Digital neurotherapy: bringing neurotechnologies to the patient’s home

As part of the launch of the report Neurotechnology for human well-being, the Bankinter Innovation Foundation continues with the informative work through a new webinar. The report is the result of the meeting of our think tank Future Trends Forum (FTF), where we convened more than 40 internationally renowned experts to discuss the repair and improvement of human capabilities through neurotechnology and other innovative applications, and to analyse the opportunities and risks that arise.

In this new webinar we have brought together two leading experts in neurotechnology and rehabilitation who participated in our think tank, Ander Ramos-Murguialday and Javier Mínguez, to explore the cutting-edge crossover between artificial intelligence (AI), robotics, smart sensors and applied neuroscience for neurological rehabilitation.

This article focuses on the intervention of Javier Mínguez. Ander Ramos-Murguialday’s presentation is summarized in this article: Rehabilitation neurotechnology: from the laboratory to everyday life.

Javier Mínguez is Co-founder and Scientific Director of Bitbrain, a Spanish neurotechnology company that he founded in 2010 together with María López, also an FTF expert. Bitbrain combines neuroscience, AI, and hardware to create innovative products. Its objective is to bring neurotechnology closer to society to improve lives. Javier is also co-founder and member of the Board of Directors of the Spanish National Node of Ebrains, an open European research infrastructure that brings together data, tools and computing facilities for brain-related research, built with interoperability as a central objective. In addition, he is Professor of Computer Science and Professor of Neurotechnology at the Schools of Biomedical Neurosciences and Engineering of the University of Zaragoza.

Throughout the webinar, Javier Mínguez takes us into how advanced digital neurotherapies are revolutionizing the diagnosis and treatment of sleep disorders and dementia, bringing personalized solutions directly to patients’ homes.

Here you can watch the webinar with Javier Mínguez:

Advanced neurotechnology: from the laboratory to the home (Javier Mínguez)

Below, we summarize the key ideas and projects of digital neurotherapies that Javier Mínguez has shared during this webinar:

Digital neurotherapy: the origins of Bitbrain

Digital neurotherapy represents one of the vanguards in neurotechnology: it is an effort dedicated to integrating neurotechnology into the patient’s daily environment. Javier Mínguez describes how, since its beginnings at the University of Zaragoza about 15 or 20 years ago, they developed a prototype capable of moving a wheelchair with thought, marking a milestone in neurotechnology. This breakthrough, which facilitated mobility for people with neuromuscular impairments by decoding brain electrical activity, laid the groundwork for Bitbrain, raising a fundamental question: How can we make these innovations accessible to society?

This question gave life to Bitbrain, with the purpose of carrying out the mission of transforming these technologies for everyday use. Going back in time, the labs were equipped with complex devices, filled with wires and electrodes, designed to capture brain activity and turn it into concrete actions. However, the vision was clear: to adapt and miniaturize these devices for home use, overcoming challenges such as background noise and the need for expert-free operation through artificial intelligence and the identification of new biomarkers.

Source: webinar Advanced neurotechnology: from the laboratory to the home (Javier Mínguez)

The company was created with the aim of bringing these technological innovations from the laboratory to the daily lives of patients, facing challenges such as the miniaturization of equipment and adaptation for home use, ensuring their effectiveness and complying with legal, medical, ethical and safety regulations.

Digital neurotherapy in action

Digital neurotherapy solutions are inserted into a broader ecosystem in order to bring medical treatment directly to the patient’s home, overcoming the barriers of time, place and access. This revolution is based on the application of software and artificial intelligence, relegating hardware to a supporting role. Bitbrain is leading this transformation, standing out for the creation of an innovative electroencephalogram made entirely of textiles, which represents a significant advance in terms of usability and convenience. This device, designed to be easily used by anyone, from children to adults, without the need for experts, is currently in the process of being evaluated to become a medical product with the support of several organizations. Artificial intelligence is used by processing data to deliver personalized diagnoses and therapies, underscoring the crucial importance of this synergy between easy-to-use hardware and sophisticated AI algorithms in the move towards more accessible and personalized health.

The role of artificial intelligence in the study of sleep

Artificial intelligence (AI) plays a crucial role in transforming sleep analytics from polysomnography studies conducted in hospitals to solutions accessible at home. Traditionally, it would take hours for a professional to manually evaluate these studies. However, recent research, including from MIT, has shown that AI can decode sleep phases with accuracy comparable to medical standards using simply low-density sensors placed on the forehead. This ability of AI to process and analyze sleep data with high accuracy, even in environments with user-generated noise, is revolutionizing digital neurotherapy, enabling accurate and personalized monitoring in the comfort of home.

Digital neurotherapy projects currently underway

Javier Mínguez presents three projects that are currently being carried out in Aragon that have to do with the dementia continuum (it is called the dementia continuum since a patient who is initially healthy goes on to subjective complaints, then goes on to mild cognitive impairment – the preclinical state of dementia – and then moves on to clinical dementia).

The first project, called HOGAR, aims to transfer neurotechnologies to the patient’s home to monitor their cognitive state, through the electroencephalogram and the polysomnograph. The four reference hospitals in Aragon are involved in this project and will work on the Alzheimer’s continuum (healthy patients, with subjective complaints, mild cognitive impairment and diagnosed Alzheimer’s). In this sense, patients receive a small kit with a sleeping band and an electroencephalogram band. Using a tablet, they are able to put on the encephalogram and make some records following certain medical standards and then, when it is time to sleep, they put on another band that helps them sleep and record the polysomnography activity. The next day they repeat it and return the kit, so that they have been the ones who have done the registration autonomously. They are now in clinical trials. So far, 10 patients out of 500 (8 healthy and 2 with mild cognitive impairment) have passed and have a 100% success rate. This project will continue its course and during 2024 it is expected to reach 500 patients who, autonomously, use this technology to monitor them at home.

The other two projects aim to improve people with dementia at a cognitive level: the ESPERANZA project and the NANA project. HOPE is an active intervention that people perform during the day and NANA is a passive intervention that occurs during sleep.

The HOPE project has a fairly established neurobiological basis: Wolfgang Klimesch discovered that there is an indicator that appears on EEGs, which positively correlates with cognitive ability, measured in terms of working memory and sustained attention. The treatment makes neuromodulation by neurofeedback: a neurofeedback model is generated to make a neuromodulation (that is, to produce a change in brain rhythms, so that cognitive ability can be improved). It is based on an unconscious form of self-learning that is achieved by “rewarding” the brain every time it does what you want it to do. In this way, the brain associates that desired behavior with something positive, so that, over time, it is made to repeat that behavior more and more frequently.

These types of interventions are relatively complex to implement in practice because this neural correlate has a great deal of interpersonal and intrapersonal variation. In other words, we all have it differently and, every day, it changes in the same person. Therefore, therapy must be personalized for each person and for each time that person uses it. These types of interventions have been shown to be effective in improving working memory and episodic memory.

The NANA project is a passive intervention during sleep. That is, the person is sleeping and the intervention occurs. The neurobiological basis in this case is that the magnitude and number of slow waves during sleep correlates positively with memory consolidation. That is, the more slow waves or magnitude they have in the deep sleep phase, the more the memory of what has happened to them during the day is consolidated. The question is, how can we improve slow waves in number and magnitude? And this was done for the first time eight years ago at the University of Tubinaga in the following way: with small sounds. That is, when slow waves are being produced, a small beep is generated that the brain hears. Large enough for the brain to respond and small enough that the person does not wake up without going through consciousness. Conclusion, you are sleeping and when the technique identifies that you are in deep sleep, certain beeps are produced that make your brain respond but you do not wake up. The beeps are generated thanks to AI, which detects when there are slow waves and predicts what these slow waves will be like, and then triggers the beeps. Those beeps prolong the slow waves, and that prolongation of slow waves improves memory. There is already a lot of evidence that this technique can be used for healthy people, and now what is being done is to learn how to use this technique for patients with Alzheimer’s, Parkinson’s, epilepsy, etc.

Don’t miss the webinar with Javier Mínguez. Here you can see it:

Advanced neurotechnology: from the laboratory to the home (Javier Mínguez)

If you want to delve deeper into this field and other technologies and innovations for human well-being, be sure to check out our report.

You can also access other #FutureTalks on the subject:

• Rehabilitation neurotechnology: from the laboratory to everyday life
• Neurotechnology for Human Well-Being: A Glimpse into the Future with Dr. Álvaro Pascual-Leone
• Women Leading the Future of Neurotechnology