Could Electricity Zap Away Chronic Disease?

It used to take Jennie Moore, a retired 60-year-old schoolteacher from Baldwin, New York, nearly an hour to get out of bed. For decades, rheumatoid arthritis left her with debilitating joint pain that made it difficult to dance at weddings and play with her grandkids.

Over the years, Moore tried a long list of medications, including Humira and Orencia, without lasting relief. Then earlier this year, she tried a radically different approach: a recently FDA-approved device that treats inflammation with electrical stimulation instead of another medication.

During a 30-minute surgery, doctors implanted a nerve stimulator the size of a multivitamin capsule into her neck to stimulate a branch of her left vagus nerve, a major communication pathway between the brain and internal organs. Each morning while she sleeps, the device delivers a brief electrical pulse designed to activate a neural circuit that controls inflammation.

A few months into treatment, Moore says that she no longer needs to use her walker to get around the neighborhood. “The pain is less. I'm moving more,” she says. “My husband jokes with me now that I walk better than him.” 

Moore is among the first to benefit from a new generation of bioelectronic medicine, which aims to treat chronic disease by stimulating specific parts of the nervous system rather than relying solely on drugs that circulate throughout the body. Electrical stimulation has been used for decades to treat conditions such as Parkinson’s, epilepsy, depression, and stroke rehabilitation, but many earlier devices required extensive surgery or multiple implanted components.

Now researchers are developing smaller, less invasive devices to treat a wider range of chronic diseases. For people like Moore, they could offer another option when medications don’t work or cause difficult side effects.

How Bioelectronic Medicine Quiets the Immune System

In 1985, a toddler named Janice was admitted to the emergency burn unit at the New York Hospital, where Kevin J. Tracey, now president and CEO of the Feinstein Institutes for Medical Research, was training to be a neurosurgeon. “Janice was surviving from her burn wounds, but inflammation, which came seemingly out of nowhere, caused her to go into shock and die in my arms,” he says. He dedicated his scientific work to figuring out why.

More than a decade later, Tracey discovered what became known as the inflammatory reflex, a neural circuit that helps regulate the body’s inflammatory response. Signals traveling through the vagus and splenic nerves ultimately prompt a subset of T cells in the spleen to release acetylcholine, which helps suppress inflammatory signals from other immune cells.

“We understand how the vagus nerve signals control inflammation better than we understand how most anti-inflammatory drugs work,” he says. For rheumatoid arthritis, some of these drugs come with a black box warning, indicating severe, life-threatening risks, and fail to help an estimated 6 to 21 percent of the people who take them.

That raised a different possibility: If researchers could activate the inflammatory reflex directly, could they control inflammation without relying solely on medication?

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In 2007, Tracey co-founded SetPoint Medical to turn that idea into a treatment for people with difficult-to-treat rheumatoid arthritis. The device sends a short, 60-second electric zap while a person sleeps to tamp down inflammation.

Researchers tested the approach in a pivotal randomized trial involving 242 people with moderate-to-severe rheumatoid arthritis. After 12 weeks, 35.2 percent of those whose devices were activated met the trial’s measure of clinical improvement, compared with 24.2 percent in the control group. Longer-term follow-up also showed continued improvement among some participants. The results helped support FDA approval of the device in 2025.

How Far Can Vagus Nerve Stimulation Go?

The success of SetPoint’s rheumatoid arthritis trial has pushed researchers to ask whether the same approach could work for other diseases.

“Frequently when you have a breakthrough, it’s because no one else is doing it, and when no one else is doing something, people are skeptical, or they simply can’t be bothered,” says David Tuveson, an oncologist and director of the Cold Spring Harbor Laboratory Cancer Center. “But when you have a positive randomized Phase 3 trial, most people’s eyebrows go up.”

Now, SetPoint Medical is moving forward with trials of two common autoimmune conditions: Crohn’s disease and multiple sclerosis. Earlier this year, the company began recruiting for an early-stage, 60-person study of relapsing-remitting multiple sclerosis to see whether the device could improve standard treatment. Tracey is also interested in whether it offers even more benefits when provided to patients at an earlier stage of rheumatoid arthritis.

Other potential uses are much further from clinical practice. A handful of early human trials are testing vagus nerve stimulators for conditions including pain, Parkinson’s, and Long COVID. Some are using an even less invasive type of device called an auricular nerve stimulator, which targets branches of the vagus nerve through the ear.

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“Many of these effects look like anti-inflammatory responses, and my colleagues and I have done some of these clinical trials,” says Tracey. “The problem is we don't have commercially available devices that have been used in these clinical trials. These are still research tools, and second, virtually all of these studies are pilot studies.”

When Drugs Aren’t Enough

The vagus nerve is only one target for bioelectronic medicine. Researchers are also exploring other nerves and sensory pathways that could offer new options when medications don’t work well or cause difficult side effects.

Tuveson, for example, is studying how nerves interact with the pancreas in pancreatic cancer. His recent research found that certain fibroblasts can recruit sympathetic nerves into the pancreas, where those nerves may help drive inflammation and cancer progression. Researchers do not yet know whether targeting those nerve signals could help treat pancreatic cancer in people.

For overactive bladder, medications can help control symptoms, but more than 70 percent discontinue taking them due to side effects like constipation and the increased risk of cognitive impairment and dementia.

FemPulse is testing an insertable vaginal device that delivers mild electrical stimulation to pelvic nerves involved in bladder control. Its pivotal trial is comparing the device with Detrol, a commonly used medication for overactive bladder. The 151-person trial is expected to finish in 2027.

Meanwhile, Silvia V. Conde, a professor at NOVA Medical School in Portugal, is researching whether targeting the carotid body, a small sensory organ deep in the neck that relays information about the body’s metabolism to the brain, could help treat cardiometabolic disease. When it becomes overactive, Conde’s research suggests it may contribute to metabolic problems.

“If we can control this information coming from the carotid body to the brain,” she says, “we can treat the development of metabolic diseases.”

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So far, much of that work remains in the early stages. Conde has shown in rodents that changing carotid body signaling can affect metabolism, while a pilot study found that people with prediabetes had increased carotid body activity. A device that sends a signal to calm the overactive carotid body could eventually help improve metabolism and blood pressure.

The Limits of Bioelectronic Medicine

The new generation of bioelectronic devices is less invasive than its predecessors, but cost and access could limit widespread adoption.

For treatment-resistant individuals like Moore, who have already tried multiple expensive medications, the tradeoff may be worth it. Some rheumatoid arthritis drugs can cost as much as $90,000 per year. While the initial cost of SetPoint’s device is high, a company-funded analysis suggests it is more cost-effective than some other medications.

Getting insurers to pay for new medical devices can also take years. Medicare reimbursement can take more than five years, while private insurers may wait for more real-world evidence of safety and effectiveness before offering coverage.

And not everyone benefits from bioelectronic medicine. Even with the FDA-approved device for rheumatoid arthritis, some individuals don’t respond as well—or at all—and researchers still don’t know why.

There are technical hurdles, too. Conde notes that researchers are working on developing softer, more flexible materials that would lead to less inflammation and scarring during implantation. They are also working to improve how precisely devices stimulate their targets and to develop algorithms that can optimize the electrical signals they deliver.

For most of the diseases now being studied, it will still take several years of larger clinical trials to know whether these devices are safe and effective. But with the first FDA approval of a minimally invasive device for rheumatoid arthritis, treating some chronic diseases with electrical signals is becoming much less hypothetical for people like Moore.

Every year, Moore’s family gathers in Mongaup State Park where they visit a waterfall. While most of her family climbs down to swim and play, she and her husband have traditionally stayed up top and watched. “I couldn't climb down, and I certainly couldn't walk around on the rocks and in the water,” said Moore. “I'm excited to see if I can get down there this year.”