About this Research Topic
In the past decade, neuroscience research has witnessed dramatic progress in the field of neuromodulation, a medical stimulation technology acting on nerves. It relies on the delivery of electrical stimuli to alter nerve activity/targeted areas. Being a non-drug-based therapy, it is generally safe and, in particular, does not have the side effects of pharmacological treatments (eg biologics, immunosuppressants).
Progress in the field is evidenced by the establishment of various funding programs such as the NIH SPARC (stimulating peripheral activities to relieve conditions) program and the DARPA’s Electrical Prescriptions (ElectRx) program, as well as intensive research on fundamentals, technological development, and emerging clinical applications of neuromodulation.
Indeed, based on the anti-inflammatory (eg anti-TNF), anti-depressive, anti-nociceptive role of the autonomic nervous system, neuromodulation opens new therapeutic avenues in the domain of chronic inflammatory diseases, such as inflammatory bowel diseases (IBD; Crohn’s disease and ulcerative colitis) rheumatoid arthritis (RA) and others immune-mediated diseases, but also chronic pain disorders such as irritable bowel syndrome, fibromyalgia, and others. In particular, neuromodulation of the autonomic nervous system (eg vagal nerve stimulation) is able to restore an imbalance of the equilibrium between the sympathetic and vagal system. In addition, through its central effect on neuronal plasticity and pathways involved in the control of inflammation, pain, and others, neuromodulation has tremendous implications in neurological diseases. The autonomic nervous system is also involved in interoceptive awareness which is perturbated in numerous conditions and restoring interoception is of interest.
Among the novel neuromodulation applications, vagal and sacral nerve stimulation are particularly important. Indeed, pilot studies have shown that vagal nerve stimulation or sacral nerve stimulation is able to improve and/or induce remission in patients with flares of RA or IBD. Vagal nerve stimulation has also potential interest in the treatment of heart failure; Indeed, an autonomic imbalance, with excess sympathetic activation and decreased vagal tone, is involved in the pathophysiology of heart failure.
From a technological perspective, much has been done to ensure progress of this field. Novel implants, with an eye of regards to miniaturized devices, have been developed, thanks to intensive research. In addition, the development of devices able to monitor physiological and or pathological signals such as vagal tone and to restore it is of interest. MRI compatible technology enables the implants as useful tools to further understand neural stimulation mechanisms. Remote programming (and telemedicine in general) could make clinical care easier and less expensive, especially for the majority of patients living in developing areas or during pandemics.
From a mechanical perspective, researchers are investigating in depth the neuroanatomy of existing neuromodulation therapies, possibly leading to novel invasive and non-invasive stimulation applications.
This Research Topic will cover current and future directions in the neuromodulation field, focusing on emerging research outputs, methods, applications, and the translational potential of the different stimulation techniques.
Original research, case studies, and review articles investigating the following subtopics are welcome:
• Novel methods of neuromodulation, such as vagal nerve stimulation, sacral neuromodulation, spinal cord stimulation, peripheral organ stimulation (eg spleen, kidney..), and transcutaneous electrical stimulation of peripheral nerves, either invasive or non-invasive
• Novel applications of neuromodulation for treating peripheral organs, such as gastrointestinal diseases, metabolic disorders, cardiovascular diseases, pulmonary diseases, and neurological disorders
• Fundamental basic research related to neuromodulation such as neuroanatomy of peripheral organs and mapping of autonomic nerves and peripheral nerves
• Advanced technological development to be used for peripheral and autonomic neuromodulation
• Modeling and simulation of autonomic and peripheral nerve functions
• Neuromodulation technologies, including device development, novel technologies, miniaturization, wireless charging, MRI compatible, feedback systems, remote program, etc.
Keywords: vagal nerve stimulation, sacral neuromodulation, peripheral organ stimulation, neuromodulation technologies, implants and miniaturized devices, autonomic and peripheral nerves mapping
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