Despite huge leaps in our understanding of the inner workings of the brain, many of the most popular therapies for psychiatric and neurological disorders are just new versions of older drugs.

Now experts say new technologies, such as electrical stimulators, could revolutionize the treatment of brain disorders. Scientists hope that within the next 5 to 20 years, these technologies will deliver some of the most sought-after breakthroughs in neuroscience, such as a truly effective treatment for Alzheimer’s disease or an alternative therapy for the large percentage of patients resistant to antidepressant drugs.

New treatments are already beginning to emerge, including brain stimulation devices to treat epilepsy, Parkinson’s disease, depression, and even obesity, as well as drugs to target nerve cell growth. At the neurotechnology industry meeting in San Francisco last week, Zack Lynch gave Technology Review the lowdown on some of the new drugs and devices that are emerging from this growing field. Lynch is on the leadership board of MIT’s McGovern Institute for Brain Research and is managing director of NeuroInsights, a market analysis company based in San Francisco.

Technology Review: Why neurotechnology?

Zack Lynch: Neuroscience is now moving from a science to an industry. What we’re really looking at is an evolution: researchers are now going beyond basic science and developing more effective therapeutics for brain-related illnesses.

The need is huge. One in four people worldwide suffer from a brain-related illness, which costs a trillion dollars a year in indirect and direct economic costs. We all know someone who is affected. That burden will continue to grow with the aging population. We have more people, and more people living longer – it’s a multiplier effect.

TR: Less than 10 years ago, neuroscientists made an exciting discovery. They found that the birth of new neurons, once thought to be confined to the developing brain, continues in adulthood. Now we know that that process, known as neurogenesis, may play a role in treating a number of diseases, including depression. How will that discovery affect development of new therapies?

ZL: Neurogenesis promises a potential preventative or nearly cure capability. Right now what we’re doing is palliative, rather than being able to target the mechanisms and potentially regrow neurons. But it’s an area that’s far out. The technology is just getting started.

TR: Research suggests that antidepressants are effective partly because they stimulate neurogenesis. So companies such as BrainCells, based in San Diego, CA, are screening compounds that promote growth of neural stem cells in the brain. They say these drugs could bring new therapies for depression and, eventually, neurodegenerative diseases.

ZL: It’s an exciting area, and the investment community is certainly interested. But the jury is still out.

TR: We’re also starting to see a new kind of therapy for brain-related illnesses – electrical stimulation. Various types of stimulation devices are now on the market to treat epilepsy, depression, and Parkinson’s disease. What are some of the near- and far-term technologies we’ll see with this kind of device?

ZL: We’re seeing explosive growth in this area because scientists are overcoming many of the hurdles in this area. One example is longer battery life, so devices don’t have to be surgically implanted every five years. Researchers are also developing much smaller devices. Advanced Bionics, for example, has a next-generation stimulator in trials for migraines.

In the neurodevice space, the obesity market is coming on strong. Several companies are working on this, including Medtronics and Leptos Biomedical. In obesity, even a small benefit is a breakthrough, because gastric bypass surgery [one of the most common treatments for morbid obesity] is so invasive.

In the next 10 years, I think we’ll start to see a combination of technologies, like maybe a brain stimulator that releases L-dopa [a treatment for Parkinson’s disease]. Whether that’s viable is a whole other question, but that possibility is there because of the microelectronics revolution.

The real breakthrough will come from work on new electrodes. This will transform neurostimulator applications. With these technologies, you can create noninvasive devices and target very specific parts of the brain. It’s like going from a Model T to a Ferrari. Those technologies will present the real competition for drugs.