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Aline Brillu (*) - 12/03/2018

Neurofeedback: Mensia - the start-up marketing a treatment for attention deficit disorders

Communication cerveau-ordinateur : utilisation du logiciel Openvibe2 au jeux vidéos (BCI Training Center, Black Sheep Studio) © Inria / Photo G. Maisonneuve

Mensia, a start-up that began life within Inria, are aiming to treat issues relating to attention span and hyperactivity in children using neurofeedback. The Koala module is already available to patients. Using OpenViBE technology, and developed by the Hybrid team at Inria, it is the first medical device to use a brain-machine interface that can be deployed at home.

300,000 families in France are affected by attention deficit disorder, with or without hyperactivity (ADHD). There is currently only one type of treatment available, an amphetamine-based medication. 200,000 families refuse to use this treatment, meaning there’s a pressing need here ”, explains Michel Du Peloux, CEO of Mensia .

For the past ten years or so, researchers have produced interesting results regarding the use of neurofeedback in treating attention disorders. 
“We found out that it was an area where there was significant room for development ”, recalls Anatole Lécuyer, an Inria researcher and co-founder of the start-up . “Mensia was set up in 2012, the idea being to offer more innovative and better adapted solutions with no side effects on the condition. ”
 The start-up then developed Mensia Koala, a brain rehabilitation device for children aged 6 and up. Centred around five different patented inventions, it has been ratified as a class IIa medical device.

So how does it work? 

Following a medical prescription being issued, the device can be rented from the Mensia website. It is comprised of a cap with electrodes and a touchscreen tablet. Each training session lasts around thirty minutes, during which time the patient will attempt to catch fish using their thoughts or to solve puzzles. A total of eleven games are available. 
“Treatment can be personalised ”, explains Michel Du Peloux. “It is adapted to the child’s electro-encephalogram and brain waves. It also features automatic thresholding, raising the difficulty level if the child is doing well or lowering the difficulty level if the child is struggling. The key thing is that the child learns how to concentrate and to focus their mental mechanisms. ” It takes an average of between 3 and 4 sessions a week over a period of 4 months to get conclusive results.  After each session, the results are sent to a doctor, who will track the progress made by the child.

A 2.0 version of OpenViBE

From the outset, the start-up has employed the use of OpenViBE, a software program coordinated by the Hybrid team at the Inria centre in Rennes that is used to process brain signals in real-time. Available in open source, the tool is used for real-time neuroscience and brain-machine interfaces. 
As Anatole Lécuyer, head of the Hybrid project team explains: “The program processes signals picked up by the electrodes before filtering them in order to get rid of any parasites they may contain. It then interprets these signals in an attempt to extract interesting brain waves. It can be used as a support for neurofeedback products. The idea here is to modify brain waves which we know are linked to certain conditions.

In 2015, Mensia and the Hybrid team set up a joint laboratory, CertiViBE , in order to develop and improve OpenViBE. “The idea was to work together in order to develop a 2.0 version of OpenViBE, which was used for Mensia Koala. This version is more stable and more mature, with genuine quality software. The goal was to lay the foundations for Koala to obtain ‘medical device’ certification. It was a real feat - this is not a common occurrence for open source software. Furthermore, the collaboration with Mensia, who have the exclusive rights, enabled us to improve the software, adding new features.

Promising early results for Mensia Koala

A clinical trial on Mensia Koala began in 2016, with 179 children in 10 hospitals across 5 countries in Europe testing the device. The results are set to be published in early June. “This is the largest ever study to combine clinical data and neurofeedback data ”, explains the CEO of the start-up. 
A progress report on 56 of those patients was published in May 2017. The results were enough to enable the device to obtain EU certification, 
showing a change in neuromarker levels in 75% of the children studied. What’s more, the side effects would appear to be minimal; only 0.02% of patients showed signs of fatigue or mild insomnia. “This study also showed that electro-encephalograms carried out at home could be of equivalent quality to those carried out in hospitals. This is very important, given that it’s the first time in the world that we have carried out live monitoring using an electro-encephalogram in the home ”, explains Michel du Peloux.

Mensia Koala was unveiled to healthcare professionals at the Congrès de l’encéphale, which ran from 24th to 26th January 2018. “There’s a lot of expectation surrounding this device, whether that's among doctors or among families. Currently, when it comes to treating ADHD, there are practically no valid alternatives to amphetamines.

It's worth noting that the start-up is already looking at a new product that could be used to treat chronic back pain.

A consortium for OpenViBE
Forty-five man-years! That’s the length of time it took Inria’s researchers and engineers to develop OpenViBE . It is now used by teams of researchers throughout the world, having been downloaded more than 50,000 times. 

It is used for a variety of different applications ”, explains Anatole Lécuyer, “ranging from people who are simply keen to test a brain-machine interface at home to prestigious academic laboratories. Within the Hybrid team, we use OpenViBE in all of our research linked to brain-machine interfaces: virtual reality, video games, but also rehabilitation in partnership with hospitals and doctors. ” 
The project team are keen to set up a consortium in order to ensure the sustainability of the software. The invitation is open to all of the organisations interested in OpenViBE (businesses, laboratories, hospitals, etc.) to become members and to take part in decisions relating to improvements or modifications. ConsorViBE will be hosted at InriaSoft.

Keywords: Mensia Technology OpenVIBE INRIA Rennes - Bretagne Atlantique Koala