The Ultimate Cure

Earnings for neurodevices are only 4 percent of what neuromeds bring in, but for a few diseases, the impact has been miraculous. Take cochlear implants. Located in the inner ear, the cochlea translates sound waves into electrical signals that are channeled to the brain to be processed into the opening swell of a Mozart concerto or raindrops beating on a window. People with damaged or congenitally malformed cochleas were condemned either to near silence or to the use of imperfect hearing aids until the 1970s, when the first cochlear devices were surgically implanted. These had an electrical apparatus that fed signals into the audio nerve through electrodes. The latest versions of the devices use tiny computers to process even complex sounds like music into signals that the brain can recognize. More than 100,000 people have had the cochlear devices implanted worldwide (out of the millions affected), and many go from being deaf or near-deaf to being able to hear most sounds and function as if they had no hearing deficit. The device, which costs $20,000 or more, has annual sales totaling $550 million, and sales are growing 15 percent a year. Leading makers include Advanced Bionics, Cochlear, and Med-El.

One truly out-there device is Cyber­kinetics’ BrainGate, which was implanted into the brain of Matt Nagle, a quadriplegic patient, in an F.D.A.-approved trial. The device enabled him to control a computer cursor with only his thoughts. The BrainGate, which was connected to the computer by a wire, uses tiny electrodes to read electrical impulses from the brain’s motor cortex. In 2005, I visited Nagle—a former high-school football star who was paralyzed as a result of injuries he suffered during a brawl on a beach in Weymouth, Massachusetts—and I watched as he gave the mental command to move his arm up and down. The machine translated these thoughts into up and down cursor motions. As Nagle got better at controlling the device, he became able to write emails and operate controls for lights and a television. He could even control a prosthetic arm. But the BrainGate was cumbersome, difficult to calibrate between brain and machine, and sometimes left Nagle feeling frustrated. The company is now recruiting patients for additional trials.

All the uncertainty of the industry hasn’t dampened the enthusiasm of Targacept’s Don deBethizy, who toils with his team of scientists just up the street from the R.J. Reynolds headquarters, a 1929 skyscraper considered an Art Deco marvel in its day, with gilt tobacco leaves on the lobby’s ceiling. Targacept broke off from R.J.R. Nabisco in August 2000, just 36 hours before the unit was to be eliminated during the messy merger process that started when Kohlberg Kravis Roberts acquired the tobacco giant in 1989. At the last minute, drug giant Aventis stepped in with a $70 million partnering deal to save Targacept and its leading Alz­heimer’s compound, which was then in Phase 1 human trials. (This drug was later killed after the unit was unable to successfully breach the blood-brain barrier, a common problem for would-be neuromeds.) After becoming an independent company, Targacept raised $123 million in three rounds of private capital investment and $72 million from stock offerings. Milestone deals with AstraZeneca to develop cognitive-disorder meds and with GlaxoSmithKline to develop treatments for pain, obesity, smoking cessation, addiction, and Parkinson’s make up the remainder of Targacept’s financing.

Content Continues Below

As deBethizy explains, nicotinic receptors control or influence memory, attention span, mood, sensitivity to pain, inflammation, movement, and cell survival. “These receptors act like volume switches,” says Merouane Bencherif, Targacept’s vice president for Preclinical Research. Nicotinic drugs work by increasing neurotransmitter activity, Bencherif says, meaning more is around to zap the receptors to improve memory and mood. Turning down neurotransmitter activity reduces pain or inflammation.

Currently, Targacept has four compounds in human trials. Their connection with nicotine? “There isn’t really a connection anymore,” says deBethizy. The compounds are chemically unrelated to nicotine, but their action in activating the receptors mimics what nicotine does.

  Page   1   |   2   |   3   |   4   |   5  

Next:   Page 5 »