Israeli Innovation: Monitoring Brain Disorders From Home With Your Phone

Montfort’s FDA-cleared neurological monitoring is used by healthcare facilities on four continents and is tracking post-Covid symptoms in Brazil.

By Abigail Klein Leichman, ISRAEL21c

People with chronic diseases are advised to stay home during the Covid-19 pandemic because they are at risk for complications should they become infected.

However, that makes it difficult to get essential medical monitoring for their conditions. And while Israel has emerged as a world leader in telemedicine, it’s easier to check heart rate and blood pressure remotely than to evaluate from a distance what is happening in the brain.

Now, patients with neurological disorders can be monitored in real time remotely, with an FDA-approved solution from Israeli startup Montfort.

Using sensors already built into smartphones, Montfort’s EncephaLog app conducts digital neurological tests for conditions such as Parkinson’s disease, Huntington’s disease, psychiatric disorders (like schizophrenia) and post-Covid-19 neurological symptoms.

This approach is not just a stop-gap measure. It’s superior to in-person checkups, says Montfort cofounder and CEO Ziv Yekutieli, an electrical engineer and brain scientist.

“About one billion people around the world suffer from neurological and psychiatric disorders. Diagnostics and treatment setting are based upon short and infrequent clinical visits, thus limiting patients’ quality of care and increasing treatment costs,” says Yekutieli.

“Evaluating the subject at a random time in the clinic does not represent the actual status of the patient in daily life, so physicians need to rely upon the subject’s self-report, which is also subjective. Montfort offers a platform for sampling the subject during regular activity.”

Remote checkups were already gaining traction, but Covid-19 turned them from “nice to have” to “must-have,” he points out.

“Moreover, many countries are starting to reimburse remote monitoring costs, which adds a strong economic incentive for telemedicine.”

EncephaLog allows the physician to choose neurological tests for each patient from a menu of options covering everything from diagnostics to drug calibration.

“The physician sends a link for the app to the patient. When the patient installs the app, he or she will see the specific tests prescribed with reminders about when to take the tests and instructions in his or her language –it can be any language,” says Yekutieli.

The tests measure parameters in three dimensions — motor (such as balance, gait, tremor), cognitive (memory, response time, pattern recognition) and mood indicators. It merges those measures with a fourth dimension of physiological records (genetics, brain scans, data from wearable devices) for a holistic picture.

The collective data and its analysis, using Montfort’s propriety algorithms and artificial intelligence (AI), lead to simpler, faster, more efficient and personalized care, Yekutieli says.

Worldwide Usage

After winning the Henry Ford AI Challenge in 2018, Montfort further developed its technology at Henry Ford headquarters in Detroit. Montfort soon got FDA approval for the first of its test modules and the rest followed within a year or so.

Today, Montfort has projects and collaborations with, among others, the Henry Ford Health System and Medtronic in the United States, Queen Mary Hospital in Hong Kong and Campus Bio-Medico di Roma in Italy.

Hospital de Clínicas de Porto Alegre in Brazil approached Montfort six months ago about using its platform to monitor motor and cognitive symptoms in hundreds of health professionals infected with Covid-19.

“For reasons that are not fully understood at this stage, the coronavirus is associated with several neurological symptoms that may have long-lasting effects,” says Yekutieli. Accordingly, Montfort added a post-Covid testing protocol.

Most of Montfort’s test modules are fully developed and commercially available for a variety of applications. A few are in a pilot phase, including some that may be embedded into products of the pharma industry, medical devices manufacturers and HMOs.

“All the tests are conducted by using the existing hardware in standard smartphones,” he stresses. “The innovation is that we leverage existing consumer technologies anyone has in their own pocket to get a medical-grade device.”

Inspired by a Teacher with ALS

A native of Ramleh, Yekutieli became intrigued with electronics and neurophysiology because his beloved high school teacher, Yair Cohen, suffered from ALS and eventually died from this neurological disease.

“That was the seed for my interest in the brain. I spent a lot of time in my first degree studying basic biology and chemistry in parallel to engineering. Then I did a master’s in electrical engineering, connecting between neurons and electronics, and a PhD on using electronic tools to offer explanations for two neurological conditions and how they affect the brain.”

Working at Intel, Yekutieli met information systems engineer Dima Gershman. They cofounded Montfort in 2014 with Yekutieli as CEO and Gershman as CTO. “For a few years we played with different ideas until in 2017 we left Intel and started working on Montfort full time.”

The company’s name is based on Mon4t — “mon” for monitor, “4” for the four dimensions it monitors, and “t” for time “because we monitor for a long period,” Yekutieli explains. (Montfort also happens to be a beautiful Crusader-era fortress in northern Israel.)

Based in Binyamina near Caesarea, Montfort has just four employees but already is breaking even and has orders into next year, says Yekutieli. The business model is software as a service (SaaS); revenues are on a pay-per-test basis at the clinic and on a per-patient per-month basis for home users.

“We are now raising a Series A round to try and leverage the Covid situation. It’s clear to everyone this kind of solution is necessary, so it’s a good time to expand.”

To the best of Yekutieli’s knowledge, no other company is as advanced in remote neurological monitoring.

“There are others that offer a specific test for a specific condition, such as concussion assessment for pro athletes. There’s a pharma company that developed an app that allows several of the tests we offer, but it is not FDA cleared; it’s only for clinical trials.”

Montfort’s advisory board includes neurologists Peter LeWitt, of Wayne State University School of Medicine and the Parkinson’s Disease and Movement Disorders Program at Henry Ford Hospital, Michigan; Dr. Hagai Bergman, of the Center for Brain Research at Hebrew University and Hadassah Medical Center; and Paul Friedemann of Charité Universitätsmedizin Berlin, Germany.