The third annual Neurotech Industry meeting in Boston kicked off yesterday morning (May 8) with some big numbers:

Two billion people each year are affected by brain-related illnesses, from stroke to depression to chronic pain, with an economic loss worldwide of about $2 trillion.

Venture capital companies invested about $1.77 billion in neuroscience-related research last year.

Worldwide, neuro-related industry profits hit $130.5 billion in 2007-- a growth of 8% from the previous year.

The numbers come from the Neurotech Industry Organization, a group formed about two years ago by a San Francisco entrepreneur named Zach Lynch, whose mission is to bring together academic researchers, companies, investors and patient advocacy groups "to give the brain a voice." The voice is also going to the legislature -- earlier this week, the NIO announced the introduction of a a bill in both houses of Congress to fund a national neurotechnology initiative. A total of $200 million would be split between the NIH, the FDA, and small business initiatives such as SBIR

Despite the statistics, the energy, and a burst of new ideas for potential treatments, a recurring theme at the meeting has been that developing treatments for brain diseases is hard row to hoe. Jay Watkins, managing director of De Novo Ventures, summed it up in a panel by recalling a comment he once made to his wife. "I've made an investment," he told her, "but you should probably think of it as a donation to Alzheimer's research." The company he was working with then, Eunoe, was developing an Alzheimer's therapy -- a shunt to drain protein tangles from the brain. Indeed, 10 years and just under $70 million later, the approach tanked.

Neuro-related treatments have a much higher failure rate in clinical trials than other kinds of therapies. In part, that's because the placebo response in conditions such as depression and chronic pain is enormous -- some estimates have it at greater than 50%. Another problem specific to neurological treatments is what's called "soft endpoints" at the FDA. Assessments for conditions like depression and schizophrenia, and even Alzheimer's and epilepsy, are subjective -- using the same scale for depression, for example, one researcher might rank a patient differently than another. So it's much tougher to determine whether a therapy works.

At lunch, I found myself sitting next to Paul Gilbert, the CEO of a company called Medavante that's working on a solution: Whether it's pain or depression or cognitive decline associated with Alzheimer's, take away local sites' financial incentives to enroll borderline patients (clinical trial sites can get as much as $10,000 for every patient they enroll) and standardize how the patients are assessed. Medavante is doing that using video conferencing and a trained team of 70 experts to do the assessment. It took about four years to convince pharma to try it, but with very first client, Bristol-Myers Squibb, the approach uncovered a significant effect in a potential drug that had shown no effect before. "They were just going to put it back on the shelf," Gilbert said.