Bioelectronic Interfaces for Neurological Disorders

Abstract

Bioelectronic interfaces that modulate neural circuits through targeted electrical stimulation offer therapeutic options for neurological disorders refractory to pharmacotherapy, yet the clinical penetration of these devices varies widely across indications and stimulation modalities. We evaluated 216 bioelectronic interface programmes deployed or trialled across neurology centres affiliated with the Nordic Technical University in Stockholm between 2014 and 2024, spanning five modality categories: deep brain stimulation for movement disorders, vagus nerve stimulation for epilepsy and depression, spinal cord stimulation for chronic pain, closed-loop responsive neurostimulation for epilepsy, and peripheral nerve stimulation for inflammatory and autonomic conditions. A Bioelectronic Interface Clinical Index (BICI) was constructed from five sub-scores -- symptom reduction efficacy, stimulation parameter optimisation, chronic device reliability, adverse event profile, and patient quality-of-life improvement -- with weights from regression against sustained clinical programme retention beyond 24 months. BICI correlated with retention at r = +0.84 and discriminated retained from discontinued programmes with an AUC of 0.882. Deep brain stimulation scored highest (mean BICI 0.826), while peripheral nerve stimulation for inflammatory conditions trailed at 0.598. Only 35.2 percent of programmes exceeded the 0.75 threshold. Symptom reduction efficacy carried the largest regression weight (beta = +0.280), followed by chronic device reliability (beta = +0.228)