Transcranial brain stimulation: closing the loop between brain and stimulation. Issue 4 (August 2016)

• Record Type: Journal Article
• Authors: Karabanov, Anke; Thielscher, Axel; Siebner, Hartwig Roman
• Is Part Of: Current opinion in neurology. Volume 29:Issue 4(2016:Aug.)
• Publication Date: 2016-08
• Subjects: brain plasticity -- brain rhythms -- closed-loop brain stimulation -- noninvasive transcranial brain stimulation (NTBS) -- open-loop brain stimulation -- state dependence; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.805
• DOI: 10.1097/WCO.0000000000000342
• Languages: English
• ISSNs: 1473-6551

Abstract

Abstract : Purpose of review: To discuss recent strategies for boosting the efficacy of noninvasive transcranial brain stimulation to improve human brain function. Recent findings: Recent research exposed substantial intra- and inter-individual variability in response to plasticity-inducing transcranial brain stimulation. Trait-related and state-related determinants contribute to this variability, challenging the standard approach to apply stimulation in a rigid, one-size-fits-all fashion. Several strategies have been identified to reduce variability and maximize the plasticity-inducing effects of noninvasive transcranial brain stimulation. Priming interventions or paired associative stimulation can be used to 'standardize' the brain-state and hereby, homogenize the group response to stimulation. Neuroanatomical and neurochemical profiling based on magnetic resonance imaging and spectroscopy can capture trait-related and state-related variability. Fluctuations in brain-states can be traced online with functional brain imaging and inform the timing or other settings of transcranial brain stimulation. State-informed open-loop stimulation is aligned to the expression of a predefined brain state, according to prespecified rules. In contrast, adaptive closed-loop stimulation dynamically adjusts stimulation settings based on the occurrence of stimulation-induced state changes. Summary: Approaches that take into account trait-related and state-related determinants of stimulation-induced plasticity bear considerable potential to establish noninvasive transcranial brain stimulation as interventional therapeutic tool.