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Digital Neurotherapeutics
Episode

John Krakauer, co-founder at MSquare Healthcare

Digital Neurotherapeutics

In this episode of Outcomes Rocket, we are privileged to feature the amazing Dr. John Krakauer, co-founder of MSquare Healthcare,  a medtech company with a mission to improve movement and cognition outcomes by bringing innovative solutions to the market.

Dr. Krakauer discusses one of M²Health’s proprietary solutions, a simulated dolphin device that could help stimulate brain recovery. He talks about Bandit the dolphin, the different studies conducted,  the importance of creating an immersive gaming experience, challenges in the studies, and the possible applications of the game. There is so much to learn about digital neurotherapeutics, so please tune in!

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Digital Neurotherapeutics

About Dr. Krakauer

Dr.John Krakauer  is a world renowned neurologist and neuroscientist. He is currently John C. Malone Professor of Neurology, Neuroscience, and Physical Medicine and Rehabilitation, and Director of the Brain, Learning, Animation, and Movement Lab (www.BLAM-lab.org) at The Johns Hopkins University School of Medicine.

Dr. Krakauer is also co-founder of the video gaming company Max and Haley, and of the creative engineering Hopkins-based project named KATA. KATA and M&H are both predicated on the idea that animal movement based on real physics is highly pleasurable and that this pleasure is hugely heightened when the animal movement is under the control of our own movements. A simulated dolphin and other cetaceans developed by KATA has led to a therapeutic game, interfaced with an FDA-approved 3D exoskeletal robot, which is being used in an ongoing multi-site rehabilitation trial for early stroke recovery. Dr. Krakauer’s book, “Broken Movement: The Neurobiology of Motor Recovery after Stroke” has been published by the MIT Press.

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Digital Neurotherapeutics with John Krakauer, Co founder and Chief Scientific and Medical Officer of M²H: Audio automatically transcribed by Sonix

Digital Neurotherapeutics with John Krakauer, Co founder and Chief Scientific and Medical Officer of M²H: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
Hey everybody, what’s going on? Saul Marquez here with the Outcomes Rockets, and thank you so much for tuning in again. Today, I have the privilege of hosting the amazing Dr. John Krakauer. He is currently John C. Malone Professor of Neurology, Neuroscience, and Physical Medicine and Rehabilitation and the Director of the Brain Learning Animation and Movement Lab at the Johns Hopkins University School of Medicine. Dr. Krakauer is the co-founder of the company M²Health, which was recently acquired by MindMaze. Now they’re a subsidiary of MindMaze. He also serves as Chief Medical Advisor for the company MindMaze and just they’re doing an incredible amount of work around the idea that animal movement based on real physics is highly pleasurable and that this pleasure is hugely heightened when the animal movement is under the control of our own movements. They have a simulated dolphin device that we’re going to be talking about. It’s a fascinating way to take care of people for early stroke recovery, which is still under trial. Dr. Krakauer was profiled in The New Yorker in 2015 and his book Broken Movement: The Neurobiology of Motor Recovery After Stroke. It was published by MIT Press in November of 2017, so he is an authority in the space and certainly thinking outside of the box. John, such a privilege to have you here on the podcast today.

John Krakauer:
Thank you so much for having me.

Saul Marquez:
Absolutely. Now we’re going to dive into M²H M Square Health and kind of how that’s now part of MindMaze, but more importantly, the technology and the work behind it all. So before we do, tell us about your inspiration. What inspires your work in this field?

John Krakauer:
Let me see how I can summarize this. Well, I mean, I’m a neurologist and a neuroscientist. My neuroscience work is very much focused on skill, movement, cognition. My clinical interest is stroke, and I realized that there was a literature going back over a century in monkey models and rodent models, showing that you could get quite a remarkable recovery after brain injury and stroke in particular with intense, high dose behavioral experiences, which were not what was being given in conventional rehabilitation. So my inspiration was how do we create a human experience that mimics what we’ve known from the animal model literature and get the same impressive recovery that we were not seeing with more conventional rehab, which is much more pragmatic, much more let’s get you home, let’s get you to cope with what you have left. You know, much more as I said learning pragmatic, coping based rather than repair, rewiring, reorganization, reversal based. So that was my inspiration. It’s how do I bring the findings in the animal model world and reproduce them in human patients?

Saul Marquez:
Fascinating. And so what was the animal model? Were they doing simulation as well?

John Krakauer:
No, no, no. In other words, you know, you can basically make rodents and monkeys do hundreds, if not thousands of repetitions of particular movements for reward. And you know, let’s be honest, you can keep them captive. You can make them do it.

Saul Marquez:
Yeah, yeah, yeah.

John Krakauer:
Whereas humans are not going to reach for a cup of coffee five hundred times or a thousand, right? So you have to find a way to make people do something which is enjoyable, stimulating, challenging but varied enough that you keep going.

Saul Marquez:
Got it! I understand now. Yes. Thank you for that clarification. And so you have this fascinating device that integrates a lot of different technologies. I’m not even going to try to explain. What I want to do is actually help the listeners understand through your words and work how you’re adding value to the field with the work that you’ve done at M²H.

John Krakauer:
Right. So I think, first of all, it’s very important to explain that the conception, the science, the piloting the trials came happened at Johns Hopkins before it spun out.

Saul Marquez:
Ok,

John Krakauer:
OK. So you know, the thinking, the animation, the science came before it spun out to be a company. Right. That’s what always happens. Right. You have an idea. So I just wanted to be very clear, and I think it’s important because the kind of work we did, which I’ll describe in a minute needs a unique set of people, and it’s not typical to have such people together in a medical school. You need animators, artists, programmers, engineers, clinicians, neuroscientists altogether. So you need to create a kind of highly multidisciplinary team to build this kind of experience. And that’s what we created. What was called the Carter Project and still is at Hopkins, the Carter Design Studio.

Saul Marquez:
Got it. No, I appreciate you making that distinction.

John Krakauer:
I just think it’s important in general because, you know, most drugs that have been discovered were developed by research dollars in universities and then got commercialized by companies. And it would be just inaccurate to make it look like the companies alone did the innovation. And I think it’s important because what you want is a perfect hybrid between the strength of the industry in the strength of Academia, and you want to be able to sort of walk that path between them. So anyway, another thing I would say is it’s not a device. I think that’s another thing that’s very important when it comes to the kind of medicine, you know, this new world, as I’m sure you know about, of digital therapeutics. It’s not a pharmacological agent. It’s not a device. It’s not a piece of hardware. It’s a software-based, immersive experience.

Saul Marquez:
Got it.

John Krakauer:
It’s the software and the animation that matter. Hardware is playing a strictly supporting role, right? It’s actually the nature of the gaming experience that is actually, we hope, having an effect on the brain and nervous system. So, you know, just to tell you if I can the sort of origin story, can I do that?

Saul Marquez:
Oh, please, I would love to. Yeah, I would love to.

John Krakauer:
Right. So in other words, you know, as I said in animal models, there were two things that were known. One was that you need to do a lot more practice to get better than is usually done. All right, you had to sort of do athlete levels of practice hours and hours a day for weeks and months, if not years. And the other thing we know from the literature is enriched environments are very, very good for brain plasticity, and we don’t want to be alone in a cage. If you’re a rodent, you want to be in with your friends, you want there to be ramps and balls and places to explore. You want it to be a colorful, social, exploratory, fun environment, which is exactly what hospitals are not.

Saul Marquez:
Right.

John Krakauer:
Hospitals are basically glorified cages, so we had to find a way to combine both the practice element with the enrichment element for humans. And I was very lucky that I teamed up when I got to Johns Hopkins from Columbia in New York with two computer scientists, Mohamad and TriMet. Roy, who we were the co-founders of Carter and co-founders of M²Health and they were extremely interested in a particular form of gaming and animation. They were very interested in movement, just like I was neuroscientifically, and I was aware that the way to create the equivalent of enrichment and high doses of practice in humans was to create some kind of immersive gaming environment. That was the way you did it. And the inspiration was that maybe people’s fascination with Pixar and Disney and the characters who move about and that’s what people like, what they like about animation is an emotion, right? They like to see animals moving, right?

Saul Marquez:
Yes.

John Krakauer:
And so we thought, OK, we’ll take it one step further. And the three of us thought that you know, not just watching passively, but you become the character. And by being in this beautiful alternative world creature rather than as a human, you get your confidence back. You would feel empowered and you would explore movements like a child does without being reminded of your deficit. So that was sort of the idea. And then the idea, of course, is the choice of a dolphin. Omar, if I recall correctly, was the one who made that choice. It’s a highly intelligent creature, expresses its intelligence through its movements, the movements it makes a continuous in the water so that you can continue to move without stopping and starting where humans do. You have that radical transformation from being on land to being underwater. So it was immersive, transformative and it encouraged all sorts of movements of your arm without being biased to moving your arm the way you usually do because you are underwater, right? It was a lot of factors, but the driving idea was to make people enjoy making a lot of movements in a novel environment and feel good about their capacity to recover.

Saul Marquez:
Totally. Yeah, that’s really great. And I also appreciate the symbolism of the dolphin, and I’m fascinated by dolphins. They’re just amazing creatures.

John Krakauer:
Well, human beings are, right? It goes all the way back to the Greek myth, the idea that dolphins were actually sailors that fell overboard and drowned transformed into dolphins. So that’s one of the origin stories of dolphins. So that one, that’s kind of, yeah. So yes, I mean, I think that was very much an inspiration that people are fascinated by them because they can tell just by looking at them swim. Even without verbal communication, they’re highly intelligent. Their playfulness, you would never call a shark swimming under the water playful, but you would about the dolphin. And playfulness is a sign of a sort of childlike intelligence.

Saul Marquez:
Mm hmm. I love it. Folks, you’re listening to this. I definitely encourage you to go check out the video of what we’re talking about. You’ll see links at the bottom of today’s podcast, where you’ll have access to those videos. Super cool simulations. I mean, the thing that always kind of threw me off was like the skeletal structure of a dolphin. They actually have metacarpals in their fins. You guys had a picture on your website showing that.

John Krakauer:
Well yes, that was actually The New Yorker when they did the profile of our work.

Saul Marquez:
Oh, OK.

John Krakauer:
They were the ones who actually did that sort of x ray of the.

Saul Marquez:
I love that.

John Krakauer:
That flipper of a dolphin. And I think that’s just to make people understand. I’m sure most people do know that dolphins are mammals and not fish.

Saul Marquez:
Well, no, I thought that was interesting. So anyway, I’m fascinated, and I guess many humans are by dolphins. So good choice.

John Krakauer:
Yeah, yeah. I think there is something fundamental primal about that, and you notice that people enjoy embodying being a dolphin.

Saul Marquez:
Yeah, so talk to us John, about how it works and how is it different than what’s available today?

John Krakauer:
Yes, I mean, I actually don’t think there has been an alternative way to date to get people to make continuous, high-intensity, high-dose movements that are not task-based. In other words, don’t pick up a cup, pick up a fork, put something on a shelf, just express your capacities rather than your tasks. Right? In other words, we wanted to stress capacities. So for example, you have capacities that you have a memory capacity, you have a verbal capacity, and those capacities can be studied and isolated without you actually having to use them within a pragmatic context. So we wanted you to sort of practice your arm skills without actually having to use them for some functional, pragmatic tasks, like reaching something, picking something up. Ok, so how do you zero in on people’s capacities, rather than on particular tasks? That was very important. And quite frankly, if you want people to be challenged to express their skill capacities whilst also thinking and doing it outside of a task context and doing it with weight support, as far as I can tell, there’s no other way to actually provide this kind of level of treatment that was being done for a century and monkeys and rodents. So in other words, yes, I suppose what you mean is why can’t you use the Nintendo Wii or why can’t you use off-the-shelf games? Well, they simply were not designed for particular scientific problems and medical problems from the get-go. You can’t just take something off the shelf and retrofit it any more than you would have somebody at home in their garage make a drug that you would then use for cancer. You want a pharmaceutical company to do it.

Saul Marquez:
Right.

John Krakauer:
So I think there’s a slight misunderstanding that if you want to do this right, you need to have the same level of high-quality expertise as you would for any other medical intervention, whether it was a device or whether it was a drug. So you need to design these based on scientific principles and specific clinical problems from the ground up in a medical school with the same attention to detail and quality that you would with any other medication. And so what has to be very clear and issue a corrective that this isn’t just buying a PlayStation, right? It’s just not going to work?

Saul Marquez:
Everything is happening through these protocols. These very, very prescriptive protocols to get that ultimate and result. Do you see the potential of integrating this into, say, like a virtual reality platform?

John Krakauer:
Yes. I mean, as I said, we are quite agnostic with respect to hardware and ways to project. It can be a screen. One could do VR, one could do air. Now I have issues with VR, many of them. One is, of course, that the over65 population don’t like it very much. You can get cybersickness. It’s not clear that you can keep those goggles on for hours and hours. It gets hot. It gets in the way of other medical equipment. You can stumble all over the place. So in other words, I’m not absolutely clear that we should jump to the conclusion that the ultimate immersive experience is VR. That is the assumption out there. But I think on many levels, especially in the medical space, that’s incorrect.

Saul Marquez:
Ok, well, mainstream and not necessarily the best fit.

John Krakauer:
Right. That said, given the problem, given the patient population, one is open to the environment or the platform that one uses to express the content. But what the magic ingredient is, the secret formula is the content.

Saul Marquez:
Got it. Making those movements. So when the person is moving the dolphin, the secret is in making those repetitive motions that are not task-based. Why is that so important and how does that become so effective? Well, this is taxpayer stuff.

John Krakauer:
Yeah, that’s a very good question. First of all, as I said, you try lifting up a glass of water five hundred times. You’ll be bored after 20. So in other words, you’re simply not going to get be able to get someone to do it.

Saul Marquez:
Okay.

John Krakauer:
Second, the problem with task-based learning is it’s very specific to the particular thing that you did. So in other words, look, I’m sure you’ve written all your life with your right arm. Yeah, why aren’t you perfect with your left?

Saul Marquez:
There’s no need.

John Krakauer:
So in other words, task-based learning suffers from what’s called the curse of task specificity. It doesn’t generalize.

Saul Marquez:
Got it. You’re looking to scale those improvements.

John Krakauer:
You want to. You want to teach capacities that are incorporated into all tasks rather than learning one task. So in other words, for generalization purposes, you want to be able to go to the core primitives that can be combinatorial. They apply to any task rather than being just good at that one task.

Saul Marquez:
Totally.

John Krakauer:
So that’s the reason. And also, it’s a lot more enjoyable to babble and try out lots of different types of movement during a session. In other words, you can go through the whole parameter space of capacities playfully not aware that you’re being fooled into practicing these capacities in so many dimensions that they’re going to be useful no matter what task you encounter later? Yeah. Does that make sense?

Saul Marquez:
It makes a lot of sense. Yeah. Yeah, yeah. You’re making the experience enjoyable, playful and it’s kind of like a head fake. You’re getting all of these things that are helping you with your day-to-day. Yeah, your day-to-day movements become part of the positive effect that you’re able to do these things. And so let’s talk about some of the results you’ve seen.

John Krakauer:
Yeah, so the first we’ve done two completed two pilot studies. One of them was published about a month ago, and that was when we did something very challenging, which is we wanted to treat patients after stroke very early after their stroke, and we wanted them to be playing the game within five to six weeks of their stroke because we knew from other work that we’ve done that you get the most bang for your buck trial by trial if you go early because there are special conditions of plasticity early after stroke that make training more effective and then that window closes. And in humans, we feel like that begins to close between five and eight weeks after stroke. So we wanted to get people doing a lot of movement and cognitive challenges early. So we basically did a pilot study where we had three groups basically. We had a group that did play Bandit the Dolphin use the Mind Pod within six weeks of stroke. We had a time on task matched traditional therapy group. In other words, we made it difficult for ourselves. We actually allowed therapists to spend as much time with the patients as we did with the dolphin, which is, and I’ll say in a minute how much that was, but it’s orders of magnitude more than what you usually get in a regular therapy session. And then we had a historical control group that we were lucky to have access to where we had age-matched patients, time-matched patients, just doing regular care. Two high-intensity high-dose populations and then a regular care population. Two ways to give the high-intensity high-dose. One is just to spend more time with the therapists. The other one is with Bandit the Dolphin. It was a lot. So you did an hour in the morning, an hour in the afternoon, five days a week for three weeks. So that would be like having two squash lessons every day, five days a week, for three weeks. Because it was time-on-task. In other words, it was an hour of continuous movement. In other words, if you rested, if you stopped, clock stopped and then restarted.

Saul Marquez:
Yeah.

John Krakauer:
In other words, just to put this in context, the average amount of time you spend doing task-based therapy with the upper limb actually moving is about 11 minutes.

Saul Marquez:
Traditionally?

John Krakauer:
Traditionally.

Saul Marquez:
Wow, that’s crazy. In your study had two hours of time-on-task.

John Krakauer:
Every day just for the upper limb.

Saul Marquez:
Wow.

John Krakauer:
Right. In other words, just a different regime, really. And what was interesting about these results, and you know, now there’s a bigger study going on that’s already begun in New Zealand in the University of Auckland, led by two colleagues, Cathy Stanley and Winston Biblio, where they’re going to run about one hundred and fifty patients through their starting even earlier. So they’ve actually done four patients so far, finishing within three weeks. Our average start date was three weeks, so that’s very exciting.

Saul Marquez:
Interesting.

John Krakauer:
But in the pilot study, we basically showed that on two outcome measures, one which is about reaching it was twice as good as regular therapy in both groups. In other words, both approaches to giving high intensity and high dose were better than regular care. And on another outcome measure, interestingly, all three were equally good, which just points to the complexity of the components of the deficit after stroke, that some of them like in the animal models clearly seem to be benefiting from this new intervention, and others are still being somewhat recalcitrant. It’s somewhat reminiscent of Parkinson’s disease or schizophrenia, where their remarkable responses of some symptoms in those diseases to medications and others are more stubborn. So we’re having an experience with a digital therapeutic, just like the pharma companies are having great results and other results not so great. I actually take this as a positive that it was better in some dimensions and that a brand new approach being a dolphin in the ocean was effective at giving high-dose, high-intensity. So my guess is that from this pilot trial and now the bigger trial going on in New Zealand, that this will be a tipping point, we will begin to see that highly immersive, enriched, emotionally engaging environments are going to be the new way to try and repair the nervous system.

Saul Marquez:
Wow, that is fascinating.

John Krakauer:
Oh, there was a second pilot, which we also did with a professor in the School Of Public Health at Hopkins, called Michelle Carlson, who she installed Bandit the Dolphin in an assisted living facility on the outskirts of Baltimore and had healthy elderly patients play three times a week for six weeks just to see if you could keep cognitive and physical fitness up in the elderly. And we’re working on that manuscript now. But the results, even in that short time frame, were positive. So in other words, you know, as you know, we’ve just gone through COVID 19 and the people who are most susceptible to dying with the over65s who are sedentary and had obesity, hypertension, diabetes. And so there’s a huge pressure to try and create cognitive motor. Cardiovascular challenges for the elderly to keep them robust and avoid frailty, and it looks like this is a very promising approach for that, too. And we also just got a grant from the Department of Defense here in the United States to use Bandit the Dolphin to try and stave off dementia in war veterans with traumatic brain injury. So there’s an increasing awareness that these holistic enriched multiple modality challenges are an effective way to treat nervous system, disease and injury.

Saul Marquez:
Fascinating. And the applications are broader than the initial discussion around stroke.

John Krakauer:
Oh, absolutely. In other words, I think that what you have to always keep in mind is that there are universal principles about how the nervous system responds to behavioral experiences, and then there are particular behavioral experiences that can be tailored to the particular deficit. But the general principle is what really matters, not focusing only on the particulars of the training experience.

Saul Marquez:
That’s for sure. How about sports? Is there a place for this in sports?

John Krakauer:
Yes, I absolutely think there is. In other words, there’s a lot of interest on the part of sports teams and, you know, places like Red Bull who are always interested in knowing, well, what are the best pre-training regimes for athletes? How do you get them to get into a zen-like state to practice capacities which aren’t always in the context of the particular sport? So my belief and you know, there are some things I can’t talk about yet, but this is going to have a very big impact on approaches to optimizing athletes’ performance that is more general than the particular sport that they engage in.

Saul Marquez:
Fascinating. We’ll leave that as a seed that’s been planted. Yes, without saying more there. No. aWell, the future is bright for these types of approaches. Having the brainpower behind it with you nd your team, John is

Saul Marquez:
Certainly a vote of huge confidence for the progress we can make with this. Let’s talk about setbacks. I mean, it hasn’t always been easy. What setback did you experience through all this that you eel was like defining?

John Krakauer:
A lot. Ok, that’s a fantastic question, and I wish it was just setbacks in the past. I mean, continuing challenges. I think there are a number of them. One is that behavioral intervention is really not been at the top of the menu for doctors. Doctors want drugs and they want surgeries and devices. They want sort of mono therapeutic approaches that give you quick fixes. Chronic disease and behavioral intervention is much more difficult. Learning to lose weight, stop smoking, exercising. These are far more difficult. They are long-term multimodal behavioral interventions. And it’s not what doctors really like, right? It’s not a coincidence in my mind that you know, a male-driven profession up until very recently was always, forgive me for saying this, about quick in and out versus the much longer sort of caring multimodal approach. And you know, and therapists, social workers have been predominantly women. So digital therapeutics, to me, is the kind of welcome revenge of the more sort of women-based professions in medicine who, in my view, were right all along. The nervous system needs long-term complex behavioral intervention to complement the short-lived drug and device approaches. But that bias is still very much with us, so we’re always fighting that. Also, rehabilitation as a profession has, which is a fabulous profession, but it’s always been about more pragmatic. It’s about getting you out of the hospital and getting you home. It’s not been about going to college for four years to get better from your injury. It’s like just going to a summer course for a few weeks. So this idea that you may need to become an athlete or a student of your disease for months and years, if not, the rest of your life is also not something that is easy for people to understand because of the economic implications of that. If I were to say to a parent, you should send your kid to school for a couple of weeks just the average length of stay on a rehab unit, they’d be shocked. But we’re saying that people after injury should just spend a couple of weeks rather than the equivalent of four years in college. Do you see, in other words, it’s such an obvious point that it is so huge that people either don’t notice it or they just can’t even imagine what the economic consequences such a view would be in the medical profession? Another big obstacle is to make it understood that you need to take really smart young nerds and artists who otherwise would go to Silicon Valley or elsewhere, and to actually give them hard salaries within medical schools to do this humancentric work. I mean, a lot of smart people out there who code and draw would much rather take their skills to make someone better than to make the iPhone 13.

Saul Marquez:
Totally.

John Krakauer:
But we don’t create that environment at universities to make such people feel that they’re as important as the doctors and the scientists, so that’s another big obstacle is you need to have a new ecosystem within the medical schools where they are considered on equal footing with the more traditional professions. And then finally, giving people this extra care is going to require major changes in reimbursement structures and insurance companies in order to offer this to human beings. And then finally, it can’t just be a luxury in the West. You have to be able to find a way to offer this to people all over the world. Right. So in other words, for all these reasons I’ve just listed, it is a huge challenge.

Saul Marquez:
It is. But you know, you’ve got your challenges defined. And if you can make progress, I think it’s worth dealing with the challenges. The reimbursement piece, in particular, is is a huge one. A lot of the device drug focus has to do with how these physicians are reimbursed. I think within the last year, especially with COVID, we’ve seen some innovation in what, you know, the CDC or the government actually uses these funds like Medicare and Medicaid money for. So they’re starting to expand what treatments are covered, et cetera. But I think we’re still to your point.

John Krakauer:
They have I mean, they’ve been, you know, they’ve opened up about telehealth, for example, and telerehabilitation and remote forms of monitoring and treatment. But I still feel like there’s a huge asymmetry between the huge success of the four vaccines that are available and the speed with which they were made. And it’s kudos to that sort of molecular approach to medicine, but far less is mentioned about why did we have so many in America people with hypertension, obesity and diabetes, and a sedentary living which made them at risk of dying from COVID. But you see, treating those chronic conditions requires a completely different approach. They cannot be considered honorary infectious diseases. So I think with COVID, we saw both the triumph of that old school mono therapeutic approach and the utter failure to know how to deal with this large, large, fragile, nonrobust population that was just waiting to be decimated by COVID 19. I would argue that you’re going to have to do what we’re doing. You’re going to create these long-term, enjoyable social complex multimodal interventions to make people more robust so that they can survive COVID even before they’re vaccinated. You see they’re like two worlds.

Saul Marquez:
Totally. Yeah. And it’s about that preventative. It’s about healing. It’s about preventing all of the chronic diseases before it actually happen.

John Krakauer:
I mean, the W.H.O. has stated that about half of people over 65 in the world which are growing the largest growing segment of the world population do no physical activity whatsoever. You have an epidemic of physical and social inactivity, but that doesn’t get talked about because the medical profession doesn’t know what to do about it. And digital therapeutics, I think, is the way in.

Saul Marquez:
Yeah, it’s good stuff. Great conversation here. And it certainly begs for a new approach in how we do things, especially with our aging communities. And what are we doing, what are we doing and how are we doing it? So what are you most excited about, John?

John Krakauer:
I’m excited about all the trials we’re doing. In other words, I’m very excited about the fact that this approach is now being tried out in Australia for multiple sclerosis and New Zealand for stroke, in Portugal for Parkinson’s Disease, here for traumatic brain injury. It’s being used in normal aging, so I’m quite excited about the incredibly high quality of the individual institutions that have partnered with us to try out this new repair based on what we call neuro digital therapeutics and actually see the result. In the end, you’re only as good as your evidence, and that’s what excites me the most is the extraordinary hard work of completing these trials and seeing if we can actually have significant effect sizes on these conditions. I would say that’s what’s exciting me the most and also to come up with new experiences. We’re working on experiences for the hand, which we didn’t really focus on. So it’s taking this approach, this neuro animation approach, and applying it more and more. And ultimately, the ultimate goal would be that you could do this in any high street, anywhere in the world.

Saul Marquez:
Love the vision. That’s very exciting. That is very exciting. Well, folks, I hope you’ve enjoyed our chat with Dr. Krakauer today. I certainly have just the promise of this type of healing power, neuro digital therapeutic. It’s exciting to me and I’m sure it is to you too. John, before we conclude, give us a closing thought. What should we be thinking about after this podcast and what’s the best place for people to reach out to you? Learn more about the company and the research and the work that you’re up to.

John Krakauer:
I would say two things. One I think that we should begin to be interested in again in holistic mind and body therapeutic approaches, that we shouldn’t only think about magic bullets, that you can dance your way to health as well as drug your way to health, and I think that’s a very important way of thinking about medicine, taking some of the sort of notions from eastern medicine and bringing them into Western medicine, getting the balance better. And you know, as I like to say, if you’re going to be sick, you might as well enjoy it. So in other words, creating something beautiful while you’re ill. But we’ve got to take all that artistic talent and ability and the quality of experiences and let sick people have them. In terms of finding out, you can definitely go to the website so you can go to the M²Health website, you can go to the Carter Hopkins website, you can go to the Blam Brain Learning Animation Lab website. There are a lot of podcasts and media appearances and papers. We keep it up to date. And then the last resort, you can email me via my assistant who is available on the Blam website.

Saul Marquez:
Ok, that sounds great. I will attest too. There are a ton of resources on the sites that Dr. Krakauer just mentioned, so dive in. You’ll have a great experience. You’ll learn a ton and ultimately just want to pause and say, Thank you, John. Really appreciate the work.

John Krakauer:
Thank you for inviting me. Thank you for really right on-point questions and I really enjoyed myself. Thank you.

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Things You’ll Learn

  • Most drugs that have been discovered were developed by research dollars in universities and then got commercialized by companies.
  • Digital therapeutics is a software-based, immersive experience.
  • We should begin to be interested in holistic mind and body therapeutic approaches.
  • There is an epidemic of physical and social inactivity, but that doesn’t get talked about because the medical profession doesn’t know what to do about it.

 

Resources

Websites Mentioned:

https://msquarehealthcare.com/

Brain Learning, Animation, and Movement Lab

Book Mentioned:

Broken Movement: The Neurobiology of Motor Recovery after Stroke (The MIT Press)