Closed-loop neurostimulation for affective symptoms and disorders: An overview

Area of Science:

• Neuroscience
• Psychiatry
• Biomedical Engineering

Background:

• Affective and anxiety disorders are globally prevalent psychiatric conditions.
• Non-invasive brain stimulation (NIBS) and neurofeedback are investigated therapeutic approaches.
• Combining these techniques in closed-loop systems offers novel treatment potential.

Purpose of the Study:

• To discuss the combination of NIBS and neurofeedback for affective and anxiety disorders.
• To review findings on NIBS (focusing on TMS) and neurofeedback (EEG, fMRI).
• To explore closed-loop brain state-dependent neuromodulation (BSDS) protocols.

Main Methods:

• Review of original findings in NIBS and neurofeedback.
• Scope review of studies combining real-time neurofeedback with NIBS in closed-loop setups (BSDS).
• Discussion of transcranial magnetic stimulation (TMS) combined with real-time functional near-infrared spectroscopy (fNIRS).

Main Results:

• NIBS, particularly TMS, and neurofeedback show promise individually.
• Closed-loop BSDS protocols integrate real-time neurofeedback with NIBS.
• TMS combined with fNIRS presents a potential solution to current BSDS limitations.

Conclusions:

• The combination of NIBS and neurofeedback, especially in closed-loop systems, is a promising avenue for treating affective and anxiety disorders.
• Further research into advanced techniques like TMS-fNIRS is warranted to overcome existing challenges in BSDS protocols.
• This integrated approach could lead to more effective, personalized neuromodulation therapies.