Biology, Engineering, Medicine and Science Reports

Gut Microbes: Nature’s Hidden Chemists with the Potential to Synthesize Therapeutics

Arun HS Kumar — Thu, 03 Jul 2025 00:00:00 +0000

The human gut microbiome, once considered a passive collection of commensal organisms, is now recognized as a dynamic biochemical factory. Among its many functions, one of the most remarkable is its capacity to synthesize complex bioactive compounds, including metabolites with pharmacological activity. This article reviews recent discoveries highlighting the drug-like molecules produced by gut microbes, explores the implications for drug discovery and personalized medicine, and proposes a framework for leveraging microbial biosynthesis as a novel therapeutic frontier.

Peripheral Nerve Stimulation Enters the Mainstream: A New Era for Long-Term, Non-Pharmacologic Pain Management

Arun HS Kumar — Thu, 03 Jul 2025 00:00:00 +0000

Chronic pain affects over 150 million individuals across Europe and the United States, posing a major public health challenge due to its complexity, persistence, and limited treatment success. This report briefly outlines a recent study presenting the largest real-world registry to date on micro-implantable peripheral nerve stimulation (PNS), including over 2,200 patients with chronic peripheral neuralgia or neuropathy. In this study 94% of patients reported clinically meaningful improvements which highlights the broad applicability, consistency, and durability of micro-IPG PNS in clinical management of chronic pain. Compared to conventional non-pharmacologic modalities such as CBT, physical therapy, acupuncture, and TENS, implantable PNS offers deeper, more targeted neuromodulation without reliance on patient adherence or exposure to systemic side effects. While challenges such as surgical implantation, patient selection, and cost remain, PNS stands poised to become a front-line, precision-based therapy for chronic neuropathic pain. To realize its full potential, broader access through primary care integration, provider training, digital support tools, and reimbursement reform is essential. As healthcare shifts away from opioids, PNS offers a transformative option to address chronic pain with long-term efficacy, safety, and scalability.

A Nose Towards the Future: Reimagining Deep Brain Stimulation with Deep Focus

Arun HS Kumar — Thu, 03 Jul 2025 00:00:00 +0000

Neuromodulation is undergoing a paradigm shift, moving beyond the binary of invasive versus non-invasive interventions. This report describes two emerging techniques, DeepFocus and Vagus Nerve Stimulation (VNS) that exemplify this evolution. DeepFocus, utilizes nasal anatomical access to deliver focal electrical stimulation to deep brain regions implicated in mood and reward, such as Brodmann area 25 and the medial orbitofrontal cortex. Paired with the DeepROAST computational platform for precise current modelling, DeepFocus demonstrates strong, targeted electric fields in cadaveric studies without requiring craniotomy. In contrast, VNS, an approved therapy for epilepsy, depression, and stroke rehabilitation, modulates brain function indirectly via afferent vagal pathways and shows durable clinical benefit, particularly when paired with task-specific rehabilitation. While DeepFocus remains in the preclinical stage, it offers unprecedented deep brain targeting with minimal invasiveness. VNS, though requiring implantation, is already integrated into standard care. These techniques are not mutually exclusive but represent complementary strategies in a growing toolkit of personalized neuromodulation that promise to transform treatment for neurological and psychiatric disorders.

Rewiring Recovery by Vagus Nerve Stimulation as a Durable Therapy for Post-Stroke Upper Limb Impairment

Arun HS Kumar — Thu, 03 Jul 2025 00:00:00 +0000

Stroke remains a leading cause of long-term disability worldwide, with persistent Upper Extremity (UE) impairment affecting a significant proportion of survivors and posing a major challenge to functional recovery and quality of life. Conventional rehabilitation approaches, including physical and occupational therapy, Constraint-Induced Movement Therapy (CIMT), and neuromodulatory adjuncts, offer modest gains, particularly when initiated early. However, these benefits often plateau in the chronic phase, leaving many patients with enduring deficits. The VNS-REHAB trial marks a pivotal advancement in post-stroke rehabilitation by pairing Vagus Nerve Stimulation (VNS) with task-specific motor training. Unlike traditional uses of VNS in epilepsy and depression where stimulation is continuous or intermittent, this approach delivers VNS in a time-locked manner during rehabilitation, enhancing neuroplasticity and motor relearning. Clinical outcomes from this randomized controlled trial demonstrate not only significant improvements in motor function but also durable, patient-relevant gains persisting for at least one year. The success of this intervention reflects a broader evolution of VNS as a neuromodulatory tool, with expanding applications in epilepsy, treatment-resistant depression, migraine, inflammatory disorders, and cognitive dysfunction. Mechanistically, VNS engages central monoaminergic pathways, modulates cortical excitability, reduces inflammation, and amplifies experience-dependent plasticity, positioning it as a potent plasticity-enhancing adjunct in neurorehabilitation. While surgical implantation and patient selection pose challenges, the findings redefine the scope of recovery in chronic stroke, offering renewed hope for meaningful functional restoration long after injury.