Advances in neuro-technology keep advancing at an astounding pace, and at times it seems like we are closer to science fiction than reality. Let’s peer into the crystal ball and look ahead at the neuroscience trends to look for in 2024!
While the use of generative AI (genAI), a branch of AI that deals with the production of various content including images, written text and audiovisual data and includes ChatGPT, has exploded over the past year, we are yet to see the extent of its impact in healthcare. This is mainly due to the lack of digitalisation of healthcare systems and clinical processes, but also because a singular AI tool or biomarker is difficult to integrate into an existing ecosystem. However, as the strain on healthcare systems grows ever greater, AI tools are needed to alleviate some of the more mundane workload. 2024 and beyond will see actions to advance genAI’s integration into healthcare with potentially transformative outcomes. Accenture forecasts that up to 40% of working hours could be positively impacted by large language models, supporting workers with administrative tasks, decision making and even personalized care. Other uses for AI extend to segmentation of tumors in breast or lung MRI scans or marking fat vs muscle tissue in CT scans, done by the thousands every day. Empowering clinicians with the automation of these processes enables them to direct their focus more exclusively towards patient care. Notably, the UK has established the NHS AI Lab with £250m of funding to accelerate the safe adoption of AI in health and care, trialing more than 40 projects, from cancer to neurodegenerative disease to mental health.
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Brain-computer interfaces (BCIs) enable communication between one’s brain and an electronic device. Ranging from non-invasive (e.g. EEG) to partially invasive (e.g. ECoG) to full-blown implants, BCIs are able to acquire brain signals, analyze them, and then translate them into commands which modulate brain activity in return or allow humans to interact with their environment through their thoughts. BCIs have the potential to help individuals with severe disabilities regain the ability to communicate and control assistive devices for walking and manipulating objects, and restore function to those affected by neurological disorders. Just this past year, Neuralink has begun the recruitment phase for its first in-human trial, a team at Braingate smashed speed records for genAI-powered thought-to-speech implant technology, and Synchron hope their emphasis on simplicity is moving their stent-like electrode ever closer to regulatory approval. Looking ahead, neurology is expected to be the fastest growing medical device specialty in 2024. A number of people are already using BCIs for basic communication and control in their daily lives. With year on year improvements in signal-acquisition hardware, clear clinical validation, viable dissemination models, and increased reliability, BCIs may soon become a widely used communication and control technology for people with disabilities and potentially for other applications as well.
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MRI machines, like computers, are under constant development. But in the case of the former, down two rather distinct paths. On one trajectory, MRI machines are growing bigger and better, while on the other, smaller and more portable.
Since the first rollout of a 7 Tesla Siemens MRI scanner, we have seen them not only used more widely in research, but also in clinical routine. However, this expanded usage results in the generation of substantial amounts of data. Larger datasets require more storage space, increased memory for analysis, prolonged transfer times between locations, and also need to be supported by sufficient computing power. The resolutions these machines provide are giving unprecedented looks into our bodies, answering questions that were previously thought unimaginable.
On the other hand, as the demand for daily clinical MRI scans rises, companies have explored the development of smaller, more portable, and cost-effective alternatives. Companies such as Hyperfine or PhysioMRI have not only managed to make their systems portable, but by reducing the magnetic field they are cheaper to produce and provide more comfort for the patient.
Even larger MRI machines are transitioning towards portability. In late 2023, Philips unveiled an industry-first mobile 1.5T MRI unit, distinguished by its lightweight design and the promise of lower costs thanks to its helium-free operations.
As access to MRI technology expands, we can anticipate a surge in studies utilizing MRI endpoints as well as more MRI-based point-of-care diagnostics.
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Psychedelic drugs have come into the spotlight for their use in a variety of psychological disorders. Often in conjunction with traditional “talk” therapies, psychedelics have been shown to help treat neurological and mental health disorders by changing the way parts of the brain communicate with one another. The hope is that two main psychedelic substances, psilocybin and MDMA, are on the verge of regulatory approval and will soon be more widely accessible. Research into psilocybin, the naturally occurring psychoactive compound found in Psilocybin mushrooms, has demonstrated a correlation between controlled usage and alleviation of symptoms in Post-traumatic stress disorder (PTSD), depression and anxiety. Simultaneously, MDMA is under investigation as a drug to treat PTSD, eating disorders, and anxiety disorders. Small doses of MDMA have shown efficacy in facilitating patients' connection with therapists, particularly when addressing traumatic experiences. Atai Life Sciences have launched a phase 1 clinical trial on an MDMA derivative, and in London a pioneering MDMA-supported psychotherapy clinic has opened.
The year 2023 marked a significant shift in the psychedelic industry, moving beyond pilot studies to an accelerated exploration across hundreds of trials, aided by new guidance from the FDA. As MDMA inches closer to potential FDA approval for PTSD treatment, the year 2024 holds the promise of unraveling whether these treatments represent genuine hope or are merely hyped possibilities.
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2024 will see the ongoing pursuit for novel PET radiotracers. In June we can expect the conclusion of a trial evaluating the use of the positron emission tomography (PET) radiotracer 18F-MK6240, which has been suggested to effectively measure increases in brain tau protein in autosomal dominant Alzheimer’s disease prior to any observed symptoms. There is an unmet need for sensitive biomarkers such as this that quantify early pathologic changes and correlate closely with disease progression and clinical outcomes. The introduction of this novel PET tracer is expected to play a key role in guiding the discovery and development of disease-modifying therapeutics for neurodegenerative diseases.
A further novel PET radiotracer, Ga-68 NODAGA-JR11, shows promise for detecting metastatic cancer lesions in patients with neuroendocrine tumors. It was shown to be more valuable than somatostatin receptor (SSTR) agonists, receptors which are overexpressed in certain cancer cells and are crucial targets for PET imaging. This new technology has the potential to improve diagnostic capabilities and significantly improve care for such patients.
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