Meet Dr. Nduka, the man who’s changing the face of Bell’s palsy.

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Dr Charles Nduka with co-founder, Graeme Cox at Emteq HQ, United Kingdom. Source: VentureBeat.

The ability to read the emotions of fellow human beings is an important part of our everyday lives. We read faces, body language and verbal cues to understand the feelings of the people we interact with. Humans have evolved to intuitively understand the motivations of those around them by interpreting the subtle expressions of the face. Emteq, a British startup based at the University of Sussex, is looking to digitise those facial expressions and use artificial intelligence to interpret them. I spoke with Dr Charles Nduka, a plastic & reconstructive surgeon and the co-founder of Emteq, to understand how this exciting piece of technology will shape the way we treat facial palsy and autism spectrum disorders (ASD) in the future.

Every great startup has an interesting backstory. What’s yours?
In my surgical practice, treating patients with facial paralysis, I was struggling with the fact that some patients who had partially recovered were not progressing as well as expected. They are given a series of exercises to do (called mirror biofeedback) which helps the patient to develop better coordination of their expressions. It became apparent that they were struggling because they generally hate spending time looking in a mirror. Patients expressed distress at having to focus daily on the parts of their face that they found most distressing. Also, whilst some patients re-learned “posed expressions” such as a polite smile, when smiling or laughing in response to a joke, their expressions often reverted and became imbalanced. I realised that a better way was needed to provide immediate and real-time feedback. I spent a year searching for a technology that would be suitable for sensing facial muscle activity and  which would be non-invasive, sensitive, could work without direct contact. I ended up visiting several labs and companies including Boston and Chicago. Only then did I discover  that a professor two miles from my home in Brighton had developed a sensor technology which was principally being used to measure heart muscle signals, could be adapted for our purpose.
I was lucky to meet serial entrepreneur Graeme Cox, who has a degree in artificial intelligence and a background in software security (he sold his last company to Dell). He could see the potential of a platform to measure facial expressions and hence emotions and joined as co-founder and CEO. We’ve been fortunate to have attracted a fantastic team of software and hardware engineers, designers and researchers to develop our initial prototypes.
Your work came about as a way to help patients with facial palsy but Emteq has also shown promise with ASD. Tell us more about this. 
Those affected by ASD struggle to recognise and respond appropriately to the facial expressions of others. Some preliminary work performed by others show promise in social interaction skills training, but thus far a technology for sensing and providing feedback on ones facial expressions has not been available. We’re currently working up a project with one of our scientific advisors, Professor Hugo Critchley to conduct a study to evaluate our system for autism as well as other conditions.
What challenges have you faced bringing Emteq to life?
They call it HARDware for a reason- developing physical devices is difficult. Small changes in the physical design or in the sensor may require adjustments in the firmware, software, algorithms or interface. We’ve been fortunate to have won a number of Innovation awards which have helped to fund development. I think that wearable technologies represent particular challenges, and technologies worn on the face probably represent one of the most difficult challenges out there.
You’re a doctor-turned-entrepreneur. What tips would you give other aspiring doctorpreneurs?
I’ve learned a huge amount from reading copious amounts, and listening to some great podcasts. One of the things that’s frustrating about being a doctor is that I can only help one patient at a time. Developing technology enables one to help people at scale, and it is this that keeps me motivated and attracts great people to the team. For aspiring entrepreneurs my favourite books are “Running Lean” by Ash Maurya “Startup CEO by Matt Blumberg, “Scrum” by JJ Sutherland, and “Disciplined Entrepreneurship” by Bill Aulet.
How has the medical community responded to your technology? 
So far, everyone I’ve spoken to has been very excited by the potential of what we’re doing. Obviously we still need to conduct large scale trials to evaluate the benefits over alternative methods and to publish the results of our research. In the case of facial paralysis, the current alternative is the use of Botulinum toxin injections in the face of patients to improve the muscle balance. Whilst this may help to mask the obvious facial asymmetry, it is costly, and does not address the underlying issue of incorrect pathways. Neuromuscular retraining using VR has the potential to provide a more sustainable solution. For mental health conditions, VR has the potential to be a game-changer. The ability to help those with social anxiety or phobias is expensive and difficult in real life whereas VR could enable multiple scenarios to be presented to patients under very controlled conditions. They could have their emotional responses monitored to ensure that the experience was not overwhelming them.
What are your thoughts on the relationship between the medical and the MedTech community generally?
There is a constant tension between the medical community and the medtech community. Doctors want to get their ideas out there and may sometime disclose their research results too early which precludes gaining patent protection. Without this, attracting investment to fund the the expensive process of prototype development and clinical trials is impossible. On the other hand, most doctors tend to be understandable conservative when evaluating new technologies. This can be frustrating for the medtech community who have spent time and money to bring an innovation to market. With the advent of 3D printing and easier tools for software prototyping,  I’m seeing more doctors looking at medical tech development which must be a good thing.
Learn more about Emteq and Dr Charles Nduka here

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