In a pilot study on humans, researchers at the University of Minnesota School of Medicine and Massachusetts General Hospital show that it is possible to improve specific functions of the human brain related to self-control and mental flexibility by fusing artificial intelligence with targeted electrical brain stimulation.
Alik Widge, MD, PhD, an assistant professor of psychiatry and a member of the Drug Addiction Discovery Team at U of M Medical School, is the lead author of the research published in Nature Biomedical Engineering. The results come from a human study at Massachusetts General Hospital in Boston of 12 patients undergoing brain surgery for epilepsy – a procedure that places hundreds of tiny electrodes in the brain to record its activity and identify the origin of the symptoms. crises.
In this study, Widge collaborated with Sydney Cash, MD, PhD of Massachusetts General Hospital, an expert in epilepsy research; and Darin Dougherty, MD, an expert in clinical brain stimulation. Together, they identified a region of the brain – the inner capsule – that improved patients’ mental function when stimulated by small amounts of electrical energy. This part of the brain is responsible for cognitive control – the process of switching from one thought pattern or behavior to another, which is impaired in most mental illnesses.
âAn example might include a person with depression who just can’t get out of a negative ‘blocked’ thought. Because it’s so essential to mental illness, finding a way to improve it could be a powerful new way to treat these illnesses, âsaid Widge.
The team developed algorithms, so that after stimulation, they can track patients’ cognitive control abilities, both from their actions and directly from their brain activity. The controller method provided stimulus pulses whenever the patients were doing less well in a laboratory cognitive control test.
“This system can read brain activity, ‘decode’ it when a patient is having difficulty, and apply a small pulse of electrical stimulation to the brain to stimulate it beyond that difficulty,” Widge said. âThe analogy I often use is an electric bicycle. When someone is pedaling but has difficulty, the bike will detect it and increase it. We made the equivalent for human mental function.
The study is the first to show that:
Specific human mental function related to mental illness can be reliably improved using precisely targeted electrical stimulation;
There are specific sub-parts of the brain’s inner capsule structure that are particularly effective for cognitive enhancement; and
A closed-loop algorithm used as a controller was twice as efficient as pacing at random times.
Some of the patients had significant anxiety in addition to their epilepsy. When they received the Cognitive Enhancement Stimulus, they said their anxiety improved as they were more able to turn their thoughts away from their distress and focus on what they wanted. Widge says this suggests that this method could be used to treat patients with anxiety, depression, or other severe, drug-resistant disorders.
âThis could be a whole new approach in the treatment of mental illness. Instead of trying to suppress the symptoms, we could give patients a tool that allows them to take control of their own minds, âWidge said. âWe could put them back in the driver’s seat. and let them feel a new sense of agency. “
The research team is now preparing for clinical trials. Since the goal of improving cognitive control is already approved by the Food and Drug Administration for deep brain stimulation, Widge says this research can be done with existing tools and devices – once a trial is officially approved – and the translation of this care into current medicine. practice can be quick.
âThe wonderful thing about these results is that we are now in a position to conduct clinical trials to further demonstrate the effectiveness and then hopefully help treatment-resistant patients who are in desperate need of treatment. additional interventions to treat their illnesses, âsaid Dougherty.
Basu I, Yousefi A, Crocker B, et al. Closed-loop enhancement and neural decoding of cognitive control in humans. Nat Biomed Ing. Published online Nov 1, 2021: 1-13. do I:10.1038 / s41551-021-00804-y
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