• Po-Yi Paul Su, Jeffrey Arle, and Lawrence Poree.
• Department of Anesthesia, University of California San Francisco, San Francisco, California, USA.
• Pain Pract. 2024 Jan 1; 24 (1): 177185177-185.

IntroductionNeuromodulation has emerged as a promising therapy for the management of chronic pain, movement disorders, and other neurological conditions. Spinal cord stimulation (SCS) is a widely used form of neuromodulation that involves the delivery of electrical impulses to the spinal cord to modulate the transmission of pain signals to the brain. In recent years, there has been increasing interest in the use of automation systems to improve the efficacy and safety of SCS. This narrative review summarizes the status of Food and Drug Administration-approved autonomous neuromodulation devices including closed loop, feedforward, and feedback systems. The review discusses the advantages and disadvantages of each system and focuses specifically on the use of these systems for SCS. It is important for clinicians to understand the expanding role of automation in neuromodulation in order to select appropriate therapies founded on automation systems to the specific needs of the patient and the underlying condition.ConclusionThe review also provides insights into the current state of the art in neuromodulation automation systems and discusses potential future directions for research in this field.© 2023 The Authors. Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.

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