» Articles » PMID: 39896232

Recent Advances in Facilitating the Translation of Bioelectronic Medicine Therapies

Overview
Date 2025 Feb 3
PMID 39896232
Authors
Affiliations
Soon will be listed here.
Abstract

Bioelectronic medicine is a growing field which involves directly interfacing with the vagus, sacral, enteric, and other autonomic nerves to treat conditions. Therapies based on bioelectronic medicine could address previously intractable diseases and provide an alternative to pharmaceuticals. However, translating a bioelectronic medicine therapy to the clinic requires overcoming several challenges, including titrating stimulation parameters to an individual's physiology, selectively stimulating target nerves without inducing off-target activation or block, and improving accessibility to clinically approved devices. This review describes recent progress towards solving these problems, including advances in mapping and characterizing the human autonomic nervous system, new sensor technology and signal processing techniques to enable closed-loop therapies, new methods for selectively stimulating autonomic nerves without inducing off-target effects, and efforts to develop open-source implantable devices. Recent commercial successes in bringing bioelectronic medicine therapies to the clinic are highlighted showing how addressing these challenges can lead to novel therapies.

References
1.
Augostini R, Afzal M, Costanzo M, Westlund R, Stellbrink C, Gutleben K . How to implant a phrenic nerve stimulator for treatment of central sleep apnea?. J Cardiovasc Electrophysiol. 2019; 30(5):792-799. PMC: 6850096. DOI: 10.1111/jce.13898. View

2.
Musselman E, Cariello J, Grill W, Pelot N . ASCENT (Automated Simulations to Characterize Electrical Nerve Thresholds): A pipeline for sample-specific computational modeling of electrical stimulation of peripheral nerves. PLoS Comput Biol. 2021; 17(9):e1009285. PMC: 8423288. DOI: 10.1371/journal.pcbi.1009285. View

3.
Thaler E, Schwab R, Maurer J, Soose R, Larsen C, Stevens S . Results of the ADHERE upper airway stimulation registry and predictors of therapy efficacy. Laryngoscope. 2019; 130(5):1333-1338. PMC: 7217178. DOI: 10.1002/lary.28286. View

4.
Seth J, Couper R, Burneo J, Suller Marti A . Effects of vagus nerve stimulation on the quality of sleep and sleep apnea in patients with drug-resistant epilepsy: A systematic review. Epilepsia. 2023; 65(1):73-83. DOI: 10.1111/epi.17811. View

5.
Ahmed U, Chang Y, Zafeiropoulos S, Nassrallah Z, Miller L, Zanos S . Strategies for precision vagus neuromodulation. Bioelectron Med. 2022; 8(1):9. PMC: 9150383. DOI: 10.1186/s42234-022-00091-1. View