The goal of the TRANSFORM project is to develop brain stimulation therapy that delivers stimulation intelligently in response to ongoing brain activity (“closed-loop” brain stimulation). To achieve that goal, we require a deeper understanding of the brain activity in different behavioral states and how stimulation alters that activity. The TRANSFORM-DBS endeavor is predicated on using detailed, real patient data to form the basis for that final closed-loop system design. To achieve this, we are leveraging two unique opportunities offered by patients undergoing epilepsy monitoring or deep brain stimulation surgery.
When medications prove insufficient to control seizures, these patients sometimes undergo implantations of electrodes within the skull, which help localize the source of seizures for surgical resection. Some of these patients generously permit us to record their brain activity for research purposes as well as for clinical care while they are hospitalized on the epilepsy monitoring unit. Similarly, patients who are already undergoing brain recording for DBS electrode placement or other neurosurgical procedures have the option to contribute their brain activity recordings to a database that will be used to better understand brain function and to design next-generation closed-loop stimulation algorithms. In both groups of patients, brain recordings are obtained as the patient engages with interactive, computer-based tasks that provide a window into the brain activity underlying a range of psychiatrically relevant brain functions including cognitive flexibility, learning, impulsivity, gambling and avoidance.These tasks directly parallel tasks that are used for patients and healthy volunteers in the fMRI and MEG scanners. In fact, some of our patients will undergo both non-invasive and invasive testing in these same tasks so that we may ultimately correlate physiological activity at different scales and in different modalities. In addition, these intracranial recordings allow us to test the impact of different forms of brain stimulation on neural activity and behavior. Together this task- and stimulation-evoked activity will form a key element of our modeling and planning activities necessary for building a new form of therapeutic device designed to aid those suffering from neuropsychiatric illness.