Toward Development of Personalized Neuromodulation Therapy

This talk outlines the emerging field of personalized neuromodulation, with a focus on closed-loop spinal cord stimulation using evoked compound action potentials (ECAPs). Unlike traditional open-loop systems, closed-loop SCS adapts in real-time to maintain optimal spinal cord activation, leading to more consistent pain relief and patient satisfaction. The speaker presents robust data from the EVOKE trial showing long-term efficacy and introduces the concept of the dose ratio (optimal at 1.4) as a personalized biomarker. The talk advocates for a shift from pain-only outcomes to holistic metrics and positions ECAP-guided therapy as a foundational step toward individualized neuromodulation.