Personalized psychiatric neuromodulation

An approach that discovers and validates the stimulation biomarker, site and parameters within a single patient before committing to chronic therapy, rather than applying one fixed target and setting to everyone. A representative protocol uses a period of inpatient multi-site intracranial recording and stimulation mapping to (i) find where and at what frequency the patient's symptom state is encoded, and (ii) find where stimulation reliably relieves that state, then programs a chronic device to the individualized mapping.

The landmark single-patient demonstration paired a decoded amygdala biomarker with responsive ventral-striatal stimulation, delivering brief stimulation only when the biomarker of a high-symptom state appeared. The approach is scientifically compelling and mechanistically explicit, but it is labor-intensive, difficult to blind, and unproven at cohort scale — each success is an existence proof rather than a generalizable therapy.