The locus coeruleus directs sensory-motor reflex amplitude across environmental contexts

Modal Analysis of Cerebrovascular Effects for Digital Health Integration of Neurostimulation Therapies-A Review of Technology Concepts

Transcranial electrical stimulation (tES) is increasingly recognized for its potential to modulate cerebral blood flow (CBF) and evoke cerebrovascular reactivity (CVR), which are crucial in conditions like mild cognitive impairment (MCI) and dementia. This study explores the impact of tES on the neurovascular unit (NVU), employing a physiological modeling approach to simulate the vascular response to electric fields generated by tES. Utilizing the FitzHugh-Nagumo model for neuroelectrical activity, we demonstrate how tES can initiate vascular responses such as vasoconstriction followed by delayed vasodilation in cerebral arterioles, potentially modulated by a combination of local metabolic demands and autonomic regulation (pivotal locus coeruleus). Here, four distinct pathways within the NVU were modeled to reflect the complex interplay between synaptic activity, astrocytic influences, perivascular potassium dynamics, and smooth muscle cell responses. Modal analysis revealed characteristic dynamics of these pathways, suggesting that oscillatory tES may finely tune the vascular tone by modulating the stiffness and elasticity of blood vessel walls, possibly by also impacting endothelial glycocalyx function. The findings underscore the therapeutic potential vis-à-vis blood-brain barrier safety of tES in modulating neurovascular coupling and cognitive function needing the precise modulation of NVU dynamics. This technology review supports the human-in-the-loop integration of tES leveraging digital health technologies for the personalized management of cerebral blood flow, offering new avenues for treating vascular cognitive disorders. Future studies should aim to optimize tES parameters using computational modeling and validate these models in clinical settings, enhancing the understanding of tES in neurovascular health.

The locus coeruleus as a global model failure system

Predictive processing models posit that brains constantly attempt to predict their sensory inputs. Prediction errors signal when these predictions are incorrect and are thought to be instructive signals that drive corrective plasticity. Recent findings support the idea that the locus coeruleus (LC) - a brain-wide neuromodulatory system - signals several types of prediction error. I discuss how these findings support models proposing that the LC signals global model failures: instances where predictions about the world are strongly violated. Focusing on the cortex, I explore the utility of this signal in learning rate control, how the LC circuit may compute the signal, and how this view may aid our understanding of neurodivergence.