Bioelectric Medicine: Clinical Applications of the Body’s Electrical System

Language: en

Overview

The human body is an electrical system. Every cell maintains a voltage across its membrane. Every heartbeat is triggered by an electrical impulse. Every thought is an electrical storm in the brain. And yet mainstream medicine has largely ignored the body’s electrical dimension, focusing instead on chemistry — drugs that bind receptors, enzymes that catalyze reactions, genes that encode proteins. The medicine cabinet is full of molecules. It is nearly empty of volts.

This is changing. Bioelectric medicine — the therapeutic manipulation of the body’s endogenous electrical systems — is emerging as a clinical frontier with applications spanning wound healing, bone regeneration, pain management, neurological disease, cancer, and developmental disorders. The tools range from ancient (acupuncture, which may work partly through bioelectric mechanisms) to cutting-edge (optogenetic implants, bioelectronic devices, ion channel pharmacology). The common principle is that the body’s electrical state is not merely a byproduct of health and disease — it is a causal factor that can be therapeutically targeted.

Michael Levin’s work on bioelectric morphogenesis provides the theoretical foundation for this emerging field. If bioelectric signals carry the patterning information that guides development, regeneration, and tissue homeostasis, then manipulating these signals should be therapeutically powerful. The clinical evidence increasingly supports this prediction. From FDA-approved bone stimulators to experimental cancer therapies, bioelectric medicine is moving from laboratory curiosity to clinical reality.

Established Clinical Applications

Bone Stimulation

The oldest and most established bioelectric therapy is electrical bone stimulation for non-union fractures — broken bones that fail to heal with conventional treatment. The scientific basis dates to the 1950s, when Yasuda in Japan and Bassett and Becker in the United States demonstrated that mechanical stress on bone produces electrical signals (piezoelectric potentials) and that applying electrical currents to bone promotes osteogenesis.

Three modalities are currently FDA-approved:

Direct current (DC) stimulation. An implanted cathode delivers 5-20 microamps of direct current to the fracture site. The cathode generates hydroxyl ions and reduces oxygen tension locally, creating an environment that promotes osteoblast activity. Brighton and colleagues at the University of Pennsylvania developed this approach in the 1970s, demonstrating healing rates of 80-90% in previously non-healing fractures.

Pulsed electromagnetic field (PEMF) therapy. External coils generate pulsed magnetic fields (typically 1-100 Hz, 0.1-20 gauss) that induce electrical currents in the bone tissue. The induced currents are thought to stimulate osteoblast proliferation and differentiation through activation of calcium signaling pathways and growth factor production. Bassett and colleagues at Columbia University pioneered PEMF for bone healing in the late 1970s, and the technology has been FDA-approved since 1979. PEMF devices (such as the EBI Bone Healing System and the Orthofix PhysioStim) are widely used for non-union fractures, spinal fusions, and fresh fracture acceleration.

Capacitive coupling. External electrodes placed on the skin on either side of the fracture generate a capacitively coupled electrical field in the tissue. Brighton developed this approach as a non-invasive alternative to implanted electrodes, demonstrating efficacy in randomized controlled trials.

The evidence base for electrical bone stimulation is substantial, with multiple meta-analyses supporting efficacy for non-union fractures (pooled healing rates of 70-90%). The mechanism involves bioelectric signaling through voltage-sensitive calcium channels, activation of the BMP signaling pathway, and promotion of mesenchymal stem cell osteogenic differentiation. It is one of the clearest demonstrations that manipulating the body’s electrical environment can promote tissue regeneration.

Wound Healing

All wounds generate endogenous electric fields — the “current of injury” first described by Emil du Bois-Reymond in the 1840s. When skin is broken, the disruption of the transepithelial potential (normally 15-50 mV, inside negative) creates a lateral electric field that persists until the wound is healed. This electric field is not incidental. It is a critical guidance signal.

Min Zhao at UC Davis has demonstrated that the wound electric field drives electrotaxis — the directed migration of cells along the field lines. Keratinocytes, fibroblasts, endothelial cells, and immune cells all migrate toward the wound center, guided by the endogenous electric field. Disrupting the field (by pharmacologically inhibiting ion transport) impairs wound healing. Augmenting the field (by applying external current) accelerates healing.

Several bioelectric wound-healing technologies are in clinical use:

Wireless microcurrent devices. The Procellera wound dressing (now Arthrex WoundSeal) contains a printed pattern of silver and zinc microcells that generate microcurrents (1-10 microamps) in the presence of wound fluid. Clinical studies have shown accelerated healing of chronic wounds, burns, and surgical incisions.

Pulsed current devices. The Accel-Heal device delivers low-frequency pulsed current through adhesive electrodes placed near the wound. A 2020 randomized controlled trial published in the International Wound Journal showed a 67% reduction in wound area at 12 weeks compared to standard care.

Negative pressure wound therapy with electrical stimulation. Combining VAC therapy with electrical stimulation has shown synergistic effects in chronic wound management.

For diabetic foot ulcers — a devastating complication affecting 15-25% of diabetics — bioelectric wound therapy offers a particularly promising approach, as the endogenous wound electric field is impaired in diabetic tissue. Restoring the bioelectric environment may address the fundamental healing deficit rather than merely managing the wound.

Transcranial Electrical Stimulation

Transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) are non-invasive brain stimulation techniques that deliver weak electrical currents (1-2 milliamps) through scalp electrodes. The currents are too weak to trigger action potentials directly, but they modulate the resting membrane potential of cortical neurons — slightly depolarizing neurons under the anode (increasing excitability) and hyperpolarizing neurons under the cathode (decreasing excitability).

tDCS has been studied in thousands of research papers and clinical trials for:

Depression. The FDA-approved tDCS device (Flow Neuroscience) is marketed for major depressive disorder in Europe. Large trials (including the ELECT trial by Brunoni et al., 2017) have shown that tDCS applied to the left dorsolateral prefrontal cortex produces antidepressant effects comparable to sertraline (Zoloft).

Chronic pain. Motor cortex tDCS has shown efficacy for fibromyalgia, neuropathic pain, and migraine in multiple trials. The mechanism involves modulation of pain processing networks, with the bioelectric stimulation changing the excitability of cortical pain circuits.

Stroke rehabilitation. tDCS applied during motor rehabilitation after stroke enhances recovery of motor function, likely by increasing the excitability of perilesional cortex and promoting neuroplasticity.

Cognitive enhancement. In healthy subjects, tDCS applied to working memory-associated cortex improves working memory performance, and stimulation of language areas improves verbal fluency. The effects are modest but consistent across studies.

The relevance to Levin’s framework is that tDCS works by changing the membrane potential of cells — the same bioelectric parameter that Levin has shown to carry morphogenetic and behavioral information. The fact that a 1-milliamp current through the scalp can alter mood, pain perception, motor function, and cognition demonstrates that the brain’s function is sensitive to its bioelectric state, consistent with the view that bioelectricity is an information-carrying medium, not merely a byproduct of neural activity.

Vagus Nerve Stimulation

Vagus nerve stimulation (VNS) delivers electrical pulses to the vagus nerve through either an implanted device (invasive VNS, FDA-approved for epilepsy and depression) or a transcutaneous earpiece or neck device (non-invasive VNS, CE-marked for several conditions). The vagus nerve — the longest cranial nerve, connecting the brain to the heart, lungs, gut, and immune system — is the body’s primary parasympathetic highway, and its electrical stimulation has remarkably broad therapeutic effects:

Epilepsy. VNS reduces seizure frequency by 25-50% in drug-resistant epilepsy. The mechanism involves vagal afferents modulating cortical excitability through brainstem relay nuclei.

Depression. VNS is FDA-approved for treatment-resistant depression. Response rates of 30-50% have been reported in long-term follow-up studies.

Inflammation. Kevin Tracey at the Feinstein Institute discovered the “inflammatory reflex” — a neural circuit in which vagal stimulation suppresses systemic inflammation through the release of acetylcholine, which acts on macrophages to reduce TNF-alpha and other pro-inflammatory cytokines. VNS for rheumatoid arthritis has shown promising results in clinical trials (the RESET-RA trial).

Post-stroke recovery. Paired VNS — vagus nerve stimulation timed to coincide with rehabilitation exercises — has been FDA-approved for upper limb motor recovery after stroke. The Vivistim system delivers VNS during physical therapy, enhancing neuroplasticity and accelerating recovery.

VNS exemplifies the bioelectric medicine principle: instead of targeting a molecular pathway with a drug, target the body’s electrical control system and let its own regulatory mechanisms produce the therapeutic effect. The vagus nerve is a bioelectric control channel that modulates multiple organ systems simultaneously. Stimulating it produces broad, coordinated therapeutic effects that no single drug can match.

Emerging Clinical Applications

Tumor Treating Fields (TTFields)

Tumor treating fields (TTFields) — alternating electric fields at 100-300 kHz delivered through transducer arrays placed on the scalp or body — represent the most significant advance in bioelectric oncology to date. The Optune device, manufactured by Novocure, is FDA-approved for newly diagnosed and recurrent glioblastoma multiforme (the most aggressive brain cancer).

The mechanism involves disruption of mitotic spindle formation during cell division. The alternating field exerts forces on charged and polarizable molecules (particularly tubulin dimers) within dividing cells, interfering with chromosome alignment and cytokinesis. Because cancer cells divide more rapidly than most normal cells, the effect is preferentially cytotoxic to tumors.

The pivotal EF-14 trial (Stupp et al., JAMA 2015, updated in JAMA 2017) demonstrated that TTFields plus temozolomide chemotherapy improved median survival in newly diagnosed glioblastoma from 16 months (temozolomide alone) to 20.9 months, with 5-year survival increasing from 5% to 13%. This was the first improvement in glioblastoma survival in over a decade.

TTFields are now being tested in pancreatic cancer (the PANOVA trial), non-small cell lung cancer (the LUNAR trial), ovarian cancer (the INNOVATE trial), and mesothelioma (the STELLAR trial). If these trials succeed, bioelectric oncology will become a major branch of cancer treatment.

From Levin’s perspective, TTFields may work through multiple mechanisms beyond mitotic disruption — including effects on membrane potential, gap junction communication, and the bioelectric signaling that maintains tissue organization. Understanding these additional mechanisms could lead to more precise and effective bioelectric cancer therapies.

Bioelectronic Medicine

The Feinstein Institutes for Medical Research (part of Northwell Health) has established a dedicated Center for Bioelectronic Medicine, led by Kevin Tracey, with the mission of developing electrical therapies for diseases currently treated with drugs. The vision is that many diseases — particularly chronic inflammatory conditions — result from dysfunction of the body’s neural regulatory circuits, and that electrical stimulation of these circuits can be more precise, more effective, and less side-effect-prone than pharmacological intervention.

The flagship programs include:

Bioelectronic treatment of rheumatoid arthritis through vagus nerve stimulation, targeting the inflammatory reflex to reduce joint inflammation without immunosuppressive drugs.

Bioelectronic treatment of Crohn’s disease and ulcerative colitis through vagal or sacral nerve stimulation, modulating the gut immune response electrically.

Bioelectronic treatment of type 2 diabetes through electrical stimulation of the hepatic branch of the vagus nerve, which modulates glucose metabolism.

The bioelectronic medicine paradigm represents a fundamental shift in therapeutics: from chemistry (drugs) to electricity (neuromodulation). Instead of flooding the body with a molecule that affects every cell it reaches, bioelectronic medicine targets specific neural circuits that regulate specific physiological functions. The precision of electrical targeting can, in principle, exceed the precision of pharmaceutical targeting — because nerves are wires, and you can stimulate specific wires.

Microcurrent Therapy

Microcurrent therapy involves the application of extremely low-level electrical currents (1-600 microamps, below the threshold of sensory perception) to injured or diseased tissue. This is distinct from conventional electrotherapy (TENS units, which operate at milliamp levels and work by sensory nerve stimulation). Microcurrent therapy operates at the cellular level, directly influencing the bioelectric state of tissue cells.

Cheng and colleagues (1982) demonstrated that microcurrent stimulation at 50-500 microamps increased ATP production by 500%, protein synthesis by 70%, and amino acid transport by 40% in rat skin cells. These effects were abolished at higher currents (above 1 milliamp), suggesting a specific bioelectric window for cellular stimulation.

Frequency-specific microcurrent (FSM), developed by Carolyn McMakin, uses paired frequencies delivered at microamperage levels. Different frequency combinations are claimed to address different tissue types and pathological states. While the evidence base for FSM is limited to case series and small trials, the clinical results reported for conditions like fibromyalgia, myofascial pain, and nerve pain are intriguing.

The conceptual framework aligns with Levin’s bioelectric hypothesis. If cells maintain specific membrane potentials and communicate through bioelectric networks, then delivering electrical signals at the appropriate amplitude and frequency could modulate cellular behavior — promoting healing, reducing inflammation, and restoring normal tissue function. Microcurrent therapy is, in essence, speaking to cells in their own electrical language.

PEMF Therapy Beyond Bone

Pulsed electromagnetic field therapy, originally approved for bone healing, is being investigated for a much broader range of conditions:

Osteoarthritis. Multiple randomized controlled trials have shown that PEMF reduces pain and improves function in knee osteoarthritis, likely through effects on chondrocyte metabolism and synovial inflammation.

Soft tissue healing. PEMF accelerates healing of ligament injuries, tendon damage, and post-surgical edema, possibly through enhanced angiogenesis and reduced inflammation.

Neurological conditions. Repetitive transcranial magnetic stimulation (rTMS), which uses similar electromagnetic principles at higher intensities, is FDA-approved for depression and OCD and is being investigated for Alzheimer’s disease, Parkinson’s disease, and chronic pain.

Depression and anxiety. Low-intensity PEMF applied to the brain (using devices like the NeoSync LFMS or the ICES system) has shown antidepressant effects in small trials, with the advantage of no cognitive side effects — unlike electroconvulsive therapy.

Ion Channel Pharmacology: The Bioelectric Drug Cabinet

Repurposing Existing Drugs

Many existing drugs that modulate ion channels — originally developed for cardiac, neurological, or psychiatric indications — have potential applications in bioelectric medicine. Levin’s framework provides the rationale for repurposing these drugs for developmental, regenerative, and oncological applications:

Ivermectin. The antiparasitic drug activates glutamate-gated chloride channels, depolarizing cells. Levin’s group used it to study depolarization-induced tumor formation. At clinical doses, it has shown unexpected anticancer activity in several tumor types — possibly through bioelectric mechanisms.

Metformin. The diabetes drug activates AMPK, which modulates ion channel activity and membrane potential. Metformin use is associated with reduced cancer risk in epidemiological studies — possibly because it helps maintain normal bioelectric states in tissues.

Minoxidil. The hair growth drug is a potassium channel opener that hyperpolarizes cells. Its ability to promote hair follicle growth may involve bioelectric promotion of differentiation and morphogenesis in the follicle stem cell niche.

Verapamil. The calcium channel blocker, used for hypertension and arrhythmias, has been found to promote wound healing and reduce scarring in multiple clinical settings. The mechanism may involve modulation of the bioelectric wound environment.

Designing Bioelectric Drugs

The future of bioelectric pharmacology involves designing drugs specifically to modulate the bioelectric environment for therapeutic purposes — not as side effects of channel blockade, but as targeted interventions in the bioelectric code.

This requires understanding the “bioelectric signature” of disease states — the specific voltage patterns, ion channel expression profiles, and gap junction configurations that characterize different pathologies. Levin’s group is mapping these signatures in cancer, birth defects, and regeneration models. Once the signature is known, drugs can be designed to correct it — restoring the normal bioelectric state and thereby restoring normal tissue behavior.

This is a fundamentally different approach from conventional drug design, which targets specific molecular pathways. Bioelectric drug design targets informational states — patterns of voltage across tissue networks. It is, in Levin’s language, “writing to the body’s software” rather than modifying its hardware.

The Deeper Integration

Bioelectric Medicine and Acupuncture

The Traditional Chinese Medicine practice of acupuncture involves inserting thin needles into specific points on the body, stimulating those points, and producing therapeutic effects at sites remote from the needles. The mechanism has been debated for centuries. The TCM explanation involves the flow of qi (vital energy) through meridians (energy channels). The biomedical community has proposed various mechanisms: release of endorphins, stimulation of peripheral nerves, connective tissue effects.

Bioelectricity offers a unifying mechanism. Helene Langevin at Harvard (previously at the University of Vermont) has shown that acupuncture points correspond to locations of increased electrical conductance on the skin surface, and that acupuncture needles, when inserted and rotated, generate measurable electrical signals in the connective tissue. These signals propagate through the tissue, potentially modulating the bioelectric state of distant organs.

The meridian system, in this interpretation, is a bioelectric communication network — a system of relatively low-resistance pathways (perhaps associated with connective tissue planes, blood vessels, or nerve pathways) that transmit electrical signals across the body. Acupuncture works by providing electrical input to this network, modulating the bioelectric state of target tissues.

This does not validate all claims of TCM. But it provides a mechanistic bridge between acupuncture’s empirical effects (which are supported by some randomized controlled trials, particularly for pain and nausea) and the bioelectric framework of Levin’s research. Acupuncture may be the oldest form of bioelectric medicine — a practice that has been manipulating the body’s electrical communication network for millennia, without knowing (in Western scientific terms) what that network was.

The Yoga of Electricity

In the yogic tradition, prana (vital energy) flows through nadis (channels) and is concentrated in chakras (energy centers). Pranayama (breath control) and asana (postures) are practiced to regulate the flow of prana and optimize the function of the subtle body. The bioelectric interpretation suggests that prana corresponds to bioelectric signaling, nadis correspond to bioelectric communication pathways (gap junction networks, connective tissue planes, nerve pathways), and chakras correspond to bioelectric integration hubs (nerve plexuses, organ centers, areas of dense gap-junctional coupling).

This interpretation is speculative but not arbitrary. The locations of the traditional chakras correspond to major nerve plexuses (sacral plexus, solar plexus, cardiac plexus, cervical plexus), which are precisely the locations of dense bioelectric integration. Yogic breathing practices alter the body’s electrical state — they change heart rate variability (a measure of autonomic nervous system function), EEG patterns, and galvanic skin response. Meditation increases coherence across brain regions, which is a bioelectric phenomenon.

If the subtle body is the bioelectric body, then yoga and pranayama are bioelectric self-regulation practices — techniques for optimizing the body’s electrical communication system through breath, posture, and attention. The yogis may have been the first bioelectric engineers, working not with electrodes and ion channel drugs but with breath and intention.

Conclusion

Bioelectric medicine is not a single technology. It is a paradigm — the recognition that the body is an electrical system and that its electrical state can be therapeutically manipulated. From FDA-approved bone stimulators and brain stimulation devices to experimental cancer treatments and ion channel pharmacology, the clinical evidence is growing that bioelectric interventions can achieve outcomes that chemical pharmacology alone cannot.

The foundation for this paradigm comes from Levin’s basic science: the demonstration that bioelectric signals carry morphogenetic information, that the body’s electrical state causally influences development, regeneration, and disease, and that manipulating bioelectric signals can produce specific, predictable therapeutic effects. The clinical applications translate this basic science into patient benefit.

For the healthcare systems of the future, bioelectric medicine offers advantages that pharmaceutical medicine cannot match: precision (targeting specific neural circuits and tissue regions rather than flooding the body with drugs), safety (electrical stimulation has fewer systemic side effects than most drugs), tunability (electrical parameters can be adjusted in real time), and reversibility (turn off the stimulator and the effect stops).

And for the ancient healing traditions — acupuncture, yoga, energy medicine — bioelectric medicine provides something they have long awaited: a mechanistic language in which their observations about the body’s electrical nature can be expressed, tested, refined, and integrated with mainstream clinical practice. The body’s electrical system is the bridge between the ancient healing arts and the medicine of the future. It has been there all along. We are only now learning how to use it.