amplify the signal
In the 2010s, Chad Bouton, a medical engineer and researcher at the Feinstein Institute for Medical Research, was experimenting with 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 limb pain or numbness after accidents, the nerve or spinal cord is only partially severed. It looked like Sharon Loudissi had a thumb injury, which means that A small amount of electrical signaling from the brain can move between the brain and the organ., It is not enough just to ignite the sensation or initiate movement.
Bouton and his team suspected that by amplifying the signal, they could help Loudisi’s brain communicate with her thumb again. But for this they needed to map the remaining neural connections.
To determine the ideal location of the electrode patch on Sharon’s neck, the team stimulated, moved the patch, stimulated, moved the patch until they found the location that allowed the dressing to communicate only with her hand. Allowed and did not send wrong signals. over your body.
Stimulating Loudissi’s neck patch is like turning up the volume on a speaker partially blocked by a piece of furniture. Once they found the spot that maximized the signal to her thumb, Sharon wore the electrode patch once a week for an hour for a total of eight weeks.
at the end of that time, Laodicei was able to generate 715% more force than his thumb, Now his thumb isn’t as strong or flexible as it used to be, but he can press a pen, use keys, and pin his shirt. “I don’t think there are words to describe how impressive it is,” he says.
Bouton says still The cost of such treatment cannot be estimated If approved by the US Food and Drug Administration (FDA), but he believes “it will be affordable and accessible to people who could benefit from it.”
short circuit ignition
While he was training as a surgeon, Feinstein Institute CEO Tracy was caring for a young girl in the burn unit of a New York hospital. He died in her arms. “We didn’t know the cause of his death,” he says. “It was disturbing.” But later, learning that he had died of sepsis, he decided to devote his future research to the disease.
He and his team discovered a protein, tumor necrosis factor (TNF), which they believed to be responsible for the little girl’s death. Researchers describe TNF’s role in promoting inflammation and its more sinister ability to attack the body’s own tissues to neutralize invading pathogens such as bacteria and viruses. Excessive inflammation can lead to sepsis, shock, and even a cytokine storm, are the result of overactive immune cells that can worsen diseases like COVID-19 by damaging the tissues that the immune system is trying to protect and heal. If you can block TNF in a patient with dangerously high cytokine levels, “you can cut off the fuel of the disease,” Tracy says.
Because of Tracy’s findings in the 1980s Development of drugs to inhibit TNF protein and reduce inflammation, Many of these drugs, such as Enbrel and Remicade, are now used to treat autoimmune diseases in which a person’s immune system destroys their healthy tissue.
But those drugs don’t work in all patients, so Tracy thought there might be a better way to target inflammation. They suspected that since the autonomic nervous system apparently controls blood pressure, digestion and other processes, Must have a reflex that controls inflammation, They focused on the vagus nerve, a dense bundle of about 100,000 nerve fibers that run from the brain, on each side of the neck, to the heart, lungs, chest, and large intestine.
“We found that Electrical Signaling in the Vagus Nerve Is Like Your Car’s Brake, “It keeps the TNF system, the inflammatory system, from getting worse,” says Tracy. Animal studies have shown that if the vagus nerve is ruptured, harmful inflammation can increase, exacerbating autoimmune diseases.
Trey and his team developed an implantable device, less than a centimeter in length, that is placed inside the neck and stimulates the vagus nerve, reducing the production of TNF. Early devices were attached to batteries implanted under the patient’s collarbone, but newer versions are the size of a fingernail and can be charged once or twice a week by wearing a metal charging collar.
The neurons that make up the vagus nerve are involved in countless processes.But the device only targets those that regulate TNF because they are more susceptible than the surrounding nerve cells, Tracy explains.
There are hundreds of clinical trials at Clinical Trials.gov (the official US government site for clinical trials) 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 inflammation control.
As for other clues, he stresses that scientists don’t yet truly understand the mechanism. He is also skeptical of those who claim to stimulate the nerve from outside the skin instead of applying electrodes. “How do they know what they’re doing?” He asks, researchers should start by identifying specific targets, such as TNF, before testing treatments.
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Electricity treatment in the future
Although scientists often think that electrical communication occurs between neurons, Michael Levine, a biologist and computer scientist at the Wyse Institute in Boston, explains that all cells in the body communicate via electricity. Their membranes have channels that open and close, allowing charged ions to flow in and out of neighboring cells, affecting how they move and work together. Along with molecular cues, electrical gradients between cells help signal to a developing embryo that it should have two eyes, for example, and the distance between them.
“This is really the future: manipulate that natural flow of information, We want to be able to program the thing with the exact currency it uses,” Levine says.
Instead of stimulating individual cells, Levine is working to replace Spatial distribution of electronic signals to different areas of the body for groups of cells to work together to heal or reproduce, He compares his strategy to programming software for the body’s genetic hardware.
This means that bioelectrical treatments can go far beyond the stimulation of individual cells with electrodes.
In frogs, for example, he and his team have used computational analysis to determine the ideal electrical environment to stimulate organ regeneration. As tadpoles, these animals can regenerate lost tissue, but as they mature, they lose that ability.
The analysis allowed them to select five drugs that would open and close the cells’ channels to achieve the desired electrical state. After amputating the animal’s hind leg, they built a portable bioreactor with these five drugs. After only 24 hours of reactor wear, the animal’s limb continued to grow for 18 months. The new organ had not fully grown back, but had skin, bone, blood vessels and nerves.,
Levine explained that it will take some time for scientists to figure out the various electrical states that guide the activity and development of human cells. But after that, consider that there is little to stand in the way of progress. Many drugs that can be used in these treatments, such as those already present in frog bioreactors. Scientists only need to know how and when to combine them to create the electrical environment the body needs.
Deep brain stimulation and vagus nerve stimulation are “good applications” of bioelectric medicine, Levine says. “I just want people to understand that this is just the tip of the iceberg.”