Headset games target brain and pain

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Headset games target brain and pain

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Richard Little Exsurgo
Exsurgo chief executive Richard Little wearing the Axon headset; the system is designed for patients to use at home [Image: Maia Hall]

Leaving the house may not be worthwhile for the pain treatment provided

A New Zealand health IT company has come up with a device to harness brain data and help people manage chronic pain.

The Axon headset with its brain/ computer interface has been developed by Exsurgo on Auckland’s North Shore to provide feedback to users and allow them to dial down their pain.

The device is registered for use with Medsafe and, while it is ready to go on the market, Exsurgo is waiting for the completion of a local trial so clinicians can have full confidence in the device, says chief executive Richard Little.

Patients play simple games on their smart device while wearing the headset, and the technology rewards pain alleviation, Mr Little says.

He sees the product as democratising chronic pain treatment and changing people’s lives.

The idea was to develop a system for pain patients to use in their own home, monitored remotely by a clinician.

The neurofeedback technology records biomarkers through the headset. The user develops a sense of agency in their pain management, feeling they are “driving” their own brain.

The electroencephalography (EEG) technology has been around for over 50 years and is used in every hospital in the world, but has never been developed beyond the existing large, complex piece of equipment, says Mr Little.

He says Exsurgo’s Axon headset will cost about NZ$2000 which will be more affordable than most other chronic pain treatments in the long run, as it does not require an on-site clinician, and will hopefully make life easier for patients and mean they don’t need other treatments.

One in five people in the world suffer from chronic pain, and the solutions for it are far from fantastic, he says.

Because chronic pain is hard to treat, these patients are often high consumers in the healthcare system as they go from specialist to specialist and are prescribed drug after drug.

Mr Little wanted to develop an efficient technology in order to save money, and “free up the human resources, the clinicians, to do their smart, human stuff”.

Exsurgo’s product has been tested in a proof-of-concept trial in the UK and in a second clinical trial in Auckland. The trials coincided with COVID-19 lockdowns, so were run remotely.

Rather than have the trial patients come into the clinic, Exsurgo couriered their Axon headsets straight to their homes, together with links to instruction videos.

Mr Little says the lockdowns were a blessing in disguise, as the home-based rather than in-patient trial sessions addressed the problem the Axon is aimed at fixing.

For people with chronic pain, leaving the house may not be worthwhile for the treatment provided, he says.

Mr Little started as an engineer and gained an interest in neurological recovery more than 20 years ago, after his mother had a stroke and his best friend developed multiple sclerosis.

He worked with the friend, Robert Irvine, now a production manager at Exsurgo, to develop a set of robotic legs, or lower limb exoskeleton, to enable people with mobility impairments to walk again.

Through this company, Rex Bionics, they would utilise thought control with a brain/machine interface, which involved reading people’s intentions to move and drive the exoskeleton to walk.

This experience in brain/machine interfaces led them to start Exsurgo, with stroke rehabilitation equipment in mind. Rex Bionics was sold to a company in China.

Exsurgo collaborated with AUT researchers on several neurological rehab projects before coming across EEG neurofeedback science, and eventually developing the Axon device.

Exsurgo funded the trial with the help of a range of investors based in New Zealand and the Middle East.

Mr Little says many patients had given up working or doing the things they loved due to their chronic pain, but the Axon headset has given them back their lives.

Exsurgo is Latin for “to stand, to rise, to recover”

Kiwi pain patients test the Axon in trial

A New Zealand clinical trial of the Axon device and its electroencephalography neurofeedback technology began last year.

The Axon’s developers, Exsurgo, funded Waitematā DHB and AUT to run the trial, with the first patients starting on the treatment in September.

AUT senior lecturer David Rice was the primary investigator.

The 116 participants had a range of chronic pain issues such as arthritis, endometriosis, musculoskeletal lower-back pain, and post-surgical and post-cancer pain.

Patients were split into two groups – half received the active treatment; half received a sham control.

They were asked to complete one 30-minute session a day, four to six days a week, over an eight-week period.

The participants were split again after the eight weeks; some received booster sessions, while patients in the control group were invited to join the active treatment group.

Results from the trial are set to be published later in the year.

Exsurgo reports 70 per cent of participants received up to a 50 per cent reduction in their pain levels.

The Axon and pain perception

The Axon neurofeedback device, from Exsurgo, measures a person’s bioelectrical responses associated with pain and uses visual and oral stimuli to reinforce positive change.

Wearing the Axon headset, people experiencing chronic pain take part in neurological exercises, playing simple games on their mobile device.

For example, they use their “thoughts” to make “balloons” float. The balloon floating is a measure of what Exsurgo calls the “anti-pain” level; as this increases, the balloon floats higher.

Exercises are designed to reward and reinforce positive change in the brain’s electrical activity, says a media release from AUT, which has been involved in a trial of the Axon. The patient learns to retrain how their brain perceives and responds to pain, in a process called neuromodulation.

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