A newly published paper by Professor Imanuel Lerman from UC San Diego reviews advancements in bioelectronic medicine and highlights promising new therapies and diagnostic methods.
The journey of bioelectronic medicine stretches from the ancient Egyptians using electric fish for headaches to the creation of pacemakers in the 1950s that regulate heart rhythms. This field, which utilizes electrical signals to diagnose and treat diseases instead of relying solely on medications, has significantly progressed and is beginning to establish its presence in modern medicine. What is the current state of this field? And what potential breakthroughs could lead to life-changing therapies and diagnostics?
Research led by Imanuel Lerman, who heads the Lerman Lab at the UC San Diego Qualcomm Institute and is associated with the UC San Diego School of Medicine’s Anesthesiology Department and the VA Center of Excellence for Stress and Mental Health, answers these questions.
“This paper serves as a roadmap for the future of bioelectronic medicine,” explained Lerman. “We aim to establish a clear direction and purpose, evidenced by our extensive list of 180 references. Our goal is to provide the necessary resources for readers wanting to delve deeper into the subject.”
Published today in the peer-reviewed journal Bioelectronic Medicine, this research was commissioned by Convergent Research, a nonprofit organization that focuses on impactful multi-entity projects that may otherwise not receive funding.
A World of Promise
Bioelectronic medicine has already made inroads into modern healthcare, surpassing traditional pacemaker technology. The US Food and Drug Administration has authorized implantable devices for treating movement disorders, such as Parkinson’s disease through deep brain stimulation, as well as spinal cord stimulation for back pain, and vagus nerve stimulation for issues like epilepsy, depression, stroke, and migraines, affecting various bodily functions.
Progress also includes advancements in noninvasive techniques. Devices can now stimulate the nervous system from outside the body. For example, transcranial magnetic stimulation was approved for depression in 2008 and has since expanded its applications to include migraines, obsessive-compulsive disorder, and smoking cessation.
Lerman and his team see a bright future ahead.
The newly published paper emphasizes the rise of noninvasive bioelectronic techniques. These methods not only eliminate surgical risks but also present notable advantages compared to conventional drug treatments.
“We believe that non-invasive neuromodulation offers significant potential,” stated Lerman, who also practices at UC San Diego Health. “Since devices don’t need refrigeration, they do not qualify as drugs. They require only electricity or a battery to function, and they can utilize the body’s natural systems to reduce inflammation.”
Moreover, when integrated with sensors, bioelectronic medical devices can form self-adjusting “closed loop” systems that cater to individual needs. This means bioelectronic devices could deliver personalized treatment continuously, adapting doses based on real-time feedback from biomarkers.
Although developing closed-loop systems requires further research, Lerman and his colleagues view them as a potentially groundbreaking approach to medical therapies.
Unique Capabilities
Beyond this framework, bioelectronic medicine could unveil revolutionary new functionalities.
One exciting possibility is its use as a diagnostic tool. Prior studies suggest that the body displays a distinct response to each infectious agent over time, creating unique “time-series” patterns that can predict the specific pathogen and guide effective treatments.
“Our aim is to create a library of pathogens,” Lerman shared. “We want to identify the distinct signatures of each pathogen and deploy the appropriate level of neuromodulation to mitigate the inflammation linked to those infections, thereby reducing their severity.”
Previous research has demonstrated disease signatures in waveform data, such as EEG and temperature readings. Lerman and his team propose that monitoring the vagus nerve and other components of the autonomic nervous system could yield crucial insights for this endeavor.
Furthermore, bioelectronic medicine holds great promise for mental health as research has increasingly recognized inflammation and the immune system’s role in various mental health issues.
“Disorders such as post-traumatic stress disorder, major depression, and generalized anxiety disorder strongly relate to the interplay between the ‘neuro-immune axis’ and inflammation regulation,” Lerman stated. “Additional pathological changes involving the vagus nerve are noted in certain neuroinflammatory conditions like long COVID and some Parkinson’s disease cases.” The connection between the gut and brain via the vagus nerve can also transmit viruses and inflammation, complicating mental health further.
Lerman suggests using bioelectronic medicine to evaluate brain inflammation severity, allowing for tailored treatments administered at the right dosage. Autonomic neurography (ANG) is anticipated to play a significant role in clinical trials, effectively categorizing mental health severity and delivering precision medicine tailored to specific treatments.
Lerman acknowledges that U.S. Defense Advanced Research Projects Agency, National Institutes of Health, Biological Advanced Research and Development Authority, and other organizations have contributed to advancing the field of bioelectronic medicine.
“We have much work ahead,” he concluded, “but these next-generation systems possess incredible potential for revolutionizing individualized and adaptive treatment approaches.”
