Electrical neuromodulation therapy for inflammatory bowel disease

Abstract

Inflammatory bowel disease (IBD) is an inflammatory disease of the gastrointestinal (GI) tract. It has financial and quality of life impact on patients. Although there has been a significant advancement in treatments, a considerable number of patients do not respond to it or have severe side effects. Therapeutic approaches such as electrical neuromodulation are being investigated to provide alternate options. Although bioelectric neuromodulation technology has evolved significantly in the last decade, sacral nerve stimulation (SNS) for fecal incontinence remains the only neuromodulation protocol commonly utilized use for GI disease. For IBD treatment, several electrical neuromodulation techniques have been studied, such as vagus NS, SNS, and tibial NS. Several animal and clinical experiments were conducted to study the effectiveness, with encouraging results. The precise underlying mechanisms of action for electrical neuromodulation are unclear, but this modality appears to be promising. Randomized control trials are required to investigate the efficacy of intrinsic processes. In this review, we will discuss the electrical modulation therapy for the IBD and the data pertaining to it.

Dorsal Root Ganglion Stimulation for the Management of Inflammatory Bowel Disease: A Case Report

“…The successful application of DRGS in this case report adds to the growing body of evidence supporting the use of electrical neuromodulation therapy in managing IBD. 7 The sustained response observed in our patient, with significant improvements in abdominal pain, bowel function, and quality of life, highlights the therapeutic potential of This manuscript was handled by: Christina L. Jeng, MD, FASA.…”

“…The incomplete response to conventional therapies in refractory cases underscores the need for alternative treatment modalities, including those that target neural pathways involved in symptom generation. 7 There are several animal and human studies regarding the treatment of IBD with bioelectric neuromodulation, mostly with vagal or sacral nerve stimulation, but none of which comment on chronic pain relief outcomes. 7 DRGS was considered in this case because of the positive response to splanchnic nerve blocks and to primarily address chronic pain.…”

“…7 There are several animal and human studies regarding the treatment of IBD with bioelectric neuromodulation, mostly with vagal or sacral nerve stimulation, but none of which comment on chronic pain relief outcomes. 7 DRGS was considered in this case because of the positive response to splanchnic nerve blocks and to primarily address chronic pain. The therapy was selected over other modalities including spinal cord stimulation based on our prior experience treating visceral abdominal pain 8 and sympatheticallymediated conditions 9 with DRGS.…”

Neuromodulation and the Gut-Brain Axis: Therapeutic Mechanisms and Implications for Gastrointestinal and Neurological Disorders

“…Neuromodulation interventions showcase significant potential in modulating inflammation within the gut [182]. By exerting influence over immune responses and inflammatory pathways, these techniques contribute to a notable reduction in inflammation and its associated detrimental effects on GI tissues.…”

Bioelectronic modulation of carotid sinus nerve to treat type 2 diabetes: current knowledge and future perspectives

“…This therapeutic approach may also have high acceptance among patients, as it may, in the future, require minimally invasive procedures while offering less interference in daily activities compared to current therapeutic options (Famm et al, 2013;Birmingham et al, 2014;Pavlov and Tracey, 2019;Gonzalez-Gonzalez et al, 2024). Bioelectronic medicine has been tested in animal models for several diseases: bladder underactivity (Chen et al, 2021), bladder overactivity (Fletcher, 2020) resistant and chronic hypertension (Annoni et al, 2019), asthma (Mehmed, 2015), and in clinical studies for chronic auto-immune disorders, such as rheumatoid arthritis (Levine et al, 2014;Koopman et al, 2016;Zachs et al, 2019;Genovese et al, 2020), inflammatory bowel disease (Bonaz et al, 2016;Yasmin et al, 2022), and systemic lupus erythematosus, among others. Stimulation of several autonomic nerves has been applied for treating these and other diseases in clinical studies as well, e.g., vagus nerve stimulation was used for obesity (Morton et al, 2016); stimulation of the carotid sinus for hypertension (Heusser et al, 2010) and heart failure (Zile et al, 2020; splenic nerve stimulation is currently under clinical studies for the treatment of rheumatoid arthritis) 1 and sacral nerve stimulation for inflammatory bowel disease (Pikov, 2023) among others.…”