Bioelectric neuromodulation for gastrointestinal disorders: effectiveness and mechanisms.


Author: Payne SC1,2, Furness JB3,4, Stebbing MJ3,4

Affiliation: <sup>1</sup>Bionics Institute, East Melbourne, Victoria, Australia. spayne@bionicsinstitute.org.

<sup>2</sup>Medical Bionics Department, University of Melbourne, Parkville, Victoria, Australia. spayne@bionicsinstitute.org.

<sup>3</sup>Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.

<sup>4</sup>Department of Anatomy and Neuroscience, University of Melbourne, Parkville, Victoria, Australia.
Conference/Journal: Nat Rev Gastroenterol Hepatol.
Date published: 2018 Nov 2
Other:
  Special Notes: doi: 10.1038/s41575-018-0078-6. [Epub ahead of print]   ,  Word Count: 207  
    The gastrointestinal tract has extensive, surgically accessible nerve connections with the central nervous system. This provides the opportunity to exploit rapidly advancing methods of nerve stimulation to treat gastrointestinal disorders. Bioelectric neuromodulation technology has considerably advanced in the past decade, but sacral nerve stimulation for faecal incontinence currently remains the only neuromodulation protocol in general use for a gastrointestinal disorder. Treatment of other conditions, such as IBD, obesity, nausea and gastroparesis, has had variable success. That nerves modulate inflammation in the intestine is well established, but the anti-inflammatory effects of vagal nerve stimulation have only recently been discovered, and positive effects of this approach were seen in only some patients with Crohn's disease in a single trial. Pulses of high-frequency current applied to the vagus nerve have been used to block signalling from the stomach to the brain to reduce appetite with variable outcomes. Bioelectric neuromodulation has also been investigated for postoperative ileus, gastroparesis symptoms and constipation in animal models and some clinical trials. The clinical success of this bioelectric neuromodulation therapy might be enhanced through better knowledge of the targeted nerve pathways and their physiological and pathophysiological roles, optimizing stimulation protocols and determining which patients benefit most from this therapy.



PMID: 30390018  DOI: 10.1038/s41575-018-0078-6