A variety of serious chronic diseases are controlled by the nervous system. Activating or inhibiting peripheral nerves can affect a variety of body functions. This effect can be used for therapeutic treatment – especially in cases where pharmaceuticals are unavailable or insufficiently successful.
The electric stimulation of nerves for the treatment of diseases provides attractive opportunities for directly interacting with neurophysiological control mechanisms and for tackling complex diseases at their roots. Given that the development of new or improved pharmaceuticals in many cases has been stagnating in recent years this option becomes increasingly important.
The benefits of such a “bioelectronic medicine” (Tracey 2014) are manifold:
- Electrically influencing nerve activity is a novel treatment modality that can access new mechanisms of action beyond drug treatment.
- Modulating individual nerves or nerve branches can induce very specific effects and may reduce side effects, e.g. on other body parts.
- Electrical signals can be immediately effective and exert their action directly at the target location since they bypass the digestive tract.
Bioelectronic medicine could address many up to now only poorly treatable medical problems like chronic and acute inflammatory diseases (e.g. irritable bowel and Crohn’s disease, rheumatoid arthritis, sepsis, lupus), diabetes, hypertension, paralysis, stress, bleeding, obesity and metabolic syndrome and possibly even cancer.
In recent years a large number of research initiatives have begun to explore and systematically develop possibilities for bioelectronic therapies. Amongst others, the Feinstein Institute in New York and the new company Galvani Bioelectronics, a joint venture of the pharmaceutical company GlaxoSmithKline and the Google life-science subsidiary Verily, are particularly active in this area.
First research successes have been achieved in several areas:
- Bladder emptying:
Electrical stimulation of the nerves controlling the bladder sphincter could enable paraplegics to achieve better bladder emptying with less risk of infection (Langdale et al., 2016).
Studying neuronal control of inflammatory responses aims to treat chronic (e.g., inflammatory bowel disease) or acute and life-threatening (sepsis) inflammations via electrical stimulation of the corresponding nerves.
First pilot studies have already shown for example that inflammatory bowel disease can be treated by stimulating the vagus nerve (Kalcun et al., 2017).
- Restoration of mobility in paralyzes, e.g. after paraplegia:
It is being investigated if electrical stimulation of peripheral motor nerves can restore the mobility of people with spinal cord injury and other paralytic conditions (Tigra et al., 2019).
- High blood pressure:
Increased blood pressure can be lowered by stimulating the vagus nerve. Nerve signals that provide information about current blood pressure may be used to automatically control the stimulation to the patient’s situation (Secencu et al., 2018).
The °AirRay cuff electrodes by CorTec are made of soft and flexible silicone. In various forms and with variable closing mechanisms, they gently enclose the nerve while ensuring good electrical insulation. They are perfect interfaces to measure the activity of nerves and to modulate their activity through electrical stimulation, both in the short and the long term.
CorTec’s °AirRay electrode technology makes it possible to produce electrodes in individualized and miniaturized forms. With this technology CorTec supports both worldwide pioneering research as well as the development of first therapies with specially adapted °AirRay Cuff electrodes.
For the general public
Apical splenic nerve electrical stimulation discloses an anti-inflammatory pathway relying on adrenergic and nicotinic receptors in myeloid cells
Guyot, Mélanie et al.; Brain, Behaviour, and Immunity 8 (2019) 238-246
Implanted Nerve Electrical Stimulation allows to Selectively Restore Hand and Forearm Movements in Patients with a Complete Tetraplegia
Wafa Tigra, Christine Azevedo, Jacques Teissier, Anthony Gelis, Bertrand Coulet, Jean-Louis Divoux, David Guiraud (2019)
bioRxiv 534362; doi: https://doi.org/10.1101/534362
The revolutionary future of bioelectronic medicine.
Bioelectron. Med. 1:1; Tracey KJ. (2014)
Phasic activation of the external urethral sphincter increases voiding efficiency in the rat and the cat
Christopher L. Langdale, Warren M. Grill; Experimental Neurology 285 (Pt B) 2016 Nov, 173-181; Neurosurgery. 2017 Nov 1;81(5):N38-N40. doi: 10.1093/neuros/nyx451.
Vagal Nerve Stimulation for Inflammatory Bowel Disease.
Kolcun JPG1, Burks SS1, Wang MY1.
An Intraneural Electrode for Bioelectronic Medicines for Treatment of Hypertension.
Sevcencu C, Nielsen TN, Struijk JJ.; Neuromodulation. 2018 Feb 14. doi: 10.1111/ner.12758. [Epub ahead of print]
Exploring selective neural electrical stimulation for upper limb functions restoration
Tigra, David Guiraud, David Andreu, Bertrand Coulet, Anthony Gelis, Charles Fattal, Pawel Maciejasz, Chloé Picq, Olivier Rossel, Jacques Teissier, Christine Azevedo Coste; European Journalf of Translational Myology 2016 26(2), 161-164
Spatial and activity-dependent catecholamine release in rat adrenal medulla under native neuronal stimulation
Kyle Wolf, Georgy Zarkua, Shyue‐An Chan, Arun Sridhar, Corey Smith; Physiological Reports Vol. 4, Iss. 27 (2016 ), 1-13
Cytokine-specific Neurograms In the Sensory Nerve
Benjamin E. Steinberg, Harold A Silverman, Sergio Robbiati, Manoj K Gunasekaran, Téa Tsaava, Emily Battinelli, Andrew Stiegler, Chad E Bouton, Sangeeta S Chavan, Kevin J Tracey, Patricio T Huerta ; Bioelectronic Medicine 2016, 7-17