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Deep Brain Provides Stimulating Market

There are signs that the field of deep brain stimulation (DBS) has gained a certain momentum of late: three start-ups raised venture rounds in 2011 and there have been two acquisitions in the space within the past year. The giants in cardiac rhythm management – Medtronic, St. Jude Medical and Boston Scientific – can leverage existing technology platforms from CRM to new diseases once served by drugs. Start-ups can help them, by validating new disease targets, and increasing procedural accuracy and efficiency.

The before-and-after videos on Medtronic PLC’s web site are compelling; before, a woman with essential tremor attempts to open her door, key in hand. Her hand shakes so violently that no matter how hard she tries, she can’t insert the key in the lock. In the “after” clip, with a steady hand, she smoothly inserts the key in the lock and turns it. That’s a demonstration of Medtronic’s Activa implanted deep brain stimulation therapy, a technology platform that has created a $400 million business for the company in the treatment of movement disorders – Parkinson’s disease, essential tremor and dystonia. For a decade and a half, Medtronic has had this product segment to itself, since its first European approval in 1993, but its hegemony is about to come under attack with the entry of St. Jude Medical Inc., which, having launched its therapy for Parkinson’s disease in Europe in 2009, is now headed for the US, and Boston Scientific Corp., which is in early clinical trials of its own deep brain stimulation (DBS) platform for Parkinson’s disease. There’s some room to share; estimates are that the DBS market for movement disorders is worth $800 million.

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