The Feinstein Institutes for Medical Research has secured a $3 million grant from the National Institute of Neurological Disorders and Stroke (NINDS) to develop groundbreaking technology for precision vagus nerve stimulation (VNS). The research, conducted in partnership with imec, a leading hub for nanoelectronics and digital technologies, aims to revolutionize treatments for a range of chronic inflammatory diseases.
Led by Stavros Zanos, MD, PhD, associate professor in the Institute of Bioelectronic Medicine, the project focuses on developing more precise, safe, and effective methods for stimulating specific fibers within the vagus nerve. This approach could significantly enhance treatment efficacy while reducing unwanted side effects.
Breakthrough in Selective Nerve Stimulation
The research team has developed a novel technique called intermittent, interferential sinusoidal current stimulation (i²CS), which uses short bursts of high-frequency electrical currents to target specific nerve fibers. This method represents a significant advancement over traditional VNS approaches, which typically activate a broad range of nerve fibers indiscriminately.
"We hope to enhance the efficacy of VNS and minimize unintended consequences or side effects," said Dr. Zanos. "This has the potential to revolutionize treatments for conditions like rheumatoid arthritis, inflammatory bowel disease, and heart failure, which are all linked to inflammation."
The vagus nerve, the largest nerve in the body, extends from the brain to various organs including the heart, lungs, stomach, and liver. Its extensive reach makes it an ideal target for bioelectronic medicine, but also creates challenges in delivering precise stimulation.
Anatomical Mapping and Technological Innovation
For the past two years, Dr. Zanos's team has been mapping the microscopic anatomy of the human vagus nerve with support from an NIH SPARC grant. This detailed mapping, combined with the specialized devices developed by imec, provides researchers with unprecedented control over vagal fiber activation.
The i²CS technique employs the principle of temporal interference, where two slightly different high-frequency currents are delivered through separate contacts of a cuff placed around the nerve. This approach enables focal activation of specific fiber groups within the nerve.
"This important grant supports research into new ways to stimulate nerves in the body in order to treat serious medical conditions," said Kevin J. Tracey, MD, president and CEO of the Feinstein Institutes and Karches Family Distinguished Chair in Medical Research. "Dr. Zanos and his colleagues are leading these cutting-edge efforts to selectively activate fibers in the vagus nerve in order to minimize side effects and maximize efficacy."
Promising Clinical Applications
The research has significant implications for treating inflammatory conditions. Recent findings published in Circulation Research demonstrated that neuromodulation can effectively treat pulmonary hypertension, a cardiovascular disease with an inflammatory component, through a noninvasive, ultrasound-based therapy.
"This is a significant step towards personalized bioelectronic medicine," Dr. Zanos noted in relation to the team's recent publication in Nature Communications. "This i²CS treatment gives us the ability to fine-tune nerve stimulation, activating fibers that produce desired therapeutic effects from selected organs, while minimizing the activation of those fibers responsible for side effects."
Traditional VNS methods often trigger physical reactions like coughing or hoarseness due to non-selective fiber activation. The new approach could overcome these limitations by enabling precise targeting of therapeutic pathways.
Advancing Bioelectronic Medicine
The Feinstein Institutes is recognized as the global scientific home of bioelectronic medicine, combining molecular medicine, neuroscience, and biomedical engineering to develop device-based therapies for disease and injury.
This research builds on years of work exploring the link between the nervous and immune systems. Feinstein Institutes researchers have identified neural targets that can be modulated to control the body's immune response and inflammation, potentially offering more effective treatments for arthritis, heart failure, inflammatory bowel diseases, diabetes, and autoimmune conditions.
Beyond inflammation control, the institute's researchers have also developed brain-computer interfaces to help people with paralysis regain sensation and limb function. These advances in bioelectronic medicine could eventually provide alternatives to pharmaceutical treatments, using the body's own nervous system to combat disease.
The collaboration between the Feinstein Institutes and imec represents a significant step forward in the field of neuromodulation, potentially transforming how chronic inflammatory diseases are treated through precise, personalized nerve stimulation approaches.
