Outsourcing Pharma had the opportunity to speak with Kazu Okuda, MD, CEO, and co-founder of Universal Brain, about the advancements in precision psychiatry, the role of objective data, and the future of mental health treatment.
What is precision psychiatry?
Precision medicine is an emerging and significant focus in psychiatry. Unlike other medical specialties, psychiatry has yet to fully leverage advanced diagnostic and therapeutic technologies. Therefore, the concept of 'precision psychiatry' holds the potential to be even more transformative in this field, offering the promise to bridge the translational gap that other areas of medicine have already begun to close.
Outsourcing Pharma (OSP): How do you see the advancements in neuroscience and technology shaping the future of precision psychiatry over the next decade?
Kazu Okuda (KO): There will be a paradigm shift soon toward utilizing objective measures to better stratify and treat psychiatric and neurological conditions. By using functional brain data to subtype or 'neurotype' specific characteristics of conditions such as depression, psychiatrists can develop a targeted approach tailored to each patient. This approach facilitates individualized care for faster treatment and improved outcomes and enables clinical trials with appropriate patient selection. In the next decade, we will no longer rely on the slow and tedious subjective treatment process that frustrates clinicians, unnecessarily extends the patient journey, and costs billions in failed clinical trials.
OSP: Can you elaborate on how objective data and novel technologies are contributing to a more nuanced understanding of complex psychiatric conditions?
KO: Event-Related Potentials (ERPs) and Electroencephalography (EEG) offer promising avenues for precision psychiatry. These objective, brain-based measures can provide deeper insights into the neurological underpinnings of depression. ERPs are tiny electrical fluctuations in the brain that happen when a person is exposed to particular stimuli or events while engaging in a cognitive or sensory task. They are time-locked to specific sensory, motor, or cognitive events, making them a safe and non-invasive way to investigate the psychophysiological correlates of mental processes. Using ERPs and EEG, clinicians can move beyond the limitations of subjective criteria, enabling more accurate and personalized treatment strategies. This approach holds the potential to drive a paradigm shift in the stratification, diagnosis, and treatment of depression, making it more precise and effective.
OSP: How do you believe personalized treatment plans can shorten the patient journey and improve outcomes for those suffering from neurological disorders?
KO: Utilizing objective data to tailor treatment plans considers the heterogeneity of conditions like depression. With over 200 identified types of depression, reliable brain function data is essential in implementing effective treatment. When we can identify subtypes or neurotypes of psychological conditions such as depression, we can implement actions that inform positive outcomes.
OSP: Could you explain the role of electroencephalography (EEP) data and multifactorial digital event-related potentials (ERPs) in developing personalized treatment plans for depression?
KO: The advent of portable and affordable EEG technology has made neurotyping an increasingly accessible and practical tool for depression diagnosis and treatment monitoring. The combination of EEG data and multifactorial digital event-related potentials (ERPs) is novel in its application of functional, interpretable brain data to improve treatment options. Wireless EEG headsets, for example, offer a patient-friendly and convenient means of obtaining functional brain biomarkers in various settings – from clinics to patients' homes. This not only simplifies the process but also allows for more frequent and consistent monitoring of treatment progress, enabling clinicians to make timely adjustments to treatment plans as needed. The use of event-related potentials in neurotyping provides an even more granular understanding of individual patient profiles, facilitating the development of highly targeted and personalized interventions that address the specific aspects of a patient's psychiatric condition.
OSP: How does targeting specific brain biomarkers help in tailoring patient selection criteria in clinical trials, particularly for the more than 200 subtypes or 'neurotypes' of depression?
KO: Over 50 million adults suffer from major depressive disorders, and those who seek treatment are met with a failure rate of over 70%. Traditional depression treatment too often falls short due to its homogenous nature, which fails to account for the heterogeneity of the disorder. There are many subtypes of depression, and not one single 'depression'. Current diagnostic methods are widely based on subjective measures and do not consider specific neural biomarkers that contribute to an individual's depression, making it difficult to predict which treatments will be most effective for a given patient.
OSP: What are the primary challenges of the current standard of care for depression, and how is Universal Brain addressing these challenges?
KO: Current approaches to treating depression lack the use of neurobiological measures. Traditionally, depression has been treated as a singular condition, with patients receiving standard treatments such as antidepressants, psychotherapy, or a combination of both. However, depression is not a homogenous disorder; it encompasses a wide range of symptoms and severities. The DSM's categorical approach fails to capture this heterogeneity, leading to a one-size-fits-all approach to treatment. By failing to tailor treatment plans to the specific needs and characteristics of each patient, traditional approaches extend the patient journey. Further, Primary Care Physicians (PCPs) prescribe most depression treatments, despite having less specialized training in neurological disorders compared to psychiatrists. Universal Brain offers an effective alternative to the trial-and-error approach by emphasizing interpretation of objective functional brain biomarkers to neurotype depression and inform improved outcomes.
OSP: How does precision psychiatry facilitate critical clinical trials for drug development, and what are the potential benefits for the pharmaceutical industry?
KO: A staggering 94% of drug trials for depressive disorders fail, at a cost of $800 million each. Neurotyping technology can be applied in psychiatric and neurological clinical drug trials. By identifying subgroups of patients with distinct neural signatures who may be more likely to respond to specific therapies, neurotyping could inform patient selection criteria in clinical trials, potentially increasing the likelihood of detecting treatment effects and accelerating drug development.
OSP: In what ways is technology making mental health treatments more precise and accessible to a broader patient population?
KO: At-home diagnostics are producing improved outcomes across the healthcare continuum. From cardiovascular health to diabetes to respiratory conditions, remote monitoring and treatment approaches are increasing access to care for millions who might not otherwise receive it. The Universal Brain platform reliably measures brain function with a low-cost, next-gen wearable headset that utilizes advanced algorithms to aid in the development of targeted treatment plans. We are delivering insights that impact positive outcomes with a gamified, patient-friendly, at-home platform.
OSP: What are your goals for the future?
KO: Our goals for the future are to first finalize collaborations with several pharmaceutical companies to leverage the Universal Brain biotyping platform to support patient recruitment and stratification for clinical trials. In parallel, we’re advancing our own clinical trials for our neurofeedback platform that enable neurofeedback to treat depression in combination with drug therapy or as a standalone treatment.
OSP: What recent technological innovations in neuroscience and digital health are
KO: We’re encouraged by the use of resting EEG in many drug trials recently. We believe advancement in leveraging tools to understand the brain is essential to advancing drug development and treatment for psychiatric disorders. We also believe this is just the beginning, and we’re excited to see how biotyping and objective measures can be used more broadly in the clinic.
