As a child in the 1980s, Jurij Dreo used to watch Star Trek on TV. “Whenever someone was horribly injured,” he recalls, “either the doctor came or they got taken to the doctor’s office. And the doctor just picked up a little gadget, waved it over their body, and immediately knew what was wrong.”
As an adult, he realised that reality was often light years away from this science fiction, at least in treatment of disorders of the brain. While doctors had access to point-of-care testing for other organs—lungs, liver, kidneys, heart—there was no clinical test for issues concerning the brain that was definitive, useful for early detection, and widely available. Instead, doctors would give patients a pen-and-paper cognitive test to fill out, or else send them for expensive tests such as an MRI or PET scan.
Dreo studied medicine in his native Slovenia but realised that his strengths lay in translating scientific findings into clinical practice. He was working as a researcher at a neuroscience lab when he met David Sakić, a cognitive scientist.
The two brain enthusiasts decided to leave academia for the startup life, creating the company BrainTrip to “empower physicians by bringing brain scanning to the point of care.”
BrainTrip was a finalist in the European Investment Bank Institute’s 2023 Social Innovation Tournament, which recognises startups making a positive impact socially, environmentally, or ethically.
A brain test without machines
According to Dreo, 92% of brain diseases are functional, damaging the fine structure and workings of the brain. These include major depression, anxiety, dementia, bipolar disorder, and Parkinson’s disease. Only eight percent are structural, such as traumatic brain injuries, stroke, epilepsy, or brain tumours.
Brain scanning tools that create images of the brain, such as MRIs, CAT scans, and PET scans, are most useful for diagnosing structural diseases. Dreo says that the best tool for detecting functional disturbances is an electroencephalogram, a test that measures electrical activity and shows up as a pattern of wavy lines.
“An electroencephalogram is also one of the cheapest brain scanning methods,” he adds. “Orders of magnitude cheaper than a traditional brain-imaging scan like an MRI.”
The catch is that an electroencephalogram is difficult to analyse. Normally, there are two ways to interpret the raw signals it produces: either a doctor analyses the squiggly lines, which requires years of training, or else a PhD-level expert calculates the objective biomarkers.
BrainTrip developed an innovative electroencephalogram analysis pipeline that not only records data, but helps to analyse it on the spot, helping a doctor to decide whether or not there is a serious possibility of a patient having dementia. “We decided to automate the PhD-level expert—basically to put a neuroscientist in every doctor’s pocket,” Dreo says.
Detecting dementia early
Dreo and Sakić decided to start by testing for dementia, as it accounts for close to 20% of all new brain disease cases and is on the rise as populations are aging.
The World Health Organization estimates that some 55 million people worldwide suffer from dementia, with nearly 10 million new cases per year. Dreo says the numbers are even higher, but only about one-third of cases are diagnosed.
In its early stages, dementia is usually functional, and can be detected with an electroencephalogram. In most cases, it gradually morphs into a structural disease, which is much more difficult to treat.
“We thought dementia is a good first target for the test, because not only is it a common disease, but also a disease for which there are currently barely any objective early detection tools,” says Dreo. “And it’s a disease for which we are hotly developing new treatments, but all these new treatments seem to be more effective the earlier you start.”
One novel treatment, Lecanemab, approved by the U.S. Food and Drug Administration and under review in Europe, slows progression by a significant 27%, but only as long as patients start it early.
The BrainTrip Dementia Index test is fast and non-invasive. Patients sit in the doctor’s office wearing a cap embedded with electroencephalogram sensors. Software records the electroencephalogram data for about eight minutes, then the data is encrypted and sent to the cloud for analysis. Within minutes, the results come back on a scale from 0-100, the 50 being the recommended cutoff for detecting early signs of dementia.
Dreo says that 95% of the tests come out as strongly negative, eliminating the possibility of neurogenerative dementia, such as Alzheimer’s disease. Though not perfect, he says the test’s 93% accuracy rate compares very favourably to state-of-the-art medical diagnostics for dementia and avoids false positives. “Its greatest strength lies as a screening test that helps physicians decide which of their patients to send for further testing.”
Making the test available and affordable
The BrainTrip Dementia Index passed a regulatory milestone, the CE marking in Europe in 2021. The letters “CE” appear on many products in the European Economic Area. It means that these products to meet high safety, health, and environmental protection requirements.
The company is now starting to commercialise the device and screening technology, offering it to a selection of innovation-friendly doctors for a trial period. Once the doctors use the device for a few months, they can decide if they want to purchase and integrate it into their regular clinical practice.
The startup’s first markets are Malta (where it has its base), Slovenia, and Austria, and it hopes to be in hospitals throughout Europe in the next two years. The company is targeting the US market for 2026, depending on Food and Drug Administration approval.
Even though the BrainTrip Dementia Index test can save medical systems a fortune in unnecessary tests and neurologists’ fees, no insurance company yet covers it, so patients must pay out of pocket to have the test performed.
“We’re trying to make it as affordable as possible,” Dreo says. The company seeks to limit the cost to 20% of the fee for a brain MRI, or around €150 to €200 per test in Europe. For typical patients of the device—often elderly couples who come in together, one worried about the other—it is a small price to pay for peace of mind.
