Dynamic network targeting for closed-loop deep brain stimulation

摘要

Deep brain stimulation (DBS) has gained wide use in movement disorders and remains an area of active research in psychiatric disorders. Recent clinical trial setbacks may reflect clinicians’ trial-and-error approach to selecting stimulation parameters [1]. Newer studies focus on “closed-loop” approaches, where DBS settings are adjusted based on an objective, brain-based readout. Those studies divide roughly into “anatomical” approaches based on targeting stimulation to specific white matter (WM) bundles and “physiologic” approaches that focus on changing pathologic signatures in brain electrical activity. We argue that success in psychiatric applications may require a synthesis of both approaches: individualized anatomically guided electrode placement coupled with biomarker-responsive targeting of network dynamics.