Why Neuroscience Trials Keep Failing and What Could Fix Them

Neuroscience has one of the toughest track records in drug development. Large trials enroll hundreds of patients, struggle with placebo response, and often end with teams chasing subgroups in secondary endpoints. In this episode of Power to the Patients, host Brandon Li speaks with two experts who approach the problem from different angles. Craig Erickson, a Psychiatrist at Cincinnati Children's and Chief Medical Advisor at Spinogenix, explains how high-density EEG, transcranial magnetic stimulation, and computer-based cognitive testing can show whether a drug is doing anything at all. Gabriel Vargas, Chief Medical Officer at CuraSen Therapeutics, shares his view of the amyloid hypothesis he once believed in, the gap between biomarker results and patient benefit, and how CuraSen reaches the brain's adrenergic system without the usual effects on the heart and metabolism. **What You’ll Learn:** - Why large, placebo-controlled trials have failed so often in autism and other neurodevelopmental disorders - How EEG, TMS, and cognitive testing can support go or no-go decisions with a handful of patients - Why Gabriel believes lecanemab and donanemab clear amyloid well but fall short of a clinically meaningful difference - Why treating apathy, depression, and agitation in Alzheimer’s still matters without disease modification - How pairing clenbuterol with nadolol lets CuraSen act on brain receptors while blocking effects in the rest of the body - Why SPG601's early data suggest it may avoid the tolerance problems seen with earlier fragile X drugs - How digital health tools could capture what happens to patients between clinic visits **About the Guests** **Craig Erickson, MD,** is a child and adolescent Psychiatrist at Cincinnati Children's Hospital Medical Center, where he directs the Cincinnati Fragile X Research and Treatment Center. He is also Chief Medical Advisor at Spinogenix and was principal investigator of the Phase 2 study of SPG601 in Fragile X syndrome (FXS). After years of negative autism trials, his work now centers on quantitative, placebo-resistant measures of brain function to guide early decisions in drug development. **Gabriel Vargas, MD, PhD,** is Chief Medical Officer at CuraSen Therapeutics, which develops oral small molecules that act on the brain's adrenergic system for psychiatric and neurodegenerative diseases. Before CuraSen, he was neuroscience therapeutic area head for early development at Amgen, where he led early development of Aimovig and oversaw digital health. Gabriel also serves on the editorial board of the journal Digital Biomarkers. # **Episode Resources** - Craig Erickson on LinkedIn - Gabriel Vargas on LinkedIn - Brandon Li on LinkedIn - With Power Website - Power on LinkedIn https://www.linkedin.com/company/withpower/ Power to the Patients is handcrafted by our friends over at: fame.so Top 3 most downloaded episodes - Inside the ALS Breakthrough: 20-Year Journey to FDA Approval with Dr. Joseph Palumbo - Why Clinical Trial Speed Kills Success - And What Top Sponsors Do Instead ft. Steve Branna - Who Really Protects Patients in Clinical Trials? With Dr. Lara Shirikjian