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Remote Brain Training – Treating chronic pain from the comfort of your own home by Richard Little, CEO, Exsurgo

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It’s good to have plans, but it’s always better to have options.

At Exsurgo, our plan was to launch the world’s biggest clinical trial of EEG Neurofeedback for the treatment of chronic pain, in conjunction with AUT and the Waitemata District Health Board. The nation’s latest staycation at alert level four has meant those plans have had to change slightly, but fortunately we still have options and we’re looking at these new restrictions as an opportunity to showcase one of the main benefits of our Axon system: it can all be done at home. 

Last year, we had the same problem: before the UK’s Covid lockdown, we had planned to conduct a proof-of-concept trial with people suffering from chronic pain. Clinical trials often rely on in-person testing and data collection and a number of medical companies have had to postpone their trials because it was deemed unsafe to continue. But we were able to send participants Axon headsets to use in their own homes, with clinical oversight offered by our study leads and regular catch-ups conducted over video software.

Remotely administered medicine (often called telehealth) showed its value during this strange cloistered period – whether it was having a consultation with the doctor via video or using an app to maintain our mental health. Many found these tools to be effective and affordable substitutes to in-person consultations and they have remained popular as the world has opened up.

As pressure on health systems continues to build, both because of our ageing population and funding constraints, remotely administered healthcare like Axon has the potential to reduce some of that pressure by allowing people to take treatment into their own hands whilst still receiving remote clinical oversight. And, for Exsurgo, even though we didn’t see the participants in person in the UK, we were still able to conduct a robust scientific study.

Our Axon technology has patients undertake neurological exercises in the form of simple animated games on a tablet or smartphone. These have been carefully calibrated to the patient’s brain readings so that when the patient generates the desirable brain activity, they are rewarded with audio and visual feedback that keeps the game moving and achieving goals. Over time, through this positive feedback we can help patients retrain their brain to interpret nerve pain signals in a different way and create new, more positive pathways.

And that is exactly what our study in the UK showed it doing: 100% of the 16 participants reported a reduction in pain, and  88% achieved a clinically relevant reduction in pain of at least 30%. Ninety-four per cent of the participants also said their sleep, mood and overall quality of life improved and anxiety and depression levels decreased.

This wasn’t just a short-term fix, either. The improvements experienced after eight weeks of neurofeedback training with the Axon system were sustained for at least 26 weeks.

Since we asked those in New Zealand who were suffering from chronic pain to come forward to be part of our next, much larger study, we have had thousands register their interest. Many of them said they were looking for a solution to an often debilitating and inescapable ailment after unsuccessfully trying a range of other treatments. So, just as we did in the UK, we will get headsets to the participants and monitor their hoped-for improvements from afar.

The impressive results of our first study and our confidence that they will be replicated in the New Zealand study hold great hope for the millions of people around the world suffering from chronic pain (defined as pain that persists for longer than three months). Chronic pain is now considered to be one of the world’s biggest health issues, with estimates suggesting one in five people live with some form of it. Studies show this number is increasing, whether due to our ageing population, the stresses of youth (where it’s thought one in three UK teenagers are affected), or even the effects of Long Covid.

As well as the personal suffering resulting from what The Guardian called ‘The Pain that Can’t be Seen’, chronic pain costs governments billions of dollars every year, both in terms of treatment and lost productivity. In the US, one study from a few years ago estimated the total costs of chronic pain within the USA alone ranged from US$560 to $635 billion. That was greater than the annual costs of heart disease, cancer, and diabetes.

Senseless deaths from the over prescription and abuse of opioids are heart breaking, particularly in the US, where over 50,000 people died in 2019. As a result, medical regulators, practitioners and the general public around the world are increasingly advocating for non-pharmaceutical treatments for chronic pain. We believe we have an important role to play in that evolution.

“Just like other parts of the body (such as our muscles) can be trained, our brains too can be trained and change the way they function. The trick to getting our brain to change, is to point it in the right direction and then it will make the changes itself.”

That insight is at the core of Exsurgo and we believe we can treat a range of other neurological conditions in the same way. The EEG technology we are harnessing is available in most hospitals and universities and has been around for decades, but it’s expensive and difficult to access. What we have done is make that technology affordable and accessible. We have given sufferers another way to treat their pain – all from the comfort of their own home. And at a time like this, when home is the only place we should be, that’s a pretty good option.

Richard Little 

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