Editorial: Electric Stimulation in the Eye and Brain - Advancements and Applications

Daisy Y. Shu¹Yukari Nakano²Kin-Sang CHO³Anton Lennikov^3*

• ¹University of New South Wales Medicine & Health, Sydney, Australia
• ²Kabushiki Kaisha Nidek, Gamagori, Japan
• ³Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, United States

Electrical stimulation (ES), once regarded as a niche or experimental intervention, has rapidly emerged as a versatile and powerful therapeutic approach for modulating, preserving, and restoring neural function in both the eye and brain at clinical (1)(2)(3) and preclinical levels (4)(5)(6). The origins of ES date back to early explorations of neurophysiological excitability, but it is only in recent decades, with the advent of advanced bioengineering, neuroimaging, and molecular techniques, that ES has gained traction as a viable therapeutic modality. This Research Topic features eight articles, including six original research articles, one review, and one case report, that collectively illustrate ES's broad therapeutic potential and mechanistic insights. These contributions reinforce the concept of the eye as a window to the brain, offering a unique platform to explore the mechanistic and clinical impact of ES across multiple dimensions-from neuroprotection and prosthetic restoration to cellular reprogramming and neurological rehabilitation.Historically, ES in ophthalmology has predominantly been associated with retinal prosthetics aimed at restoring vision through direct stimulation of retinal neurons. However, the work by Yoo et al. (7) broadens this paradigm by introducing the concept of modulation efficiency ratio (MER), a novel metric comparing the responsiveness of retinal ganglion cells (RGCs) in health versus degenerated primate retina. Their findings illustrate that pathological hyperactivity in diseased retinal tissues significantly impairs RGC responsiveness to ES. This critical insight underscores the necessity for developing adaptive stimulation strategies tailored specifically to the altered biophysical environment of diseased tissues, marking a pivotal shift from a solely restorative focus toward proactive neuroprotective strategies. Effective therapeutic ES demands not only precision in waveform and dosage, but also stable and effective interfaces with the neural substrate. Addressing this critical need, Shpun et al. (11) present compelling data on how biomimetic surface modifications, using integrin-targeted peptides like RGD and YIGSR, significantly enhance the retinal cell adhesion gold electrode surfaces. Their interdisciplinary study bridges material science and cellular biology, establishing foundational design principles for next-generation neuroelectronic devices that prioritize both electrical performance and biocompatibility.Similarly, Abbott et al. ( 12) present a minimally invasive, chronically implantable suprachoroidal device engineered for long-term neuroprotective stimulation. Their rigorous preclinical safety assessment in feline models confirms not only biotolerance, but also positional stability and minimal inflammatory response, all critical prerequisites for successful clinical application.Together, these bioengineering-focused studies demonstrate that successful ES therapy is inseparable from the interface: where electrical signals interact with biological tissues. Better adhesion, precise localization of current delivery, and demonstrated long-term safety will dramatically increase the translational viability of ES.The therapeutic scope of ES is not limited to the retina. Indeed, two studies in this collection extend the therapeutic promise of ES into the domain of post-stroke visual rehabilitation, involving re-engagement of cortical plasticity. Both studies underscore the synergistic potential of pairing ES with behavioral therapy, achieving enhanced visual performance and facilitating large-scale neural network reorganization.Crucially, these cortical stimulation studies mirror the common themes emerging from retinal ES research: whether at the level of the retina or the cortex, ES can engage endogenous repair pathways, rewire surviving circuits, and restore meaningful function.Taken together, the studies in this Research Topic advance a compelling new framework: ES as a versatile, systems-level therapy for neurodegeneration, circuit dysfunction, and tissue repair across retinal and cortical networks. What was once considered speculative is now emerging as a promising clinical therapy, propelled forward by rigorous experimentation, innovative models, and advancements in device engineering. We are witnessing the evolution of an interdisciplinary field that integrates bioelectric mechanisms, neurobiology, material science, and rehabilitative medicine into a coherent therapeutic framework. This collection stands as a testament to the transformative power of electricity, not only to stimulate but also as a therapeutic tool to protect neural tissues, restore lost function, and heal.