Interview With Alessandro Maggi, Founder of Ecate LLC

In this edition of the founder spotlight interview, we’re featuring Alessandro Maggi, founder of Ecate LLC, a medical technology company established in 2020 that focuses on developing neural interfaces to help paralyzed patients regain lost functions.

Alessandro is working to create a bi-directional, closed-loop spinal cord machine interface to bridge the communication gap between the brain and body for those with paralysis. His work at Ecate involves developing neural probes that act as a relay station, capturing information from the brain and sending it to microscopic robotic devices and pressure sensors to create a new communication channel to the limbs, effectively bypassing the injury site. He also delivered a keynote on neural interfaces for bridging spinal cord injuries at the Longevity Summit Dublin 2024. 

With a blend of technology and determination, Alessandro Maggi is forging a path towards a more connected and functional future for those living with paralysis.

Could you share a bit about your background and what inspired you to start Ecate? We’re also curious to know how your previous roles, such as at Apple, influenced your decision to focus on neural interfaces.?

I studied Medical Engineering (MS, PhD) with a minor in Aerospace at Caltech. I was the first student admitted to the Medical Engineering program, which was designed to combine electrical, mechanical, and materials science engineering with medical applications. Professors from these departments wanted a program focused specifically on medical devices. Unlike Caltech’s Bioengineering program, which leans more toward biology, Medical Engineering was entirely focused on devices—fabrication, control systems, materials development, modeling, and so on.

Since it was a new program, they asked us to pick a focus area. I was working in a micromechanics lab at the time, so I ended up taking more courses in mechanics and aerospace, which became my minor. In my final year at Caltech, I proposed a project on spinal cord–machine interfaces with the ultimate goal to transfer a terminal patient’s central nervous system into a robotic body to extend their lifespan. 

I submitted the idea to JPL through their “JPL Next” program. It was well received, but they didn’t have the funding, so they suggested I find a job while they looked for resources. That’s how I ended up at Apple, working for a couple of years on the development of the pixel array for the Apple Vision Pro. After leaving Apple, I started assembling the Ecate team and began fundraising. Eventually we secured an NSF SBIR grant to pursue the project independently—and that’s how Ecate was born.

Can you walk us through the innovation process at Ecate? How does Ecate’s technology handle the complexities of neural signal processing, particularly in decoding and encoding neural activity in the spinal cord?

At Ecate, we reduce the complexity of neural signal processing by focusing on the white matter of the spinal cord. The brain is incredibly complex—it has fractured somatotopy, information is exchanged in 3D across a vast volume, and behavior depends on millions of synapses. In contrast, the white matter of the spinal cord is much more structured.

In a somewhat oversimplified way I would say that the spinal cord tracts transfer information in a one-dimensional path—either up or down—with little to no synaptic interference. These tracts typically consist of 50–100 axons that activate together when a given motor or sensory input is activated. For instance, when your finger touches a surface sensory information travels from your finger to your spinal cord where it ascends to your brain through one of these axon bundles until it reaches the thalamus.  Most of these tracts have already been mapped, and they follow clear somatotopic organization, making it far easier to target specific functions.

By placing our probe directly into the relevant tract within the white matter, we can access neural signals without the need for complex decoding algorithms or real-time interpretation—greatly simplifying signal processing.

For example, if we want efferent information related to a patient’s intention to move their leg, we can implant our probe in a known location of the corticospinal tract. This allows us to detect motor intent directly. It’s similar to placing an intracranial probe in the lower-limb area of M1 in the brain, but without interference from competing synapses.

There are two other major advantages compared to recording from M1. First, M1 is much larger than the efferent regions of the spinal cord, meaning a much larger neural probe would be needed to record equivalent motor activity from the brain. Second, activation of neurons in M1 doesn’t guarantee that a movement will occur—those signals still need to be processed and approved by areas like the prefrontal and frontal cortex. In contrast, once a motor command reaches the spinal cord, the decision has already been made. So by recording from the spinal cord, we bypass that uncertainty and capture the motor intent with higher confidence.

How does Ecate differentiate itself from other companies in the neural interface space, and what strategic advantages do you believe your approach offers?

(1) Location: The spinal cord is significantly simpler to sense and stimulate compared to the brain.

(2) Density and Efficiency: All motor and sensory pathways are tightly packed within a small cross-sectional area of the spinal cord—roughly 1 cm². This means we don’t need thousands of electrodes to achieve effective recording or stimulation.

For example, in a patient with a spinal cord injury at the T5 level, we would need no more than 100 electrodes (each around 30×30 μm²) to detect the motor commands sent from the brain to the lower body. Each spinal tract is approximately 100μm in diameter, making targeting both feasible and efficient.

Let’s say a patient is completely paralyzed below T7, and we aim to restore full lower-body sensation and volitional motor control. In this case, no more than 100 sensing electrodes and 100 stimulating electrodes—strategically placed just above the injury—would be needed. This level of precision and minimal hardware footprint is a major advantage over brain-based interfaces, which typically require orders of magnitude more electrodes and far more complex decoding.

What are some of the most significant technical challenges you face in developing these interfaces? How do you address ethical concerns related to neural interfaces, such as privacy, consent, and potential misuse?

(1) Stabilizing the intraspinal probe: One of the most critical challenges is ensuring that the intraspinal probe remains fixed relative to the spinal cord. Any relative motion can damage tissue or degrade signal quality. We’ve developed a fixation method that couples the probe directly to the spinal cord while mechanically decoupling it from the vertebrae and surrounding muscles, which are subject to movement. This maintains stability without impeding natural biomechanics.

(2) Wallerian degeneration and scarring: After spinal cord injury, axons often undergo degeneration. However, recent findings show that many axons actually survive the injury, even if not fully intact. Our system is designed to target and utilize these surviving axons for both stimulation and recording. The main drawback is that signals from these axons tend to be lower in amplitude compared to those from the brain, especially over time.

Ethical Considerations:
Personally, I prefer working on challenges grounded in physics and engineering—those that can be quantified and modeled. But we recognize that ethical considerations around neural interfaces—like privacy, consent, and potential misuse—are important. To address these, we brought on Ben Cogan, who studied ethics extensively at university and helps guide our thinking in this space.

How do you plan to ensure that Ecate’s technology is accessible to diverse populations, including those in lower-income communities or developing countries?

I’m a strong advocate for public healthcare and for improving programs like Medicare, Medicaid, and Medi-Cal, which I believe are the most effective paths to ensuring broad access to life-changing therapies. In highly capitalist healthcare systems like the one in the U.S.—where profit-driven private insurance seems to take priority—delivering quality care to most people becomes challenging. 

I grew up in a country with a strong public healthcare system and come from a working-class family, so I’ve seen firsthand how vital a public safety net can be. I had surgery for a thyroid tumor when I was younger, and I know that if my family had been living in the U.S. at the time, the experience would have been financially devastating for us.

To help address these challenges, we’re working closely with doctors in county hospitals and with patient advocacy groups. Their input is helping us better understand the needs of underserved communities and how to make our technology more accessible.

Despite the structural barriers, we’re committed to making our future devices available to all patients who need them—regardless of their economic situation or background.

How do you anticipate changes in the regulatory environment impacting the development and deployment of neural interfaces, and how is Ecate preparing for these changes?

I would say they are definitely concerning. The recent trend of weakening regulations can be dangerous to the patient. Strict, well-enforced regulatory standards are essential to developing safe and effective medical devices—especially in high-risk, emerging fields like neural interfaces.

The FDA should be given more resources and personnel to properly evaluate medical startups and ensure the data submitted is both truthful and reproducible. Currently it feels like regulatory safeguards are being eroded which is a major concern when looking at patient outcomes.

We’ve engaged with the FDA from the very beginning. Our goal is to build a collaborative and strong relationship where key experimental steps are guided and reviewed in alignment with regulatory expectations. For a technology as novel and potentially impactful as neural interfaces, we believe it’s absolutely critical to have strong, reproducible preclinical evidence before any IDEs are approved.

Ecate’s innovative approach to neural interfaces holds promise for revolutionizing the treatment of paralysis – Looking ahead a few years, what do you envision as the ultimate goal for Ecate and its contribution to the field of neural interfaces?

Our ultimate goal is to make it possible to transplant the central nervous system (CNS) of a terminally ill patient into a robotic body, extending life beyond the limits of biological decline. But while that vision drives us, we recognize that it must be grounded in rigorous, step-by-step validation to ensure that each stage of the technology actually improves patient quality of life.

Our current focus is on paralysis as a proof of concept—specifically targeting one of the most debilitating and often overlooked symptoms spinal cord injury (SCI) patients face: micturition dysfunction. Loss of bladder control is not just a matter of convenience; it’s one of the leading causes of hospitalizations in this population due to recurrent urinary tract infections (UTIs), which significantly impact both lifespan and well-being.

We’re developing a fully implantable, bi-directional closed-loop spinal cord interface that aims to restore both sensation and volitional motor control over micturition. Our goal is to eliminate UTIs and give patients back control over a basic bodily function—something many of us take for granted. If successful, this will demonstrate that spinal cord–machine interfaces can safely and effectively re-establish communication between the brain and body.

Once we’ve validated this approach, our next steps will focus on restoring limb sensation and voluntary movement. Each milestone brings us closer to our broader mission: enabling the full transfer of the CNS into a robotic system to preserve consciousness and extend life in patients facing terminal illness.

Are any strategic partnerships or collaborations crucial for Ecate’s success, and how do you foster these relationships?

Yes, absolutely. Neural interfaces are not standalone devices—they must work in coordination with actuators, sensors, robotic limbs, and other systems. It’s nearly impossible for a small startup to cover all these areas of expertise internally.

For example, our first device focuses on restoring bladder fullness sensation in SCI patients and enabling them to urinate independently. This requires collaboration with partners that can stimulate the bladder based on signals from our intraspinal probe, which detects when the patient needs to void.

To make this possible, we’ve partnered with Amber-Tx, a UK-based company that manufactures sacral nerve stimulators. We’ve also established key collaborations with USC to broaden our clinical engagement—connecting with neurosurgeons, urologists, and SCI patients to inform both our technical development and clinical strategy.

Strategic partnerships like these are essential to accelerating development, ensuring clinical relevance, and bringing real solutions to patients.

Could you describe your overall experience with Eqvista’s valuation services? What made you choose Eqvista over other providers for your valuation needs? 

One of our co-founders, Jesse Horwitz, had great experience with you guys and I fully trust him so we worked with you and it was a great experience!

What advice would you give to entrepreneurs interested in starting companies in the medical technology sector?

I don’t see myself as a typical entrepreneur, so I may not be the best person to give advice in that area. Starting a company wasn’t something I ever really planned—I’ve always believed that research and technology development, especially in healthcare, should be publicly funded and accessible. In an ideal world, this project would have lived within a national lab but due to a lack of available funding, I had to take the startup route to move the work forward.

If there’s one piece of advice I’d offer, it’s this: only start a medical technology company if you’re truly mission-driven. This space is tough—most startups fail, and the rewards, if they come, can take a decade or more. It’s not something to pursue lightly or for short-term gain.

For context, before founding Ecate, I worked at Apple, where I had a comfortable salary and a great work-life balance. Since starting the company in 2019, I’ve significantly reduced my income and work much longer hours—often 10–12 hours a day, 7 days a week. It’s a demanding path, so staying motivated by a clear purpose is essential.