The Start of a New Chapter in Medicine: Bioelectronic Medicine

Bioelectronic medicine is the study of the activities that take place within the nervous system via device technology that reads electrical activity within the body. Modulating this activity opens new doors to real-time diagnostics of patients’ nervous systems and bodily performance, which can help develop new treatment. Such treatments are being developed by surgeons all around the world, including neurosurgeon Kevin Tracey, a pioneer in the field of bioelectronic medicine and president of the Feinstein Institute for Medical Research. 

Dr. Tracey has a TedTalk concerning the science behind why septic shock happens. Septic shocks are life-threatening conditions that occur when blood pressure drops dangerously low after infection. Dr. Tracey’s experiment found that it was not bacteria, but actually the immune system that directly caused the shock by creating too much tumor necrosis factor (TNF), a multifunctional cytokine (a type of protein) that plays important roles in cell survival, differentiation, and death.

Further investigating how the immune system causes septic shocks, Dr. Tracey studied what happens to rats when they experience strokes. He gave the rats an experimental drug to induce a stroke, and as expected, the drug blocked TNF production in the brain. But that wasn’t the only place it was blocked; what Dr. Tracey found “baffling” was that TNF was blocked throughout the entire body. With no previously known connections between the brain and TNF production in the immune system, Dr. Tracey and his team began to search for such a connection, which ultimately led them to the vagus nerve. This nerve plays an important role in the regulation of metabolic homeostasis, which controls specific involuntary body functions such as digestion, heart rate, and the immune system. However, through this experiment, Dr. Tracey discovered that the vagus nerve was also controlling TNF production throughout the body, proven by the electrical stimulation of the vagus nerve in rats, which turned off TNF in the body. 

Applying this discovery to patient treatment, a device can use electrons to replace monoclonal anti-TNF, which downregulates TNF-induced immune responses through a process called vagus nerve stimulation. By electrically stimulating the vagus nerve, brain activity can be altered in order to treat certain conditions. There are several devices available for vagus nerve stimulation, including an implantable device that has been FDA-approved for treating epilepsy, a seizure disorder, and depression. This process is done by surgically implanting the device under the skin of the chest, using a wire to connect the device to the left vagus nerve, which is more likely to contribute to the condition. Another FDA-approved vagus nerve stimulation device for stroke rehabilitation uses exercise to create new pathways in the brain to help patients regain function in their hands or arms.

It almost seems surreal that neural signals in the body can be deciphered and modified to replace medications through bioelectronic medicine. By beginning to replace some medications with bioelectronic treatments, the damaging side effects listed on the backs of standard prescription drugs could be avoided entirely.