Every year in the US, about $13bn is spent on treatments for many of the estimated one in 10 children with attention deficit hyperactivity disorder.
This usually involves a prescription of stimulant drugs such as Adderall and Ritalin, which have stirred controversy over their risks and benefits. But what if these could be replaced, at least in some cases, by a non-pharmacological alternative?
Akili Interactive Labs is a Boston-based start-up developing mobile video games to treat ADHD and other neurological conditions including autism, depression, Alzheimer’s disease and traumatic brain injuries.
The company’s lead product, called Project: Evo, aims to train the brains of children with ADHD to prioritise between a competing blizzard of information and stimuli. Akili last month raised $30.5m of equity investment to fund a large-scale clinical trial after encouraging data from earlier studies.
“We’re seeing the emergence of an entirely new category of non-pharmacological therapies . . . to target some of the most underserved patient populations and disrupt massive markets,” says John Spinale of Jazz Venture Partners, which took part in the fundraising.
Big pharmaceuticals groups are taking the technology seriously. Shire, the dominant producer of ADHD drugs, has invested in Akili and Pfizer is working with the company on Alzheimer’s research.
Software-based “digital therapies” of the kind pioneered by Akili are part of a growing range of mobile technologies aiming to test and in some cases even enhance mental health. The global market for cognitive assessment and training is already worth $2.4bn, according to M & M, the research company, and is expected to triple to $7.5bn by 2020.
The growth is being driven by an increasing burden of age-related conditions such as dementia and, says M & M, the “rise in brain fitness awareness”. These trends have coincided with technological advances which are opening the way to more sophisticated and clinically-credible products.
Take, for example, UK-based Cambridge Cognition, which has developed touchscreen tests and research tools for more than a dozen conditions from Alzheimer’s and Parkinson’s disease to epilepsy and schizophrenia.
Its “neuropsychological assessments” are based on work dating back to the 1980s by renowned Cambridge neuroscientists Barbara Sahakian and Trevor Robbins. But it is breakthroughs in mobile technology that have allowed them to be commercialised via tablet computers.
The company’s Cantab Mobile tests have been used on more than 20,000 patients to measure cognitive functions such as memory, reaction time, attention span and decision making through simple games and puzzles.
Much of the demand has so far come from medical researchers. But the biggest long-term potential comes from its use as a diagnostic tool in healthcare. The product already has marketing authorisation in Europe as a medical device and the company is planning to seek approval from the US Food and Drug Administration.
Both Akili and Cambridge Cognition are positioning themselves as serious medical technology companies in contrast to consumer-focused “brain-training” apps, which have been growing in popularity but also drawing scrutiny over questionable scientific claims.
Lumos Labs this month agreed to pay the US Fair Trade Commission $2m to settle false marketing allegations against its Lumosity brain-training game. The company had claimed its games helped users perform better at work and could even alleviate symptoms of Alzheimer’s disease.
The FTC said: “Lumosity preyed on consumers’ fears about age-related cognitive decline . . . [but] simply did not have the science to back up its ads”.
The case highlights wider questions over the reliability of the proliferating range of fitness apps and wearable devices being used by people to help monitor and manage their health.
Akili and Cambridge Cognition aim to overcome these concerns by showing that mental as well as physical health can benefit from the convergence of mobile technology and medical science.