From ancient Egypt’s use of electric fish to treat headaches to the creation of pacemakers for heart rhythm regulation in the 1950s, bioelectronic medicine—an emerging field that utilizes electrical signals rather than drugs to diagnose and treat diseases—has come a long way. But where does the field stand today, and what promising opportunities lie ahead for transformative therapies and diagnostics? New research led by Imanuel Lerman, head of the Lerman Lab at the UC San Diego Qualcomm Institute and UC San Diego School of Medicine, sheds light on the exciting future of bioelectronic medicine.

“This paper is a roadmap for the future of the field,” said Lerman. “We’re planting a flag to show what we’re planning to do and why, providing the resources for those who want to dive deeper into the research.” Published in Bioelectronic Medicine, the study aims to chart the course for bioelectronic medicine’s next phase.

While sophisticated pacemakers are perhaps the most well-known application, bioelectronic medicine has already carved out a significant space in modern healthcare. Implantable devices approved by the U.S. Food and Drug Administration (FDA) are now being used to treat conditions like Parkinson’s disease (via deep brain stimulation), back pain (via spinal cord stimulation), and a variety of neurological and mental health disorders, including epilepsy, depression, stroke, and migraines (via vagus nerve stimulation).

More recently, non-invasive techniques are gaining traction. One such method, transcranial magnetic stimulation (TMS), was FDA-approved for depression in 2008 and has since expanded to treat other conditions, including migraine pain, obsessive-compulsive disorder, smoking cessation, and anxiety-related depression.

Lerman and his team see great promise in the future of bioelectronic medicine, particularly with the rise of non-invasive neuromodulation, which bypasses the need for invasive surgery and offers some unique advantages over traditional pharmaceutical treatments.

Non-invasive neuromodulation is emerging as a powerful tool, offering scalability and convenience over drugs. Unlike medications, which require refrigeration and have complex dosing regimens, bioelectronic devices can run on electricity or batteries and don’t require the user to take a specific dose. This flexibility opens up new possibilities, including the ability to use the body’s own systems to reduce inflammation and regulate other vital processes.

Another groundbreaking development is the potential to create “closed-loop” systems that pair bioelectronic devices with sensors to adjust treatment in real-time based on a patient’s needs. By continuously monitoring biomarkers, these devices could deliver highly personalized care, adapting dosages of treatment on the fly, unlike fixed-dose pharmaceuticals.

Though still in the early stages of development, Lerman and colleagues see closed-loop systems as a game-changer in delivering truly individualized medicine.

Beyond treatment, bioelectronic medicine has the potential to revolutionize diagnostics. Recent research has suggested that the body responds to different pathogens in distinct ways, creating unique “time-series” patterns. These patterns, when monitored, could offer a way to identify infections early and guide tailored treatment strategies.

“The goal is to build a pathogen library,” Lerman explained. “We want to pinpoint the unique signature of each pathogen and use neuromodulation to control inflammation and mitigate the severity of infections.”

Another promising application is in mental health, where inflammation and immune system dysregulation play a critical role in conditions like PTSD, depression, and anxiety disorders. Research has shown that the vagus nerve, which is involved in regulating immune responses, can be a critical target for treatment.

“Many mental health disorders are closely linked to the neuro-immune axis, where inflammation in the brain affects mood and cognition,” Lerman noted. “By assessing and regulating brain inflammation through bioelectronic devices, we could offer targeted treatments with more precision.”

Autonomic neurography (ANG), which can measure nerve activity in the autonomic nervous system, could become a powerful tool in clinical trials, providing objective measures of mental health severity and guiding more personalized, adaptive treatments.

While bioelectronic medicine is still in its infancy, its potential to create individualized, adaptive treatments is vast. The convergence of neuromodulation, real-time sensors, and artificial intelligence could lead to groundbreaking therapies for a wide array of conditions, from chronic pain and neurological disorders to infections and mental health challenges.

“There’s still much to be done,” Lerman concluded, “but the potential for next-generation bioelectronic systems to transform personalized medicine and adaptive treatments is enormous. These technologies could shape the future of healthcare in profound ways.”

By Impact Lab