RebrAIn is a very young start-up, specialized in targeting the brain areas that cause essential tremor and Parkinson’s diseases treated by Deep Brain Stimulation (DBS). Created on January 4, 21 by Emmanuel Cuny, Professor of Neurosurgery at the University of Bordeaux and a renowned practitioner at Bordeaux University Hospital, and Nejib Zemzemi, Doctor of Applied Mathematics and Scientific Computing at Inria, the young start-up has already signed a business license with SATT Aquitaine Science Transfert.

Supported therefore by SATT Aquitaine, the project benefited from a maturation fund of 171 k€ and was incubated in chrysa-link.

Worldwide, 6,300,000 people have Parkinson’s disease (the number of cases doubled between 1990 and 2015), and about 39,000,000 people are estimated to suffer from the essential tremor (0.5% of the world’s population). In France alone, 300,000 people suffer from essential tremor, 10% of whom have a severe form that prevents everyday activities, and 160,000 suffer from Parkinson’s disease. Physically handicapping and socially embarrassing, these pathologies are treated by medication (dopamine for Parkinson’s disease) or by neurosurgical intervention: Deep Cerebral Stimulation (implantation of electrodes in the brain). This is proposed when dopamine treatment for Parkinson’s disease proves ineffective. It is estimated that 10% of Parkinson’s patients could be treated in this way, but to date, less than 3% eligible for deep brain stimulation have undergone surgery.

CPS is particularly effective, but its effectiveness is highly dependent on the precision with which the target brain area to be stimulated is identified. To compensate for these inaccuracies, intraoperative electrophysiology is performed while the patient is awake. The duration of the procedure, the risks (accentuated by the electrophysiology), and the heavy equipment required for this surgery are obstacles to more systematic recourse to SPC.

This technology is therefore considered promising and the market is already ready to welcome it. This is what Emmanuel Cuny and Nejib Zemzemi evaluated, and decided to combine their expertise to create an intelligent device and an OptimDBS software platform, enabling the effective targeting of brain areas to be stimulated and treated by the surgeon. Its use aims to standardize and simplify surgery, reduce the risks and make it less traumatic for the patient. RebrAIn should thus facilitate access to CPS and increase the number of patients treated. The technology, protected by a patent and a software registration, is based on an AI to continuously teach the software to better target, on the OptimDBS software and on a blockchain collaborative registry of health data.

Deep Cerebral Stimulation is an invasive medical treatment consisting of surgically implanting electrodes in the brain, connected to a box placed under the skin, which delivers a low intensity electric current to specific structures located deep in the brain, such as the thalamus or certain basal ganglion nuclei, such as the subthalamic nucleus or globus pallidus. The sites stimulated vary according to the indication. This treatment can indeed be used to treat neurological diseases, such as Parkinson’s disease, tremors or dystonias, but also more rarely psychological disorders that are resistant to other forms of treatment, such as severe forms of OCD or depression.

The introduction of RebrAIn’s brain targeting technology offers many benefits:

• less or even non-invasive surgical techniques against neurodegenerative pathologies,
• a significant improvement in patients’ quality of life compared to the best known medical treatment,
• standardization of the procedure and data collection, leading to a homogenization of practices and a significant reduction in the cost of the intervention,
• the setting up of a common and shared registry involving doctors, patients and patient associations, which will facilitate the management of patients,
• an increase in the number of patients treated: given the large number of eligible patients and the simplification of surgery, but also the safety that this targeting can bring in the lesional techniques of radiosurgery or HIFU (High Intensity Focused Ultrasound).

The two founders of ReBrAIn have the ambition to “become the world leader in targeting in Deep Brain Stimulation, in a market that by 2025 could reach 300 million euros, thanks to our ability to increase the number of patients eligible for CPS. We are optimistic about the progress of our project as clinical proof of the device’s efficacy is well advanced: around 40 patients have already been successfully treated with RebrAIn technology! »

Translated from Focus sur RebrAIn, la start-up qui ambitionne de révolutionner le ciblage chirurgical de la Stimulation Cérébrale Profonde