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Start-up to scale-up - The story of how one start-up challenged the status quo in neuromodulation


For the Scientists:

Konstantinos Alataris is not a well known name beyond the neuromodulation circles. This is because he deliberately chooses to live a life that goes under the radar. But his contribution to the field of neuromodulation is immense. While spinal cord stimulation has been targeted for treatment of pain for the last 50 years, there was one consistent manner in which stimulation of spinal cord was performed. It was using frequencies around 100 Hz labeled as traditional spinal cord stimulation by the challenger, Nevro.

For the patients:

What Nevro did was very unique - Unique in the manner in which it challenged the system. The traditional explanation for efficacy of spinal cord stimulation was the Melzack and Wall's gate theory of pain, ably explained by our first guest (Warren Grill). Nevro's founders via their background in neural plasticity and neural network could not comprehend why such an impactful theory did not produce more than 50% efficacy. They set out to change the system and started a unique set of animal and in-silico experiments to show that stimulation frequencies have a huge impact on firing of the wide dynamic range neurons that control pain in the dorsal column of the spinal cord. They hypothesized and showed that 100 Hz, 5 kilohertz and even 10 Kilohertz - all had different type of effect.


Armed with this information, they pushed forward with their clinical trials and did not just stop with demonstrating efficacy. They went one step further and ran head-to-head comparison between traditional spinal cord stimulation and their methodology. All of their results can be found here. You can take a look at the data and consult with your pain physician about the benefits.


For the leaders:

The untold story of this podcast deals with how very people actually knew of the background of how this daring vision came to be. It was a vision that demonstrated to the world that despite established players, good science can triumph. Listen to Konstantinos' diplomacy when we pushed him for challenges and nay-sayers and how he dealt with it. It is a lesson in leadership but also a testament to his personality.


Finally, we were also pleasantly surprised at how he positioned the auricular vagus stimulation - Vorso Corp. Here are some articles about the work that Vorso is doing.


Rheumatoid Arthritis:

Public information: https://www.healio.com/news/rheumatology/20191015/vagus-nerve-stimulation-wanders-into-mainstream-rheumatology


Scientific Information:

EULAR Abstract Archive
.pdf
Download PDF • 640KB

Post-partum depression: http://med.stanford.edu/womensneuroscience/research/current-studies.html




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