Cracking the neural code, treating paralysis and the future of bioelectronic medicine

Abstract

The human nervous system is a vast network carrying not only sensory and movement information, but also information to and from our organs, intimately linking it to our overall health. Scientists and engineers have been working for decades to tap into this network and ‘crack the neural code’ by decoding neural signals and learning how to ‘speak’ the language of the nervous system. Progress has been made in developing neural decoding methods to decipher brain activity and bioelectronic technologies to treat rheumatoid arthritis, paralysis, epilepsy and for diagnosing brain‐related diseases such as Parkinson's and Alzheimer's disease. In a recent first‐in‐human study involving paralysis, a paralysed male study participant regained movement in his hand, years after his injury, through the use of a bioelectronic neural bypass. This work combined neural decoding and neurostimulation methods to translate and re‐route signals around damaged neural pathways within the central nervous system. By extending these methods to decipher neural messages in the peripheral nervous system, status information from our bodily functions and specific organs could be gained. This, one day, could allow real‐time diagnostics to be performed to give us a deeper insight into a patient's condition, or potentially even predict disease or allow early diagnosis. The future of bioelectronic medicine is extremely bright and is wide open as new diagnostic and treatment options are developed for patients around the world.

Molecular and Functional Neuroscience in Immunity

“…However, it is an open question whether other pathogens generate different brain representations and whether those would be different from stimuli that act through the same nerves but are not directly related to immune homeostasis, e.g., metabolic molecules. The use of neural decoding technology to further decipher pathogen and immune molecule signals via peripheral nerves and in the CNS will be useful in gaining more specific insight (135). Elucidating brain representations of peripheral immune functions and highlighting the specific contribution of sensory immune signaling will enable a broader view of the immunological homunculus.…”

“…Current technology, including deep brain stimulation, transcranial magnetic stimulation, and transcranial direct current stimulation (153, 154), may one day be redirected to treating inflammatory and autoimmune conditions. The rapidly growing field of bioelectronic medicine generates breakthrough technological advances in treating paralysis and other diseases by utilizing closed-loop devices (135, 155, 156). It is exciting to envision the future use of closed-loop devices in deciphering and regulating neuro-immune communication.…”

“…This symbiotic relationship has been integral to the development of bioelectronic medicine, in which advances in neurobiology are transformed into novel treatments of inflammatory diseases and a broad spectrum of other diseases with limited treatment options (135, 155, 156). …”

Printable microscale interfaces for long-term peripheral nerve mapping and precision control

“…Furthermore, we demonstrate flexible, precision control of an end organ (here: the songbird syrinx, a complex vocal organ containing six muscles (Goller and Suthers, 1996)) to produce distinct, physiologically relevant articulatory states -in this case stereotyped, fictive vocalizations. Such stable mapping and modulation may enable longitudinal rather than cross-sectional experiments, allowing studies of how PNS dynamics are shaped by developmental processes, how changes in nerve signaling correlate with biomarker patterns during disease progression, and whether peripheral neural plasticity can be directed therapeutically via modulatory interventions (Bouton, 2017;Famm et al, 2013;Ganguly et al, 2011;Grill et al, 2009;Lütcke et al, 2013;Marder and Goaillard, 2006).…”

Interfacing with the nervous system: a review of current bioelectric technologies

“…Bioelectronic medicine, as a field, developed from work on modulation of neural networks to treat pathologies (e.g., vagus nerve stimulation has been used to successfully activate the inflammatory reflex and improve rheumatoid arthritis symptoms) [62]. Other examples of bioelectronic medicine include implantation of electrodes on the cortex itself to decode neural signals and drive movement of prosthetic limbs [16,17].…”