A causal wiring diagram of transdiagnostic brain functions
Brigham And Women'S Hospital, Boston MA
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Abstract
Brain imaging has long been criticized for revealing correlations rather than causes. In recent years, there has been a rapid growth of focal brain stimulation technology, which can bring us closer to studying causes. If stimulating a speciï¬c brain circuit causes a speciï¬c behavioral change, then that circuit can be inferred to have a causal role in that behavior. However, the number of potential stimulation sites is practically inï¬nite. This makes it diï¬cult to test the causal relevance of every possible stimulation target and every possible behavior. There is a need for a systematic wiring diagram that narrows the ï¬eld of potential options, enabling researchers and clinicians to make informed decisions about stimulation targets. In this proposal, we will develop this wiring diagram. Using highly-sampled resting-state functional MRI scans as well as cutting-edge brain stimulation protocols, we will randomly apply stimulation to diï¬erent targets in each participant. To address the problem of a near-inï¬nite target space, we will narrow it down by mapping whole-brain connectivity of each target, not just its location. As a result, we will have information about every brain region for every participant, enabling us to draw whole-brain-level contrasts. Using this information, we will map the circuitry connected to TMS sites that modulate a wide range of diï¬erent behaviors relevant to mental illness, including transdiagnostic behaviors and diagnosis-speciï¬c symptoms. We will include patients with major depression, obsessive- compulsive disorder, schizophrenia, and generalized anxiety disorder. If successful, the study will yield a multidimensional atlas of causal brain circuitry, which can be used by future researchers and clinicians to select a stimulation target that is appropriate for the a speciï¬c patient based on their symptoms and objective emotional testing.
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