Satori Neuro: Could you describe what you’re developing over at Motif Neurotech, and why?
Jacob Robinson: We’re building miniature, implantable bioelectronics. The devices are about the size of a pea, and they act like pacemakers for the brain without requiring brain surgery. The idea was to build an electrical stimulator that can be given to an outpatient in a 20-minute procedure that’s no more invasive than a nose job. It’s designed to fit within the one-centimeter thickness of the skull and be cosmetically invisible.
About a third of people with mental health disorders, particularly things like major depressive disorder, don’t respond to medication, so they’re struggling without effective drugs. In these patients, an electrical stimulator can reach the brain circuits directly to retrain them.
SN: Where did that name ‘Motif’ come from?
JR: It came from the thesis we have for the company, which is that it’s the pattern of brain activity that’s the root cause of mental health disorders. For the last decades, we have been treating psychiatric illness as some kind of chemical imbalance, but now we’re realizing that’s not the case. These are fundamentally brain circuit disorders. And if we could play the right patterns of activity in the right space and time—the right motifs—we could help people recover.
SN: What stage are you at today?
JR: We have built prototypes and shown that the core technology is powerful enough to engage brain networks, despite its small size. In a brain surgery operating room, surgeons perform a stage where they map out the motor cortex of their patients. We were allowed to use our little device during this window, and sure enough, the patients’ fingers moved in response to it. That was a really validating moment.
SN: Psychiatrists often say that transcranial magnetic stimulation (TMS) is a real hassle in their patients’ lives. Does your device target the same circuits as TMS?
JR: TMS has shown us how effective brain stimulation can be when we target it to the right place with the right timing. Unfortunately, the treatment struggles because it lacks durability, meaning you have to keep going into the clinic in order to stay healthy. The median time to relapse after six weeks of therapy—five days a week—is only eleven months. Our device is intended to target those same networks but to do it without traveling to the clinic.
SN: So could it function as a replacement for TMS?
JR: Maybe, maybe not. The first step to getting well may be to go to a TMS clinic to see if neuromodulation is going to be effective for you. If it is, and you are like most patients in that the relief is temporary, you may then decide that you want to have that relief permanently.
SN: I imagine there are some special ways you would need to power a device like that. Have you run up against limitations, and if so, how have you overcome them?
JR: The vast majority of FDA-approved electronics today are based on cardiac pacemaker architectures. We looked at this problem and said, “Well, if you weren’t tied down to the previous history of electronic devices, how would you design something specifically to address brain circuits?” For one thing, you wouldn’t want a battery pack with wires that went from your chest to your brain. In fact, you would ideally have a wireless device that doesn’t touch the surface of the brain at all.
The problem with doing it that way is that tiny batteries don’t usually store much energy. It’s also hard to transmit energy to them using magnetic induction (the process we use to recharge everything else) because the coil has to be so small that it can’t capture much of a magnetic field. So we’ve spent the last 10 years in my lab at Rice University trying to solve this problem.
Our solution still uses a magnetic field—these are handy because our bodies are mostly transparent to them—but instead of the wire loop, we use materials called magnetoelectrics that vibrate, more than 200,000 times per second, in the presence of that field. You then pair that vibrational energy with a piezoelectric crystal which converts it into electrical energy matching that frequency. It’s both much more efficient and much more reliable than magnetic induction at that small scale.
SN: That’s really neat. I was reading a suggestion the other day that one could potentially use substances that are already within the body, like glucose, to power implants like this in the future. Could you see that happening?
JR: I’m really excited about opportunities to harvest energy from the body. But when we looked at it, the amount you can get from a small device, whether it’s the body’s heat in motion or an acidic environment, it’s between 10 and 100 times less energy than we would need to stimulate the brain. New technologies might be invented that produce dramatically more power, but the state of the art today can’t harvest the kind of energy that we need.
SN: Could you foresee a future where the precision of these technologies so convincingly bests drugs that it becomes a first therapy, rather than being reserved for treatment-resistant patients?
JR: In the 1960s when cardiac pacemakers were invented, the first few people who did that were really pioneers. Nobody imagined a world where they would be normalized for cardiac care and people would even be given pacemakers prophylactically to keep their hearts healthier for longer. So there was a period of normalization where people got used to the idea alongside the technological improvement.
The same is going to be true in psychiatry in the near future. At first it will be people who look to brain stimulation as a life-sustaining therapy in the face of agonizing depression. But there will be, in my opinion, a future where brain stimulation provides so many more advantages over drugs that it will become a treatment of choice. Side effect profiles of neuromodulation are dramatically lower than they are for most drugs. That makes sense because we’re not delivering medicine to your whole body through your gut—only to the circuit that needs it.
Secondly, bioelectronic medicine, like what we’re building at Motif, can provide brain recordings that could allow us to predict a future mental health event and avoid it going forward. Imagine having a copilot for your mental health, a digital assistant that’s going to keep you healthy over a long period of time based on your own brain activity.
SN: What does the next year hold for Motif?
JR: We’re working toward getting FDA approval to begin a clinical trial. That involves document control on our process and doing biocompatibility and safety testing in large animals. If the FDA approves it, the trial would be for patients with treatment-resistant depression. We hope to be able to show that stimulation over the region of the brain that we’re targeting is safe for those patients, and we hope to find patients who recover as a result of that therapy.
Dr. Jacob Robinson is CEO of Motif Neurotech. He is a Professor in Electrical & Computer Engineering and Bioengineering at Rice University.