Mood variations decoded from multi-site intracranial human brain activity

Role of electrophysiological activity and interactions of lateral habenula in the development of depression-like behavior in a chronic restraint stress model

Closed-loop deep brain stimulation (DBS) system offers a promising approach for treatment-resistant depression, but identifying universally accepted electrophysiological biomarkers for closed-loop DBS systems targeting depression is challenging. There is growing evidence suggesting a strong association between the lateral habenula (LHb) and depression. Here, we took LHb as a key target, utilizing multi-site local field potentials (LFPs) to study the acute and chronic changes in electrophysiology, functional connectivity, and brain network characteristics during the formation of a chronic restraint stress (CRS) model. Furthermore, our model combining the electrophysiological changes of LHb and interactions between LHb and other potential targets of depression can effectively distinguish depressive states, offering a new way for developing effective closed-loop DBS strategies.

Neural Decoding and Feature Selection Techniques for Closed-Loop Control of Defensive Behavior

Objective

Many psychiatric disorders involve excessive avoidant or defensive behavior, such as avoidance in anxiety and trauma disorders or defensive rituals in obsessive-compulsive disorders. Developing algorithms to predict these behaviors from local field potentials (LFPs) could serve as foundational technology for closed-loop control of such disorders. A significant challenge is identifying the LFP features that encode these defensive behaviors.

Approach

We analyzed LFP signals from the infralimbic cortex and basolateral amygdala of rats undergoing tone-shock conditioning and extinction, standard for investigating defensive behaviors. We utilized a comprehensive set of neuro-markers across spectral, temporal, and connectivity domains, employing SHapley Additive exPlanations for feature importance evaluation within Light Gradient-Boosting Machine models. Our goal was to decode three commonly studied avoidance/defensive behaviors: freezing, bar-press suppression, and motion (accelerometry), examining the impact of different features on decoding performance.

Main results

Band power and band power ratio between channels emerged as optimal features across sessions. High-gamma (80-150 Hz) power, power ratios, and inter-regional correlations were more informative than other bands that are more classically linked to defensive behaviors. Focusing on highly informative features enhanced performance. Across 4 recording sessions with 16 subjects, we achieved an average coefficient of determination of 0.5357 and 0.3476, and Pearson correlation coefficients of 0.7579 and 0.6092 for accelerometry jerk and bar press rate, respectively. Utilizing only the most informative features revealed differential encoding between accelerometry and bar press rate, with the former primarily through local spectral power and the latter via inter-regional connectivity. Our methodology demonstrated remarkably low time complexity, requiring <110 ms for training and <1 ms for inference.

Significance

Our results demonstrate the feasibility of accurately decoding defensive behaviors with minimal latency, using LFP features from neural circuits strongly linked to these behaviors. This methodology holds promise for real-time decoding to identify physiological targets in closed-loop psychiatric neuromodulation.

Robust adaptive deep brain stimulation control of in-silico non-stationary Parkinsonian neural oscillatory dynamics

Objective. Closed-loop deep brain stimulation (DBS) is a promising therapy for Parkinson's disease (PD) that works by adjusting DBS patterns in real time from the guidance of feedback neural activity. Current closed-loop DBS mainly uses threshold-crossing on-off controllers or linear time-invariant (LTI) controllers to regulate the basal ganglia (BG) Parkinsonian beta band oscillation power. However, the critical cortex-BG-thalamus network dynamics underlying PD are nonlinear, non-stationary, and noisy, hindering accurate and robust control of Parkinsonian neural oscillatory dynamics.Approach. Here, we develop a new robust adaptive closed-loop DBS method for regulating the Parkinsonian beta oscillatory dynamics of the cortex-BG-thalamus network. We first build an adaptive state-space model to quantify the dynamic, nonlinear, and non-stationary neural activity. We then construct an adaptive estimator to track the nonlinearity and non-stationarity in real time. We next design a robust controller to automatically determine the DBS frequency based on the estimated Parkinsonian neural state while reducing the system's sensitivity to high-frequency noise. We adopt and tune a biophysical cortex-BG-thalamus network model as an in-silico simulation testbed to generate nonlinear and non-stationary Parkinsonian neural dynamics for evaluating DBS methods.Main results. We find that under different nonlinear and non-stationary neural dynamics, our robust adaptive DBS method achieved accurate regulation of the BG Parkinsonian beta band oscillation power with small control error, bias, and deviation. Moreover, the accurate regulation generalizes across different therapeutic targets and consistently outperforms current on-off and LTI DBS methods.Significance. These results have implications for future designs of closed-loop DBS systems to treat PD.

Trajectory Modeling and Response Prediction in Transcranial Magnetic Stimulation for Depression

Repetitive transcranial magnetic stimulation (rTMS) therapy could be improved by better and earlier prediction of response. Latent class mixture (LCMM) and non-linear mixed effects (NLME) modelling have been applied to model the trajectories of antidepressant response (or non-response) to TMS, but it is not known whether such models can predict clinical outcomes. We compared LCMM and NLME approaches to model the antidepressant response to TMS in a naturalistic sample of 238 patients receiving rTMS for treatment resistant depression (TRD), across multiple coils and protocols. We then compared the predictive power of those models. LCMM trajectories were influenced largely by baseline symptom severity, but baseline symptoms provided little predictive power for later antidepressant response. Rather, the optimal LCMM model was a nonlinear two-class model that accounted for baseline symptoms. This model accurately predicted patient response at 4 weeks of treatment (AUC = 0.70, 95% CI = [0.52-0.87]), but not before. NLME offered slightly improved predictive performance at 4 weeks of treatment (AUC = 0.76, 95% CI = [0.58 - 0.94], but likewise, not before. In showing the predictive validity of these approaches to model response trajectories to rTMS, we provided preliminary evidence that trajectory modeling could be used to guide future treatment decisions.

Consistent spectro-spatial features of human ECoG successfully decode naturalistic behavioral states

Objective

Understanding the neural correlates of naturalistic behavior is critical for extending and confirming the results obtained from trial-based experiments and designing generalizable brain-computer interfaces that can operate outside laboratory environments. In this study, we aimed to pinpoint consistent spectro-spatial features of neural activity in humans that can discriminate between naturalistic behavioral states.

Approach

We analyzed data from five participants using electrocorticography (ECoG) with broad spatial coverage. Spontaneous and naturalistic behaviors such as "Talking" and "Watching TV" were labeled from manually annotated videos. Linear discriminant analysis (LDA) was used to classify the two behavioral states. The parameters learned from the LDA were then used to determine whether the neural signatures driving classification performance are consistent across the participants.

Main results

Spectro-spatial feature values were consistently discriminative between the two labeled behavioral states across participants. Mainly, θ, α, and low and high γ in the postcentral gyrus, precentral gyrus, and temporal lobe showed significant classification performance and feature consistency across participants. Subject-specific performance exceeded 70%. Combining neural activity from multiple cortical regions generally does not improve decoding performance, suggesting that information regarding the behavioral state is non-additive as a function of the cortical region.

Significance

To the best of our knowledge, this is the first attempt to identify specific spectro-spatial neural correlates that consistently decode naturalistic and active behavioral states. The aim of this work is to serve as an initial starting point for developing brain-computer interfaces that can be generalized in a realistic setting and to further our understanding of the neural correlates of naturalistic behavior in humans.

Hippocampal sharp-wave ripples correlate with periods of naturally occurring self-generated thoughts in humans

Core features of human cognition highlight the importance of the capacity to focus on information distinct from events in the here and now, such as mind wandering. However, the brain mechanisms that underpin these self-generated states remain unclear. An emerging hypothesis is that self-generated states depend on the process of memory replay, which is linked to sharp-wave ripples (SWRs), which are transient high-frequency oscillations originating in the hippocampus. Local field potentials were recorded from the hippocampus of 10 patients with epilepsy for up to 15 days, and experience sampling was used to describe their association with ongoing thought patterns. The SWR rates were higher during extended periods of time when participants' ongoing thoughts were more vivid, less desirable, had more imaginable properties, and exhibited fewer correlations with an external task. These data suggest a role for SWR in the patterns of ongoing thoughts that humans experience in daily life.

Event detection and classification from multimodal time series with application to neural data

The detection of events in time-series data is a common signal-processing problem. When the data can be modeled as a known template signal with an unknown delay in Gaussian noise, detection of the template signal can be done with a traditional matched filter. However, in many applications, the event of interest is represented in multimodal data consisting of both Gaussian and point-process time series. Neuroscience experiments, for example, can simultaneously record multimodal neural signals such as local field potentials (LFPs), which can be modeled as Gaussian, and neuronal spikes, which can be modeled as point processes. Currently, no method exists for event detection from such multimodal data, and as such our objective in this work is to develop a method to meet this need. Here we address this challenge by developing the multimodal event detector (MED) algorithm which simultaneously estimates event times and classes. To do this, we write a multimodal likelihood function for Gaussian and point-process observations and derive the associated maximum likelihood estimator of simultaneous event times and classes. We additionally introduce a cross-modal scaling parameter to account for model mismatch in real datasets. We validate this method in extensive simulations as well as in a neural spike-LFP dataset recorded during an eye-movement task, where the events of interest are eye movements with unknown times and directions. We show that the MED can successfully detect eye movement onset and classify eye movement direction. Further, the MED successfully combines information across data modalities, with multimodal performance exceeding unimodal performance. This method can facilitate applications such as the discovery of latent events in multimodal neural population activity and the development of brain-computer interfaces for naturalistic settings without constrained tasks or prior knowledge of event times.

Elevated phase amplitude coupling as a depression biomarker in epilepsy

Depression is prevalent in epilepsy patients and their intracranial brain activity recordings can be used to determine the types of brain activity that are associated with comorbid depression. We performed case-control comparison of spectral power and phase amplitude coupling (PAC) in 34 invasively monitored drug resistant epilepsy patients' brain recordings. The values of spectral power and PAC for one-minute segments out of every hour in a patient's study were correlated with pre-operative assessment of depressive symptoms by Beck Depression Inventory-II (BDI). We identified an elevated PAC signal (theta-alpha-beta phase (5-25 Hz)/gamma frequency (80-100 Hz) band) that is present in high BDI scores but not low BDI scores adult epilepsy patients in brain regions implicated in primary depression, including anterior cingulate cortex, amygdala and orbitofrontal cortex. Our results showed the application of PAC as a network-specific, electrophysiologic biomarker candidate for comorbid depression and its potential as treatment target for neuromodulation.

Multimodal subspace identification for modeling discrete-continuous spiking and field potential population activity

Objective.Learning dynamical latent state models for multimodal spiking and field potential activity can reveal their collective low-dimensional dynamics and enable better decoding of behavior through multimodal fusion. Toward this goal, developing unsupervised learning methods that are computationally efficient is important, especially for real-time learning applications such as brain-machine interfaces (BMIs). However, efficient learning remains elusive for multimodal spike-field data due to their heterogeneous discrete-continuous distributions and different timescales.Approach.Here, we develop a multiscale subspace identification (multiscale SID) algorithm that enables computationally efficient learning for modeling and dimensionality reduction for multimodal discrete-continuous spike-field data. We describe the spike-field activity as combined Poisson and Gaussian observations, for which we derive a new analytical SID method. Importantly, we also introduce a novel constrained optimization approach to learn valid noise statistics, which is critical for multimodal statistical inference of the latent state, neural activity, and behavior. We validate the method using numerical simulations and with spiking and local field potential population activity recorded during a naturalistic reach and grasp behavior.Main results.We find that multiscale SID accurately learned dynamical models of spike-field signals and extracted low-dimensional dynamics from these multimodal signals. Further, it fused multimodal information, thus better identifying the dynamical modes and predicting behavior compared to using a single modality. Finally, compared to existing multiscale expectation-maximization learning for Poisson-Gaussian observations, multiscale SID had a much lower training time while being better in identifying the dynamical modes and having a better or similar accuracy in predicting neural activity and behavior.Significance.Overall, multiscale SID is an accurate learning method that is particularly beneficial when efficient learning is of interest, such as for online adaptive BMIs to track non-stationary dynamics or for reducing offline training time in neuroscience investigations.

Data augmentation for invasive brain-computer interfaces based on stereo-electroencephalography (SEEG)

Objective.Deep learning is increasingly used for brain-computer interfaces (BCIs). However, the quantity of available data is sparse, especially for invasive BCIs. Data augmentation (DA) methods, such as generative models, can help to address this sparseness. However, all the existing studies on brain signals were based on convolutional neural networks and ignored the temporal dependence. This paper attempted to enhance generative models by capturing the temporal relationship from a time-series perspective.Approach. A conditional generative network (conditional transformer-based generative adversarial network (cTGAN)) based on the transformer model was proposed. The proposed method was tested using a stereo-electroencephalography (SEEG) dataset which was recorded from eight epileptic patients performing five different movements. Three other commonly used DA methods were also implemented: noise injection (NI), variational autoencoder (VAE), and conditional Wasserstein generative adversarial network with gradient penalty (cWGANGP). Using the proposed method, the artificial SEEG data was generated, and several metrics were used to compare the data quality, including visual inspection, cosine similarity (CS), Jensen-Shannon distance (JSD), and the effect on the performance of a deep learning-based classifier.Main results. Both the proposed cTGAN and the cWGANGP methods were able to generate realistic data, while NI and VAE outputted inferior samples when visualized as raw sequences and in a lower dimensional space. The cTGAN generated the best samples in terms of CS and JSD and outperformed cWGANGP significantly in enhancing the performance of a deep learning-based classifier (each of them yielding a significant improvement of 6% and 3.4%, respectively).Significance. This is the first time that DA methods have been applied to invasive BCIs based on SEEG. In addition, this study demonstrated the advantages of the model that preserves the temporal dependence from a time-series perspective.

Ethical considerations for integrating multimodal computer perception and neurotechnology

Background

Artificial intelligence (AI)-based computer perception technologies (e.g., digital phenotyping and affective computing) promise to transform clinical approaches to personalized care in psychiatry and beyond by offering more objective measures of emotional states and behavior, enabling precision treatment, diagnosis, and symptom monitoring. At the same time, passive and continuous nature by which they often collect data from patients in non-clinical settings raises ethical issues related to privacy and self-determination. Little is known about how such concerns may be exacerbated by the integration of neural data, as parallel advances in computer perception, AI, and neurotechnology enable new insights into subjective states. Here, we present findings from a multi-site NCATS-funded study of ethical considerations for translating computer perception into clinical care and contextualize them within the neuroethics and neurorights literatures.

Methods

We conducted qualitative interviews with patients (n = 20), caregivers (n = 20), clinicians (n = 12), developers (n = 12), and clinician developers (n = 2) regarding their perspective toward using PC in clinical care. Transcripts were analyzed in MAXQDA using Thematic Content Analysis.

Results

Stakeholder groups voiced concerns related to (1) perceived invasiveness of passive and continuous data collection in private settings; (2) data protection and security and the potential for negative downstream/future impacts on patients of unintended disclosure; and (3) ethical issues related to patients' limited versus hyper awareness of passive and continuous data collection and monitoring. Clinicians and developers highlighted that these concerns may be exacerbated by the integration of neural data with other computer perception data.

Discussion

Our findings suggest that the integration of neurotechnologies with existing computer perception technologies raises novel concerns around dignity-related and other harms (e.g., stigma, discrimination) that stem from data security threats and the growing potential for reidentification of sensitive data. Further, our findings suggest that patients' awareness and preoccupation with feeling monitored via computer sensors ranges from hypo- to hyper-awareness, with either extreme accompanied by ethical concerns (consent vs. anxiety and preoccupation). These results highlight the need for systematic research into how best to implement these technologies into clinical care in ways that reduce disruption, maximize patient benefits, and mitigate long-term risks associated with the passive collection of sensitive emotional, behavioral and neural data.

Modeling and dissociation of intrinsic and input-driven neural population dynamics underlying behavior

Neural dynamics can reflect intrinsic dynamics or dynamic inputs, such as sensory inputs or inputs from other brain regions. To avoid misinterpreting temporally structured inputs as intrinsic dynamics, dynamical models of neural activity should account for measured inputs. However, incorporating measured inputs remains elusive in joint dynamical modeling of neural-behavioral data, which is important for studying neural computations of behavior. We first show how training dynamical models of neural activity while considering behavior but not input or input but not behavior may lead to misinterpretations. We then develop an analytical learning method for linear dynamical models that simultaneously accounts for neural activity, behavior, and measured inputs. The method provides the capability to prioritize the learning of intrinsic behaviorally relevant neural dynamics and dissociate them from both other intrinsic dynamics and measured input dynamics. In data from a simulated brain with fixed intrinsic dynamics that performs different tasks, the method correctly finds the same intrinsic dynamics regardless of the task while other methods can be influenced by the task. In neural datasets from three subjects performing two different motor tasks with task instruction sensory inputs, the method reveals low-dimensional intrinsic neural dynamics that are missed by other methods and are more predictive of behavior and/or neural activity. The method also uniquely finds that the intrinsic behaviorally relevant neural dynamics are largely similar across the different subjects and tasks, whereas the overall neural dynamics are not. These input-driven dynamical models of neural-behavioral data can uncover intrinsic dynamics that may otherwise be missed.

Neural response properties predict perceived contents and locations elicited by intracranial electrical stimulation of human auditory cortex

Intracranial electrical stimulation (iES) of auditory cortex can elicit sound experiences with a variety of perceived contents (hallucination or illusion) and locations (contralateral or bilateral side), independent of actual acoustic inputs. However, the neural mechanisms underlying this elicitation heterogeneity remain undiscovered. Here, we collected subjective reports following iES at 3062 intracranial sites in 28 patients (both sexes) and identified 113 auditory cortical sites with iES-elicited sound experiences. We then decomposed the sound-induced intracranial electroencephalogram (iEEG) signals recorded from all 113 sites into time-frequency features. We found that the iES-elicited perceived contents can be predicted by the early high-γ features extracted from sound-induced iEEG. In contrast, the perceived locations elicited by stimulating hallucination sites and illusion sites are determined by the late high-γ and long-lasting α features, respectively. Our study unveils the crucial neural signatures of iES-elicited sound experiences in human and presents a new strategy to hearing restoration for individuals suffering from deafness.

Time-varying generalized linear models: characterizing and decoding neuronal dynamics in higher visual areas

To create a behaviorally relevant representation of the visual world, neurons in higher visual areas exhibit dynamic response changes to account for the time-varying interactions between external (e.g., visual input) and internal (e.g., reward value) factors. The resulting high-dimensional representational space poses challenges for precisely quantifying individual factors' contributions to the representation and readout of sensory information during a behavior. The widely used point process generalized linear model (GLM) approach provides a powerful framework for a quantitative description of neuronal processing as a function of various sensory and non-sensory inputs (encoding) as well as linking particular response components to particular behaviors (decoding), at the level of single trials and individual neurons. However, most existing variations of GLMs assume the neural systems to be time-invariant, making them inadequate for modeling nonstationary characteristics of neuronal sensitivity in higher visual areas. In this review, we summarize some of the existing GLM variations, with a focus on time-varying extensions. We highlight their applications to understanding neural representations in higher visual areas and decoding transient neuronal sensitivity as well as linking physiology to behavior through manipulation of model components. This time-varying class of statistical models provide valuable insights into the neural basis of various visual behaviors in higher visual areas and hold significant potential for uncovering the fundamental computational principles that govern neuronal processing underlying various behaviors in different regions of the brain.

Electome network factors: Capturing emotional brain networks related to health and disease

Therapeutic development for mental disorders has been slow despite the high worldwide prevalence of illness. Unfortunately, cellular and circuit insights into disease etiology have largely failed to generalize across individuals that carry the same diagnosis, reflecting an unmet need to identify convergent mechanisms that would facilitate optimal treatment. Here, we discuss how mesoscale networks can encode affect and other cognitive processes. These networks can be discovered through electrical functional connectome (electome) analysis, a method built upon explainable machine learning models for analyzing and interpreting mesoscale brain-wide signals in a behavioral context. We also outline best practices for identifying these generalizable, interpretable, and biologically relevant networks. Looking forward, translational electome analysis can span species and various moods, cognitive processes, or other brain states, supporting translational medicine. Thus, we argue that electome analysis provides potential translational biomarkers for developing next-generation therapeutics that exhibit high efficacy across heterogeneous disorders.

To be or not to be hallucinating: Implications of hypnagogic/hypnopompic experiences and lucid dreaming for brain disorders

The boundaries between waking and sleeping-when falling asleep (hypnagogic) or waking up (hypnopompic)-can be challenging for our ability to monitor and interpret reality. Without proper understanding, bizarre but relatively normal hypnagogic/hypnopompic experiences can be misinterpreted as psychotic hallucinations (occurring, by definition, in the fully awake state), potentially leading to stigma and misdiagnosis in clinical contexts and to misconception and bias in research contexts. This Perspective proposes that conceptual and practical understanding for differentiating hallucinations from hypnagogic/hypnopompic experiences may be offered by lucid dreaming, the state in which one is aware of dreaming while sleeping. I first introduce a possible systematization of the phenomenological range of hypnagogic/hypnopompic experiences that can occur in the transition from awake to REM dreaming (including hypnagogic perceptions, transition symptoms, sleep paralysis, false awakenings, and out-of-body experiences). I then outline how metacognitive strategies used by lucid dreamers to gain/confirm oneiric lucidity could be tested for better differentiating hypnagogic/hypnopompic experiences from hallucinations. The relevance of hypnagogic/hypnopompic experiences and lucid dreaming is analyzed for schizophrenia and narcolepsy, and discussed for neurodegenerative diseases, particularly Lewy-body disorders (i.e. Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies), offering testable hypotheses for empirical investigation. Finally, emotionally positive lucid dreams triggered or enhanced by training/induction strategies or by a pathological process may have intrinsic therapeutic value if properly recognized and guided. The overall intention is to raise awareness and foster further research about the possible diagnostic, prognostic, and therapeutic implications of hypnagogic/hypnopompic experiences and lucid dreaming for brain disorders.

Closed-loop neurostimulation for the treatment of psychiatric disorders

Despite increasing prevalence and huge personal and societal burden, psychiatric diseases still lack treatments which can control symptoms for a large fraction of patients. Increasing insight into the neurobiology underlying these diseases has demonstrated wide-ranging aberrant activity and functioning in multiple brain circuits and networks. Together with varied presentation and symptoms, this makes one-size-fits-all treatment a challenge. There has been a resurgence of interest in the use of neurostimulation as a treatment for psychiatric diseases. Initial studies using continuous open-loop stimulation, in which clinicians adjusted stimulation parameters during patient visits, showed promise but also mixed results. Given the periodic nature and fluctuations of symptoms often observed in psychiatric illnesses, the use of device-driven closed-loop stimulation may provide more effective therapy. The use of a biomarker, which is correlated with specific symptoms, to deliver stimulation only during symptomatic periods allows for the personalized therapy needed for such heterogeneous disorders. Here, we provide the reader with background motivating the use of closed-loop neurostimulation for the treatment of psychiatric disorders. We review foundational studies of open- and closed-loop neurostimulation for neuropsychiatric indications, focusing on deep brain stimulation, and discuss key considerations when designing and implementing closed-loop neurostimulation.

Dynamical flexible inference of nonlinear latent factors and structures in neural population activity

Modelling the spatiotemporal dynamics in the activity of neural populations while also enabling their flexible inference is hindered by the complexity and noisiness of neural observations. Here we show that the lower-dimensional nonlinear latent factors and latent structures can be computationally modelled in a manner that allows for flexible inference causally, non-causally and in the presence of missing neural observations. To enable flexible inference, we developed a neural network that separates the model into jointly trained manifold and dynamic latent factors such that nonlinearity is captured through the manifold factors and the dynamics can be modelled in tractable linear form on this nonlinear manifold. We show that the model, which we named 'DFINE' (for 'dynamical flexible inference for nonlinear embeddings') achieves flexible inference in simulations of nonlinear dynamics and across neural datasets representing a diversity of brain regions and behaviours. Compared with earlier neural-network models, DFINE enables flexible inference, better predicts neural activity and behaviour, and better captures the latent neural manifold structure. DFINE may advance the development of neurotechnology and investigations in neuroscience.

Closing the loop in psychiatric deep brain stimulation: physiology, psychometrics, and plasticity

Deep brain stimulation (DBS) is an invasive approach to precise modulation of psychiatrically relevant circuits. Although it has impressive results in open-label psychiatric trials, DBS has also struggled to scale to and pass through multi-center randomized trials. This contrasts with Parkinson disease, where DBS is an established therapy treating thousands of patients annually. The core difference between these clinical applications is the difficulty of proving target engagement, and of leveraging the wide range of possible settings (parameters) that can be programmed in a given patient's DBS. In Parkinson's, patients' symptoms change rapidly and visibly when the stimulator is tuned to the correct parameters. In psychiatry, those same changes take days to weeks, limiting a clinician's ability to explore parameter space and identify patient-specific optimal settings. I review new approaches to psychiatric target engagement, with an emphasis on major depressive disorder (MDD). Specifically, I argue that better engagement may come by focusing on the root causes of psychiatric illness: dysfunction in specific, measurable cognitive functions and in the connectivity and synchrony of distributed brain circuits. I overview recent progress in both those domains, and how it may relate to other technologies discussed in companion articles in this issue.

Macroscopic resting-state brain dynamics are best described by linear models

It is typically assumed that large networks of neurons exhibit a large repertoire of nonlinear behaviours. Here we challenge this assumption by leveraging mathematical models derived from measurements of local field potentials via intracranial electroencephalography and of whole-brain blood-oxygen-level-dependent brain activity via functional magnetic resonance imaging. We used state-of-the-art linear and nonlinear families of models to describe spontaneous resting-state activity of 700 participants in the Human Connectome Project and 122 participants in the Restoring Active Memory project. We found that linear autoregressive models provide the best fit across both data types and three performance metrics: predictive power, computational complexity and the extent of the residual dynamics unexplained by the model. To explain this observation, we show that microscopic nonlinear dynamics can be counteracted or masked by four factors associated with macroscopic dynamics: averaging over space and over time, which are inherent to aggregated macroscopic brain activity, and observation noise and limited data samples, which stem from technological limitations. We therefore argue that easier-to-interpret linear models can faithfully describe macroscopic brain dynamics during resting-state conditions.

Unsupervised learning of stationary and switching dynamical system models from Poisson observations

Objective. Investigating neural population dynamics underlying behavior requires learning accurate models of the recorded spiking activity, which can be modeled with a Poisson observation distribution. Switching dynamical system models can offer both explanatory power and interpretability by piecing together successive regimes of simpler dynamics to capture more complex ones. However, in many cases, reliable regime labels are not available, thus demanding accurate unsupervised learning methods for Poisson observations. Existing learning methods, however, rely on inference of latent states in neural activity using the Laplace approximation, which may not capture the broader properties of densities and may lead to inaccurate learning. Thus, there is a need for new inference methods that can enable accurate model learning.Approach. To achieve accurate model learning, we derive a novel inference method based on deterministic sampling for Poisson observations called the Poisson Cubature Filter (PCF) and embed it in an unsupervised learning framework. This method takes a minimum mean squared error approach to estimation. Terms that are difficult to find analytically for Poisson observations are approximated in a novel way with deterministic sampling based on numerical integration and cubature rules.Main results. PCF enabled accurate unsupervised learning in both stationary and switching dynamical systems and largely outperformed prior Laplace approximation-based learning methods in both simulations and motor cortical spiking data recorded during a reaching task. These improvements were larger for smaller data sizes, showing that PCF-based learning was more data efficient and enabled more reliable regime identification. In experimental data and unsupervised with respect to behavior, PCF-based learning uncovered interpretable behavior-relevant regimes unlike prior learning methods.Significance. The developed unsupervised learning methods for switching dynamical systems can accurately uncover latent regimes and states in population spiking activity, with important applications in both basic neuroscience and neurotechnology.

Internal states as a source of subject-dependent movement variability are represented by large-scale brain networks

Humans' ability to adapt and learn relies on reflecting on past performance. These experiences form latent representations called internal states that induce movement variability that improves how we interact with our environment. Our study uncovered temporal dynamics and neural substrates of two states from ten subjects implanted with intracranial depth electrodes while they performed a goal-directed motor task with physical perturbations. We identified two internal states using state-space models: one tracking past errors and the other past perturbations. These states influenced reaction times and speed errors, revealing how subjects strategize from trial history. Using local field potentials from over 100 brain regions, we found large-scale brain networks such as the dorsal attention and default mode network modulate visuospatial attention based on recent performance and environmental feedback. Notably, these networks were more prominent in higher-performing subjects, emphasizing their role in improving motor performance by regulating movement variability through internal states.

Exploring Spatio-Spectral Electroencephalogram Modulations of Imbuing Emotional Intent During Active Piano Playing

Imbuing emotional intent serves as a crucial modulator of music improvisation during active musical instrument playing. However, most improvisation-related neural endeavors have been gained without considering the emotional context. This study attempts to exploit reproducible spatio-spectral electroencephalogram (EEG) oscillations of emotional intent using a data-driven independent component analysis framework in an ecological multiday piano playing experiment. Through the four-day 32-ch EEG dataset of 10 professional players, we showed that EEG patterns were substantially affected by both intra- and inter-individual variability underlying the emotional intent of the dichotomized valence (positive vs. negative) and arousal (high vs. low) categories. Less than half (3-4) of the 10 participants analogously exhibited day-reproducible ( ≥ three days) spectral modulations at the right frontal beta in response to the valence contrast as well as the frontal central gamma and the superior parietal alpha to the arousal counterpart. In particular, the frontal engagement facilitates a better understanding of the frontal cortex (e.g., dorsolateral prefrontal cortex and anterior cingulate cortex) and its role in intervening emotional processes and expressing spectral signatures that are relatively resistant to natural EEG variability. Such ecologically vivid EEG findings may lead to better understanding of the development of a brain-computer music interface infrastructure capable of guiding the training, performance, and appreciation for emotional improvisatory status or actuating music interaction via emotional context.

EEG-Based Parkinson's Disease Recognition via Attention-Based Sparse Graph Convolutional Neural Network

Parkinson's disease (PD) is a complicated neurological ailment that affects both the physical and mental wellness of elderly individuals which makes it problematic to diagnose in its initial stages. Electroencephalogram (EEG) promises to be an efficient and cost-effective method for promptly detecting cognitive impairment in PD. Nevertheless, prevailing diagnostic practices utilizing EEG features have failed to examine the functional connectivity among EEG channels and the response of associated brain areas causing an unsatisfactory level of precision. Here, we construct an attention-based sparse graph convolutional neural network (ASGCNN) for diagnosing PD. Our ASGCNN model uses a graph structure to represent channel relationships, the attention mechanism for selecting channels, and the L1 norm to capture channel sparsity. We conduct extensive experiments on the publicly available PD auditory oddball dataset, which consists of 24 PD patients (under ON/OFF drug status) and 24 matched controls, to validate the effectiveness of our method. Our results show that the proposed method provides better results compared to the publicly available baselines. The achieved scores for Recall, Precision, F1-score, Accuracy and Kappa measures are 90.36%, 88.43%, 88.41%, 87.67%, and 75.24%, respectively. Our study reveals that the frontal and temporal lobes show significant differences between PD patients and healthy individuals. In addition, EEG features extracted by ASGCNN demonstrate significant asymmetry in the frontal lobe among PD patients. These findings can offer a basis for the establishment of a clinical system for intelligent diagnosis of PD by using auditory cognitive impairment features.

Multifunctional fibers enable modulation of cortical and deep brain activity during cognitive behavior in macaques

Recording and modulating neural activity in vivo enables investigations of the neurophysiology underlying behavior and disease. However, there is a dearth of translational tools for simultaneous recording and localized receptor-specific modulation. We address this limitation by translating multifunctional fiber neurotechnology previously only available for rodent studies to enable cortical and subcortical neural recording and modulation in macaques. We record single-neuron and broader oscillatory activity during intracranial GABA infusions in the premotor cortex and putamen. By applying state-space models to characterize changes in electrophysiology, we uncover that neural activity evoked by a working memory task is reshaped by even a modest local inhibition. The recordings provide detailed insight into the electrophysiological effect of neurotransmitter receptor modulation in both cortical and subcortical structures in an awake macaque. Our results demonstrate a first-time application of multifunctional fibers for causal studies of neuronal activity in behaving nonhuman primates and pave the way for clinical translation of fiber-based neurotechnology.

Inferring cognitive state underlying conflict choices in verbal Stroop task using heterogeneous input discriminative-generative decoder model

Objective. The subthalamic nucleus (STN) of the basal ganglia interacts with the medial prefrontal cortex (mPFC) and shapes a control loop, specifically when the brain receives contradictory information from either different sensory systems or conflicting information from sensory inputs and prior knowledge that developed in the brain. Experimental studies demonstrated that significant increases in theta activities (2-8 Hz) in both the STN and mPFC as well as increased phase synchronization between mPFC and STN are prominent features of conflict processing. While these neural features reflect the importance of STN-mPFC circuitry in conflict processing, a low-dimensional representation of the mPFC-STN interaction referred to as a cognitive state, that links neural activities generated by these sub-regions to behavioral signals (e.g. the response time), remains to be identified.Approach. Here, we propose a new model, namely, the heterogeneous input discriminative-generative decoder (HI-DGD) model, to infer a cognitive state underlying decision-making based on neural activities (STN and mPFC) and behavioral signals (individuals' response time) recorded in ten Parkinson's disease (PD) patients while they performed a Stroop task. PD patients may have conflict processing which is quantitatively (may be qualitative in some) different from healthy populations.Main results. Using extensive synthetic and experimental data, we showed that the HI-DGD model can diffuse information from neural and behavioral data simultaneously and estimate cognitive states underlying conflict and non-conflict trials significantly better than traditional methods. Additionally, the HI-DGD model identified which neural features made significant contributions to conflict and non-conflict choices. Interestingly, the estimated features match well with those reported in experimental studies.Significance. Finally, we highlight the capability of the HI-DGD model in estimating a cognitive state from a single trial of observation, which makes it appropriate to be utilized in closed-loop neuromodulation systems.

Post-stimulus encoding of decision confidence in EEG: toward a brain-computer interface for decision making

Objective.When making decisions, humans can evaluate how likely they are to be correct. If this subjective confidence could be reliably decoded from brain activity, it would be possible to build a brain-computer interface (BCI) that improves decision performance by automatically providing more information to the user if needed based on their confidence. But this possibility depends on whether confidence can be decoded right after stimulus presentation and before the response so that a corrective action can be taken in time. Although prior work has shown that decision confidence is represented in brain signals, it is unclear if the representation is stimulus-locked or response-locked, and whether stimulus-locked pre-response decoding is sufficiently accurate for enabling such a BCI.Approach.We investigate the neural correlates of confidence by collecting high-density electroencephalography (EEG) during a perceptual decision task with realistic stimuli. Importantly, we design our task to include a post-stimulus gap that prevents the confounding of stimulus-locked activity by response-locked activity and vice versa, and then compare with a task without this gap.Main results.We perform event-related potential and source-localization analyses. Our analyses suggest that the neural correlates of confidence are stimulus-locked, and that an absence of a post-stimulus gap could cause these correlates to incorrectly appear as response-locked. By preventing response-locked activity from confounding stimulus-locked activity, we then show that confidence can be reliably decoded from single-trial stimulus-locked pre-response EEG alone. We also identify a high-performance classification algorithm by comparing a battery of algorithms. Lastly, we design a simulated BCI framework to show that the EEG classification is accurate enough to build a BCI and that the decoded confidence could be used to improve decision making performance particularly when the task difficulty and cost of errors are high.Significance.Our results show feasibility of non-invasive EEG-based BCIs to improve human decision making.

Decoding Depression Severity From Intracranial Neural Activity

BACKGROUND

Disorders of mood and cognition are prevalent, disabling, and notoriously difficult to treat. Fueling this challenge in treatment is a significant gap in our understanding of their neurophysiological basis.

METHODS

We recorded high-density neural activity from intracranial electrodes implanted in depression-relevant prefrontal cortical regions in 3 human subjects with severe depression. Neural recordings were labeled with depression severity scores across a wide dynamic range using an adaptive assessment that allowed sampling with a temporal frequency greater than that possible with typical rating scales. We modeled these data using regularized regression techniques with region selection to decode depression severity from the prefrontal recordings.

RESULTS

Across prefrontal regions, we found that reduced depression severity is associated with decreased low-frequency neural activity and increased high-frequency activity. When constraining our model to decode using a single region, spectral changes in the anterior cingulate cortex best predicted depression severity in all 3 subjects. Relaxing this constraint revealed unique, individual-specific sets of spatiospectral features predictive of symptom severity, reflecting the heterogeneous nature of depression.

CONCLUSIONS

The ability to decode depression severity from neural activity increases our fundamental understanding of how depression manifests in the human brain and provides a target neural signature for personalized neuromodulation therapies.

State-specific modulation of mood using intracranial electrical stimulation of the orbitofrontal cortex

BACKGROUND

Orbitofrontal cortex (OFC) is a promising target for intracranial electrical stimulation (iES) aimed at improving mood states. However, knowledge gaps remain regarding the underlying neural mechanisms of iES effects, such as the effect of the OFC target in comparison with other emotional network targets, the impact of brain state at the time of stimulation, and the neural response induced by iES at both local and network scales.

OBJECTIVE

Our study aims to address the neural mechanisms underlying the effects of iES in improving mood states.

METHODS

We conducted a study in 24 epilepsy patients who received iES through implanted electrodes in the emotional network and compared the effects of iES on multiple targets in the emotional network.

RESULTS

We found that only iES applied to the orbitofrontal cortex (OFC) led to mood improvement and changes in neural activity. We also observed that iES to the OFC suppressed the delta-theta power when the brain was in a low mood state. Moreover, the iES to the OFC decreased delta-theta power and increased gamma power at local regions within the emotional network, and enhanced the information flow through the frequency domain among regions within the emotional network.

CONCLUSIONS

These findings provide insight into the neural correlates of iES-induced mood improvement and support the potential of iES as a therapeutic intervention for mood disorders.

Subject-Independent EEG Emotion Recognition Based on Genetically Optimized Projection Dictionary Pair Learning

One of the primary challenges in Electroencephalogram (EEG) emotion recognition lies in developing models that can effectively generalize to new unseen subjects, considering the significant variability in EEG signals across individuals. To address the issue of subject-specific features, a suitable approach is to employ projection dictionary learning, which enables the identification of emotion-relevant features across different subjects. To accomplish the objective of pattern representation and discrimination for subject-independent EEG emotion recognition, we utilized the fast and efficient projection dictionary pair learning (PDPL) technique. PDPL involves the joint use of a synthesis dictionary and an analysis dictionary to enhance the representation of features. Additionally, to optimize the parameters of PDPL, which depend on experience, we applied the genetic algorithm (GA) to obtain the optimal solution for the model. We validated the effectiveness of our algorithm using leave-one-subject-out cross validation on three EEG emotion databases: SEED, MPED, and GAMEEMO. Our approach outperformed traditional machine learning methods, achieving an average accuracy of 69.89% on the SEED database, 24.11% on the MPED database, 64.34% for the two-class GAMEEMO, and 49.01% for the four-class GAMEEMO. These results highlight the potential of subject-independent EEG emotion recognition algorithms in the development of intelligent systems capable of recognizing and responding to human emotions in real-world scenarios.

The correlation between upper body grip strength and resting-state EEG network

Current research in the field of neuroscience primarily focuses on the analysis of electroencephalogram (EEG) activities associated with movement within the central nervous system. However, there is a dearth of studies investigating the impact of prolonged individual strength training on the resting state of the brain. Therefore, it is crucial to examine the correlation between upper body grip strength and resting-state EEG networks. In this study, coherence analysis was utilized to construct resting-state EEG networks using the available datasets. A multiple linear regression model was established to examine the correlation between the brain network properties of individuals and their maximum voluntary contraction (MVC) during gripping tasks. The model was used to predict individual MVC. The beta and gamma frequency bands showed significant correlation between RSN connectivity and MVC (p < 0.05), particularly in left hemisphere frontoparietal and fronto-occipital connectivity. RSN properties were consistently correlated with MVC in both bands, with correlation coefficients greater than 0.60 (p < 0.01). Additionally, predicted MVC positively correlated with actual MVC, with a coefficient of 0.70 and root mean square error of 5.67 (p < 0.01). The results show that the resting-state EEG network is closely related to upper body grip strength, which can indirectly reflect an individual's muscle strength through the resting brain network.

First-in-human prediction of chronic pain state using intracranial neural biomarkers

Chronic pain syndromes are often refractory to treatment and cause substantial suffering and disability. Pain severity is often measured through subjective report, while objective biomarkers that may guide diagnosis and treatment are lacking. Also, which brain activity underlies chronic pain on clinically relevant timescales, or how this relates to acute pain, remains unclear. Here four individuals with refractory neuropathic pain were implanted with chronic intracranial electrodes in the anterior cingulate cortex and orbitofrontal cortex (OFC). Participants reported pain metrics coincident with ambulatory, direct neural recordings obtained multiple times daily over months. We successfully predicted intraindividual chronic pain severity scores from neural activity with high sensitivity using machine learning methods. Chronic pain decoding relied on sustained power changes from the OFC, which tended to differ from transient patterns of activity associated with acute, evoked pain states during a task. Thus, intracranial OFC signals can be used to predict spontaneous, chronic pain state in patients.

Multimodal subspace identification for modeling discrete-continuous spiking and field potential population activity

Learning dynamical latent state models for multimodal spiking and field potential activity can reveal their collective low-dimensional dynamics and enable better decoding of behavior through multimodal fusion. Toward this goal, developing unsupervised learning methods that are computationally efficient is important, especially for real-time learning applications such as brain-machine interfaces (BMIs). However, efficient learning remains elusive for multimodal spike-field data due to their heterogeneous discrete-continuous distributions and different timescales. Here, we develop a multiscale subspace identification (multiscale SID) algorithm that enables computationally efficient modeling and dimensionality reduction for multimodal discrete-continuous spike-field data. We describe the spike-field activity as combined Poisson and Gaussian observations, for which we derive a new analytical subspace identification method. Importantly, we also introduce a novel constrained optimization approach to learn valid noise statistics, which is critical for multimodal statistical inference of the latent state, neural activity, and behavior. We validate the method using numerical simulations and spike-LFP population activity recorded during a naturalistic reach and grasp behavior. We find that multiscale SID accurately learned dynamical models of spike-field signals and extracted low-dimensional dynamics from these multimodal signals. Further, it fused multimodal information, thus better identifying the dynamical modes and predicting behavior compared to using a single modality. Finally, compared to existing multiscale expectation-maximization learning for Poisson-Gaussian observations, multiscale SID had a much lower computational cost while being better in identifying the dynamical modes and having a better or similar accuracy in predicting neural activity. Overall, multiscale SID is an accurate learning method that is particularly beneficial when efficient learning is of interest.

Closed-Loop Deep Brain Stimulation for Psychiatric Disorders

ABSTRACT

Deep brain stimulation (DBS) is a well-established approach to treating medication-refractory neurological disorders and holds promise for treating psychiatric disorders. Despite strong open-label results in extremely refractory patients, DBS has struggled to meet endpoints in randomized controlled trials. A major challenge is stimulation "dosing"-DBS systems have many adjustable parameters, and clinicians receive little feedback on whether they have chosen the correct parameters for an individual patient. Multiple groups have proposed closed loop technologies as a solution. These systems sense electrical activity, identify markers of an (un)desired state, then automatically deliver or adjust stimulation to alter that electrical state. Closed loop DBS has been successfully deployed in movement disorders and epilepsy. The availability of that technology, as well as advances in opportunities for invasive research with neurosurgical patients, has yielded multiple pilot demonstrations in psychiatric illness. Those demonstrations split into two schools of thought, one rooted in well-established diagnoses and symptom scales, the other in the more experimental Research Domain Criteria (RDoC) framework. Both are promising, and both are limited by the boundaries of current stimulation technology. They are in turn driving advances in implantable recording hardware, signal processing, and stimulation paradigms. The combination of these advances is likely to change both our understanding of psychiatric neurobiology and our treatment toolbox, though the timeframe may be limited by the realities of implantable device development.

Invasive Computational Psychiatry

Computational psychiatry, a relatively new yet prolific field that aims to understand psychiatric disorders with formal theories about the brain, has seen tremendous growth in the past decade. Despite initial excitement, actual progress made by computational psychiatry seems stagnant. Meanwhile, understanding of the human brain has benefited tremendously from recent progress in intracranial neuroscience. Specifically, invasive techniques such as stereotactic electroencephalography, electrocorticography, and deep brain stimulation have provided a unique opportunity to precisely measure and causally modulate neurophysiological activity in the living human brain. In this review, we summarize progress and drawbacks in both computational psychiatry and invasive electrophysiology and propose that their combination presents a highly promising new direction-invasive computational psychiatry. The value of this approach is at least twofold. First, it advances our mechanistic understanding of the neural computations of mental states by providing a spatiotemporally precise depiction of neural activity that is traditionally unattainable using noninvasive techniques with human subjects. Second, it offers a direct and immediate way to modulate brain states through stimulation of algorithmically defined neural regions and circuits (i.e., algorithmic targeting), thus providing both causal and therapeutic insights. We then present depression as a use case where the combination of computational and invasive approaches has already shown initial success. We conclude by outlining future directions as a road map for this exciting new field as well as presenting cautions about issues such as ethical concerns and generalizability of findings.

Closed-loop enhancement and neural decoding of cognitive control in humans

Deficits in cognitive control-that is, in the ability to withhold a default pre-potent response in favour of a more adaptive choice-are common in depression, anxiety, addiction and other mental disorders. Here we report proof-of-concept evidence that, in participants undergoing intracranial epilepsy monitoring, closed-loop direct stimulation of the internal capsule or striatum, especially the dorsal sites, enhances the participants' cognitive control during a conflict task. We also show that closed-loop stimulation upon the detection of lapses in cognitive control produced larger behavioural changes than open-loop stimulation, and that task performance for single trials can be directly decoded from the activity of a small number of electrodes via neural features that are compatible with existing closed-loop brain implants. Closed-loop enhancement of cognitive control might remediate underlying cognitive deficits and aid the treatment of severe mental disorders.

Modeling and dissociation of intrinsic and input-driven neural population dynamics underlying behavior

Neural dynamics can reflect intrinsic dynamics or dynamic inputs, such as sensory inputs or inputs from other regions. To avoid misinterpreting temporally-structured inputs as intrinsic dynamics, dynamical models of neural activity should account for measured inputs. However, incorporating measured inputs remains elusive in joint dynamical modeling of neural-behavioral data, which is important for studying neural computations of a specific behavior. We first show how training dynamical models of neural activity while considering behavior but not input, or input but not behavior may lead to misinterpretations. We then develop a novel analytical learning method that simultaneously accounts for neural activity, behavior, and measured inputs. The method provides the new capability to prioritize the learning of intrinsic behaviorally relevant neural dynamics and dissociate them from both other intrinsic dynamics and measured input dynamics. In data from a simulated brain with fixed intrinsic dynamics that performs different tasks, the method correctly finds the same intrinsic dynamics regardless of task while other methods can be influenced by the change in task. In neural datasets from three subjects performing two different motor tasks with task instruction sensory inputs, the method reveals low-dimensional intrinsic neural dynamics that are missed by other methods and are more predictive of behavior and/or neural activity. The method also uniquely finds that the intrinsic behaviorally relevant neural dynamics are largely similar across the three subjects and two tasks whereas the overall neural dynamics are not. These input-driven dynamical models of neural-behavioral data can uncover intrinsic dynamics that may otherwise be missed.

Use of Invasive Brain-Computer Interfaces in Pediatric Neurosurgery: Technical and Ethical Considerations

Invasive brain-computer interfaces hold promise to alleviate disabilities in individuals with neurologic injury, with fully implantable brain-computer interface systems expected to reach the clinic in the upcoming decade. Children with severe neurologic disabilities, like quadriplegic cerebral palsy or cervical spine trauma, could benefit from this technology. However, they have been excluded from clinical trials of intracortical brain-computer interface to date. In this manuscript, we discuss the ethical considerations related to the use of invasive brain-computer interface in children with severe neurologic disabilities. We first review the technical hardware and software considerations for the application of intracortical brain-computer interface in children. We then discuss ethical issues related to motor brain-computer interface use in pediatric neurosurgery. Finally, based on the input of a multidisciplinary panel of experts in fields related to brain-computer interface (functional and restorative neurosurgery, pediatric neurosurgery, mathematics and artificial intelligence research, neuroengineering, pediatric ethics, and pragmatic ethics), we then formulate initial recommendations regarding the clinical use of invasive brain-computer interfaces in children.

Status of mandatory treatment of mentally ill offenders without criminal responsibility in China: Information from 5,262 mandatory treatment judgments

Background

To avoid public health risks, all governments ensure monitoring and treatment of mentally ill persons if they offend and assess their level of criminal responsibility. The Criminal Procedure Law of the People's Republic of China (2013) instituted special procedures. However, there are few articles in English which explain the implementation of mandatory treatment procedures in China.

Methods

We collected 5,262 qualified documents from 2013 to 2021 from the China Judgments Documents Online. We analyzed social demographic characteristics, trial-related information as well as the mandatory treatment-related content, to investigate the mandatory treatment of China's mentally ill offenders without criminal responsibility, from 2013 to 2021. Simple descriptive statistics and chi-square tests were used to compare differences among several types of documents.

Results

There was an overall change trend of the number of documents: increasing year by year from 2013 to 2019 after the implementation of the new law, but with sharp decrease in 2020 and 2021 during covid-19 pandemic. From 2013 to 2021, a total of 3,854 people had applications made for mandatory treatment, of whom 3,747 (97.2%) were given mandatory treatment, 107 (2.8%) had applications rejected. "Schizophrenia and other psychotic disorders" was the most common diagnosis in both groups and all offenders receiving mandatory treatment (3,747, 100.0%) were considered to have no criminal responsibility. A total of 1,294 patients had applications made for relief of mandatory treatment, of whom 827 (63.9%) were subsequently approved for relief, 467 (36.1%) were rejected. A total of 118 patients had applications for relief two or more times, and 56 (47.5%) were finally relieved.

Conclusion

Our study presents the Chinese model of a criminal mandatory treatment system to the international community which has been in operation since the implementation of the new law. Legislatory changes and covid-19 pandemic can have effect on the number of mandatory treatment cases. Patients, their close relatives and mandatory treatment institutions have the right to apply for relief from mandatory treatment, but the final decision in China is taken by the court.

Predictive neuromodulation of cingulo-frontal neural dynamics in major depressive disorder using a brain-computer interface system: A simulation study

Introduction

Deep brain stimulation (DBS) is a promising therapy for treatment-resistant major depressive disorder (MDD). MDD involves the dysfunction of a brain network that can exhibit complex nonlinear neural dynamics in multiple frequency bands. However, current open-loop and responsive DBS methods cannot track the complex multiband neural dynamics in MDD, leading to imprecise regulation of symptoms, variable treatment effects among patients, and high battery power consumption.

Methods

Here, we develop a closed-loop brain-computer interface (BCI) system of predictive neuromodulation for treating MDD. We first use a biophysically plausible ventral anterior cingulate cortex (vACC)-dorsolateral prefrontal cortex (dlPFC) neural mass model of MDD to simulate nonlinear and multiband neural dynamics in response to DBS. We then use offline system identification to build a dynamic model that predicts the DBS effect on neural activity. We next use the offline identified model to design an online BCI system of predictive neuromodulation. The online BCI system consists of a dynamic brain state estimator and a model predictive controller. The brain state estimator estimates the MDD brain state from the history of neural activity and previously delivered DBS patterns. The predictive controller takes the estimated MDD brain state as the feedback signal and optimally adjusts DBS to regulate the MDD neural dynamics to therapeutic targets. We use the vACC-dlPFC neural mass model as a simulation testbed to test the BCI system and compare it with state-of-the-art open-loop and responsive DBS treatments of MDD.

Results

We demonstrate that our dynamic model accurately predicts nonlinear and multiband neural activity. Consequently, the predictive neuromodulation system accurately regulates the neural dynamics in MDD, resulting in significantly smaller control errors and lower DBS battery power consumption than open-loop and responsive DBS.

Discussion

Our results have implications for developing future precisely-tailored clinical closed-loop DBS treatments for MDD.

Microscale multicircuit brain stimulation: Achieving real-time brain state control for novel applications

Neurological and psychiatric disorders typically result from dysfunction across multiple neural circuits. Most of these disorders lack a satisfactory neuromodulation treatment. However, deep brain stimulation (DBS) has been successful in a limited number of disorders; DBS typically targets one or two brain areas with single contacts on relatively large electrodes, allowing for only coarse modulation of circuit function. Because of the dysfunction in distributed neural circuits - each requiring fine, tailored modulation - that characterizes most neuropsychiatric disorders, this approach holds limited promise. To develop the next generation of neuromodulation therapies, we will have to achieve fine-grained, closed-loop control over multiple neural circuits. Recent work has demonstrated spatial and frequency selectivity using microstimulation with many small, closely-spaced contacts, mimicking endogenous neural dynamics. Using custom electrode design and stimulation parameters, it should be possible to achieve bidirectional control over behavioral outcomes, such as increasing or decreasing arousal during central thalamic stimulation. Here, we discuss one possible approach, which we term microscale multicircuit brain stimulation (MMBS). We discuss how machine learning leverages behavioral and neural data to find optimal stimulation parameters across multiple contacts, to drive the brain towards desired states associated with behavioral goals. We expound a mathematical framework for MMBS, where behavioral and neural responses adjust the model in real-time, allowing us to adjust stimulation in real-time. These technologies will be critical to the development of the next generation of neurostimulation therapies, which will allow us to treat problems like disorders of consciousness and cognition.

Overcoming the Domain Gap in Neural Action Representations

Relating behavior to brain activity in animals is a fundamental goal in neuroscience, with practical applications in building robust brain-machine interfaces. However, the domain gap between individuals is a major issue that prevents the training of general models that work on unlabeled subjects. Since 3D pose data can now be reliably extracted from multi-view video sequences without manual intervention, we propose to use it to guide the encoding of neural action representations together with a set of neural and behavioral augmentations exploiting the properties of microscopy imaging. To test our method, we collect a large dataset that features flies and their neural activity. To reduce the domain gap, during training, we mix features of neural and behavioral data across flies that seem to be performing similar actions. To show our method can generalize further neural modalities and other downstream tasks, we test our method on a human neural Electrocorticography dataset, and another RGB video data of human activities from different viewpoints. We believe our work will enable more robust neural decoding algorithms to be used in future brain-machine interfaces.

Modeling and inference methods for switching regime-dependent dynamical systems with multiscale neural observations

Objective.Realizing neurotechnologies that enable long-term neural recordings across multiple spatial-temporal scales during naturalistic behaviors requires new modeling and inference methods that can simultaneously address two challenges. First, the methods should aggregate information across all activity scales from multiple recording sources such as spiking and field potentials. Second, the methods should detect changes in the regimes of behavior and/or neural dynamics during naturalistic scenarios and long-term recordings. Prior regime detection methods are developed for a single scale of activity rather than multiscale activity, and prior multiscale methods have not considered regime switching and are for stationary cases.Approach.Here, we address both challenges by developing a switching multiscale dynamical system model and the associated filtering and smoothing methods. This model describes the encoding of an unobserved brain state in multiscale spike-field activity. It also allows for regime-switching dynamics using an unobserved regime state that dictates the dynamical and encoding parameters at every time-step. We also design the associated switching multiscale inference methods that estimate both the unobserved regime and brain states from simultaneous spike-field activity.Main results.We validate the methods in both extensive numerical simulations and prefrontal spike-field data recorded in a monkey performing saccades for fluid rewards. We show that these methods can successfully combine the spiking and field potential observations to simultaneously track the regime and brain states accurately. Doing so, these methods lead to better state estimation compared with single-scale switching methods or stationary multiscale methods. Also, for single-scale linear Gaussian observations, the new switching smoother can better generalize to diverse system settings compared to prior switching smoothers.Significance.These modeling and inference methods effectively incorporate both regime-detection and multiscale observations. As such, they could facilitate investigation of latent switching neural population dynamics and improve future brain-machine interfaces by enabling inference in naturalistic scenarios where regime-dependent multiscale activity and behavior arise.

Modern views of machine learning for precision psychiatry

In light of the National Institute of Mental Health (NIMH)'s Research Domain Criteria (RDoC), the advent of functional neuroimaging, novel technologies and methods provide new opportunities to develop precise and personalized prognosis and diagnosis of mental disorders. Machine learning (ML) and artificial intelligence (AI) technologies are playing an increasingly critical role in the new era of precision psychiatry. Combining ML/AI with neuromodulation technologies can potentially provide explainable solutions in clinical practice and effective therapeutic treatment. Advanced wearable and mobile technologies also call for the new role of ML/AI for digital phenotyping in mobile mental health. In this review, we provide a comprehensive review of ML methodologies and applications by combining neuroimaging, neuromodulation, and advanced mobile technologies in psychiatry practice. We further review the role of ML in molecular phenotyping and cross-species biomarker identification in precision psychiatry. We also discuss explainable AI (XAI) and neuromodulation in a closed human-in-the-loop manner and highlight the ML potential in multi-media information extraction and multi-modal data fusion. Finally, we discuss conceptual and practical challenges in precision psychiatry and highlight ML opportunities in future research.

Toward biophysical markers of depression vulnerability

A major difficulty with treating psychiatric disorders is their heterogeneity: different neural causes can lead to the same phenotype. To address this, we propose describing the underlying pathophysiology in terms of interpretable, biophysical parameters of a neural model derived from the electroencephalogram. We analyzed data from a small patient cohort of patients with depression and controls. Using DCM, we constructed biophysical models that describe neural dynamics in a cortical network activated during a task that is used to assess depression state. We show that biophysical model parameters are biomarkers, that is, variables that allow subtyping of depression at a biological level. They yield a low dimensional, interpretable feature space that allowed description of differences between individual patients with depressive symptoms. They could capture internal heterogeneity/variance of depression state and achieve significantly better classification than commonly used EEG features. Our work is a proof of concept that a combination of biophysical models and machine learning may outperform earlier approaches based on classical statistics and raw brain data.

Amplitude and frequency modulation of subthalamic beta oscillations jointly encode the dopaminergic state in Parkinson's disease

Brain states in health and disease are classically defined by the power or the spontaneous amplitude modulation (AM) of neuronal oscillations in specific frequency bands. Conversely, the possible role of the spontaneous frequency modulation (FM) in defining pathophysiological brain states remains unclear. As a paradigmatic example of pathophysiological resting states, here we assessed the spontaneous AM and FM dynamics of subthalamic beta oscillations recorded in patients with Parkinson's disease before and after levodopa administration. Even though AM and FM are mathematically independent, they displayed negatively correlated dynamics. First, AM decreased while FM increased with levodopa. Second, instantaneous amplitude and instantaneous frequency were negatively cross-correlated within dopaminergic states, with FM following AM by approximately one beta cycle. Third, AM and FM changes were also negatively correlated between dopaminergic states. Both the slow component of the FM and the fast component (i.e. the phase slips) increased after levodopa, but they differently contributed to the AM-FM correlations within and between states. Finally, AM and FM provided information about whether the patients were OFF vs. ON levodopa, with partial redundancy and with FM being more informative than AM. AM and FM of spontaneous beta oscillations can thus both separately and jointly encode the dopaminergic state in patients with Parkinson's disease. These results suggest that resting brain states are defined not only by AM dynamics but also, and possibly more prominently, by FM dynamics of neuronal oscillations.

NeuralTree: A 256-Channel 0.227-μJ/Class Versatile Neural Activity Classification and Closed-Loop Neuromodulation SoC

Closed-loop neural interfaces with on-chip machine learning can detect and suppress disease symptoms in neurological disorders or restore lost functions in paralyzed patients. While high-density neural recording can provide rich neural activity information for accurate disease-state detection, existing systems have low channel counts and poor scalability, which could limit their therapeutic efficacy. This work presents a highly scalable and versatile closed-loop neural interface SoC that can overcome these limitations. A 256-channel time-division multiplexed (TDM) front-end with a two-step fast-settling mixed-signal DC servo loop (DSL) is proposed to record high-spatial-resolution neural activity and perform channel-selective brain-state inference. A tree-structured neural network (NeuralTree) classification processor extracts a rich set of neural biomarkers in a patient- and disease-specific manner. Trained with an energy-aware learning algorithm, the NeuralTree classifier detects the symptoms of underlying disorders (e.g., epilepsy and movement disorders) at an optimal energy-accuracy trade-off. A 16-channel high-voltage (HV) compliant neurostimulator closes the therapeutic loop by delivering charge-balanced biphasic current pulses to the brain. The proposed SoC was fabricated in 65nm CMOS and achieved a 0.227μJ/class energy efficiency in a compact area of 0.014mm2/channel. The SoC was extensively verified on human electroencephalography (EEG) and intracranial EEG (iEEG) epilepsy datasets, obtaining 95.6%/94% sensitivity and 96.8%/96.9% specificity, respectively. In-vivo neural recordings using soft μECoG arrays and multi-domain biomarker extraction were further performed on a rat model of epilepsy. In addition, for the first time in literature, on-chip classification of rest-state tremor in Parkinson's disease (PD) from human local field potentials (LFPs) was demonstrated.

Wearable Seismocardiography‐Based Assessment of Stroke Volume in Congenital Heart Disease

Background

Patients with congenital heart disease (CHD) are at risk for the development of low cardiac output and other physiologic derangements, which could be detected early through continuous stroke volume (SV) measurement. Unfortunately, existing SV measurement methods are limited in the clinic because of their invasiveness (eg, thermodilution), location (eg, cardiac magnetic resonance imaging), or unreliability (eg, bioimpedance). Multimodal wearable sensing, leveraging the seismocardiogram, a sternal vibration signal associated with cardiomechanical activity, offers a means to monitoring SV conveniently, affordably, and continuously. However, it has not been evaluated in a population with significant anatomical and physiological differences (ie, children with CHD) or compared against a true gold standard (ie, cardiac magnetic resonance). Here, we present the feasibility of wearable estimation of SV in a diverse CHD population (N=45 patients).

Methods and Results

We used our chest‐worn wearable biosensor to measure baseline ECG and seismocardiogram signals from patients with CHD before and after their routine cardiovascular magnetic resonance imaging, and derived features from the measured signals, predominantly systolic time intervals, to estimate SV using ridge regression. Wearable signal features achieved acceptable SV estimation (28% error with respect to cardiovascular magnetic resonance imaging) in a held‐out test set, per cardiac output measurement guidelines, with a root‐mean‐square error of 11.48 mL and R 2 of 0.76. Additionally, we observed that using a combination of electrical and cardiomechanical features surpassed the performance of either modality alone.

Conclusions

A convenient wearable biosensor that estimates SV enables remote monitoring of cardiac function and may potentially help identify decompensation in patients with CHD.

Spatiotemporal dynamics of human high gamma discriminate naturalistic behavioral states

In analyzing the neural correlates of naturalistic and unstructured behaviors, features of neural activity that are ignored in a trial-based experimental paradigm can be more fully studied and investigated. Here, we analyze neural activity from two patients using electrocorticography (ECoG) and stereo-electroencephalography (sEEG) recordings, and reveal that multiple neural signal characteristics exist that discriminate between unstructured and naturalistic behavioral states such as “engaging in dialogue” and “using electronics”. Using the high gamma amplitude as an estimate of neuronal firing rate, we demonstrate that behavioral states in a naturalistic setting are discriminable based on long-term mean shifts, variance shifts, and differences in the specific neural activity’s covariance structure. Both the rapid and slow changes in high gamma band activity separate unstructured behavioral states. We also use Gaussian process factor analysis (GPFA) to show the existence of salient spatiotemporal features with variable smoothness in time. Further, we demonstrate that both temporally smooth and stochastic spatiotemporal activity can be used to differentiate unstructured behavioral states. This is the first attempt to elucidate how different neural signal features contain information about behavioral states collected outside the conventional experimental paradigm.

Deep Brain Stimulation for Depression Informed by Intracranial Recordings

The success of deep brain stimulation (DBS) for treating Parkinson's disease has led to its application to several other disorders, including treatment-resistant depression. Results with DBS for treatment-resistant depression have been heterogeneous, with inconsistencies largely driven by incomplete understanding of the brain networks regulating mood, especially on an individual basis. We report results from the first subject treated with DBS for treatment-resistant depression using an approach that incorporates intracranial recordings to personalize understanding of network behavior and its response to stimulation. These recordings enabled calculation of individually optimized DBS stimulation parameters using a novel inverse solution approach. In the ensuing double-blind, randomized phase incorporating these bespoke parameter sets, DBS led to remission of symptoms and dramatic improvement in quality of life. Results from this initial case demonstrate the feasibility of this personalized platform, which may be used to improve surgical neuromodulation for a vast array of neurologic and psychiatric disorders.