­en­tist turned pol­i­cy-mak­er turned entre­pre­neur, shared a deep dive into the land­scape of health­care inno­va­tion: We have seen $15 Bil­lion invest­ed in Health Tech since 2012, in over a thou­sand new com­pa­nies … yet men­tal health­care has not tru­ly evolved while brain and men­tal dis­or­ders remain among the costli­est con­di­tions in the US, with an annu­al bur­den esti­mat­ed at $200+ Billion.

 

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Same thing regard­ing aging and brain health: the need is very real and very large, both in devel­oped and in emerg­ing coun­tries. At least there we see stronger signs of advo­cates and pol­i­cy­mak­ers begin­ning to take note. For exam­ple, Sarah Lenz Lock from AARP spoke about the need for improved dig­i­tal assess­ments that are evi­dence-based and per­son­al­ized, help­ing mil­lions of old­er adults self-mon­i­tor their brain health and delay cog­ni­tive and mem­o­ry problems.

 

A num­ber of researchers shared pop­u­la­tion-lev­el ways to pro­mote life­long brain health. For exam­ple, Belén Guer­ra-Car­ril­lo at UC-Berke­ley dis­cussed how Big Data com­ing from new online and mobile plat­forms can inform pol­i­cy. Dr. David Bartrés-Faz from the Barcelona Brain Health Ini­tia­tive described how track­ing behaviors–that sus­tain neur­al func­tion­ing in advanced age—can help per­son­al­ize inter­ven­tions, and how they are mea­sur­ing lifestyle fac­tors in a large, 3,000-subject-strong, ran­dom­ized trial.

 

2. Solutions Start with Early Detection and Digital Phenotyping

A very inge­nious pre­sen­ta­tions came from Jan Samzelius of Neu­raMetrix, one of the win­ners of the Brain­no­va­tions Pitch Con­test. His team, with a back­ground in cyber­se­cu­ri­ty, dis­cov­ered a method of assess­ing typ­ing cadence which could enable ear­ly detec­tion of neu­rode­gen­er­a­tive dis­eases, from Alzheimer’s Dis­ease to Parkinson’s. The sys­tem can run silent­ly (yes, per­mis­sion and pri­va­cy will be issues to address) in the back­ground of a per­son­al com­put­er or smart­phone, inte­grat­ing hun­dreds of vari­ables in a per­sons’ key­board cadence and flag­ging unusu­al patterns.

Anoth­er great exam­ple came from Nan­cy Briefs of Dig­i­tal Cog­ni­tion Tech­nolo­gies, which has adapt­ed a tra­di­tion­al neu­ropsy­cho­log­i­cal test (the ‘Clock Draw­ing Task’) and com­bined it with machine learn­ing to pro­vide fast, afford­able, and scal­able detec­tion of cog­ni­tive changes.

Mind­strong Health has been at the fore­front of dig­i­tal phe­no­typ­ing. Dr. Tom Insel dis­cussed how ‘dig­i­tal exhaust’ –data tak­en from smart phones– can be used to pro­vide objec­tive, con­tin­u­ous, and proac­tive mark­ers of mood, cog­ni­tion, and behav­ior. The firm has found that vari­ables extract­ed through machine learn­ing are as good at pre­dict­ing cog­ni­tive func­tion as the test-retest reli­a­bil­i­ty of numer­ous cog­ni­tive tests, pre­sent­ing the oppor­tu­ni­ty for scal­able and non­in­va­sive solu­tions to detect men­tal health dis­or­ders.  Fur­ther, the infor­ma­tion gained from these meth­ods could be used by clin­i­cians and patients not only to enable ear­ly inter­ven­tion but also to mon­i­tor progress over time, some­thing that is rarely done today.

3. And continue with Lifestyle and Digital Health/ Medicine interventions

The upcom­ing ‘dig­i­tal cav­al­ry,’ as described by Dr. Oliv­er Har­ri­son from Tele­fon­i­ca Inno­va­tion, will be high­ly com­ple­men­tary to the ear­ly detec­tion and dig­i­tal phe­no­typ­ing ini­tia­tives out­lined above.

For exam­ple, Dr. Eddie Mar­tuc­ci of Akili Inter­ac­tive Labs shared find­ings from a recent­ly-pub­lished ran­dom­ized con­trolled tri­al (RCT) sup­port­ing the use of ‘pre­scrip­tion’ video games to tar­get symp­toms of atten­tion deficit hyper­ac­tiv­i­ty dis­or­der (ADHD), while rep­re­sen­ta­tives at Click Ther­a­peu­tics, Sin­cro­lab, and Myn­dY­ou out­lined a new wave of per­son­al­ized cog­ni­tive training/ ther­a­py pro­grams. Going fur­ther, researchers at Neu­roscape and UCSF pre­sent­ed vir­tu­al and aug­ment­ed real­i­ty plat­forms for mul­ti­modal bio-sens­ing, adap­tive eval­u­a­tion and brain-body train­ing, which could well help upgrade brain health­care and cog­ni­tive rehab in the near term.

 

 

Some of the ideas dis­cussed were sim­ple yet high­ly inspired. Dr. Albert Kwon and col­leagues at Aug­men­tX craft­ed an aug­ment­ed real­i­ty adap­ta­tion of mir­ror box ther­a­py to poten­tial­ly pro­vide home-based treat­ment for stroke vic­tims. Emma Yang, the youngest Speak­er being just 13-years old, unveiled Time­less — a dig­i­tal app using arti­fi­cial intel­li­gence to help per­sons with Alzheimer’s Dis­ease to remem­ber events, stay con­nect­ed, and engage with friends and family.

4. Open issues: data security, privacy, equity 

While explor­ing the oppor­tu­ni­ties, Sum­mit par­tic­i­pants also detailed the con­cerns over data secu­ri­ty, pri­va­cy, equi­ty, and ethics.

Dr. Simone Schurle at ETH Zurich sur­veyed bio­med­ical sys­tems for neu­ro-mon­i­tor­ing and inter­ven­tion and issued a pow­er­ful call for respon­si­ble devel­op­ment: new plat­forms and devices can pro­duce great good in health care, but also have the capac­i­ty for mis­use and harm.

 

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Dr. Álvaro Pas­cual-Leone at Har­vard Med­ical School dis­cussed state-of-the-art neu­ro­mod­u­la­tion, which offers a sig­nif­i­cant and large­ly untapped oppor­tu­ni­ty, while Dr. Anna Wexler from Uni­ver­si­ty of Penn­syl­va­nia high­light­ed real-world issues expe­ri­enced by home-based users and cham­pi­oned the need for bet­ter eco­log­i­cal research and cus­tomer pro­tec­tion, giv­en the onrush of ‘do-it-your­self’ home devices and loose­ly reg­u­lat­ed products.

Mul­ti­ple speak­ers dis­cussed major con­cerns regard­ing pri­va­cy and per­son­al auton­o­my raised by big data plat­forms, and poten­tials way forward.

5. The Time to Engage is Now

Giv­en every­thing dis­cussed above, now is the prime moment for change­mak­ers, investors, clin­i­cians and allied health­care pro­fes­sion­als to engage with the dig­i­tal brain health rev­o­lu­tion in ways that can ben­e­fit all.

Sig­nif­i­cant advances are com­ing, have come, and will con­tin­ue to come. Researchers, inno­va­tors and prac­ti­tion­ers should work togeth­er to direct the flow of the upcom­ing ‘dig­i­tal cav­al­ry’ and shape the Future of Brain Health – togeth­er we can bet­ter rec­og­nize needs, pro­vide feed­back on imple­men­ta­tion, and make sure that those who suf­fer receive actu­al benefits.

At the same time, we have a respon­si­bil­i­ty to iden­ti­fy and pre­empt eth­i­cal con­cerns and to guide respon­si­ble devel­op­ment and appro­pri­ate use. If users and pro­fes­sion­als pull back from these advances out of pro­pri­ety con­cerns, turf war, or feel­ings of threat, a great oppor­tu­ni­ty will be lost. Our brain/ men­tal health care prob­lems will only get worse, not better.

 

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Let’s, togeth­er, explore and dis­cuss how to use every avail­able tool in the toolk­it to address the very real and very unmet needs of 7+ bil­lion peo­ple in the 21^st Century.

– Alvaro Fer­nan­dez is the CEO & Edi­tor-in-Chief of Sharp­Brains, and Bran­don Frank is a PhD can­di­date at Ford­ham Uni­ver­si­ty with a con­cen­tra­tion in Neuropsychology.

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Learn More & Register:

2019 Sharp­Brains Vir­tu­al Sum­mit: The Future of Brain Health (May 7–9th)