EMU: non-invasive neuromodulation system with high spatiotemporal precision guided by functional biomarkers in real time

• Grant number: 22/11557-5
• Support Opportunities: Research Infrastructure Program - Technology and Innovation
• Start date: November 01, 2023
• End date: October 31, 2030
• Field of knowledge: Health Sciences - Medicine - Psychiatry
• Principal Investigator: Marcelo Queiroz Hoexter
• Grantee: Marcelo Queiroz Hoexter
• Host Institution: Instituto de Psiquiatria Doutor Antonio Carlos Pacheco e Silva (IPq). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Elizabeth Shephard ; Eurípedes Constantino Miguel Filho ; João Pereira Leite

Abstract

Decades of neuroscience research have identified potential biomarkers involved in neuropsychiatric disorders, with those that reflect brain functioning - characterized primarily by functional neuroimaging and electrophysiology - particularly promising. However, the use of these findings in clinical trials is challenging. Non-invasive neuromodulation of neural circuits, performed by means of transcranial electrical or magnetic stimulation, is established as an adjuvant treatment in neurology and psychiatry, especially for patients who are refractory to first-line therapies (pharmacology and psychotherapy). While some stimulation protocols already have proven clinical efficacy, recent evidence, both basic and clinical, converges to indicate that such therapies could achieve greater therapeutic efficacy through the individualized configuration of anatomical, temporal and functional targets, an approach known as personalized neuromodulation. The present system is composed of integrated, synchronized and compatible equipment, with the sole purpose of configuring and activating transcranial electrical and magnetic stimulations for modulation and application at specific functional states by real-time data analysis of electroencephalography, peripheral sensors (electromyography, heart rate, galvanic skin response, fist accelerometer and respiration) and functional near-infrared spectroscopy on an anatomical target located by neuronavigation during cognitive demand. The system is dedicated to constituting a platform for studies in personalized neuromodulation, opening new lines of investigation that include: (a) Optimization of the efficacy of brain stimulation by anatomical and temporal individualization and by application during specific functional and cognitive states; (b) Identification of multidimensional neurophysiological biomarkers and validation for clinical use as predictors, targets, guides or markers of treatment response in neuropsychiatry; (c) Mechanistic investigation between neural plasticity, neural rhythms, cognition and behavior; (d) Development of non-invasive brain-machine interface algorithms and devices with a focus on clinical neuromodulation and neuroenhancement for open dissemination or entrepreneurial purposes. (AU)