Much like a cardiac stress test measuring heart function in active and resting states, an audio-guided test from Israeli startup Neurosteer assesses the brain in challenged and relaxed states for early detection of Parkinson’s, Alzheimer’s and vascular dementia, among other indications. 

Founded in 2015 by its developer, Tel Aviv University computer science and neuroscience professor Nathan Intrator, Neurosteer’s device is the world’s first wearable, medical-grade brain activity interpretation platform. 

Neurosteer’s FDA-cleared Class II device essentially reinvents EEG (electroencephalography) technology, which records the brain’s spontaneous electrical activity.

With Neurosteer, EEGs can be performed without a trained technician and without a neurologist to interpret the results. 

Power of music

The system is also unique because it employs the power of music.

“We provide cognitive and emotional challenges to the brain using music, and then look at the brain’s response. Music makes the test more pleasant for the subjects,” Intrator tells ISRAEL21c. 

“Patients listen to verbal instructions and then hear multiple musical notes. They are asked to press a button when a certain note is played or when a note is played following a note that was either the same or different. Then we use relaxing music to bring them to resting-state brain activity, which is one of the first brain functions to be damaged in neurodegenerative disorders.”

A disposable adhesive electrode strip worn on the forehead transmits signals to a sensor as the patient listens to the music and instructions through headphones. The signals are interpreted with cloud-based software using FDA-cleared biomarkers also developed by the company. Results are graphically displayed on a monitor and are available afterward via the Neurosteer portal.

The musical component of the system was developed by the company’s director of cognitive assessment, Tel Aviv University lecturer Neta Maimon, a professional cellist and PhD in cognitive psychology.

“My heart lies in the intersection between music, technology, cognitive neuroscience, and data analysis. I’m passionately exploring the various ways in which the combination of these topics can improve people’s lives,” she said.

15-minute dementia detection

With 12 employees split among Neurosteer’s offices in Tel Aviv, Los Angeles and New York, the company started by marketing the device to private longevity clinics for assessing neurological effects of aging, stress, anxiety, cognitive decline and/or depression. 

Neurosteer now is raising money to accelerate clinical validation trials aimed to get the device FDA cleared for additional medical uses.

For example, it’s been tested in Israel over the past year to assess Parkinson’s and essential tremor patients. It was even tested on Tibetan monks to see the effect of meditation on the brain.

A study at Mount Sinai Medical Center in New York uses Neurosteer’s device to monitor neurocritical ICU patients for adverse brain events. Intrator points out that in the cardiac ICU, treating heart issues alone ignores the critical fact that the cardiorespiratory system’s main purpose is to provide oxygenated blood to the brain. 

“Without monitoring the brain at the same time, quite a bit of damage can be caused to the brain while the person is in the cardiac or neuro ICU – it’s called ‘post-ICU syndrome.’ There are 80,000 ICU beds in the US and we are determined to provide our very small, easy-to-use device to alert clinicians automatically, on a timely basis, so as to reduce brain damage that may be occurring.”

Another clinical study is soon starting at the Boston University Alzheimer’s Disease Research Center in cooperation with a nearby US Veterans Administration hospital on the detection of Alzheimer’s and differentiation from vascular dementia.

Right technology at the right time

Fortunately for Neurosteer, there is a new wave of demand for assessing early signs of neurodegenerative diseases.

“In February 2023, the FDA approved the first drug to slow Alzheimer’s,” says Intrator. A similar drug was approved this year.

“Suddenly it became very important to detect if a person has Alzheimer’s as early as possible — even with no clear signs of cognitive decline — because the drugs cannot revert the condition, only slow it down.”

In the US, patients can be approved for the new medications if a radioactive PET scan shows beta-amyloid buildup in the brain, a typical symptom of Alzheimer’s. 

But because people with vascular dementia (calcification of arteries that reduces flow of oxygenated blood to the brain) cannot take this new class of drugs, an MRI is also necessary. 

Neurosteer’s platform would provide a noninvasive and much less expensive alternative, says Intrator. 

“Now the market is very hot. Seniors are flocking to physicians to get tested every time they forget where they left their keys.”

15-minute test

Intrator emphasizes that early cognitive decline, as well as trauma, stress and anxiety, are often well managed by meditation, lifestyle and diet changes, and brain stimulation exercises. The Neurosteer device can provide feedback on brain activity to optimize the use of such techniques for specific conditions.

However, similar to how 40 years ago people started taking statins in early middle age to prevent heart attacks in old age, many would like to take the new drugs to prevent Alzheimer’s. 

“But this drug has a lot of side effects and has to be prescribed carefully. That’s why there is a need for a massively deployable test that can clearly indicate if there is buildup of beta amyloids and generally a change in cognitive function,” says Intrator.

“We are progressing in the direction of a single 15-minute audio-guided test that will be able to detect risk of Alzheimer’s and vascular dementia,” says Intrator. 

“This is potentially the key to mass deployment. We intend to bring it to primary care physicians so there will be no need to wait months for appointments for radioactive brain scans and MRIs. It can be done during the annual checkup. The nurse can put our little patch on the forehead and the person can self-run the test.”

US residents can find out where the Neurosteer test is available by emailing info@neurosteer.com.