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Closed-Loop Brain Stimulation

2023· review· en· W4386955501 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
fundA Canadian funder is recorded on the work.

Bibliographic record

VenueBiological Psychiatry · 2023
Typereview
Languageen
FieldNeuroscience
TopicTranscranial Magnetic Stimulation Studies
Canadian institutionsUniversity of TorontoCentre for Addiction and Mental Health
FundersH2020 European Research CouncilTemerty Faculty of Medicine, University of TorontoHorizon 2020European Research CouncilTakeda Pharmaceutical CompanyUniversity of TorontoBundesministerium für Bildung und ForschungHorizon 2020 Framework ProgrammeDeutsche ForschungsgemeinschaftEberhard Karls Universität TübingenEuropean CommissionFondation Brain CanadaTakeda Pharmaceuticals U.S.A.
KeywordsNeuroscienceStimulationTranscranial magnetic stimulationBrain stimulationStimulus (psychology)ElectroencephalographyBrain activity and meditationPsychologyHuman brainDeep brain stimulationMedicineCognitive psychology

Abstract

fetched live from OpenAlex

In the same way that beauty lies in the eye of the beholder, what a stimulus does to the brain is determined not simply by the nature of the stimulus, but by the nature of the brain receiving the stimulus, at that instant of time. Therapeutic brain stimulation, over the past decades, typically applied open-loop fixed protocols and has largely ignored this principle. Only recent neuro-technological advancements enabled us to predict the nature of the brain (i.e., the electrophysiological brain state in the next instant of time) with sufficient temporal precision in the range of milliseconds, using feedforward algorithms applied to EEG time series data. This allows stimulation exclusively whenever the targeted brain area is in a prespecified excitability or connectivity state. Preclinical studies showed that repetitive stimulation during a particular brain state (e.g., high-excitability state), but not during other states, results in lasting modification (e.g., long-term potentiation) of the stimulated circuits. Here we survey the evidence that this is also possible at the systems level of human cortex, using EEG-informed transcranial magnetic stimulation (EEG-TMS). We discuss critically opportunities and difficulties to develop brain state-dependent stimulation for more effective long-term modification of pathological brain networks (e.g., in major depressive disorder) than achievable with conventional fixed protocols. The same real-time EEG-TMS technology will allow closing the loop by recording the effects of stimulation. This information may serve for stimulation protocol adaptation to maximize the treatment response. This way, brain states control brain stimulation, introducing a paradigm-shift from open-loop to closed-loop stimulation. In the same way that beauty lies in the eye of the beholder, what a stimulus does to the brain is determined not simply by the nature of the stimulus, but by the nature of the brain receiving the stimulus, at that instant of time. Therapeutic brain stimulation, over the past decades, typically applied open-loop fixed protocols and has largely ignored this principle. Only recent neuro-technological advancements enabled us to predict the nature of the brain (i.e., the electrophysiological brain state in the next instant of time) with sufficient temporal precision in the range of milliseconds, using feedforward algorithms applied to EEG time series data. This allows stimulation exclusively whenever the targeted brain area is in a prespecified excitability or connectivity state. Preclinical studies showed that repetitive stimulation during a particular brain state (e.g., high-excitability state), but not during other states, results in lasting modification (e.g., long-term potentiation) of the stimulated circuits. Here we survey the evidence that this is also possible at the systems level of human cortex, using EEG-informed transcranial magnetic stimulation (EEG-TMS). We discuss critically opportunities and difficulties to develop brain state-dependent stimulation for more effective long-term modification of pathological brain networks (e.g., in major depressive disorder) than achievable with conventional fixed protocols. The same real-time EEG-TMS technology will allow closing the loop by recording the effects of stimulation. This information may serve for stimulation protocol adaptation to maximize the treatment response. This way, brain states control brain stimulation, introducing a paradigm-shift from open-loop to closed-loop stimulation.

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Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.981
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0010.000
Insufficient payload (model declined to judge)0.0000.003

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.293
GPT teacher head0.420
Teacher spread0.127 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it