Neuromodulation

Definition

The targeted modulation of neural activity via electrical, chemical, or other stimuli. Applied to specific neural targets, it can influence pain, movement, autonomic function, and immune regulation without broadly affecting the nervous system.

Invasive and non-invasive approaches

Neuromodulation encompasses a broad range of approaches sharing a core principle: by changing activity in specific nerves or neural circuits, it is possible to change physiological function in targeted ways.

Invasive neuromodulation involves implanting devices that deliver electrical stimulation directly to nerves or specific brain regions. Examples include deep brain stimulation for Parkinson's disease, spinal cord stimulation for chronic pain, and implantable vagus nerve stimulators for epilepsy and depression.

Non-invasive neuromodulation delivers stimulation through the skin, avoiding surgery. Transcutaneous auricular vagus nerve stimulation (taVNS) is one example, accessing vagal pathways through the outer ear. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) target brain circuits non-invasively.

In the context of inflammation and immune regulation, vagal neuromodulation is the most active area of research. The goal is to stimulate the vagus nerve precisely enough to engage the cholinergic anti-inflammatory pathway without producing unintended systemic effects.

Reviewed by

Ulf Andersson

Professor of Pediatric Rheumatology, Karolinska Institutet

Worked at Karolinska for five decades as a clinician and a basic scientist focusing on inflammation. Co-discoverer of HMGB1 as the prototype alarmin molecule. Honorary doctor at Hofstra University in New York. Highly Cited Clarivate Researcher Web of Science awards.

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