Electricity is revolutionizing medicine: find out how it’s applied to depression and inflammation

Signal amplification

In 2010, Chad Bouton, a medical engineer and researcher at the Feinstein Institutes for Medical Research, was testing electrodes implanted in the brain to help paralyzed patients regain movement. In 2019 he wondered if he could use electricity to help patients without opening their skulls.

In most cases of extremity pain or numbness after accidents, the nerve or spinal cord is only partially severed. This appears to be the case with Sharon Laudessi’s thumb injury, which means that A small amount of electrical signals can be transmitted from the brain between the brain and the limb; It is not enough just to provoke a sensation or start a movement.

Bouton and his team suspected that by boosting the signal, they could help Odyssey’s brain communicate with his thumb again. But for this they needed to map the remaining neural connections.

To determine the ideal location for the electrical patch on Sharon’s neck, the team stimulated and moved the patch and stimulated and moved the patch, until they found the spot that only allowed the bandage to contact her hand and not send false signals. All on your body.

Stimulating a Laudisi patch is like turning up the volume on a speaker that has been partially blocked by a piece of furniture. Once she found the location that increased the signals to her thumb, Sharon wore the electrode patch once a week for an hour at a time for eight weeks.

at the end of that time, Laudisi was able to generate 715% more power with his thumb. Now his thumb is no longer as strong or floppy as it was before, but he can press down on the pen, use the keys, and hold his shirt. “I don’t think there are words to describe how impressive it is,” he says.

Botton says it still The cost of such treatment cannot be estimated If approved by the US Food and Drug Administration (FDA), but he believes it “would be affordable and accessible to many who could benefit from it.”

Ignition short circuit

When he was training as a surgeon, Tracy, CEO of the Feinstein Institute, was caring for a young girl in the burn unit at New York Hospital. Died in her arms. “We did not know the cause of his death,” he says. “It was annoying.” But later, after learning that he died of sepsis, he decided to devote his future research to this disease.

He and his team discovered a protein, tumor necrosis factor (TNF), which they believe was responsible for the young girl’s death. The researchers described the role of tumor necrosis factor in promoting inflammation to neutralize invading pathogens such as bacteria and viruses, and its sinister ability to attack body tissues. Excessive inflammation can cause sepsis, shock, and even cellular storms, a result of overactive immune cells that can exacerbate diseases such as COVID-19 by damaging the very tissues that the immune system is trying to protect and heal. If you can block TNF in a patient with dangerously elevated cytokine levels, “you can cut disease fuel,” says Tracy.

Tracy’s findings in the 1980s led to the emergence of Development of drugs to inhibit the TNF protein and reduce inflammation. Many of these medications, such as Enbrel and Remicade, are now used to treat autoimmune diseases in which a person’s immune system destroys healthy tissue.

But these drugs don’t work for all patients, so Tracy thought there might be a better way to target the inflammation. He suspected that because the autonomic nervous system reflexively controls blood pressure, digestion, and other processes, There must be a reaction that controls the inflammation. Focus on the vagus nerve, a dense bundle of about 100,000 nerve fibers that travel from the brain, along each side of the neck, through the heart, lungs, and chest, and down to the large intestine.

“We found out Electrical signals in the vagus nerve are like the brakes on your car. It stops TNF, the inflammatory system, from breaking down,” says Tracy. Animal studies have shown that if the vagus nerve is cut, harmful inflammation can increase, exacerbating autoimmune diseases.

Tray and his team have developed an implantable device, less than a centimeter long, that is placed inside the neck and stimulates the vagus nerve, thereby reducing TNF production. Early devices were attached to batteries implanted under a patient’s collarbone, but later versions are the size of a tiny fingernail and can be charged by wearing a metal charging collar once a week or so.

The neurons that make up the vagus nerve are involved in countless processesTracy explains that the device only targets those that regulate TNF because they are so sensitive compared to surrounding neurons.

There are hundreds of clinical trials on Clintrials.gov (the official US government website for clinical trials) testing forms of vagus nerve stimulation to treat conditions ranging from COVID-19 to chronic pain. Some applications have more scientific backing than others, Tracy notes, citing stroke recovery (for which the FDA has already approved a vagus nerve device) and controlling inflammation.

For other indications, he emphasized, scientists may not yet understand the mechanisms. He is also suspicious of those who claim that they stimulate the nerve from outside the skin rather than implanting an electrode. Wondering “How do they know what they’re doing?” He stressed that researchers must start by identifying specific targets such as tumor necrosis factor (TNF) before testing treatments.

(Related content: End of inflammation? New approach could treat dozens of diseases)

Electrotherapy in the future

Although scientists often think that electrical communication occurs between neurons, Michael Levine, a biologist and computer scientist at the Wyss Institute in Boston, points out that all cells in the body communicate through electricity. They have channels in their membranes that open and close, allowing charged ions to flow in and out of neighboring cells, affecting how they grow and work together. Besides molecular signals, electrical gradients between cells help signal to the developing fetus that it should have two eyes, for example, and the space between them.

“This is really the future: Manipulating this natural flow of information. We want to be able to program the thing with the exact currency it’s using,” says Levine.

Instead of stimulating individual cells, Levine works to change Spatial distribution of electronic signals in different areas of the body to drive groups of cells to work together for healing or regeneration. He compares his strategy to software programming of the body’s genetic machinery.

This means that bioelectrical treatments can go far beyond stimulating individual cells with electrodes.

In frogs, for example, he and his team used computational analysis to determine the ideal electrical environment to stimulate limb regeneration. As tadpoles, these animals can regenerate lost tissues, but lose most of this ability as they mature.

The analysis allowed him to choose five drugs that would open and close cell channels to reach the desired electrical state. After amputating the animal’s hind leg, they created a portable bioreactor with these five drugs. After just 24 hours of wearing the reactor, the animal’s limbs continued to grow for 18 months. The new limb was not fully grown, but it had skin, bone, blood vessels, and nerves..

Levin explained that it will take scientists some time to learn the different electrical states that direct the activity and development of human cells. But then, keep in mind that there is not much standing in the way of progress. There are actually many drugs that can be used in these treatments, such as those found in the frog bioreactor. Scientists just need to know how and when they are combined to create the electrical environments the body would need.

Levine says deep brain stimulation and vagus nerve stimulation are “good applications” of bioelectrical medicine. “I just want people to understand that this is the tip of the iceberg.”

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