In a pilot human study, researchers from the University of Minnesota Medical School and Massachusetts General Hospital show it is possible to improve specific human brain functions related to self-control and mental flexibility by merging artificial intelligence with targeted electrical brain stimulation.
Alik Widge, MD, PhD, an assistant professor of psychiatry and member of the Medical Discovery Team on Addiction at the U of M Medical School, is the senior author of the research published in Nature Biomedical Engineering. The findings come from a human study conducted at Massachusetts General Hospital in Boston among 12 patients undergoing brain surgery for epilepsy -- a procedure that places hundreds of tiny electrodes throughout the brain to record its activity and identify where seizures originate.
In this study, Widge collaborated with Massachusetts General Hospital's Sydney Cash, MD, PhD, an expert in epilepsy research; and Darin Dougherty, MD, an expert in clinical brain stimulation. Together, they identified a brain region -- the internal capsule -- that improved patients' mental function when stimulated with small amounts of electrical energy. That part of the brain is responsible for cognitive control -- the process of shifting from one thought pattern or behavior to another, which is impaired in most mental illnesses.
The team developed algorithms, so that after stimulation, they could track patients' cognitive control abilities, both from their actions and directly from their brain activity. The controller method provided boosts of stimulation whenever the patients were doing worse on a laboratory test of cognitive control.
The study shows that
- A specific human mental function linked to mental illness can be reliably enhanced using precisely targeted electrical stimulation;
- There are specific sub-parts of the internal capsule brain structure that are particularly effective for cognitive enhancement; and
- A closed-loop algorithm used as a controller was twice as effective than stimulating at random times.
Some of the patients had significant anxiety in addition to their epilepsy. When given the cognitive-enhancing stimulation, they reported that their anxiety got better, because they were more able to shift their thoughts away from their distress and focus on what they wanted. Researchers said that this suggests this method could be used to treat patients with severe and medication-resistant anxiety, depression or other disorders.
The research team is now preparing for clinical trials. Because the target for improving cognitive control is already approved by FDA for deep brain stimulation, researchers said this can be done with existing tools and devices -- once a trial is formally approved -- and the translation of this care to current medical practice could be rapid.