BrainChat and patient-guided learning

39:30Well, we've covered a lot of AI doom and gloom. >> Yes. Because well, there's a lot of AI doom and gloom. >> Yes. But this one I think is genuinely uplifting because it's the promise of AI that got me excited about it in the first place all those years ago when we got the first chat GPT moment and everyone was like oh this is going to change the world the future you know it's going to be the future um this isn't the apocalypse this is actually great now it seems like ah I don't know um in any case this particular story it's about personalized medicine this time it's for epilepsy patients the story comes out of the University of Pennsylvania. The headline reads, "AI

40:11platform allows real time conversation between patients and their medical devices." I think it's really, really cool. >> This is interesting. >> Now, in this case, when I say personalized medicine, I'm talking about really a personalized machine for medicine. Okay, we've covered things like this in the past. We have pacemakers that regulate your heart. We have colear implants that digitize sound. And we've got deep brain stimulators that suppress the tremors of Parkinson's disease and epilepsy. Now, these are marvels of modern engineering, but they're all entirely silent to the patient that is housing

40:52>> these machines, right? Like if you get a medical implant today, the device records your physiological data and then it stores it in some black box effectively, right? Some kind of USB drive or something. And then months go by, weeks go by, depending on what the treatment is. You go to the clinic, the physician downloads whatever the data is, and then only the physician really understands what's going on, and then he or she or they are going to be going through and understanding, and you're essentially locked out of that loop. >> That's actually really good. I never thought about that. Yeah, it's really cool. >> Like the patient who is creating the medical data >> is out of the loop, right? the physician

41:33kind of just like uses the patient for the data and then tries to understand the patient from the data. But there's no real feedback that's happening, right? Nowhere is this disconnect even more critical than with the treatment of epilepsy. Globally, around 70 million people live with epilepsy. Epilepsy, a third of them get seizures that simply do not respond to medication. A seizure is basically a temporary episode of abnormal excessive activity in the brain. It's like synchronized neural networks. It can sometimes make a person experience convolutions, brief loss of awareness, unusual sensations,

42:15disturbance in memory. There's a myriad of different things that a seizure can do. And a single seizure does not automatically mean epilepsy. But if you're prone to this recurrence over time, then it's it's reason to diagnose with epilepsy. Now, sometimes drugs work, but then there are drugresistant patients. As with almost every brain disease, there are drugresistant patients. In this case, um, one of the ways that we try to combat it is with implantable neurom modulation devices. This is where we stick an electrode into the brain that is that that has the ability to

42:58read the electrical signals and then pump electricity in. So what this thing is going to do is read brain waves and in principle it can detect seizures using the brain wave profile and then it can also provide current into the brain to mess with the neural circuits and then perhaps stop the seizure. Right? And the history of this of these types of devices has a rich rich um history. You've got the earliest FDA approved devices in 1997. Something like the Vegas nerve stimulation. This is purely open loop. This is something where you actually

43:39stimulate the vagus nerve that's like down near your neck, >> not actually in the brain. And what you're actually doing, you can think of it as like a lawn mower. Not a lawn mower, a lawn sprinkler. >> Okay. >> Okay. That just like turns on and then it like sprinkles. >> It's doing that but with electricity. It's this is what we would call open loop. >> Okay. because there's no feedback coming from the brain and there there's no it's just it's on a timer >> and it's just like going it's just stimulating the the vagus nerve at regular intervals. >> It doesn't know if the grass is growing. It doesn't know what patches of grass are growing more than others. Any of

44:19that kind of stuff. >> Any of that kind of stuff. It's just blindly implementing. >> I know it needs water. >> Yeah. And and and it it had its effects. >> Sure. And it was great. 2013 there was a massive leap into closed loop systems. So this is the RNS system which is the responsive neuro stimulation. Meaning I've got some kind of read mechanism that is going to maybe identify that a seizure is happening and then only stimulate when the seizure is happening. Right? So this is where the responsive thing comes in.