Prosenex
Objective Novel Rapid Neuropathy Screening

As a disease that humanity has known and studied for over two millennia, diabetes has gone from virtually untreatable to extremely manageable in the last century. Today, while the disease is manageable, its hard-to-detect complications are taking center stage. Painful and painless peripheral neuropathy are the most devastating diabetes complications, resulting in limb loss and disability. The condition frequently correlates with cardiovascular complications and vision loss. Painful neuropathy diminishes patients’ quality of life, frequently partly relieved by multiple medications, including opiates. Painless neuropathy often causes sole and plantar pressure wounds, eventually triggering lower extremity amputations.

Over the years, physicians have utilized archaic neuropathy screening such as monofilament and tuning fork-based testing, which enables doctors to assess the degree of a patient’s sensitivity/numbness to touch and vibration. These commonly accepted methods deliver inconsistent results, greatly influenced by a provider’s experience and preferences. This leaves a huge gap in screening where physicians especially miss painless neuropathy, largely affecting small nerve fibers which are often the first ones to degrade.

To bridge this gap, Dr. Boris Golosarsky (MD, FASAM), a practicing board certified Internal and Addiction Medicine physician in New Hampshire, envisioned the development of a neuropathy screening device capable of detecting small fiber nerve damage and providing consistent and objective results. Subsequently, after partnering with Michael Brown and Jim Bernhard, who have a cumulative six-decade experience in electronics design and engineering respectively, Dr. Golosarsky developed the solution and named it Dynamic Neuroscreening Device (DND). Soon after, the trio started Prosenex as an organization tasked with commercializing the solution to physicians across the U.S. and the world at large.

DND is a non-invasive alternative for accurate and objective neuropathy screening for diabetic patients or individuals who are at risk of the disease. “DND enables uniform temperature and vibration sensitivity-based discrimination stimuli that helps physicians set a baseline for a patient’s neuropathy and accurately track the improvement/deterioration of their condition over time,” says Michael Brown, president at Prosenex. Another key competitive advantage that DND has is its intuitive ‘hammerhead’ design, which enables caregivers to easily place the device in any position on a patient’s extremity and accurately test their neuropathy.

Prosenex’s device has two modes: vibration discrimination and temperature discrimination. The vibration mode enables physicians to control the amplitude of the vibrations across five different segments. The tuning fork is an age-old and widely accepted screening test. Therefore, Prosenex developed DND’s vibration mode to emulate that and enable physicians to leverage a familiar screening methodology.

But unlike the tuning fork, DND delivers graded measurements and objective results, thereby facilitating the establishment of a baseline for a patient’s level of neuropathy and driving better treatment over time. On the other hand, the solution’s temperature discrimination mode leverages DND’s two temperature pads. “Physicians can fix one pad at 25 °C while the other pad can vary from 15-23°C in 2-degree increments in the cold mode and 27-40°C in 2-degree increments in the warm mode,” explains Jim Bernhard, VP of engineering at Prosenex. As a result, the doctor can clearly discern the difference in a patient’s sensitivity to temperature stimuli. Brown elaborates, “DND enables physicians to wake the patient up to their neuropathy with its ability to effectively highlight the nerve damage on their extremities via our innovative temperature pads.”

With such unparalleled capabilities, Prosenex has assisted numerous physicians since its inception in 2013. A prime example of its impact on a physician’s neuropathy screening is that of Dr. Axel Rohrmann who has been using DND for over a year. With Prosenex’s device, the doctor was able to enhance the efficiency of their complete neuro-vascular assessment as well as improve their ability to detect ulceration risks significantly early. “The DND has replaced my tuning fork and we are able to get reproducible screening results through testing both large and small nerve fiber functions,” stated Dr. Rohrmann.

Similarly, Prosenex has ignited several other success stories owing to DND’s unmatched competencies in enhancing neuropathy screening. In fact, the company’s success is perfectly illustrated with its accolades, which include multiple Dynamic Neuroscreening Device awards from the New Hampshire High Tech Council, a bronze medal for Global Medical Design Excellence, and a winner’s trophy at the T1D/M2D2 Diabetes Innovation Challenge.

Moving forward, Prosenex is on track to expand its distribution network as a way to grow its clientele across the U.S. and globally. From a product standpoint, the company has plans to release new cordless and BT-connectable versions of the current DND, which will boost the device’s portability and allow physicians to seamlessly add the results of a patient’s neuropathy screening directly to their EMRs. To conclude, Bernhard reiterates the ethos of Prosenex, “We will continue improving DND to enable physicians in stopping diabetes complications in their tracks and enhance patient outcomes in a highly compliant and effective manner.”