Neuromodulation: Past, Present, and Future

XIE Hu-tao, ZHANG Jian-guo

Abstract

Neuromodulation technology is one of the medical fields currently experiencing the most rapid development, witnessing a surge in the types of modulation techniques and a constant expansion of indications. Consequently, hundreds of thousands of patients with functional neurological disorders have benefited from the advancements in the field all over the world. Nevertheless, some challenges remain, for exmaple, the lack of a thorough understanding of the mechanism of neuromodulation, the long-standing controversy over the optimal targets of neuromodulation, the lack of reliable efficacy predictors, and the cumbersome and inefficient mode of postoperative programming. We anticipate that these issues will be resolved with the continued advancement in medical technology and the gradual revelation of the neural network mechanism of brain disorders. More individualized, precise, and intelligent neuromodulation technology will be the main direction of development in the future. Herein, we reviewed and commented on the evolution of neuromodulation technology, the current status of its applications, and its prospective development.

 

Keywords: Neuromodulation, Brain disorder, Deep brain stimulation, Spinal cord stimulation, Vagus nerve stimulation

 

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References


GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol，2019，18(5): 459–480.

GBD 2016 Epilepsy Collaborators. Global, regional, and national burden of epilepsy, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol，2019，18(4): 357–375.

COHEN S P， VASE L， HOOTEN W M. Chronic pain: An update on burden, best practices, and new advances. Lancet，2021，397(10289): 2082–2097.

LU J， XU X， HUANG Y， et al. Prevalence of depressive disorders and treatment in China: A cross-sectional epidemiological study. Lancet Psychiatry，2021，8(11): 981–990.

GILDENBERG P L. Evolution of neuromodulation. Stereotact Funct Neurosurg，2005，83(2/3): 71–79.

BENABID A L， POLLAK P， LOUVEAU A， et al. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol，1987， 50(1/2/3/4/5/6): 344–346.

BOVE F， MULAS D， CAVALLIERI F， et al. Long-term outcomes (15 years) after subthalamic nucleus deep brain stimulation in patients with Parkinson disease. Neurology， 2021: 10.1212/WNL.0000000 000012246[2022-01-05]. https://doi.org/10.1212/WNL.00000000 00012246.

LEE D J， LOZANO C S， DALLAPIAZZA R F， et al. Current and future directions of deep brain stimulation for neurological and psychiatric disorders. J Neurosurg，2019，131(2): 333–342.

SHEN L， JIANG C， HUBBARD C S， et al. Subthalamic nucleus deep brain stimulation modulates 2 distinct neurocircuits. Ann Neurol，2020， 88(6): 1178–1193.

LOZANO A M， LIPSMAN N. Probing and regulating dysfunctional circuits using deep brain stimulation. Neuron，2013，77(3): 406–424.

VEDAM-MAI V， DEISSEROTH K， GIORDANO J， et al. Proceedings of the eighth annual deep brain stimulation think tank: Advances in optogenetics， ethical issues affecting DBS research， neuromodulatory approaches for depression， adaptive neurostimulation， and emerging DBS technologies. Front Hum Neurosci， 2021， 15: 644593[2022-01-05]. https://doi.org/10.3389/fnhum.2021.644593.

MEROLA A， SINGH J， REEVES K， et al. New frontiers for deep brain stimulation: Directionality， sensing technologies， remote programming， robotic stereotactic assistance， asleep procedures， and connectomics. Front Neurol， 2021， 12: 694747 [2022-01-05]. https://doi.org/10.3389/fneur.2021.694747.

ZHANG J， HU W， CHEN H， et al. Implementation of a novel bluetooth technology for remote deep brain stimulation programming: The pre- and post-COVID-19 Beijing experience. Mov Disord，2020，35(6): 909–910.

MEROLA A， ROMAGNOLO A， RIZZI L， et al. Impulse control behaviors and subthalamic deep brain stimulation in Parkinson disease. J Neurol，2017，264(1): 40–48.

FASANO A， LANG A E. Unfreezing of gait in patients with Parkinson's disease. Lancet Neurol，2015，14(7): 675–677.

XIE T， BLOOM L， PADMANABAN M， et al. Long-term effect of low frequency stimulation of STN on dysphagia, freezing of gait and other motor symptoms in PD. J Neurol Neurosurg Psychiatry，2018，89(9): 989–994.

THEVATHASAN W， DEBU B， AZIZ T， et al. Pedunculopontine nucleus deep brain stimulation in Parkinson's disease: A clinical review. Mov Disord，2018，33(1): 10–20.

POZZI N G， CANESSA A， PALMISANO C， et al. Freezing of gait in Parkinson's disease reflects a sudden derangement of locomotor network dynamics. Brain，2019，142(7): 2037–2050.

RIGOARD P， BASU S， DESAI M， et al. Multicolumn spinal cord stimulation for predominant back pain in failed back surgery syndrome patients: A multicenter randomized controlled trial. Pain，2019，160(6): 1410–1420.

GEURTS J W， SMITS H， KEMLER M A， et al. Spinal cord stimulation for complex regional pain syndrome type I: A prospective cohort study with long-term follow-up. Neuromodulation，2013，16(6): 523–529.

DE VOS C C， MEIER K， ZAALBERG P B， et al. Spinal cord stimulation in patients with painful diabetic neuropathy: A multicentre randomized clinical trial. Pain，2014，155(11): 2426–2431.

TSIGARIDAS N， NAKA K， TSAPOGAS P， et al. Spinal cord stimulation in refractory angina. A systematic review of randomized controlled trials. Acta Cardiol，2015，70(2): 233–243.

UBBINK D T， VERMEULEN H. Spinal cord stimulation for non-reconstructable chronic critical leg ischaemia. Cochrane Database Syst Rev，2013，2013(2): CD004001.

KNOTKOVA H， HAMANI C， SIVANESAN E， et al. Neuromodulation for chronic pain. Lancet，2021，397(10289): 2111–2124.

KAPURAL L， YU C， DOUST M W， et al. Novel 10-kHz high-frequency therapy (HF10 therapy) is superior to traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain: The SENZA-RCT randomized controlled trial. Anesthesiology，2015，123(4): 851–860.

DEER T， SLAVIN K V， AMIRDELFAN K， et al. Success using neuromodulation with BURST (SUNBURST) Study: Results from a prospective, randomized controlled trial using a novel burst waveform. Neuromodulation，2018，21(1): 56–66.

DEER T R， LEVY R M， KRAMER J， et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: A randomized comparative trial. Pain，2017，158(4): 669–681.

LEE S W， LI Q， LIBBUS I， et al. Chronic cyclic vagus nerve stimulation has beneficial electrophysiological effects on healthy hearts in the absence of autonomic imbalance. Physiol Rep， 2016， 4(9): e12786[2022-01-05]. https://doi.org/10.14814/phy2.12786.

FAN J J， SHAN W， WU J P， et al. Research progress of vagus nerve stimulation in the treatment of epilepsy. CNS Neurosci Ther，2019， 25(11): 1222–1228.

RYVLIN P， RHEIMS S， HIRSCH L J， et al. Neuromodulation in epilepsy: State-of-the-art approved therapies. Lancet Neurol，2021，20(12): 1038–1047.

ENGLOT D J， ROLSTON J D， WRIGHT C W， et al. Rates and predictors of seizure freedom with vagus nerve stimulation for intractable epilepsy. Neurosurgery，2016，79(3): 345–353.

JAIN P， ARYA R. Vagus nerve stimulation and seizure outcomes in pediatric refractory epilepsy: Systematic review and meta-analysis. Neurology， 2021: 10.1212/WNL.0000000000012030[2022-01-05]. https://doi.org/10.1212/WNL.0000000000012030.

EGGLESTON K S， OLIN B D， FISHER R S. Ictal tachycardia: the head-heart connection. Seizure，2014，23(7): 496–505.

FISHER R S， AFRA P， MACKEN M， et al. Automatic vagus nerve stimulation triggered by ictal tachycardia:Clinical outcomes and device performance--The U. S.E-37 Trial. Neuromodulation，2016，19(2): 188–195.

BOON P， VONCK K， VAN RIJCKEVORSEL K， et al. A prospective, multicenter study of cardiac-based seizure detection to activate vagus nerve stimulation. Seizure，2015，32: 52–61.

XU W， ZHANG C， DEEB W， et al. Deep brain stimulation for Tourette's syndrome. Transl Neurodegener， 2020， 9: 4[2022-01-05]. https://translationalneurodegeneration.biomedcentral.com/articles/10. 1186/s40035-020-0183-7. doi: 10.1186/s40035-020-0183-7.

ROEDIGER J， DEMBEK T A， WENZEL G， et al. StimFit-A data-driven algorithm for automated deep brain stimulation programming. Mov Disord，2022，37(3): 574–584.


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