About this Research Topic
The therapeutic use of electrical stimulation to influence biological functions and/or pathological processes in the body has been recently termed “electroceuticals”. In this Research Topic, we will cover the most commonly used techniques of “neural electroceuticals," i.e. those types of electrical modulation of the brain that seem to represent the new frontiers both to treat neurological and psychiatric diseases when no other effective treatments are available as well as to enhance cognitive functions.
The rapid increase of neurological and psychiatric disorders in the high and middle income countries in the last 20 years and their consequent impact on public health drove the exponential rise in research activity on neural electroceuticals, in order to develop complementary/alternative interventions to the traditional pharmaceutical or, in some psychiatric conditions, brain lesion options. The enthusiasm toward this approach is due to the fact that the effects of electrical stimulation are reversible to a certain extent. Electrical neuromodulation can be achieved in several ways, some of which are invasive (i.e. they require surgical intervention) such as deep brain stimulation (DBS) or some types of brain machine interfaces (BMI), other are less invasive, such as vagal nerve stimulation (VNS), and some other are not invasive at all, such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and electroconvulsive therapy (ECT). It must be stressed that even when the treatment requires surgery, the progressive miniaturization of technology allows a very focused approach, thus minimizing the risks for patients while maximizing the therapeutic benefits. Some neuromodulation techniques are well-established and routinely used treatments, such as DBS for treating advanced Parkinson’s disease, or patients with essential tremor and dystonia. However, the clinical effects of the majority of these approaches are still under investigation. For instance, the application of DBS for several disorders of mind (e.g. drug-resistant depression, obsessive-compulsive disorders, and addiction) is promising, but still largely controversial. Similarly, there is evidence that TMS and tDCS can improve cognition and ameliorate symptoms in neuropsychiatric disorders, but results tend to have a large variability. The efficacy of VNS and ECT in the treatment of depression surely has a potential but their applicability has been tempered by the appearance of considerable side-effects and by the greatly variance of individual responses. Finally, even though BMIs have recently achieved impressive results in restoring sensory and motor disabilities in neurological patients there are still many steps that have to be made before these devices would become really effective.
All in all, the current fervor for neural electroceuticals techniques contrasts with the paucity of mechanistically understanding of how electrical stimulation causes behavioral changes and, in many cases, of large clinical studies testing unequivocally the benefits. The aim of this special topic is twofold. On the one hand, we will provide the reader with new insights into the progress that has been made in this field. On the other hand, we will also to give room to the discussion of pros and cons of the applicability of neural electroceuticals according to the disease at play.
Keywords: deep brain stimulation (DBS), vagal nerve stimulation (VNS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), BMI (Brain machine interfaces), electroconvulsive therapy (ECT)
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