Dr Peter Staats, Chief Medical Officer of National Spine and Pain Centers, Chief Medical Officer of electroCore, Inc, and Chair, Board of Examination, World Institute of Pain, describes the bioelectronics revolution and shares its potential
Bioelectronic medicine is an emerging field that’s making waves in the healthcare industry. It harnesses the power of electrical signals in the body to manage and treat disease. The human body has a complex web of neurons and support structures that are incredibly important in inflammation, homeostasis and human disease. Relatively small changes in their electric fields can lead to huge health benefits. In recent years, innovative devices have been developed which stimulate the body to heal itself and return to a healthier state by working in synergy with the neurological system.
These devices and technologies are providing us with a different way of managing disease, and have the potential to revolutionise our approach to a wide range of diseases. One of the unique benefits of bioelectronic devices is that because they target specific neural electrical circuits and regulate electrical impulses in our body, they can more precisely intervene at the source of the problem than some pharmaceutical agents. As a result of their targeted nature and role in the inherent optimisation of the body’s own nervous system they often also have fewer side effects compared to more conventional drugs. The reason for this is that chemical-based treatments typically flood the body without restricting their action to specific organs or tissues. By contrast, bioelectronic devices use the power of our own body’s electrical impulses in place of chemical agents that may lead to unwanted side effects.
Due to the benefits offered by bioelectronic medicine, advocates argue that they could play a leading role in transforming health care in the coming years. I have been implanting devices to modify patients’ electrical signals for a quarter of a century, so the concept is not a new one. However, the field is constantly evolving and recently there have been some exciting breakthroughs. Over the last few years, advancements have been made to delivery systems, including the miniaturisation of devices alongside the emergence of non-invasive treatment options, which effectively removes the need for a surgeon to implant a device.
These advancements have made bioelectronic medicine much more accessible to the masses. People are no longer faced with the expensive costs or the risks associated with a surgical approach to try them. Surgeons previously needed to make an educated guess as to whether a patient would respond well to a costly implant or not. Fortunately, completely non-invasive therapies are available allowing patients and physicians more options and greater flexibility. Patients are now able to try these therapies to see whether they help them, meaning that long-term therapies will only be paid for if they are effective. Furthermore, these devices are often billed monthly like pharmaceutical treatments, as opposed to a singular large surgical cost for something that may not be effective. These developments therefore not only have the potential to save costs for healthcare systems, but also enables us to provide more personalised care as a result.
The growing awareness of the devastating impact of opioid addiction means that now, more than ever, attention is being given towards finding different approaches to treating chronic pain. It is important to recognize the problems that countries such as the USA have faced with what has been termed the ‘opiate crisis’. We must remember that people have turned to opiates to alleviate their unrelenting pain. Instead of simply saying no to opiates, we must instead offer effective and safe alternatives for treating pain, while avoiding the problems of addiction that led to the crisis in the first place.
Let’s take headache as an example. Bioelectronic medicine is sparking interest in the area, offering a safe and effective alternative to control pain. Patients experience a variety of headaches because of an alteration of the excitability and chemical milieu of the brain. When the excitability of the nervous system changes, the production of neurotransmitters also changes and areas of the brain become activated with headaches as a result. By stimulating the vagus nerve, we have been able to show changes in the excitability and production of neurotransmitters to alter electric fields in the brain and are able to treat the pain as a result.
Stimulation of the vagus nerve has also been studied in both animals and humans in modifying peripheral inflammation, as well as central inflammation. A number of companies are studying how the vagus nerve can help with disease from epilepsy to obesity, rheumatoid arthritis and fibromyalgia to name a few.
The innovation and excitement that already surrounds bioelectronic medicine has attracted interest from the medical device and pharmaceutical big players, blurring the distinction between a device and a drug. Boston Scientific, GlaxoSmithKline (GSK) and Medtronic are some examples of those drawn by the promise of bioelectronic medicine. GSK in particular has shown a special interest and has set up a $50 million ‘action potential venture fund’ to support start-up companies that research and develop bioelectronic devices.
But this revolution isn’t a playing field solely for big pharma. So, what can we learn from the approaches taken by smaller technology companies, in the discovery of innovation and novel platforms in this domain?
At electroCore, we’re committed to challenging the status quo through our scientific development, enabling us to be one of the pioneers in this new frontier of medicine. Our mission is to deliver groundbreaking technology that shifts the treatment paradigm in neurology and rheumatology. As part of this, we have developed technology to harness the power of the vagus nerve, the longest nerve in the body, which runs down from the brain to every major organ. It primarily serves as the communication between the brain and the body by bringing information from each organ to the brain. In comparison to most bioelectronic devices, which are surgically implanted, our technology enables us to administer vagus nerve stimulation non-invasively by delivering a signal through the skin to either the right or left branches of the vagus nerve in the neck. This simple action results in a complex response. It affects many key functions in the brain and the body, including neurotransmitter levels, inflammation levels, and metabolism, helping to treat people who suffer from a variety of conditions.
Bioelectronic medicine has the potential to transform the way that pain and disease is understood and treated, driving meaningful improvements in the care and outcomes for patients with chronic and debilitating diseases. The future is bright and advancements that could be potentially life-changing are being made every day. I look forward to seeing its full potential being realised.
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