Researchers from the University of Minnesota Medical School, Massachusetts General Hospital and University of Minnesota Medical School have shown that targeted electrical brain stimulation can improve certain brain functions in humans.
Alik Widge MD, PhD is an assistant professor of psychology and member of U of M Medical School's Medical Discovery Team on Addiction. He is the principal author of the Nature Biomedical Engineering research. These findings are based on a study of 12 epilepsy patients who underwent brain surgery at Massachusetts General Hospital. This procedure involves placing hundreds of electrodes in the brain to monitor its activity and pinpoint where seizures occur.
Widge worked with Sydney Cash, MD at Massachusetts General Hospital, PhD, an epilepsy researcher; and Darin Dougherty MD, an expert on clinical brain stimulation. They discovered a brain area called the "internal capsule" that improves mental function when it is stimulated with low amounts of electrical energy. This part of the brain is responsible to cognitive control, the process of changing from one thought pattern or behaviour to another. Most mental illnesses affect this area of the brain.
An example of this is a person suffering from depression who can't shake a negative thought. Widge stated that this is a key component of mental illness and finding a way can help it improve could be a powerful way to treat these illnesses."
The algorithm was developed by the team to track cognitive control abilities of patients after stimulation. This could be done both through their actions and their brain activity. The controller method gave stimulation boosts to patients who were performing worse in a cognitive control laboratory test.
Widge stated that the system could read brain activity and 'decode' it to determine when a patient has difficulty. Then, it would apply small amounts of electrical stimulation to their brains to help them through that difficulty. An electric bike is an analogy that I use often. The bike detects when someone is pedaling but has difficulty and it augments it. The equivalent has been created for mental function in humans.
This is the first study to prove that:
Using precisely targeted electrical stimulation, you can reliably improve a specific mental function that is linked to mental illness.
Certain sub-parts within the internal capsule brain structure are especially effective for cognitive enhancement.
The effectiveness of a closed-loop algorithm as a controller was two times greater than that of stimulating at random times.
Many of the patients suffered from severe anxiety and epilepsy. They reported feeling less anxious after receiving cognitive-enhancing stimulation. This was because they were able to focus on their goals and shift their attention away from their distress. Widge believes this could be used to treat severe anxiety, depression and other disorders.
"This could be an entirely new approach to treating mental illness. Widge stated that instead of suppressing symptoms, patients could be given a tool that allows them to take control of their minds. We could give them a way to feel more agency and put them back in control.
The research team is currently preparing for clinical trials. Widge states that the FDA has approved deep brain stimulation to improve cognitive control. This means that this research can be performed with current tools and devices. Once a trial is approved, Widge believes the translation of the care into medical practice will be quick.
Dougherty stated, "The great thing about these findings was that we now have the ability to conduct clinical trials to further prove effectiveness and then hopefully move on to helping treatment-resistant patient who are desperately in need of additional interventions to treat their illness."
This work was made possible by grants from Defense Advanced Research Projects Agency.
