Please use this identifier to cite or link to this item:
http://hdl.handle.net/10397/93232
Title: | The intervention, the patient and the illness : personalizing non-invasive brain stimulation in psychiatry | Authors: | Padberg, F Bulubas, L MizutaniTiebel, Y Burkhardt, G Kranz, GS Koutsouleris, N Kambeitz, J Hasan, A Takahashi, S Keeser, D Goerigk, S Brunoni, AR |
Issue Date: | Jul-2021 | Source: | Experimental neurology, July 2021, v. 341, 113713 | Abstract: | Current hypotheses on the therapeutic action of non-invasive brain stimulation (NIBS) in psychiatric disorders build on the abundant data from neuroimaging studies. This makes NIBS a very promising tool for developing personalized interventions within a precision medicine framework. NIBS methods fundamentally vary in their neurophysiological properties. They comprise repetitive transcranial magnetic stimulation (rTMS) and its variants (e.g. theta burst stimulation – TBS) as well as different types of transcranial electrical stimulation (tES), with the largest body of evidence for transcranial direct current stimulation (tDCS). In the last two decades, significant conceptual progress has been made in terms of NIBS targets, i.e. from single brain regions to neural circuits and to functional connectivity as well as their states, recently leading to brain state modulating closed-loop approaches. Regarding structural and functional brain anatomy, NIBS meets an individually unique constellation, which varies across normal and pathophysiological states. Thus, individual constitutions and signatures of disorders may be indistinguishable at a given time point, but can theoretically be parsed along course- and treatment-related trajectories. We address precision interventions on three levels: 1) the NIBS intervention, 2) the constitutional factors of a single patient, and 3) the phenotypes and pathophysiology of illness. With examples from research on depressive disorders, we propose solutions and discuss future perspectives, e.g. individual MRI-based electrical field strength as a proxy for NIBS dosage, and also symptoms, their clusters, or biotypes instead of disorder focused NIBS. In conclusion, we propose interleaved research on these three levels along a general track of reverse and forward translation including both clinically directed research in preclinical model systems, and biomarker guided controlled clinical trials. Besides driving the development of safe and efficacious interventions, this framework could also deepen our understanding of psychiatric disorders at their neurophysiological underpinnings. | Keywords: | Affective disorders Bipolar disorder Major depression NIBS Non-invasive brain stimulation Precision medicine Repetitive transcranial magnetic stimulation RTMS Schizophrenia TDCS Transcranial direct current stimulation |
Publisher: | Academic Press | Journal: | Experimental neurology | EISSN: | 0014-4886 | DOI: | 10.1016/j.expneurol.2021.113713 | Rights: | © 2021 Elsevier Inc. All rights reserved. ©2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/ The following publication Padberg, F., Bulubas, L., Mizutani-Tiebel, Y., Burkhardt, G., Kranz, G. S., Koutsouleris, N., ... & Brunoni, A. R. (2021). The intervention, the patient and the illness–Personalizing non-invasive brain stimulation in psychiatry. Experimental Neurology, 341, 113713 is available at https://doi.org/10.1016/j.expneurol.2021.113713. |
Appears in Collections: | Journal/Magazine Article |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Kranz_Intervention_Patient_Patient.pdf | Pre-Published version | 1.03 MB | Adobe PDF | View/Open |
Page views
39
Last Week
0
0
Last month
Citations as of May 5, 2024
Downloads
203
Citations as of May 5, 2024
SCOPUSTM
Citations
15
Citations as of May 3, 2024
WEB OF SCIENCETM
Citations
12
Citations as of May 2, 2024
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.