The use of implants that can electrically stimulate or record electrophysiological or neurochemical activity in nervous tissue is rapidly expanding. Despite remarkable results in clinical studies and increasing market approvals, the mechanisms underlying the therapeutic effects of neuroprosthetic and neuromodulation devices, as well as their side effects and reasons for their failure, remain poorly understood. A major assumption has been that the signal-generating neurons are the only important target cells of neural-interface technologies. However, recent evidence indicates that the supporting glial cells remodel the structure and function of neuronal networks and are an effector of stimulation-based therapy. Here, we reframe the traditional view of glia as a passive barrier, and discuss their role as an active determinant of the outcomes of device implantation. We also discuss the implications that this has on the development of bioelectronic medical devices.

可以电刺激或记录神经组织中的电生理或神经化学活动的植入物的使用正在迅速扩大。尽管临床研究取得了显著成果并且市场批准不断增加，但神经假体和神经调节装置治疗效果的机制及其副作用和失败原因仍然知之甚少。一个主要的假设是，信号生成神经元是神经接口技术唯一重要的目标细胞。然而，最近的证据表明，支持神经胶质细胞重塑神经元网络的结构和功能，并且是基于刺激的治疗的效应器。在这里，我们重新构建了神经胶质细胞作为被动屏障的传统观点，并讨论了它们作为装置植入结果的主动决定因素的作用。我们还讨论了这对生物电子医疗设备的发展的影响。