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Next generation bioelectronic medicine: making the case for non-invasive closed-loop autonomic neuromodulation
Imanuel Lerman1,2,3,4, Yifeng Bu5, Rahul Singh5
1Department of Electrical and Computer Engineering, University of California San Diego, Atkinson Hall, 3195 Voigt Dr., La Jolla, CA, 92093, USA. ilerman@health.ucsd.edu.
Bioelectronic Medicine
|January 20, 2025
Summary
Bioelectronic medicine advances with closed-loop systems integrating monitoring and neuromodulation for brain and body disorders. Future systems aim to dynamically adjust autonomic nervous system function for precision healthcare.
Area of Science:
- Bioelectronic medicine
- Neuromodulation
- Autonomic nervous system regulation
Background:
- Bioelectronic medicine has evolved from basic electrical therapies to sophisticated closed-loop systems.
- Early innovations like pacemakers and deep brain stimulation laid the groundwork for current technologies.
- This review examines the historical and technological trajectory of bioelectronic medicine.
Purpose of the Study:
- To review the progression of bioelectronic medicine, focusing on closed-loop systems.
- To highlight invasive and non-invasive neuromodulation techniques for various disorders.
- To present the potential of closed-loop non-invasive autonomic neuromodulation for personalized healthcare.
Main Methods:
- Review of historical and technological advancements in bioelectronic medicine.
- Emphasis on invasive techniques (implantable devices) and non-invasive methods (focused ultrasound, autonomic neurography).
- Discussion of closed-loop autonomic neuromodulation for conditions like sepsis and chronic inflammation.
Main Results:
- Closed-loop systems offer transformative potential for therapeutic interventions.
- Non-invasive autonomic neuromodulation shows promise for conditions such as sepsis and chronic inflammation.
- Development of dynamic closed-loop systems for autonomic nervous system modulation is a significant opportunity.
Conclusions:
- Knowledge gaps, including signal noise, signal drift, and confounding effects of therapies, hinder current closed-loop autonomic neuromodulation development.
- Continuous feedback and real-time adjustments are key to overcoming these barriers.
- Next-generation closed-loop systems represent the forefront of precision medicine, enabling individualized and adaptive treatments.
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