Shima Motamedi

Polycystic ovary syndrome (PCOS) is a heterogeneous multisystem disorder characterized by reproductive, metabolic, and neuroendocrine abnormalities. Current management primarily targets individual manifestations through lifestyle modifications and pharmacological therapy, while growing evidence implicates altered autonomic and neuroendocrine regulation in PCOS pathophysiology. Electroceuticals (ECs) and neuromodulatory interventions may represent potential non-pharmacological approaches for modulating neural pathways involved in reproductive and metabolic regulation. This review examines the biological rationale, experimental evidence, and available clinical findings supporting the investigation of such interventions in PCOS. From a biomedical perspective, ECs may offer potential advantages in PCOS management; however, the limited evidence currently available precludes definitive conclusions regarding their short- and long-term therapeutic effects and potential adverse effects in humans. Therefore, further specialized preclinical and clinical studies are warranted to evaluate the safety and efficacy of this promising approach.

Bioelectric signaling plays an essential role in regulating cellular, tissue, and organ functions. Electroceuticals (ECs) are device-mediated interventions that modulate biological activity through controlled electrical stimulation or related neuromodulatory approaches. They have attracted interest as potential therapeutic strategies for complex disorders, including metabolic syndrome (MetS), which involves interconnected metabolic abnormalities and neurophysiological dysregulation, involving pathways associated with autonomic control, inflammation, and brain-derived neurotrophic factor (BDNF). This narrative review examines the historical development, potential mechanisms, therapeutic applications, technological advances, limitations of ECs in the context of MetS, and identifies priorities for future research. The relevant literature was identified through searches of PubMed, Embase, Scopus, Web of Science, Google Scholar, and ClinicalTrials.gov using related keywords and phrases. The available evidence suggests that EC modalities may influence neuro-metabolic and autonomic pathways relevant to glucose regulation, energy balance, inflammation, and other components of MetS. However, the strength of the evidence varies across interventions and outcomes. Interpretation of clinical findings is complicated by heterogeneous stimulation protocols and the frequent co-administration of dietary interventions, exercise, weight-management strategies, or interventions associated with substantial weight loss. These factors limit the ability to isolate the independent effects of neuromodulation. Further challenges include the absence of standardized stimulation parameters, uncertainty regarding optimal treatment protocols, potential adverse effects, and limited long-term clinical evidence. Accordingly, ECs should currently be considered investigational approaches rather than established treatments for MetS. Well-designed long-term clinical trials are needed to determine their efficacy, safety, durability, and optimal therapeutic parameters.

Bioelectricity is a fundamental characteristic of biological systems, affecting cells, tissues, organs, and the organism as a whole. Therefore, monitoring and modulating bioelectric states through electroceuticals (ECs) may offer new solutions for many modern diseases that lack specific therapies or are resistant to current pharmaceuticals. Today, metabolic syndrome (MetS) is a significant health challenge, with many of its underlying processes and molecular factors (e.g., brain-derived neurotrophic factor) that rely on a physiological bioelectric system. This narrative review aims to highlight the opportunities and challenges of ECs in managing MetS and to explore potential future approaches in this therapeutic discipline by searching for related words and phrases in PubMed, Embase, Scopus, Web of Science, Google Scholar, and ClinicalTrials.gov. ECs can modulate neuro-metabolic and autonomic circuits, which may influence multiple components of MetS. The most important limitations of this section include the lack of standardized and well-defined safe therapeutic parameters, lack of precise targeted dosing parameters, risk of potential adverse effects of autonomic stimulation, and lack of comprehensive and long-term clinical data on the effect of ECs on MetS. Therefore, it can be concluded that ECs currently could represent a supportive complementary therapy in the field of MetS, which requires more comprehensive and detailed research to create a possible strong therapeutic approach in the future.