Closing the loop between brain and electrical stimulation: towards precision neuromodulation treatments

Area of Science:

• Neuroscience
• Neuromodulation
• Computational Psychiatry

Background:

• Noninvasive brain stimulation (NIBS) shows promise for psychiatric and neurologic disorders.
• Significant inter- and intra-individual variability in response to NIBS hinders treatment efficacy.
• Current one-size-fits-all approaches are suboptimal for enhancing stimulation outcomes.

Purpose of the Study:

• To explore the integration of transcranial electrical stimulation (tES) with real-time functional magnetic resonance imaging (rtfMRI) for individually optimized neuromodulation.
• To establish closed-loop tES-fMRI systems for personalized treatment strategies.
• To address the challenge of optimizing tES for individual patient responses.

Main Methods:

• Developing closed-loop tES-fMRI systems to optimize stimulation parameters in real-time.
• Minimizing the difference between the current brain state model and a desired state to maximize clinical outcomes.
• Investigating key methodological aspects: stimulation/acquisition timing, fMRI context, brain oscillations, dose-response, brain targets, and optimization algorithms.

Main Results:

• Closed-loop tES-fMRI offers advantages over non-individualized or open-loop systems.
• This technology enables objective optimization within a clinically relevant context, such as reducing drug cue reactivity in substance use disorder.
• The approach considers both inter- and intra-individual variations for personalized neuromodulation.

Conclusions:

• Closed-loop tES-fMRI represents a significant advancement in neuromodulation.
• It provides a framework for designing personalized transcranial electrical stimulation protocols in precision psychiatry.
• Utilizing multi-level brain and behavior measures enables tailored stimulation for improved clinical outcomes.