Precision Inhibitory Stimulation of Individual-Specific Cortical Hubs Disrupts Information Processing in Humans

Noninvasive brain stimulation (NIBS) is a promising treatment for psychiatric and neurologic conditions, but outcomes are variable across treated individuals. In principle, precise targeting of individual-specific features of functional brain networks could improve the efficacy of NIBS interventions. Network theory predicts that the role of a node in a network can be inferred from its connections; as such, we hypothesized that targeting individual-specific "hub" brain areas with NIBS should impact cognition more than nonhub brain areas. Here, we first demonstrate that the spatial positioning of hubs is variable across individuals but reproducible within individuals upon repeated imaging. We then tested our hypothesis in healthy individuals using a prospective, within-subject, double-blind design. Inhibition of a hub with continuous theta burst stimulation disrupted information processing during working-memory more than inhibition of a nonhub area, despite targets being separated by only a few centimeters on the right middle frontal gyrus of each subject. Based upon these findings, we conclude that individual-specific brain network features are functionally relevant and could leveraged as stimulation sites in future NIBS interventions.