Neuromodulation in Emergency Neurology: A Network-Based Approach to Brain–Body Regulation Beyond Structural Disease

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Abstract
Neuromodulation has emerged as an innovative therapeutic approach that extends neurosurgical indications beyond structural disease toward the dynamic regulation of neural networks and brain–body interactions. This review analyzes the current and potential role of neuromodulation in emergency neurology, focusing on its capacity to influence key physiological mechanisms such as thalamocortical connectivity, autonomic regulation, neuroinflammation, and neuroplasticity. A structured narrative review was conducted using scientific databases including PubMed, Scopus, and Web of Science, selecting peer-reviewed studies relevant to neuromodulation techniques such as deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation. The findings indicate that neuromodulation demonstrates significant applicability in conditions such as refractory epilepsy, traumatic brain injury, stroke, and disorders of consciousness, particularly when conventional therapies are insufficient. Non-invasive techniques show advantages in feasibility and safety, while invasive approaches provide targeted and sustained modulation in selected cases. Additionally, the analysis highlights disparities in implementation across international contexts, including Mexico, Colombia, and Ecuador, where access to advanced technologies varies. Overall, neuromodulation represents a promising and evolving strategy in emergency neurology, with the potential to improve outcomes through the modulation of complex neural and systemic processes.