Our central nervous system (CNS) is a vast and complex network comprised of our brain and spinal cord. This beautifully intricate system communicates via electrical impulses along our nerves. But sometimes, things can go wrong within this complex network due to medical conditions like Parkinson’s disease, chronic pain, and depression.
Since the 1960s, doctors have been exploring how to treat these kinds of medical conditions via a therapy called neuromodulation.
“Our brain cells, called neurons, work together in networks by sending electric impulses,” explained Ahmad El Kouzi, MD, a neurologist with Endeavor Health. “Neuromodulation is the science that studies the alteration of the electric signal at the neuronal network level to help address specific symptoms.”
Neuromodulation can help with medical issues like chronic pain, tremors due to conditions like Parkinson’s disease, seizures due to epilepsy, and even mood disorders like depression.
Types of neuromodulation
Neuromodulation works by stimulating the body’s nervous system. There are different types of neuromodulation, which Dr. El Kouzi differentiates as invasive versus noninvasive.
One noninvasive method involves using medications to adjust chemicals in the brain to help with mood or pain perception.
“Noninvasive types of neuromodulation include medications to treat symptoms like seizures or mood disorders,” he said. “The problem with medications is that they can have side effects and can alter other body functions, which could lead to serious undesired reactions.”
Another noninvasive method involves using magnetic fields to stimulate certain brain areas (e.g., transcranial magnetic stimulation, or TMS). For example, a coil placed on a patient’s head delivers magnetic pulses to the brain to help with neurogenic dysphagia.
On the other hand, invasive methods work by sending electrical impulses to certain areas of the brain or nerves (e.g., deep brain stimulation, or DBS). Invasive neuromodulation methods require minor surgical procedures to implant physical devices within the body to modulate nerve activity.
“Invasive methods like the vagal nerve stimulator, the deep brain stimulator, and the spinal cord stimulator target a specific area of the brain, the spinal cord, or the peripheral nervous system for symptom control while avoiding side effects,” said Dr. El Kouzi.
Because these invasive neuromodulation methods can target specific areas in the brain and spinal cord, these technologies are often able to help patients enjoy symptom control that can be difficult to achieve with medications alone.
“People with essential tremor due to Parkinson's disease may have medication-resistant tremor,” said Dr. El Kouzi. “By targeting a specific collection of neurons in the brain, the tremor may completely resolve.”
This specific targeting via a neuromodulation device can also help lessen symptoms for conditions like epilepsy and obsessive-compulsive disorder.
Future advancements
Experts in neuromodulation have been studying how this therapy impacts patients with depression, and according to Dr. El Kouzi, many physicians are publishing promising results in scientific journals.
“The field is rapidly advancing towards applying precision medicine that targets specific areas of the brain based on patient symptoms,” he said. “Experts are also studying the use of adaptive techniques to deliver electric stimulation as-needed based on feedback from the nervous system.”
Neuromodulation is a rapidly expanding field. Scientists are also studying targeted, less-invasive neuromodulation techniques such as transcutaneous electric stimulation and magnetic stimulation. These methods use electric and magnetic fields to stimulate the nervous system without requiring surgery.
“This field of research is rapidly evolving, and exciting breakthroughs are happening,” said Dr. El Kouzi.
Patient focus at Endeavor Health
As the field of neuromodulation continues to grow, Dr. El Kouzi and his team at Endeavor Health never lose sight of the heart of it all — the patient.
“At Endeavor Health, our patients are the center of our care,” said Dr. El Kouzi. “If a patient will benefit from neuromodulation, we invest our efforts in understanding each patient to help us gauge the right therapy for them based on their specific needs and desires.”
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