Closed-loop neuromodulation systems: next-generation treatments for psychiatric illness

International Review of Psychiatry
Meng-Chen Lo, Alik S Widge

Abstract

Despite deep brain stimulation's positive early results in psychiatric disorders, well-designed clinical trials have yielded inconsistent clinical outcomes. One path to more reliable benefit is closed-loop therapy: stimulation that is automatically adjusted by a device or algorithm in response to changes in the patient's electrical brain activity. These interventions may provide more precise and patient-specific treatments. This article first introduces the available closed-loop neuromodulation platforms, which have shown clinical efficacy in epilepsy and strong early results in movement disorders. It discusses the strengths and limitations of these devices in the context of psychiatric illness. It then describes emerging technologies to address these limitations, including pre-clinical developments such as wireless deep neurostimulation and genetically targeted neuromodulation. Finally, ongoing challenges and limitations for closed-loop psychiatric brain stimulation development, most notably the difficulty of identifying meaningful biomarkers for titration, are discussed. This is considered in the recently-released Research Domain Criteria (RDoC) framework, and how neuromodulation and RDoC are jointly very well suited to addre...Continue Reading

References

Nov 1, 1982·Electroencephalography and Clinical Neurophysiology·J Gotman
Dec 23, 2000·Science·J B TenenbaumJ C Langford
Jun 14, 2003·Neural Computation·Anne C Smith, Emery N Brown
Jun 15, 2004·Current Opinion in Neurobiology·Magdalene M MoranDavid E Clapham
Mar 8, 2005·Neuron·Helen S MaybergSidney H Kennedy
Aug 16, 2006·Neuron·Bede M BroomeGilles Laurent
Oct 3, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·Michael S OkunWayne K Goodman
Nov 15, 2007·Proceedings of the National Academy of Sciences of the United States of America·Lauren M JonesDonald B Katz
Jan 1, 2008·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Felice T SunRobert E Wharen
May 15, 2008·The Journal of Nervous and Mental Disease·Heather E McNeelySidney H Kennedy
Jul 22, 2008·Biological Psychiatry·Andres M LozanoSydney H Kennedy
Oct 10, 2008·Biological Psychiatry·Donald A MaloneBenjamin D Greenberg
Apr 3, 2009·The Journal of Clinical Investigation·Helen S Mayberg
Aug 4, 2009·Journal of Computational Neuroscience·Liam PaninskiWei Wu
Sep 15, 2009·Biological Psychiatry·Mohammed R MiladScott L Rauch
Dec 8, 2009·Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society·Scott StanslaskiTim Denison
Feb 23, 2010·Nature Neuroscience·Mark M ChurchlandKrishna V Shenoy
Apr 22, 2010·CNS Neuroscience & Therapeutics·Ansgar Rougemont-BückingMohammed R Milad
May 21, 2010·JAMA : the Journal of the American Medical Association·Thomas R Insel, Philip S Wang
Aug 18, 2010·Stereotactic and Functional Neurosurgery·Ihtsham U HaqMichael S Okun
Feb 3, 2011·The American Journal of Psychiatry·Sidney H KennedyAndres M Lozano
Sep 16, 2011·Neurology·Martha J Morrell, UNKNOWN RNS System in Epilepsy Study Group
Jan 26, 2012·IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society·Scott StanslaskiTimothy Denison
Apr 5, 2012·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Bettina H BewernickThomas E Schlaepfer
Aug 31, 2012·The Journal of Neuroscience : the Official Journal of the Society for Neuroscience·Adrián Ponce-AlvarezRanulfo Romo
Feb 21, 2013·Brain Research·Gary Aston-Jones, Karl Deisseroth
Mar 26, 2013·Nature Methods·Misha B AhrensPhilipp J Keller
Apr 4, 2013·Stereotactic and Functional Neurosurgery·Paul H StypulkowskiJonathon E Giftakis
May 16, 2013·BMC Medicine·Bruce N Cuthbert, Thomas R Insel
Jun 4, 2013·Neurosurgical Focus·J Nicole BentleyParag G Patil
Jul 16, 2013·Annals of Neurology·Simon LittlePeter Brown
Nov 5, 2013·Nature Neuroscience·Debajit SahaBaranidharan Raman
Nov 26, 2013·American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics : the Official Publication of the International Society of Psychiatric Genetics·Gráinne McLoughlinMing T Tsuang
Feb 12, 2014·The Journal of Neuropsychiatry and Clinical Neurosciences·Sarah L GarnaatSteven A Rasmussen
Mar 13, 2014·Journal of Neural Engineering·Alik S Widge, Chet T Moritz

❮ Previous
Next ❯

Citations

May 20, 2017·International Review of Psychiatry·Irving M Reti
Nov 9, 2017·Harvard Review of Psychiatry·Darin D Dougherty, Alik S Widge
Oct 31, 2018·Journal of Advanced Nursing·Nina O'Grady
Aug 17, 2019·Journal of Neural Engineering·Nicole R ProvenzaAlik S Widge
Jul 12, 2019·The British Journal of Radiology·Leo P Sugrue, Rahul S Desikan
Sep 27, 2019·Journal of Psychopharmacology·Aline Santos MonteDanielle S Macedo
Jun 15, 2018·Journal of Clinical Psychopharmacology·Sahil MunjalStephen Ferrando
Apr 6, 2018·Frontiers in Neuroscience·Alik S WidgeDarin D Dougherty
Apr 2, 2020·Ethics & Human Research·Ian Stevens, Frederic Gilbert
Aug 13, 2017·Journal of Neuroengineering and Rehabilitation·Mahboubeh Parastarfeizabadi, Abbas Z Kouzani
Apr 3, 2019·Nature Reviews. Neurology·Walid BouthourPaul Krack
Sep 4, 2019·Nature Biotechnology·Shaun R Patel, Charles M Lieber
Dec 19, 2018·Cold Spring Harbor Perspectives in Medicine·Stavros Zanos
Jan 15, 2021·Journal of Medical Ethics·Ian Stevens, Frederic Gilbert
Feb 7, 2020·Neuroscience and Biobehavioral Reviews·Vojislav MaricJyoti Mishra
Sep 4, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Sean J NagelSaul Wilson
Mar 10, 2021·Nature Biomedical Engineering·Sang Min WonJohn A Rogers
Apr 18, 2021·Nature Biomedical Engineering·Julio I Chapeton, Kareem A Zaghloul
Jun 3, 2021·Journal of Personalized Medicine·Alexander FedotchevAnna Zemlianaia
Jun 10, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Jason YuenYoonbae Oh
Jul 31, 2021·Journal of Neural Engineering·Kristin K SellersEdward F Chang

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain-Computer Interface

A brain-computer interface, also known as a brain-machine interface, is a bi-directional communication pathway between an external device and a wired brain. Here is the latest research on this topic.

Related Papers

IEEE Engineering in Medicine and Biology Magazine : the Quarterly Magazine of the Engineering in Medicine & Biology Society
Dorin Panescu
Neurosurgery Clinics of North America
Jose F Tellez-Zenteno, Samuel Wiebe
© 2022 Meta ULC. All rights reserved