A Systematic Overview of Bioelectronic Medicine and its Impact on Medical Technology

Bioelectronic Medicine is evolving rapidly, and this is an exciting time to be involved. Continuous innovative preclinical research and development enables the investigation of novel diagnostic and therapeutic approaches in inflammatory and autoimmune illnesses, paralysis, and diabetes, among other conditions. This discipline encompasses material science, organic chemistry, biophysics, atomic Medicine, neuroscience, immunology, bioengineering, electrical, mechanical, and software engineering, mathematics, and computerized reasoning, as well as other essential and therapeutic disciplines [1]. Bioelectronic Medicine aims to advance our understanding of the diagnosis and treatment of infections and diseases such as cancer, rheumatoid joint pain, incendiary internal illness, obesity, diabetes, arthritis, loss of motion, visual impairment, ischemia, organ transplantation, cardiovascular disease, neurodegenerative diseases, and mortality. Bioelectronic Medication is based on electrical motions in the sensory system. Its primary focus is on incorporating information into the administrative parts of the sensory system, as well as advancements that record, stimulate, or inhibit neurological movements to alter specific molecular devices. Bioelectronic technologies are largely used to monitor and control natural cycles, acquire insight into host and microbe physiology and illness etiology, restore musculoskeletal capability and adaptability, and treat mobility loss and other important diseases. Across the globe, innovative preclinical and clinical preliminaries exploring novel diagnostic and therapeutic breakthroughs are being conducted. Bioelectronic Medication encourages contributions from various disciplines, including research, innovation, and medical services, on topics such as concepts, local community impact, administrative and legal implications, and patient criticism. Thus, bioelectronics is a future job, with enormous potential for the general public, as electronics are extremely costeffective when mass-produced. By substituting electrons for pharmaceuticals, that concept represents a significant leap forward in therapeutic safety and efficacy [1,2].

Interfaces are required in bioelectronic medicine to gain access to the following neural systems:

Electrodes

Complementary metal oxide semiconductors, penetrating electrodes made of silicon, fine, life, time, and cuff electrode arrays made of polymers, and so on. Platinum, platinum-iridium, gold, noble metals, alloys, laser-patterned, and others.

Polymers Include Polydimethyl Siloxane (PDMS), polyimide, parylene, fluidized crystal polymer, SU-8 photoresist, sheet or film polyimide, and polyurethane.

Lights

Diodes that emit light for optogenetic stimulation and energy transfer devices such as inductors, antennas, and ultrasonic transducers [3].

Treatment of hypertension with bioelectronic medicine

Antihypertensive pharmacotherapy is successful only to a degree. A significant proportion of patients have blood pressure readings over the guidelines while being treated with at least three medications at maximally tolerated doses, a condition known as resistant hypertension. The sympathetic nervous system is a good homeostatic mechanism for changing hemodynamics during stress or illness. Regrettably, in certain circumstances, this process escapes the carotid sinus’s physiologic regulation, resulting in resistant hypertension via various mechanisms [3]. A carotid sinus lead and a pulse generator comprise the system for giving baroreflex activation therapy in hypertension (Barostim neo system, CVRx, Inc., Minneapolis, Minnesota). The lead has a 40cm lead body that terminates in a circular backer 41 with a 2.0mm iridium oxide– coated platinum–iridium disk electrode. Like how a pacemaker is implanted, a subcutaneous infraclavicular chest wall pocket is formed to fit the pulse generator. The carotid sinus is surgically exposed before the electrodes being placed via a transverse cervical incision over the carotid bifurcation. Sensitivity is determined by observing hemodynamic changes associated with acute baroreflex activation, such as decreases in pulse rate or blood pressure due to increased parasympathetic or decreased sympathetic traffic, or both. After determining the precise location of the electrode, six sutures are introduced through the backer and adventitia in a regular pattern around the perimeter of the electrode backer.

The opposite end of the lead is inserted into the pulse generator pocket through a subcutaneous tube and connected to the pulse generator. Finally, the surgery is completed by closing all incisions. In the absence of side effects such as an increased heart rate or a reduction in blood pressure, treatment is initiated with a low dose [3-6].

Pre-planning

Bioelectronics is a word that has become more often used in recent years to refer to this multidisciplinary field. Progress is expected in all of these sectors for innovation in cross-cutting areas such as measurement and characterization of physiologic regions and neuromodulation. Unlike in previous ages, scientific research is routinely conducted as part of an education program in all countries. As a result, scientists have written thousands of publications. As a result, it was determined to review this emerging subject.

Process of data collection

Due to the ongoing global epidemic, several countries have reported lockdowns, complicating physical data collecting. As a result, it was agreed that data would be gathered over the internet. Google Scholar, Research-Gate, and PubMed search engines were used to gather information. Numerous documents, articles, and paper works on websites were assembled and important information. Several web resources were consulted to obtain an useable outcome. Priority was given to information gathered over the last decade through inquiries and clinical trials. Additionally, necessary data were gathered and analyzed from earlier investigations. Bioelectronic medicine, neuromodulation, hypertension, rheumatoid arthritis, diabetes, central nervous system disorders, and paralysis were used as search terms to locate information on the internet.

We focused on five conditions (hypertension, rheumatoid arthritis, common CNS diseases, diabetes mellitus, and paralysis) in this study and used revolutionary bioelectronic medicine therapy strategies.

Bioelectronic medicine in hypertension

Neurostimulation with bioelectronic medicine, which involves electrical stimulation of the carotid sinus nerve (Hering’s nerve) or the carotid sinus itself to reduce blood pressure, is a last-resort option for treating a patient’s condition when drug-resistant hypertension medication or surgical procedures are either impossible or impractical. To lower blood pressure, people have used electrical stimulation of the carotid sinus nerve (Hering’s nerve) or the carotid sinus itself, and both animals and humans have studied Left Vagus Nerve Stimulation (LVNS) with positive and adequate results [7,8] Table 1.

Table 1: Highlights of researches on the use of neural feedback signals in nerve stimulation for the treatment of hypertension using bioelectronic medicine.

Bioelectronic medicine in Rheumatoid Arthritis (RA)

Numerous studies have demonstrated that the vagus nerve has the ability to control the immune system and decrease inflammation in both viral and inflammatory disorders [8-11]. Cervical vagal stimulation has been proven in a growing number of trials to effectively control experimental and clinical arthritis, particularly in persons who are resistant to traditional antirheumatic medications [12-20] Tables 2 & 3.

Table 2: Highlights of studies and bioelectronic devices that have showed optimistic consequences in preclinical or clinical trials in both in vivo and in vitro models to reduce inflammatory or pro-inflammatory cytokine levels in the treatment of RA.

Table 3: Some recently treatable CNS disease with BME.

Bioelectronic medicine in CNS disease

After implantation, CNS therapy can begin with a low dose of stimulation [21-27]. Gradually stimulation is increased that listed on Table 4.

Table 4: CNS stimulation intensity of BME.

Bioelectronic medicine in Diabetes Mellitus (DM)

Due to the fact that diabetes is a metabolic disease, it can be handled in a variety of ways, including weight loss, metabolic management, glucose utilization or glycemic control, lowering insulin resistance, and modifying insulin activity in the body [28- 41]. BME also focuses on these areas when it comes to managing diabetes Table 5.

Table 5: DM management in several ways that applied CL-BME and neuromodulation.

Bioelectronic medicine in paralysis

Decades of research into how movement information is stored in the brain, as well as the development of chronic neural interfaces and neural decoding methods, have paved the way for neural bypass technology in bioelectronics [42-45] Table 6.

Table 6: Consequence of BME in treatment of paralysis.

We make a few observations about the recent content of Bioelectronic Medicine, which covered several critical aspects of the field’s current state. In bioelectronic medicine, it is critical to focus on how information is encoded and how different brain networks are associated. Numerous investigations and laboratory or clinical experiments on neural decoding (understanding the language of the human nervous system) and functional connectivity mapping have been done, and numerous others are now underway. For instance, developing closed-loop methods and equipment adds a control system to an already vast and complicated control system, such as the human nervous system, which treats diabetes and hypertension. Concentrating on the transfer, storage, and connectivity of information would be critical in bioelectronic medicine for the treatment of paralysis, obesity, and other CNS illnesses such as epilepsy or migraine. We will have a greater understanding of the neurological system in the distant future if we can record, study, and interpret these signals to treat disorders with bioelectronic therapy that does not include any painful drug processes.

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