Enhancing ECAP Fidelity and Objectivity to Improve Patient Experience

Neuromodulation therapies, including spinal cord stimulation, deep brain stimulation, and peripheral nerve stimulation, are increasingly used to treat pain and neurological disorders. However, outcomes remain variable, with some patients experiencing substantial benefit while others achieve limited or no improvement. There is a need for better tools to guide patient selection, therapy optimization, and outcome prediction. Biomarkers-objective biological indicators that reflect physiological or pathological processes-have the potential to transform the field by enabling more precise and personalized neuromodulation strategies. Speakers in this session will review neurophysiological markers such as evoked compound action potentials, neuroimaging signatures, electrophysiological signals including circadian rhythms and their impact on pain, and data from SCS programmers as well as wearable technology that may predict treatment response. The speakers will examine the strengths and limitations of existing evidence, as well as the challenges involved in translating biomarker discoveries from research settings into routine clinical practice. Ethical considerations, data integration, and the role of artificial intelligence in analyzing complex biomarker datasets will also be addressed. By highlighting both the promise and the challenges of biomarker-driven neuromodulation, this session aims to provide clinicians and researchers with a comprehensive overview of how objective biological signals may guide the evolution of neuromodulation therapies toward more personalized, precise, and effective treatments for pain and neurological disorders.